The cost of insulin is a serious problem for many people who live with insulin-dependent diabetes in the United States.
That’s why some people turn to Walmart’s ReliOn Insulin and other over-the-counter insulins.
In this article, we’ll discuss what kinds of insulin are available from Walmart’s “ReliOn” brand, what they cost, how they work, and if they are a good option for you.
Update: We have added a list of announcements and new products to the end of this article. Please read the full article before skipping to the end as it’s important to understand the different types of insulin available from Walmart before choosing one.
Walmart’s ReliOn Insulin
The over-the-counter insulin from Walmart that costs about $25 per vial is limited to two types of insulin:
- Regular (insulin R)
- NPH (insulin N)
You can also get a premixed combination of NPH and Regular called 70-30.
Both of these insulins are what’s called “synthetic human insulin”. It’s different from newer insulins that are called insulin analogs.
Both require a very rigid eating schedule. In the “old days” of type 1 diabetes management, a patient taking Regular and NPH insulin would have to eat a very specific number of carbohydrates every 2 to 3 hours.
If you don’t adhere to a consistent eating schedule and carbohydrate quantity, you will experience recurring severe low blood sugars.
For example, as a child with type 1 diabetes in the 90s, I followed a regimen like this:
- 8 a.m.: 45 grams of carbohydrate
- 10:30 a.m.: 15 grams of carbohydrate
- 12 p.m.: 60 grams of carbohydrate
- 3 p.m.:15 grams of carbohydrate
- 6 p.m.: 60 grams of carbohydrate
- 8:30 p.m.: 15 grams of carbohydrate
Your life is ruled by the clock when you’re taking these types of insulin compared to the flexibility and freedom that comes with today’s insulin options.
Patients who switch to these insulins without guidance from a healthcare professional may be unaware that these insulins do not work in the body like the newer insulin they were likely taking before. This can lead to severe blood sugar fluctuations and be potentially fatal.
Let’s take a closer look at Regular and NPH insulin.
Regular insulin
Regular insulin is also referred to as “short-acting” insulin and is taken several times per day.
It used to be the only option for managing your blood sugar around meals, but compared to today’s “rapid” and “fast” acting insulins, Regular insulin is very slow-working because it stays in your system for a long time, up to 8 hours, and peaks nearly 4 hours after injecting it.
If you don’t eat every 2 to 3 hours while taking multiple daily doses of Regular insulin, you will experience multiple low blood sugars.
More modern insulin is active in your bloodstream within 15 minutes and out of your bloodstream within 4 hours. This means you don’t have to worry about dropping low or feeding that insulin dose after 2 to 3 hours of taking it.
In hospitals, patients will find that when receiving insulin via IV, short-acting insulin is still commonly used based on traditional “sliding scale” insulin dosing protocols.
NPH insulin
NPH insulin is also referred to as “intermediate-acting” insulin. It used to be the only “background” insulin option, but much like Regular insulin, it pales in comparison to today’s other background options.
NPH only stays in your system for anywhere from 10 to 16 hours and has to be taken twice per day in order to cover your 24-hour background insulin needs.
It also takes several hours to become active in your bloodstream, and it peaks at approximately 4 to 6 hours after taking it. Today’s long-acting insulin options — Basalgar, Lantus, Levemir, Tresiba, Toujeo — have generally no peak at all.
The peak in NPH contributes to the rigid eating schedule a person must follow if they’re using these older insulins to manage their blood sugars.
Do you need a prescription?
In short, no, you do not need a prescription to buy Walmart’s Regular or NPH insulin. However, you won’t find it sitting on the counter next to the Tylenol either.
You’ll have to go to a Walmart store and ask a pharmacist for a vial in order to purchase it.
While it’s considered an “over-the-counter” medication now, it’s still managed very carefully by the pharmacy because it needs to be refrigerated and it’s still a high-value medication despite being only $25 per vial.
Is Walmark insulin a good option for you?
Considering that today’s most modern insulin options cost at least $300 per vial, the affordability of Walmart’s insulin is appealing. Unfortunately, the rigid schedule and limitations of these insulins truly make them a “last resort” option.
They are especially challenging for younger children who have unpredictable eating habits and an inevitably lesser understanding of how important it is to eat a specific amount of food at a specific time of day.
These insulins will help you stay alive if you truly cannot afford more modern insulin. If they are the only type of insulin you have access to, then yes, it is a good option for you.
If you can get more modern insulin through your health insurance or one of the many financial assistance programs that exist today, you’d be better off going that route.
Sure, it’s nice that these older insulins are easily accessible but they are not the solution for a long, healthy, full life for a person with diabetes. They are the last resort.
