| Mixtard 40 | |
| R/Neutral/NPH/Isophane Mix by Novo Nordisk | |
| intermediate-acting | r-DNA/GE/GM |
| U40, U100 | isophane |
| Line | Novo |
| Also known as | Penmix 40[1], Actraphane 40/60 |
| Similar to | |
| Action in dogs |
|
| Use and Handling | |
|---|---|
| Type | cloudy |
| Shelf Life | 30 months |
| When opened | 6 weeks room temp. |
| In pen | 6 weeks room temp. |
| Notes |
|
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. 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 | ||
|---|---|---|
|
All Intermediate-acting | |
| 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 | 60/40 | 40% R/Neutral Insulin 60% NPH/Isophane Insulin |
| 50/50 | 50/50 | 50% R/Neutral Insulin 50% NPH/Isophane Insulin |