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.