Changes: Humulina 40/60

Revision as of 13:06, 13 June 2010

Use and Handling
Humulina 40/60
R/Neutral/NPH/Isophane Mix by Eli Lilly
intermediate-acting	r-DNA/GE/GM
U100	isophane
Line	Humulin
Also known as	Huminsulin Profil IV, Humulin 40/60, Humulin 60/40, Humulin M4, Humuline 40/60, Profil 40, Umuline Profil 40 Names of Lilly r-DNA/GE/GM insulins worldwide
Similar to	Actraphane 40/60 Mixtard 40 Penmix 40^[1]
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 40/60 insulin.

An intermediate-acting, mixed insulin like Humulin 40/60, Huminsulin Profil IV, Humuline 40/60, Humulin M4, Penmix 40 and Mixtard 40^[2] of 40% R/neutral insulin and 60% NPH/isophane insulin^[3] made by Eli Lilly. Humulina 40/60, like Mixtard 40^[4] contains 60% isophane insulin crystals.

Mixtard 40 was discontinued December 31, 2007.^[5]^[6] Humulin 40/60 is also no longer available.

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

[1] Medsafe NZ Penmix 40

[2] Prescribing Novo Insulins

[3] RxMed Humulin 40/60

[4] EMEA Scientific Discussion-Mixtard

[5] Insulin Discontinuations-UK

[6] Chart of Discontinued Novo Human Insulins

[1]

[2]

[3]

[4]

[5]

[6]

@@ Line 37: / Line 37: @@
 [[Image:40_60.jpg|thumb|300px|left|Time activity profile for 40/60 insulin.]]
 <br clear=left>
-An intermediate-acting, mixed insulin like [[Humulin 40/60]], [[Huminsulin Profil IV]], [[Humuline 40/60]], [[Humulin M4]], [[Penmix 40]] and [[Mixtard 40]]<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 [[Eli Lilly]]. Humulina 40/60, like [[Mixtard 40]]<ref>[http://www.emea.europa.eu/humandocs/PDFs/EPAR/mixtard/226802en6.pdf EMEA Scientific Discussion-Mixtard]</ref> contains 60% [[isophane]] insulin crystals.
+An intermediate-acting, mixed insulin like [[Humulin 40/60]], [[Huminsulin Profil IV]], [[Humuline 40/60]], [[Humulin M4]], [[Penmix 40]] and [[Mixtard 40]]<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 [[Eli Lilly]]. Humulina 40/60, like [[Mixtard 40]]<ref>[http://www.ema.europa.eu/humandocs/PDFs/EPAR/mixtard/226802en6.pdf EMEA Scientific Discussion-Mixtard]</ref> contains 60% [[isophane]] insulin crystals.
 Mixtard 40 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> Humulin 40/60 is also no longer available.
@@ Line 43: / Line 43: @@
 [[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.
-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<ref>[http://www.remedyfind.com/treatments/0/346/Insulin:%20Humulin%2010/90%20etc.%20(R%20Human;%20NPH%20Insulin) Humulin 10/90-NPH;R Human Insulin Remedyfind.com]</ref>. Regardless of how this is written, it means that the insulin is made up of 70% NPH/isophane insulin and 30% R/neutral 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: