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{{Insulin|
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{|class="wikitable" align="right" width="300" bgcolor="powderblue"|
bgcolor=#cae1ff|
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! colspan="2" style="background:#cae1ff; width:300px;font-size:10pt" | Insuman Comb 30
fgcolor=#000080|
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|-
name=Insuman Comb 30|
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|colspan="2" style="background:aliceblue; width:300px; text-align:center;font-size:9pt" |[[Mixed insulins|R/Neutral/NPH/Isophane Mix]] by [[Aventis]]
generic=[[Mixed insulins|R/Neutral/NPH/Isophane Mix]]|
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|-
mfg=[[Aventis]]|
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| colspan="2" style="background:#bcd2ee; width:300px; text-align:center;font-size:9pt"|[[intermediate-acting]]
|- align="center" style="background:#cae1ff;border-bottom:3px solid grey;"|
+
|-
action=[[intermediate-acting]]|
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|colspan="2" style="background:#bcd2ee; width:300px; text-align:center;font-size:9pt"|[[r-DNA/GE/GM]]
origin=[[r-DNA/GE/GM]]|
+
|-
strength=U100|
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!colspan="1" style="background:#bcd2ee; width:150px; text-align:center;font-size:9pt" | U40, U100
suspension=[[isophane]]|
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|colspan="1" style="background:#bcd2ee; width:150px;text-align:center;font-size:9pt"|[[isophane]]
line=[[Insuman]]|
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|-
aliases=[[Winthrop Comb 30]]|
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|colspan="2" style="background:aliceblue; width:300px;font-size:9pt; text-align:left" | '''Action in dogs:'''
similar= 
 
*[[Actraphane 30/70]]
 
*[[Huminsulin Profil III]]
 
*[[Humulin 3/7]]
 
*[[Humulin 30/70]]
 
*[[Humulin 70/30]]
 
*[[Humulin M3]]
 
*[[Humulin Mix 30/70]]
 
*[[Humulina 30/70]]
 
*[[Humuline 30/70]]
 
*[[Mixtard 30]]
 
*[[Novolin 30R]]
 
*[[Novolin 70/30]]
 
*[[Penmix 30]]<ref>{{cite web|url=http://www.medsafe.govt.nz/Profs/DataSheet/PenmixMixtardProtaphaneinj.htm|title=Penmix 30|publisher= Medsafe NZ}}</ref>
 
*[[Profil 30]]
 
*[[ReliOn/Novolin 70/30]]
 
*[[Umuline Profil 30]]
 
 
<br>[http://images3.wikia.nocookie.net/__cb20100602042136/diabetesindogs/images/2/23/WW_Humuline.pdf Names of Lilly r-DNA/GE/GM insulins worldwide]|
 
dogaction=&nbsp;
 
