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{|class="wikitable" align="right" width="300" bgcolor="powderblue"|
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{{Insulin|
  
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! colspan="2" style="background:#ccc; width:300px;font-size:10pt" | Mixtard 40
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bgcolor=#CCC|
  
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|-
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fgcolor=#0000|
  
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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 [[Novo Nordisk]]
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name=Mixtard 40|
  
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|-
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generic=[[Mixed insulins|R/Neutral/NPH/Isophane Mix]]|
  
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|colspan="2" style="background:#bcd2ee; width:300px; text-align:center;font-size:9pt"|[[intermediate-acting]]
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mfg=[[Novo Nordisk]]|
  
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|-
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action=[[intermediate-acting]]|
  
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|colspan="2" style="background:#bcd2ee; width:300px; text-align:center;font-size:9pt"|[[r-DNA/GE/GM]]
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origin=[[r-DNA/GE/GM]]|
  
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|-
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strength=U100|
  
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! colspan="1" style="background:#bcd2ee; width:150px; text-align:center;font-size:9pt" | U40, U100
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suspension=[[isophane]]|
  
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|colspan="1" style="background:#bcd2ee; width:150px;text-align:center;font-size:9pt"|[[isophane]]
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line=[[Novo Nordisk|Novo]]|
  
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|-
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aliases=[[Penmix 40]]<ref>[http://www.medsafe.govt.nz/Profs/DataSheet/PenmixMixtardProtaphaneinj.htm Medsafe NZ Penmix 40]</ref>, [[Actraphane 40/60]]|
  
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|colspan="2" style="background:aliceblue; width:300px;font-size:9pt; text-align:left" | '''Action in dogs:'''
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similar=&nbsp;
  
⚫
*[[Humulin 40/60]],
 
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*[[Huminsulin Profil IV]],
  
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*[[Humulina 40/60]],
  
⚫
*[[Humuline 40/60]]
  
⚫
*[[Humulin M4]]
  
⚫
*[[Profil 40]]
  
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*[[Umuline Profil 40]]
  
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*[http://images3.wikia.nocookie.net/__cb20100602042136/diabetesindogs/images/2/23/WW_Humuline.pdf Names of Lilly r-DNA/GE/GM insulins worldwide]|
  
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dogaction=&nbsp;
  
 
*onset 0.5-3h,
 
*onset 0.5-3h,
 
*peak 2-10h,
 
*peak 2-10h,
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*duration 4-24h|
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*duration 4-24h
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|-
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cloudyorsoluble=[[cloudy]]|
  
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| colspan="2" style="background:aliceblue; width:300px;font-size:9pt; text-align:left" | '''Line:''' [[Novo Nordisk|Novo]]
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shelflife= 30 months|
  
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|-
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openedlife= 6 weeks room temp.|
  
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| colspan="2" style="background:aliceblue; width:300px; font-size:9pt;text-align:left"| '''Also known as:''' [[Actraphane 40/60]], [[Penmix 40]]
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penlife= 6 weeks room temp.|
  
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handlingnotes=&nbsp;
  
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*protect from light and heat
  
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*Do Not Freeze
  
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*Do not use if product does not [[re-suspend]]
  
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*[[Rolling insulin|Roll]]
  
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*Do not use [[intravenously]]
  
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*Do not refrigerate in use cartridges/pens.
  
⚫
}}
  
   
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|-
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| colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left"| '''Similar to:''' [[Huminsulin Profil IV]], [[Humulin 40/60]],<br> [[Humulina 40/60]], [[Humuline 40/60]], [[Humulin M4]],<br>[[Umuline Profil 40]], [[Profil 40]], [[Humulin 60/40]]<br><br>[http://images3.wikia.nocookie.net/__cb20100602042136/diabetesindogs/images/2/23/WW_Humuline.pdf Names of Lilly r-DNA/GE/GM insulins worldwide]
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|-
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|colspan="2" style="background:#ccc; width:300px;text-align:center;font-size:9pt" | '''Use and Handling:'''
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|-
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|colspan="1" style="background:aliceblue; width:150px;font-size:9pt;text-align:left"|'''Shelf Life:''' 30 months
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| colspan="1" style="background:aliceblue; width:150px;font-size:9pt;text-align:left" |'''Type:''' [[cloudy]]
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|-
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| colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left" | '''When Opened:''' 6 weeks room temp.
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|-
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|colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left"| '''In Pen:''' 6 weeks room temp.
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|-
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|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>
  ⚫
|}
   
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[[Image:40 60.jpg|thumb|left|250px|Time activity profile for Mixtard 40.]]
⚫
[[Image:Insulin_40_60.gif|thumb|left|200px|Time activity profile for Mixtard 40.]]An intermediate-acting, mixed insulin<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 [[Novo Nordisk]]. Mixtard 40<ref>[http://www.emea.europa.eu/humandocs/PDFs/EPAR/mixtard/226802en6.pdf EMEA Scientific Discussion-Mixtard]</ref> contains 60% [[isophane]] insulin crystals, as does [[Penmix 40]], [[Humuline 40/60]], [[Humulin M4]], [[Humulina 40/60]], and [[Huminsulin Profil IV]].
  
