|R/Neutral/NPH/Isophane Mix by Novo Nordisk|
| Action in dogs:
|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 
Note that some countries have the brand name in U40 strength.
An intermediate-acting, mixed insulin  of 40% R/neutral insulin and 60% NPH/isophane insulin  made by Novo Nordisk. Mixtard 40  contains 60% isophane insulin crystals, as does Penmix 40, Humuline 40/60, Humulin M4, Humulina 40/60, and Huminsulin Profil IV.
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:
|Non-Analog Mixed Insulins|
|Insulin Is||Expressed As||Expressed As|
|10% R/Neutral Insulin|
90% NPH/Isophane Insulin
|20% R/Neutral Insulin|
80% NPH/Isophane Insulin
|30% R/Neutral Insulin|
80% NPH/Isophane Insulin
|40% R/Neutral Insulin|
60% NPH/Isophane Insulin
|50% R/Neutral Insulin|
50% NPH/Isophane Insulin
- ↑ Maddison, Jill E.,Page, Stephen W.,Church, David B. (2008). Small Animal Clinical Pharmacology. Saunders Ltd..
- ↑ Prescribing Novo Insulins.
- ↑ Humulin 40/60. RxMed.com.
- ↑ Scientific Discussion-Mixtard. EMEA.
- ↑ Insulin Discontinuations-UK. NHS.
- ↑ Chart of Discontinued Novo Human Insulins. Novo Nordisk.