 
*onset 0.5-3h,
 
*onset 0.5-3h,
 
*peak 2-10h,
 
*peak 2-10h,
*duration 4-24h|
+
*duration 4-24h
cloudyorsoluble=[[cloudy]]|
+
|-
shelflife= 24 months|
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|colspan="2" style="background:aliceblue; width:300px;font-size:9pt; text-align:left" | '''Line:''' [[Insuman]]
openedlife= 4 weeks room temp.|
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|-
penlife= 4 weeks room temp.|
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| colspan="2" style="background:aliceblue; width:300px; font-size:9pt;text-align:left"| '''Also known as:''' [[Winthrop Comb 30]]
handlingnotes=&nbsp;
+
*protect from light and heat
+
|-
*Do Not Freeze
+
| colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left"| '''Similar to:''' [[Huminsulin Profil III]], [[Humulin 3/7]]<br>[[Humulin 30/70]], [[Humulina 30/70]], [[Humuline 30/70]], [[Humulin M3]], [[Profil 30]], &nbsp;[[Umuline Profil 30]]<br>[[Humulin 70/30]], [[Humulin Mix 30/70]]<br>[[Humulin ReliOn 70/30]]<br>
*Do not use if product does not [[re-suspend]]
+
[[Actraphane 30/70]], [[Mixtard 30]], [[Penmix 30]]<br>[[Novolin 70/30]], [[Novolin 30R]], [[ReliOn/Novolin 70/30]]<br><br>
*[[Rolling insulin|Roll]]
+
[http://images3.wikia.nocookie.net/__cb20100602042136/diabetesindogs/images/2/23/WW_Humuline.pdf Names of Lilly r-DNA/GE/GM insulins worldwide]
*Do not use [[intravenously]]
+
|-
*Do not refrigerate in use cartridges/pens.
+
| colspan="2" style="background:#cae1ff; width:300px;text-align:center;font-size:9pt" | '''Use and Handling:'''
}}
+
|-
[[Image:Insuman.PNG|thumb|left|300px|Insuman insulins in pen cartridge form.]]<br clear=left>This 70% NPH/isophane crystal<ref> {{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000201/WC500033779.pdf|title=Scientific Discussion-Insuman|publisher=EMEA}}</ref> and 30% R/neutral insulin mix<ref>{{cite web|url=http://images2.wikia.nocookie.net/diabetesindogs/images/7/7f/Insuman_Comb_25_patient_info_leaflet.pdf |title=Patient Information Leaflet-Insuman Comb 25|publisher=Sanofi-Aventis}}</ref><ref>{{cite web|url=http://web.archive.org/web/20080208084240/http://www.drgc.cwc.net/Care_pathway/Patient_information/Insulin/Insuman_insulins.htm |title=Insuman Prescribing Information}}</ref> is intermediate-acting and made by [[Aventis]] as part of its Insuman line of products.<ref>{{cite web|url=http://www.yorkshirediabetes.com/downloads/A11456_Range_Poster.pdf |title=Aventis Poster-Insuman & Lantus Insulins|publisher=Sanofi-Aventis}}</ref><ref>{{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000201/WC500033779.pdf|title=Scientific Discussion-Insuman|publisher=EMEA}}</ref>
+
|colspan="1" style="background:aliceblue; width:150px;font-size:9pt;text-align:left"|'''Shelf Life:''' 24 months
  +
  +
|colspan="1" style="background:aliceblue; width:150px;font-size:9pt;text-align:left" | '''Type:''' [[cloudy]]
  +
|-
  +
|colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left" | '''When Opened:''' 4 weeks room temp.
  +
|-
  +
|colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left"| '''In Pen:''' 4 weeks room temp.
  +
|-
  +
| colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left" | '''Notes:''' Protect from light and heat<br> Do Not Freeze, [[Resuspending insulin|Resuspend]]<br> Do not use if product does not [[re-suspend]]<br>Do not use [[intravenously]] <ref>{{cite web|title=Small Animal Clinical Pharmacology|author=Maddison, Jill E.,Page, Stephen W.,Church, David B.|year=2008|publisher=Saunders Ltd.|isbn=0702028584|page=510|url=http://www.amazon.com/Animal-Clinical-Pharmacology-Maddison-DipVetClinStud/dp/0702028584/ref=sr_1_1?s=books&ie=UTF8&qid=1296451134&sr=1-1}}</ref><br>Do not refrigerate in use cartridges/pens.
  +
|}
  +
  +
[[Image:Insuman.PNG|thumb|left|300px|Insuman insulins in pen cartridge form.]]<br clear=left>This 70% NPH/isophane crystal <ref> {{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000201/WC500033779.pdf|title=Scientific Discussion-Insuman|publisher=EMEA}}</ref> and 30% R/neutral insulin mix <ref>{{cite web|url=http://images2.wikia.nocookie.net/diabetesindogs/images/7/7f/Insuman_Comb_25_patient_info_leaflet.pdf |title=Patient Information Leaflet-Insuman Comb 25|publisher=Sanofi-Aventis}}</ref><ref>{{cite web|url=http://web.archive.org/web/20080208084240/http://www.drgc.cwc.net/Care_pathway/Patient_information/Insulin/Insuman_insulins.htm |title=Insuman Prescribing Information}}</ref> is intermediate-acting and made by [[Aventis]] as part of its Insuman line of products. <ref>{{cite web|url=http://www.yorkshirediabetes.com/downloads/A11456_Range_Poster.pdf |title=Aventis Poster-Insuman & Lantus Insulins|publisher=Sanofi-Aventis}}</ref><ref>{{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000201/WC500033779.pdf|title=Scientific Discussion-Insuman|publisher=EMEA}}</ref>
   
 
While this type of Insuman insulin is approved and sold in the EU and elsewhere, it is the only one of the Insuman insulins not offered in the UK.
 
