Changes: Actraphane 40/60

Revision as of 01:43, 22 July 2010

Use and Handling
Actraphane 40/60
R/Neutral/NPH/Isophane Mix by Novo Nordisk
intermediate-acting	r-DNA/GE/GM
U100	isophane
Line	Novo
Also known as	Mixtard 40, Penmix 40^[1]
Similar to	Huminsulin Profil IV Humulin 40/60 Humulin 60/40 Humulin M4 Humulina 40/60 Humuline 40/60 Profil 40 Umuline Profil 40 Names of Lilly r-DNA/GE/GM insulins worldwide
Action in dogs	onset 0.5-3h, peak 2-10h, duration 4-24h
Type	cloudy
Shelf Life	30 months
When opened	6 weeks room temp.
In pen	6 weeks room temp.
Notes	protect from light and heat Do Not Freeze Do not use if product does not re-suspend Roll Do not use intravenously Do not refrigerate in use cartridges/pens.

Time activity profile for Actraphane 40/60.

An intermediate-acting, mixed insulin^[2] of 40% R/neutral insulin and 60% NPH/isophane insulin^[3] made by Novo Nordisk. Mixtard 40^[4] contains 60% isophane insulin crystals.

This insulin is similar to Lilly's Humulina 40/60, Humulin M4, Humuline 40/60, and Huminsulin Profil IV, to Novo's Penmix 40 and Mixtard 40, which was was discontinued December 31, 2007.^[5]^[6] It is also similar to the discontinued North American offering of Lilly-Humulin 40/60.

Mixed insulins cover a wide range as they can be animal origin, r-DNA/GE/GM origin or analog insulins. They can also vary in the fraction (amount or percent) of the two types (R/neutral and NPH/isophane) of insulin used to make a non-analog mix, and in the percentage of fast/rapid-acting analog insulin and slower-acting protamine suspended analog insulin.

For some reason, those in the US choose to list the slower, NPH/isophane based insulin fraction first, such as Humulin or Novolin 70/30. The rest of the world gives the faster insulin top billing and the result is 30/70. Regardless of how this is written, it means that the insulin is made up of 70% NPH/isophane insulin and 30% R/neutral insulin.

The most common mixes are 70/30 (30/70) (non analog) or 75/25 (25/75) (analog). There are no currently-marketed mixes which combine insulins of different origins. Eli Lilly's form of beef/pork Iletin and Novo Nordisk's Lentard were discontinued some time ago. Here are the most common ones that could cause confusion:

Non-Analog Mixed Insulins
	All Intermediate-acting

Expressed As	Expressed As	Insulin Is
10/90	90/10	10% R/Neutral Insulin 90% NPH/Isophane Insulin
20/80	80/20	20% R/Neutral Insulin 80% NPH/Isophane Insulin
30/70	70/30	30% R/Neutral Insulin 70% NPH/Isophane Insulin
40/60	60/40	40% R/Neutral Insulin 60% NPH/Isophane Insulin
50/50	50/50	50% R/Neutral Insulin 50% NPH/Isophane Insulin

References

↑ Medsafe NZ Penmix 40
↑ Prescribing Novo Insulins.
↑ RxMed-Humulin 40/60
↑ Scientific Discussion-Mixtard. EMEA.
↑ Insulin Discontinuations-UK. NHS-UK.
↑ Chart of Discontinued Novo Human Insulins. Novo Nordisk.

[1] Medsafe NZ Penmix 40

[2] Prescribing Novo Insulins.

[3] RxMed-Humulin 40/60

[4] Scientific Discussion-Mixtard. EMEA.

[5] Insulin Discontinuations-UK. NHS-UK.

[6] Chart of Discontinued Novo Human Insulins. Novo Nordisk.

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[2]

[3]

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[6]

@@ Line 42: / Line 42: @@
 [[Image:40_60.jpg|thumb|left|300px|Time activity profile for Actraphane 40/60.]]
 <br clear=left>
-An intermediate-acting, mixed insulin<ref>[http://web.archive.org/web/20080208084240/http://www.drgc.cwc.net/Care_pathway/Patient_information/Insulin/Novo_insulins.htm Prescribing Novo Insulins]</ref> of 40% R/neutral insulin and 60% NPH/isophane insulin<ref>[http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20H)/HUMULIN.html RxMed-Humulin 40/60]</ref> made by [[Novo Nordisk]]. Mixtard 40<ref>[http://diabetesindogs.wikia.com/wiki/Actraphane_30/70 EMEA Scientific Discussion-Mixtard]</ref> contains 60% [[isophane]] insulin crystals.
+An intermediate-acting, mixed insulin<ref>{{cite web|url=http://web.archive.org/web/20080208084240/http://www.drgc.cwc.net/Care_pathway/Patient_information/Insulin/Novo_insulins.htm |title=Prescribing Novo Insulins}}</ref> of 40% R/neutral insulin and 60% NPH/isophane insulin<ref>[http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20H)/HUMULIN.html RxMed-Humulin 40/60]</ref> made by [[Novo Nordisk]]. Mixtard 40<ref>{{cite web|url=http://diabetesindogs.wikia.com/wiki/Actraphane_30/70 |title=Scientific Discussion-Mixtard|publisher=EMEA}}</ref> contains 60% [[isophane]] insulin crystals.
-This insulin is similar to Lilly's [[Humulina 40/60]], [[Humulin M4]], [[Humuline 40/60]], and [[Huminsulin Profil IV]], to Novo's Penmix 40 and Mixtard 40, which was was discontinued December 31, 2007.<ref>[http://www.ukmicentral.nhs.uk/therapeu/pace/PACE0604.pdf Insulin Discontinuations-UK]</ref><ref>[http://www.yorkshirediabetes.com/downloads/A4Humandis.pdf Chart of Discontinued Novo Human Insulins]</ref> It is also similar to the discontinued North American offering of Lilly-[[Humulin 40/60]].
+This insulin is similar to Lilly's [[Humulina 40/60]], [[Humulin M4]], [[Humuline 40/60]], and [[Huminsulin Profil IV]], to Novo's Penmix 40 and Mixtard 40, which was was discontinued December 31, 2007.<ref>{{cite web|url=http://www.ukmicentral.nhs.uk/therapeu/pace/PACE0604.pdf |title=Insulin Discontinuations-UK|publisher=NHS-UK}}</ref><ref>{{cite web|url=http://www.yorkshirediabetes.com/downloads/A4Humandis.pdf |title=Chart of Discontinued Novo Human Insulins|publisher=Novo Nordisk}}</ref> It is also similar to the discontinued North American offering of Lilly-[[Humulin 40/60]].
 [[Mixed insulins]] cover a wide range as they can be [[:Category:Origin|animal]] origin, [[r-DNA/GE/GM]] origin or [[analog]] insulins. They can also vary in the fraction (amount or percent) of the two types (R/neutral and NPH/isophane) of insulin used to make a non-analog mix, and in the percentage of fast/rapid-acting analog insulin and slower-acting protamine suspended analog insulin.