03-10-2026

Change in Regular Insulin Vial Availability

Change in Regular Insulin Vial Availability

March 10, 2026

The Ontario Poison Centre (OPC) is aware that Eli Lilly has plans to discontinue Humulin R ® (short-acting regular insulin) 100 units/mL vials by April 30, 2026. 

Novo Nordisk will continue to manufacture Novolin® ge Toronto 100 units/mL vials. However,  the company has advised that it may not be able to provide sufficient supply to meet short term demand following this change. This could result in a temporary shortage beginning in March 2026. 

Eli Lilly has indicated that an additional 2 months of stock will be available to help support supply until Novo Nordisk can increase production.

Regular insulin is the key component of high-dose insulin and euglycemic (HDIE) therapy, used in the management of  beta-blocker and calcium channel blocker overdose as well as other causes of severe bradycardia and hypotension. For this indication, insulin is typically administered at ≥1 unit/kg/hour. To avoid fluid overload, insulin infusions are commonly prepared  at concentrations 10-16 units/mL.

Considerations:

·         Although regular insulin as 100 units/mL is available in cartridges for insulin pens, withdrawing insulin from cartridges to prepare HDIE infusions is not recommended due to safety risks associated with accessing the cartridges.

·         Reserve existing supplies of regular insulin vials for HDIE therapy where possible.

·         Consider including regular insulin vials as part of regional antidote sharing agreements as a reserve supply in case of shortages.

·         If regular insulin vials are unavailable, contact OPC to discuss alternatives (1-800-268-9017 (toll-free)).Additional information will be posted as it becomes available.