While this type of Insuman insulin is approved and sold in the EU and elsewhere, it is the only one of the Insuman insulins not offered in the UK.
  +
  +
==Why Lente doesn't equal 70/30==
  +
[[Image:Lente-70 30.jpg|thumb|300px|left|Direct comparison of insulin activity profiles for Lente and 70/30 insulins. The early strong action from the non-suspended R/neutral/normal insulin is seen at the "bump" from hours 0-6.]]
  +
<br clear=left>
  +
Let's look at the differences in the two insulins. Lente is comprised of 70 % [[:Category:Long-acting|long-acting]] [[Ultralente]] insulin and 30% [[:Category:Short-acting|short-acting]] [[Semilente]] insulin. So proportions of a long-acting and short-acting insulin are being combined to produce a [[:Category:Intermediate-acting|intermediate-acting]] insulin. Both Ultralente and Semilente insulin are [[suspension|suspended]] by adding [[:Category:Zinc|zinc]] and the size of their respective insulin crystals. The largest insulin crystals are those of Ultralente, while Semilente contains the smallest, or microcrystals. Simply put, you're combining a long insulin and a short insulin to make an intermediate-acting one.<ref>{{cite web|url=http://images1.wikia.nocookie.net/diabetesindogs/images/4/42/2010_T35-greco-western-2010.pdf|title=Treating Diabetes Mellitus in Dogs and Cats|author=Greco, Deborah|publisher=Western Veterinary Conference|year=2010}}</ref>
  +
  +
70/30 insulin starts with 70% [[NPH]]/isophane insulin, an [[:Category:Intermediate-acting|intermediate-acting]] insulin which is suspended by [[Protamine|protamine]]. To that, 30% [[R]]/neutral/normal insulin, which is [[:Category:Short-acting|short-acting]] and [[Soluble insulin|soluble]], meaning there is no suspension; nothing is added to this insulin to delay its action. In this case, you are taking an intermediate-acting insulin with a suspension and adding to it a short-acting one with no suspension to create an intermediate-acting insulin.
  +
  +
So we have an insulin ([[:Category:Lente|Lente]]), made up of a long-acting and short-acting insulin, both with [[:Category:Zinc|zinc]] suspensions, and a [[:Category:Mixed|mixed]] insulin (70/30), made from an intermediate-acting [[:Category:Isophane|protamine]] suspended insulin and a short-acting one without any suspension. Because of these differences, the insulin action profile for these two insulins is going to be quite different, even though both insulins are classed as intermediate-acting.
   
 
[[Mixed insulins]] cover a wide range as they can be [[:Category:Origin|animal]] origin, [[r-DNA/GE/GM]] origin or [[analog]] insulins. The non-analog mixed insulins are made up of [[:Category:Intermediate-acting|intermediate-acting]] [[NPH]]/isophane insulin and [[:Category:Short-acting|short-acting]] [[R]]/neutral. normal insulin. The analog mixes are made from [[:Category:Intermediate-acting|intermediate-acting]] protamine-suspended analog insulin (suspended similar to NPH/isophane insulin) and [[:Category:Fast-acting|fast-acting]] analog insulin. 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.
 
[[Mixed insulins]] cover a wide range as they can be [[:Category:Origin|animal]] origin, [[r-DNA/GE/GM]] origin or [[analog]] insulins. The non-analog mixed insulins are made up of [[:Category:Intermediate-acting|intermediate-acting]] [[NPH]]/isophane insulin and [[:Category:Short-acting|short-acting]] [[R]]/neutral. normal insulin. The analog mixes are made from [[:Category:Intermediate-acting|intermediate-acting]] protamine-suspended analog insulin (suspended similar to NPH/isophane insulin) and [[:Category:Fast-acting|fast-acting]] analog insulin. 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.
Line 37: Line 46:
 
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:
 
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:
   
{| align="center" width="500" border="1" bgcolor="powderblue"|
+
{| class="collapsible collapsed" align="center" width="500" border="1" bgcolor="powderblue"|
! bgcolor="#BCD2EE" colspan="3" |Non-Analog Mixed Insulins
+
! bgcolor="BCD2EE" colspan="3" |Non-Analog Mixed Insulins
 
|-
 
|-
 
! bgcolor="lightcyan" width="200" |[[Image:Intermediate_acting.jpg|200px]]
 
! bgcolor="lightcyan" width="200" |[[Image:Intermediate_acting.jpg|200px]]
 
! bgcolor="#cae1ff" colspan="2" |All [[Intermediate-acting]]
 
! bgcolor="#cae1ff" colspan="2" |All [[Intermediate-acting]]
|}
+
|-
{|class="collapsible collapsed" align="center" width="500" border="1" bgcolor="powderblue"|
+
! colspan="1" bgcolor="aliceblue"|Insulin Is
 
