Short answer: The Novolin R label gives each dose under the skin approximately 30 minutes before the start of a meal, usually alongside an intermediate or long-acting insulin. The dose is individualized by metabolic needs, glucose monitoring and goals, and the label gives no fixed starting dose. Use in insulin pumps is not recommended. The label has no missed-dose rule.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Novolin R is approved for: Novolin R is a short-acting human insulin approved to improve blood sugar control in adults and children with diabetes (section 1).
Source
NOVOLIN R (insulin human) injection, for subcutaneous or intravenous use, prescribing information and Patient Information. Novo Nordisk. DailyMed, version published December 8, 2022. DailyMed setid aee7f1f3-612c-4027-8ce9-4fd1f41eed71
Novolin R is injected under the skin of the abdomen, buttocks, thigh or upper arm approximately 30 minutes before the start of a meal, rotating sites within the same region. By injection it is generally used with an intermediate or long-acting insulin (sections 2.2 and 2.3).
It is U-100 (100 units/mL) in a 10 mL multiple-dose vial and a 3 mL FlexPen that dials in 1-unit steps. It is not recommended in insulin pumps because it can precipitate, and it is given into a vein only under medical supervision (sections 2.1, 2.2, 3 and 16.1).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Situation | What the label says |
|---|---|
| When to inject | Approximately 30 minutes before the start of a meal |
| Dose | Individualized by route, metabolic needs, glucose monitoring and glucose goal; no fixed starting dose is given |
| Switching from another insulin | The dose may need adjusting |
| Mixing | With Novolin N; Novolin R drawn into the syringe first; inject immediately |
| Insulin pump | Not recommended because of the risk of precipitation |
| IV infusion (under medical supervision) | 0.05 to 1 unit/mL in polypropylene bags; stable 24 hours at room temperature |
| Presentation | Unopened, refrigerated 36-46 F | Unopened, room temperature | In use (opened), room temperature |
|---|---|---|---|
| 10 mL multiple-dose vial | Until expiration date | 42 days up to 77 F (25 C) | 42 days up to 77 F (25 C) (Do not refrigerate) |
| 3 mL FlexPen | Until expiration date | 28 days up to 86 F (30 C) | 28 days up to 86 F (30 C) (Do not refrigerate) |
Dose changes may be needed with changes in physical activity, meal content or timing, kidney or liver function, or during acute illness. Glucose is checked more often during any change to the insulin regimen.
The dose may need adjusting when Novolin R is used with certain other drugs.
Novolin R is never frozen, not used if it has been frozen or after the expiration date, and kept from excess heat or light. The needle is removed after each FlexPen injection, and vial users take a new syringe or needle each time.
Patients are taught how to handle illness, stress, an inadequate or skipped insulin dose, an accidental extra dose, too little food and skipped meals. The label does not spell out what to do in each case.
The Novolin R label gives no missed-dose rule. Section 17 says patients are instructed on handling an inadequate or skipped insulin dose, but neither the prescribing information nor the Patient Information says what to do.
The dose may need adjusting when switching from another insulin to Novolin R.
Any change of insulin strength, maker, type, site or method is made under close medical supervision with more frequent glucose checks. In type 2 diabetes, other diabetes medicines may need adjusting.
In Dose Track you set up Novolin R as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.