Canine Diabetes Wiki
Mixtard 40
R/Neutral/NPH/Isophane Mix by Novo Nordisk
U40, U100 isophane
Action in dogs:
  • onset 0.5-3h,
  • peak 2-10h,
  • duration 4-24h
Line: Novo
Also known as: Actraphane 40/60, Penmix 40
Similar to: Huminsulin Profil IV, Humulin 40/60,
Humulina 40/60, Humuline 40/60, Humulin M4,
Umuline Profil 40, Profil 40, Humulin 60/40

Names of Lilly r-DNA/GE/GM insulins worldwide
Use and Handling:
Shelf Life: 30 months Type: cloudy
When Opened: 6 weeks room temp.
In Pen: 6 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]
40 60

Time activity profile for Mixtard 40.

Note that some countries have the brand name in U40 strength.

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, as does Penmix 40, Humuline 40/60, Humulin M4, Humulina 40/60, and Huminsulin Profil IV.

Mixtard 40 was discontinued December 31, 2007. [5][6]

Lilly's Humulin 40/60 for the North American market was similar, and is also discontinued.

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:


  1. Maddison, Jill E.,Page, Stephen W.,Church, David B. (2008). Small Animal Clinical Pharmacology. Saunders Ltd..
  2. Prescribing Novo Insulins.
  3. Humulin 40/60.
  4. Scientific Discussion-Mixtard. EMEA.
  5. Insulin Discontinuations-UK. NHS.
  6. Chart of Discontinued Novo Human Insulins. Novo Nordisk.

Related pages
40 60
40 60
40 60
40 60
Humulin M4
Profil 40
Humulin 40/60
Penmix 40