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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=#dcdcdc| |
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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=U40, 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=[[Actraphane 40/60]], [[Penmix 40]]<ref>[http://www.medsafe.govt.nz/Profs/DataSheet/PenmixMixtardProtaphaneinj.htm Medsafe NZ Penmix 40]</ref>| |
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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= |
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− | *[[Huminsulin Profil IV]] |
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⚫ | |||
− | *[[Humulin 60/40]] |
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⚫ | |||
⚫ | |||
− | *[[Humuline 40/60]] |
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⚫ | |||
− | *[[Umuline Profil 40]] |
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− | |||
− | <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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− | dogaction= |
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*onset 0.5-3h, |
*onset 0.5-3h, |
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*peak 2-10h, |
*peak 2-10h, |
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− | *duration 4-24h |
+ | *duration 4-24h |
+ | |- |
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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= |
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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: |
+ | [[Image:40 60.jpg|thumb|left|250px|Time activity profile for Mixtard 40.]] |
+ | <br clear=left> |
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{| |
{| |
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|-valign="top" |
|-valign="top" |
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|style="height:1px;border:0;" colspan="3"| |
|style="height:1px;border:0;" colspan="3"| |
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|-valign="top" |
|-valign="top" |
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− | |style="padding:5px;border:2px solid #b9f1f0;background-color:#f0f8ff;" width=" |
+ | |style="padding:5px;border:2px solid #b9f1f0;background-color:#f0f8ff;" width="100%"| |
'''Note that some countries have the brand name in U40 strength.''' |
'''Note that some countries have the brand name in U40 strength.''' |
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|} |
|} |
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− | An intermediate-acting, mixed insulin<ref> |
+ | 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]]. |
− | Mixtard 40 was discontinued December 31, 2007.<ref> |
+ | 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. |
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− | [[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. 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. |
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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"| |
+ | {| class="collapsible collapsed" align="center" width="500" border="1" bgcolor="powderblue"| |
− | ! bgcolor=" |
+ | ! bgcolor="BCD2EE" colspan="3" |Non-Analog Mixed Insulins |
|- |
|- |
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! bgcolor="lightcyan" width="200" |[[Image:Intermediate_acting.jpg|200px]] |
! bgcolor="lightcyan" width="200" |[[Image:Intermediate_acting.jpg|200px]] |
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− | ! bgcolor=" |
+ | ! bgcolor="#cae1ff" colspan="2" |All [[Intermediate-acting]] |
− | | |
+ | |- |
− | + | ! colspan="1" bgcolor="aliceblue"|Insulin Is |
|
! colspan="1" bgcolor="aliceblue"| Expressed As |
! colspan="1" bgcolor="aliceblue"| Expressed As |
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!colspan="1" bgcolor="aliceblue"|Expressed As |
!colspan="1" bgcolor="aliceblue"|Expressed As |
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⚫ | |||
|- |
|- |
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⚫ | |||
⚫ | |||
! colspan="1" bgcolor="ivory"|10/90 |
! colspan="1" bgcolor="ivory"|10/90 |
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⚫ | |||
⚫ | |||
|- |
|- |
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⚫ | |||
⚫ | |||
! colspan="1" bgcolor="ivory"|20/80 |
! colspan="1" bgcolor="ivory"|20/80 |
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⚫ | |||
⚫ | |||
|- |
|- |
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− | ! colspan="1" bgcolor="ivory"|30/ |
+ | ! 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 |
+ | ! colspan="1" bgcolor="ivory"|30/70 |
|- |
|- |
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⚫ | |||
⚫ | |||
! 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]] |
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⚫ | |||
⚫ | |||
|- |
|- |
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⚫ | |||
− | !colspan="1" bgcolor="ivory"|50/50 |
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! 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]] |
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⚫ | |||
⚫ | |||
|} |
|} |
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==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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+ | |||
+ | |- |
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+ | |<center>[[Penmix 40]]</center> |
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[[Category:Insulins]] |
[[Category:Insulins]] |
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[[Category:Mixed]] |
[[Category:Mixed]] |
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[[Category:Phosphate]] |
[[Category:Phosphate]] |
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[[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:
| |
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] |
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:
Non-Analog Mixed Insulins | ||
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All Intermediate-acting | ||
Insulin Is | Expressed As | Expressed As |
10% R/Neutral Insulin 90% NPH/Isophane Insulin |
90/10 | 10/90 |
20% R/Neutral Insulin 80% NPH/Isophane Insulin |
80/20 | 20/80 |
30% R/Neutral Insulin 80% NPH/Isophane Insulin |
70/30 | 30/70 |
40% R/Neutral Insulin 60% NPH/Isophane Insulin |
60/40 | 40/60 |
50% R/Neutral Insulin 50% NPH/Isophane Insulin |
50/50 | 50/50 |
References[]
- ↑ 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.