Latest updates
July 6, 2021 – Walmart today announced that it will begin selling its own private brand, rapid-acting, analog insulin called ReliOn NovoLog. The new insulin is now available in Walmart pharmacies and is expected to also be available in Sam’s Club stores in mid-July. You need a prescription to purchase this insulin.
It will be available in two different forms: either $73 per vial (10 mL each, or 1,000 units) or $86 for a package of five prefilled insulin pens (FlexPens, each with 3 mL, or 300 units).
Walmart’s private label insulin will be manufactured by Novo Nordisk and is similar to Novo Nordisk’s NovoLog brand.
William
I have used Reli-On R & N for three years now, it is working good with only one problem: weight gain. I gained about 40 pounds in last three years, and my waist size goes from 36” to 44” now. I have to buy new shirts and pants too. Doctors did remind me the weight gain problems and advices me to drink glucose control shakes etc., but it doesn’t work at all.
Any advices you can share will be appreciated.
Thanks,
Christel Oerum
Good to hear that it works well to lower your blood sugars. These are some of the resources we have on the website on insulin and weight:
https://diabetesstrong.com/insulin-side-effects/
https://diabetesstrong.com/insulin-weight-gain-does-tighter-control-make-you-loosen-your-belt/
Irma Talamantes
OMG thank you for all this information! I can’t afford prescription insulin, I have no choice, but Reli-on insulin. I realized there were peaks when I started, but lately my bi-polar issues are causing serious sleep deprivation. The critical factor of low peaks have resulted in falls and poop accidents, due to weakness in my limbs. This information will help me to better a regimen for sleep and assure I am ready for sleep before taking the injection. Thanks so much for this valuable information!
Penny K Pecor
I have been using novolog & Triseba insulin for yrs and after I got the Dexcom6 my A1c has improved drastically. Very comforting. Now my insurance has changed me to Humalog & Toujeo. The results are devastating…i have no control with my numbers. As if I’m not even taking any insulin with meals at all. Im going to Walmart tomorrow & purchase R and get myself back on track.
Christel Oerum
If you find that the switch is significantly impacting your management I’d suggest you talk to your endo and start a case with the insurance company. If you’re allergic or in any way have a bad reaction to the insulin they switch you to, you can fight it.
Becky
Thanks for all you input. I now understand how to use Novolin N by Walmart and should see a lowering of my blood sugar.I like many was on Humilin N when my insurance stopped paying for my insulin so I can’t afford the $200.00 price per vial and had no choice but to try Walmarts Reli On brand. Hopefully my sugar levels will go back down to a safe level again now I have a better understanding of what to do. God bless you all.
Larry
I’m type 2 diabetic and I recently retired 12-31-2020 due to covid. I found out that my insurance from TRS doesn’t do much on covering my insulin which will cost me $1508 for a 90 day supply which I can’t afford. I tried the PAP and got turned down for help cause I have private insurance. They said there’s nothing they can do. I am 59 years old and still have 6 more years until medicare kicks in. I’m running out of options. Will the walmart insulin work on me?
Christel Oerum
I’m sorry you’re in such an unreasonable heartbreaking situation. If the Walmart insulin will work for you depends on which type of insulin you need. If you use NovoLog or Humalog the ReliOn NovoLog should work for you as it’s the same type of insulin. The Walmart Regular and NPH do not work the same way. It might still work for you but you’ll need your doctor to teach you how to use it
Mark
Walmart’s Reli-On Insulin didn’t work for me. I was using it in December 2020 when I got COVID. I ended up in the ICU with COVID and it pushed me into ketoacidosis. I learned that the Walmart insulin was doing nothing for my blood sugar levels. It may work for other people, but, apparently it wasn’t working for me.
Kay Holmes
Have used R and Nph insulin since 1989. At first on my daughter diagnosed type 1 after chicken pox destroyed her pancreas. Barbara Davis medical center in Denver taught me how to take care of a toddler in diapers with diabetes. She was pure muscles, so we always had to allow more food, little less insulin. She is now 33 and is very healthy and has one daughter. I saved over 50 thousand dollars buying r and n for her at Walmart since I changed from Walgreens. 1989 Walgreens price was 37.00 per bottle. Within a few years it went to 75.00 per bottle. Most of those years we didn’t have insurance and if we did it was still much cheaper to buy from Walmart!
Diane Glasgow
You are absolutely right. As a retired R.N. and wife of a Type 1 diabetic for 40 years NPH and R used to be the ones used most often. Pharmaceutical CEO’s would have the public think these older insulins are not as effective. This is just not the case. Big Pharma is lining their pockets as usual.
Tanya
I use nph and regular and couldn’t be happier. I’ve used an insulin pump, and mdi with analogs. I noticed an improvement switching from Levemir to NPH which was unexpected… I feel a lot better. Maybe some people react better to human insulin? I split the nph 3 ways (7am, 3pm, and 10pm) and don’t get peaks. Like most type 1s who are into tight control I apply Bernsteins methods and eat low carb. I have more freedom than when i was on a pump and do not need to follow a rigid schedule. If you need to eat carbs to avoid lows, you are taking too much insulin.
