Canine Diabetes Wiki
Don't have an account?
Register
Register
in: Templates, Insulins, Mixed,
and 9 more

Changes: Mixtard 40

Back to page
Edit
No edit summary
No edit summary
Line 31: Line 31:
   
   
−
[[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]].
 +
[[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]].
   
 
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>
  
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>
   
 
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.
  +
  +
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.
  +
  +
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"|
  +
! bgcolor="powderblue" colspan="4" |Non-Analog Mixed Insulins
  +
|-
  +
! width="100" bgcolor="aliceblue"| Expressed As
  +
!width="100" bgcolor="aliceblue"|Expressed As
  +
! width="200" bgcolor="aliceblue"|Insulin Is
  +
|-
  +
! width="100" bgcolor="ivory"|10/90
  +
!width="100" bgcolor="ivory"|90/10
  +
! width="200" bgcolor="ivory"|10% [[R|R/Neutral Insulin]]<br />90% [[NPH|NPH/Isophane Insulin]]
  +
|-
  +
! width="100" bgcolor="ivory"|20/80
  +
!width="100" bgcolor="ivory"|80/20
  +
! width="200" bgcolor="ivory"|20% [[R|R/Neutral Insulin]]<br />80% [[NPH|NPH/Isophane Insulin]]
  +
|-
  +
! width="100" bgcolor="ivory"|30/70
  +
!width="100" bgcolor="ivory"|70/30
  +
! width="200" bgcolor="ivory"|30% [[R|R/Neutral Insulin]]<br />70% [[NPH|NPH/Isophane Insulin]]
  +
|-
  +
! width="100" bgcolor="ivory"|40/60 (Mixtard 40)
  +
!width="100" bgcolor="ivory"|60/40
  +
! width="200" bgcolor="ivory"|40% [[R|R/Neutral Insulin]]<br />60% [[NPH|NPH/Isophane Insulin]]
  +
|-
  +
! width="100" bgcolor="ivory"|50/50
  +
!width="100" bgcolor="ivory"|50/50
  +
! width="200" bgcolor="ivory"|50% [[R|R/Neutral Insulin]]<br />50% [[NPH|NPH/Isophane Insulin]]
  +
|}
   
 
==References==
  
==References==

Revision as of 17:43, 16 January 2010

Mixtard 40
R/Neutral/NPH/Isophane Mix by Novo Nordisk
intermediate-acting r-DNA/GE/GM
U100 isophane
Line Novo
Also known as Penmix 40[1], Actraphane 40/60
Similar to  
Action in dogs  
  • onset 0.5-3h,
  • peak 2-10h,
  • duration 4-24h
Use and Handling
Type cloudy
Shelf Life 30 months
When opened 6 weeks room temp.
In pen 6 weeks room temp.
Notes  
  • protect from light and heat
  • Do Not Freeze
  • Do not use if product does not re-suspend
  • Roll
  • Do not use intravenously
  • Do not refrigerate in use cartridges/pens.


Insulin 40 60

Time activity profile for Mixtard 40.

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.

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. 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[7]. 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
Expressed As Expressed As Insulin Is
10/90 90/10 10% R/Neutral Insulin
90% NPH/Isophane Insulin
20/80 80/20 20% R/Neutral Insulin
80% NPH/Isophane Insulin
30/70 70/30 30% R/Neutral Insulin
70% NPH/Isophane Insulin
40/60 (Mixtard 40) 60/40 40% R/Neutral Insulin
60% NPH/Isophane Insulin
50/50 50/50 50% R/Neutral Insulin
50% NPH/Isophane Insulin

References

  1. ↑ Medsafe NZ Penmix 40
  2. ↑ Prescribing Novo Insulins
  3. ↑ RxMed-Humulin 40/60
  4. ↑ EMEA Scientific Discussion-Mixtard
  5. ↑ Insulin Discontinuations-UK
  6. ↑ Chart of Discontinued Novo Human Insulins
  7. ↑ Humulin 10/90-NPH;R Human Insulin Remedyfind.com
Community content is available under CC-BY-SA unless otherwise noted.