! colspan="1" bgcolor="aliceblue"| Expressed As
 
! colspan="1" bgcolor="aliceblue"| Expressed As
 
!colspan="1" bgcolor="aliceblue"|Expressed As
 
!colspan="1" bgcolor="aliceblue"|Expressed As
! colspan="1" bgcolor="aliceblue"|Insulin Is
 
 
|-
 
|-
! colspan="1" bgcolor="ivory"|10/90
 
!colspan="1" bgcolor="ivory"|90/10
 
 
! colspan="1" bgcolor="ivory"|10% [[R|R/Neutral Insulin]]<br />90% [[NPH|NPH/Isophane Insulin]]
 
! colspan="1" bgcolor="ivory"|10% [[R|R/Neutral Insulin]]<br />90% [[NPH|NPH/Isophane Insulin]]
  +
!colspan="1" bgcolor="ivory"|90/10
  +
! colspan="1" bgcolor="ivory"|10/90
 
|-
 
|-
! colspan="1" bgcolor="ivory"|20/80
 
!colspan="1" bgcolor="ivory"|80/20
 
 
! colspan="1" bgcolor="ivory"|20% [[R|R/Neutral Insulin]]<br />80% [[NPH|NPH/Isophane Insulin]]
 
! colspan="1" bgcolor="ivory"|20% [[R|R/Neutral Insulin]]<br />80% [[NPH|NPH/Isophane Insulin]]
  +
!colspan="1" bgcolor="ivory"|80/20
  +
! colspan="1" bgcolor="ivory"|20/80
 
|-
 
|-
! colspan="1" bgcolor="ivory"|30/70
+
! colspan="1" bgcolor="ivory"|30% [[R|R/Neutral Insulin]]<br />80% [[NPH|NPH/Isophane Insulin]]
 
!colspan="1" bgcolor="ivory"|70/30
 
!colspan="1" bgcolor="ivory"|70/30
! colspan="1" bgcolor="ivory"|30% [[R|R/Neutral Insulin]]<br />70% [[NPH|NPH/Isophane Insulin]]
+
! colspan="1" bgcolor="ivory"|30/70
 
|-
 
|-
! colspan="1" bgcolor="ivory"|40/60
 
! colspan="1" bgcolor="ivory"|60/40
 
 
! colspan="1" bgcolor="ivory"|40% [[R|R/Neutral Insulin]]<br />60% [[NPH|NPH/Isophane Insulin]]
 
! colspan="1" bgcolor="ivory"|40% [[R|R/Neutral Insulin]]<br />60% [[NPH|NPH/Isophane Insulin]]
  +
! colspan="1" bgcolor="ivory"|60/40
  +
! colspan="1" bgcolor="ivory"|40/60
 
|-
 
|-
! colspan="1" bgcolor="ivory"|50/50
 
!colspan="1" bgcolor="ivory"|50/50
 
 
! colspan="1" bgcolor="ivory"|50% [[R|R/Neutral Insulin]]<br />50% [[NPH|NPH/Isophane Insulin]]
 
! colspan="1" bgcolor="ivory"|50% [[R|R/Neutral Insulin]]<br />50% [[NPH|NPH/Isophane Insulin]]
  +
!colspan="1" bgcolor="ivory"|50/50
  +
! colspan="1" bgcolor="ivory"|50/50
 
|}
 
|}
   
 
==References==
 
==References==
<references/>
+
{{Reflist|colwidth=30em}}
 
   
 
==More Information==
 
==More Information==
   
*[http://www.yorkshirediabetes.com/downloads/A11456_Range_Poster.pdf Yorkshire Diabetes-Chart of Insuman Insulin Ranges]
+
*[http://www.yorkshirediabetes.com/downloads/A11456_Range_Poster.pdf Chart of Insuman Insulin Ranges] Yorkshire Diabetes
  +
  +
  +
<center>'''Related pages'''</center>
  +
{|align="center" width="600"
  +
  +
|<center>[[Image:NVN18370 73077 5.jpg|100px]]</center>
  +
|<center>[[Image:Mixtard30.jpg|100px]]</center>
  +
|<center>[[Image:HumilinLILLY.jpg|100px]]</center>
  +
|<center>[[Image:21941f.png|100px]]</center>
  +
|<center>[[Image:30 70.jpg|100px]]</center>
  +
  +
|-
  +
|<center>[[Novolin 70/30]]</center>
  +
|<center>[[Mixtard 30]]</center>
  +
|<center>[[Humulin 70/30]]</center>
  +
|<center>[[Humulin M3]]</center>
  +
|<center>[[Winthrop Comb 30]]</center>
  +
|}
  +
[[Category:30-70]]
 
[[Category:Templates]]
 
[[Category:Templates]]
 
[[Category:Insulins]]
 