Chris Meyer
What do you mean nph and regular?
Christel Oerum
Both types of insulin are described in detail in the article. If you don’t want to read the introduction just click on the #2 Regular insulin or #3 NPH insulin and you’ll be taken directly to the explanation
Analog Objector
When I was first diagnosed I was put on regular human insulin. After several years I got a better job with insurance that fully covered my medications and I was put on insulin analogs (Humalog, Lantus). At first, they did seem to offer the benefits mentioned in this article, but after several years of use, I noticed absolutely zero difference in terms of meal flexibility. I am now on the exact same regimented eating schedule as when I was taking regular insulin. With Humalog especially, I have noticed that it can peak up to 5 hours after taking it requiring constant and diligent monitoring well after the supposed peak times. Additionally, I have noticed a wide array of side-effects that no doctor seems to take seriously, most notably recurrent acne. I am near 40, weight lift regularly, and never had a problem with acne even during my teenage years. I now always have 2 or 3 painful and large acne sores either on my face or back, usually in strange spots like around my ears and in the middle of my back. Additionally, I typically have around 15 to 20 small pimples on my back and shoulders. Another side-effect I have noticed is recurrent dry skin on the soft tissue around my eyes. Almost all the side-effects I have noticed on insulin analogs are skin related, though my endo remains incredulous and thinks its only possible to have a reaction at the injection site due to zinc content in the solution, despite my apparent skin dryness and recurrent cyst-like acne sores.
In my research on insulin analogs, I was shocked to discover that they are all genetically modified. This is true of human insulin as well, but the difference being that human insulin is modified simply to mimic the insulin molecule found in your body, while insulin analogs have been genetically modified to disperse from your fat cells in a time frame that supposedly more closely mimics dispersal from a functioning pancreas. This seems a strange methodology to me, as the fat cells in non-diabetics are not involved in the dispersal of insulin at all.
Additionally, when analogs first hit the market in the 90s, they later had to be recalled due to the fact that they were shown to contain cancer-causing agents. Also, possibly due to the Big Three (Eli Lilly, Novo Nordisk, and Sanofi Aventis) stranglehold on the global insulin market, it is difficult to even find information that may be interpreted as negative toward their incredibly expensive, flagship analog products, despite many type 1 diabetics I’ve talked to having similar misgivings and/or side-effects from years of insulin analog use.
In any case, I can’t even get my doctors to prescribe me human insulin now, and if I want to take it I must go to Walmart and purchase it out of pocket. It is a strange state of affairs, and it seems many public figures and diabetic activists instead of demanding more transparency from these companies, simply want government to step in and pay the grossly inflated price tag for insulin that, in my case and many others, simply does not provide the benefits claimed by their manufacturers.
Caron
Thank you Ginger and Sysy for that very helpful information!
Sysy
I can see how those who expect one insulin to automatically interchange with a different one will get into trouble or not see results they want.
For those who don’t know though: R has uses outside of the typical diet that make it amazing for many people and definitely not just a last resort. If you eat very low carb, you can use R with the same flexibility as any other faster acting insulin.
I use R for meals and so does my type 1 daughter. We eat very low carb so we don’t need any or much fast acting for meals and the R covers our high protein meals perfectly. It’s a game changer and I’m so glad Walmart has it for cheap otherwise we wouldn’t be able to afford it due to our huge insurance deductible. My A1c is 5.1 and my daughter’s is 5.0! To achieve this we follow the protocol outlined in Dr. Bernstein’s Diabetes Solution. I know many people don’t want to change what they eat but we personally love our diet and the non-diabetic blood sugars we get with it. R is a necessary component of what we do and the success and ease we have in managing our diabetes. Exercise and lows become a non-issue! It’s just great, and I’ve tried lots of things in my time with type 1. Lots of people are doing this low carb and R regimen and really thriving. And many of us buy or bake very low carb treats so we don’t have to even limit ourselves to savory foods only.
Many thanks to Walmart for supplying it at a low cost and over-the-counter to diabetics in all of the 50 states except Indiana where a certain pharmaceutical company has seemingly intervened.
Ginger Vieira
Sysy! Thank you for sharing this unique and lesser-known approach to using Regular insulin!
Dina
I agree and I also follow Dr Bernstein’s protocols as well. This insulin should never be considered a last resort. I used it when I was first diagnosed in ‘71 and wish I understand then what I know now about it working better with a low carb high protein diet.
I too am grateful for Walmart selling this insulin at such an affordable price that makes it available to those in need.
Thanks for speaking out!