Insuhuman Comb 50 | |
R/Neutral/NPH/Isophane Mix by Aventis | |
intermediate-acting | r-DNA/GE/GM |
U40, U100 | Isophane |
Line | Insuman |
Also known as | Insuman Comb 50, Winthrop Comb 50 |
Similar to | |
Action in dogs |
|
Use and Handling | |
---|---|
Type | cloudy |
Shelf Life | 24 months |
When opened | 4 weeksroom temp. |
In pen | 4 weeks room temp. |
Notes |
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Note that some countries have the brand name in U40 strength. |
This is an Aventis mixed, intermediate-acting insulin[2] comprised of 50% R/neutral and 50% NPH/isophane crystal insulin[3], one of its Insuman line of products[4].
Eli Lilly produced a comparable insulin for North America: Humulin 50/50[5]; they also formerly produced this insulin in the EU & UK under the brand name Humulin M5[6]. M5 was discontinued in July 2004[7]. Other Lilly insulin that are similar are Humulina 50/50 and Humuline 50/50.
Novo Nordisk produced two: Actraphane 50/50[8] and the now discontinued Mixtard 50[9].
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 50
- ↑ Electronic Medicines Compendium (EMC) UK-Patient Information Leaflet-Insuman Comb 50
- ↑ EMEA Scientific Discussion-Mixtard
- ↑ Aventis Poster-Insuman & Lantus Insulins
- ↑ Humulin 50/50-NPH;R Human Insulin Remedyfind.com
- ↑ Lilly EU/UK Product Sheet & Time Activity Profiles
- ↑ Withdrawal of Humulin M5
- ↑ EMEA Scientific Discussion-Actraphane
- ↑ Insulins & Mixtures-NHS UK