[[Category:Insulins]]
Line 88: Line 96:
 
[[Category:Meta-cresol]]
 
[[Category:Meta-cresol]]
 
[[Category:Content]]
 
[[Category:Content]]
  +
[[Category:Currently marketed insulins]]

Latest revision as of 23:23, May 23, 2012

Insuman Comb 30
R/Neutral/NPH/Isophane Mix by Aventis
intermediate-acting
r-DNA/GE/GM
U40, U100 isophane
Action in dogs:
  • onset 0.5-3h,
  • peak 2-10h,
  • duration 4-24h
Line: Insuman
Also known as: Winthrop Comb 30
Similar to: Huminsulin Profil III, Humulin 3/7
Humulin 30/70, Humulina 30/70, Humuline 30/70, Humulin M3, Profil 30,  Umuline Profil 30
Humulin 70/30, Humulin Mix 30/70
Humulin ReliOn 70/30

Actraphane 30/70, Mixtard 30, Penmix 30
Novolin 70/30, Novolin 30R, ReliOn/Novolin 70/30

Names of Lilly r-DNA/GE/GM insulins worldwide

Use and Handling:
Shelf Life: 24 months Type: cloudy
When Opened: 4 weeks room temp.
In Pen: 4 weeks room temp.
Notes: Protect from light and heat
Do Not Freeze, Resuspend
Do not use if product does not re-suspend
Do not use intravenously [1]
Do not refrigerate in use cartridges/pens.
Insuman

Insuman insulins in pen cartridge form.


This 70% NPH/isophane crystal [2] and 30% R/neutral insulin mix [3][4] is intermediate-acting and made by Aventis as part of its Insuman line of products. [5][6]

While this type of Insuman insulin is approved and sold in the EU and elsewhere, it is the only one of the Insuman insulins not offered in the UK.

Why Lente doesn't equal 70/30Edit

Lente-70 30

Direct comparison of insulin activity profiles for Lente and 70/30 insulins. The early strong action from the non-suspended R/neutral/normal insulin is seen at the "bump" from hours 0-6.


Let's look at the differences in the two insulins. Lente is comprised of 70 % long-acting Ultralente insulin and 30% short-acting Semilente insulin. So proportions of a long-acting and short-acting insulin are being combined to produce a intermediate-acting insulin. Both Ultralente and Semilente insulin are suspended by adding zinc and the size of their respective insulin crystals. The largest insulin crystals are those of Ultralente, while Semilente contains the smallest, or microcrystals. Simply put, you're combining a long insulin and a short insulin to make an intermediate-acting one.[7]

70/30 insulin starts with 70% NPH/isophane insulin, an intermediate-acting insulin which is suspended by protamine. To that, 30% R/neutral/normal insulin, which is short-acting and soluble, meaning there is no suspension; nothing is added to this insulin to delay its action. In this case, you are taking an intermediate-acting insulin with a suspension and adding to it a short-acting one with no suspension to create an intermediate-acting insulin.

So we have an insulin (Lente), made up of a long-acting and short-acting insulin, both with zinc suspensions, and a mixed insulin (70/30), made from an intermediate-acting protamine suspended insulin and a short-acting one without any suspension. Because of these differences, the insulin action profile for these two insulins is going to be quite different, even though both insulins are classed as intermediate-acting.

Mixed insulins cover a wide range as they can be animal origin, r-DNA/GE/GM origin or analog insulins. The non-analog mixed insulins are made up of intermediate-acting NPH/isophane insulin and short-acting R/neutral. normal insulin. The analog mixes are made from intermediate-acting protamine-suspended analog insulin (suspended similar to NPH/isophane insulin) and fast-acting analog insulin. 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:

ReferencesEdit

  1. Maddison, Jill E.,Page, Stephen W.,Church, David B. (2008). Small Animal Clinical Pharmacology. Saunders Ltd..
  2. Scientific Discussion-Insuman. EMEA.
  3. Patient Information Leaflet-Insuman Comb 25. Sanofi-Aventis.
  4. Insuman Prescribing Information.
  5. Aventis Poster-Insuman & Lantus Insulins. Sanofi-Aventis.
  6. Scientific Discussion-Insuman. EMEA.
  7. Greco, Deborah (2010). Treating Diabetes Mellitus in Dogs and Cats. Western Veterinary Conference.

More InformationEdit


Related pages
NVN18370 73077 5
Mixtard30
HumilinLILLY
21941f
30 70
Novolin 70/30
Mixtard 30
Humulin 70/30
Humulin M3
Winthrop Comb 30
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