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<br clear=left>
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{|
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|-valign="top"
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|style="height:1px;border:0;" colspan="3"|
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|-valign="top"
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|style="padding:5px;border:2px solid #b9f1f0;background-color:#f0f8ff;" width="100%"|
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'''Note that some countries have the brand name in U40 strength.'''
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|}
  ⚫
An intermediate-acting, mixed insulin <ref>{{cite web|url=http://web.archive.org/web/20080208084240/http://www.drgc.cwc.net/Care_pathway/Patient_information/Insulin/Novo_insulins.htm |title=Prescribing Novo Insulins}}</ref> of 40% R/neutral insulin and 60% NPH/isophane insulin <ref>{{cite web|url=http://www.rxmed.com/b.main/b2.pharmaceutical/b2.1.monographs/CPS-%20Monographs/CPS-%20(General%20Monographs-%20H)/HUMULIN.html|title= Humulin 40/60|publisher=RxMed.com}}</ref> made by [[Novo Nordisk]]. Mixtard 40 <ref>{{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000428/WC500029819.pdf|title=Scientific Discussion-Mixtard|publisher=EMEA}}</ref> contains 60% [[isophane]] insulin crystals, as does [[Penmix 40]], [[Humuline 40/60]], [[Humulin M4]], [[Humulina 40/60]], and [[Huminsulin Profil IV]].
   
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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>
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Mixtard 40 was discontinued December 31, 2007. <ref>{{cite web|url=http://www.ukmicentral.nhs.uk/therapeu/pace/PACE0604.pdf |title=Insulin Discontinuations-UK|publisher=NHS}}</ref><ref>{{cite web|url=http://www.yorkshirediabetes.com/downloads/A4Humandis.pdf |title=Chart of Discontinued Novo Human Insulins|publisher=Novo Nordisk}}</ref>
   
 
Lilly's [[Humulin 40/60]] for the North American market was similar, and is also discontinued.
  
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. 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 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.
   
−
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:
  
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:
   
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{| align="center" width="500" border="1" bgcolor="powderblue"|
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{| class="collapsible collapsed" align="center" width="500" border="1" bgcolor="powderblue"|
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! bgcolor="powderblue" colspan="3" |Non-Analog Mixed Insulins
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! 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]]
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! bgcolor="lightcyan" colspan="2" |All [[Intermediate-acting]]
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! bgcolor="#cae1ff" colspan="2" |All [[Intermediate-acting]]
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|}
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|-
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{| align="center" width="500" border="1" bgcolor="powderblue"|
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! 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
 
|-
  
|-
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! colspan="1" bgcolor="ivory"|30/70
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! 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
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! colspan="1" bgcolor="ivory"|30% [[R|R/Neutral Insulin]]<br />70% [[NPH|NPH/Isophane Insulin]]
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! colspan="1" bgcolor="ivory"|30/70
 
|-
  
|-
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! colspan="1" bgcolor="ivory"|40/60
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! 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"|60/40
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! colspan="1" bgcolor="ivory"|40% [[R|R/Neutral Insulin]]<br />60% [[NPH|NPH/Isophane Insulin]]
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! colspan="1" bgcolor="ivory"|40/60
 
|-
  
|-
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! colspan="1" bgcolor="ivory"|50/50
  
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!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==
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{{Reflist|colwidth=30em}}
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<references/>
  
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<center>'''Related pages'''</center>
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{|align="center" width="600"
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|<center>[[Image:40 60.jpg|120px]]</center>
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|<center>[[Image:40 60.jpg|120px]]</center>
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|<center>[[Image:40 60.jpg|120px]]</center>
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|<center>[[Image:40 60.jpg|120px]]</center>
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|-
  ⚫
|<center>[[Humulin M4]]</center>
  ⚫
|<center>[[Profil 40]]</center>
  ⚫
|<center>[[Humulin 40/60]]</center>
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|<center>[[Penmix 40]]</center>
  ⚫
[[Category:40-60]]
 
[[Category:Insulins]]
  
[[Category:Insulins]]
 
[[Category:Mixed]]
  
[[Category:Mixed]]
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[[Category:Phosphate]]
  
[[Category:Phosphate]]
 
[[Category:Content]]
  
[[Category:Content]]
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[[Category:Discontinued insulins]]

Latest revision as of 23:23, 23 May 2012

Mixtard 40
R/Neutral/NPH/Isophane Mix by Novo Nordisk
intermediate-acting
r-DNA/GE/GM
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:


References[]

  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. RxMed.com.
  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
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