Editing Novolin 70/30

{|class="wikitable"  align="right" width="300"  bgcolor="powderblue"|
! colspan="2" style="background:#cae1ff; width:300px;font-size:10pt" | Novolin 70/30
|-
|colspan="2" style="background:aliceblue; width:300px; text-align:center;font-size:9pt" |[[Mixed insulins|R/Neutral/NPH/Isophane Mix]] by [[Novo Nordisk]]
|-
| colspan="2" style="background:#bcd2ee; width:300px; text-align:center;font-size:9pt"|[[intermediate-acting]]
|-
|colspan="2" style="background:#bcd2ee; width:300px; text-align:center;font-size:9pt"|[[r-DNA/GE/GM]]
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!colspan="1" style="background:#bcd2ee; width:150px; text-align:center;font-size:9pt" | U100
|colspan="1" style="background:#bcd2ee; width:150px;text-align:center;font-size:9pt"|[[isophane]]
|-
|colspan="2" style="background:aliceblue; width:300px;font-size:9pt; text-align:left" | '''Action in dogs:'''
*onset 0.5-3h, 
*peak 2-10h, 
*duration 4-24h
|-
|colspan="2" style="background:aliceblue; width:300px;font-size:9pt; text-align:left" | '''Line:''' [[Novolin]]
|-
| colspan="2" style="background:aliceblue; width:300px; font-size:9pt;text-align:left"| '''Also known as:''' [[Actraphane 30/70]],  [[Mixtard 30]]<ref>{{cite web|url=http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=15974 |title=Patient Information Leaflet-Mixtard 30|publisher=Novo Nordisk}}</ref><br>[[Penmix 30]],<ref>{{cite web|url=http://www.medsafe.govt.nz/Profs/DataSheet/PenmixMixtardProtaphaneinj.htm |title=Penmix 40|publisher=Medsafe NZ}}</ref> [[Novolin 30R]], [[ReliOn/Novolin 70/30]]
|-
| colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left"| '''Similar to:''' [[Huminsulin Profil III]], [[Humulin 3/7]]<br>[[Humulin 30/70]], [[Humulina 30/70]], [[Humuline 30/70]], [[Humulin M3]], [[Profil 30]], &nbsp;[[Umuline Profil 30]]<br>[[Humulin 70/30]], [[Humulin Mix 30/70]]<br>[[Humulin ReliOn 70/30]]<br>[[Insuman Comb 30]],  [[Winthrop Comb 30]]<br><br>[http://images3.wikia.nocookie.net/__cb20100602042136/diabetesindogs/images/2/23/WW_Humuline.pdf Names of Lilly r-DNA/GE/GM insulins worldwide]
|-
| colspan="2" style="background:#cae1ff; width:300px;text-align:center;font-size:9pt" | '''Use and Handling:'''
|-
|colspan="1" style="background:aliceblue; width:150px;font-size:9pt;text-align:left"|'''Shelf Life:''' 24 months

|colspan="1" style="background:aliceblue; width:150px;font-size:9pt;text-align:left" | '''Type:''' [[cloudy]] 
|-
|colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left" | '''When Opened:''' 6 weeks room temp.
|-
|colspan="2" style="background:aliceblue; width:300px;font-size:9pt;text-align:left"| '''In Pen:''' 6 weeks room temp.
|-
| 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>
|}

[[Image:NVN18370 73077 5.jpg|thumb|left|250px|Novolin Mixed 70/30 insulin-30% R/Neutral and 70% NPH/isophane.]]
<br clear=left>
This is the [[Novo Nordisk]] brand name for one of the mixed 30% R/neutral, 70% NPH/isophane crystal insulin it sells in North America; the other is [[ReliOn/Novolin 70/30]].

The same insulin made by the same company is called [[Mixtard 30]] <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><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> and [[Actraphane 30/70]] <ref>{{cite web|url=http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Scientific_Discussion/human/000427/WC500025430.pdf|title=Scientific Discussion-Actraphane|publisher=EMEA}}</ref><ref>{{cite web|url=http://www.leedsth.nhs.uk/sites/diabetes/information/InsulinMixtures.php |title=Insulins & Mixtures|publisher=NHS}}</ref> once you cross the Atlantic.

Other comparable insulins made by other companies are: [[Humulin M3]],  <ref>{{cite web|url=http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=13403 |title=Patient Information Leaflet-Humulin M3|publisher=Eli Lilly}}</ref><ref>{{cite web|url=http://web.archive.org/web/20060504084959/www.drgc.cwc.net/Care_pathway/Patient_information/Insulin/Humulin_M3.htm |title=Humulin M3 Prescribing Information}}</ref><ref>{{cite web|url=http://www.yorkshirediabetes.com/downloads/1071_LLY_Diabetes_RangeChar.pdf|title= Lilly EU/UK Product Sheet & Time Activity Profiles|publisher=Eli Lilly}}</ref> [[Humulin 70/30]], <ref>[http://www.revolutionhealth.com/drugs-treatments/humulin-70-30 Humulin 70/30-NPH;R Human Insulin]</ref>  [[Umuline Profil 30]], [[Huminsulin Profil III]], [[Humulina 30/70]], [[Humuline 30/70]], [[Insuman Comb 30]] and [[Winthrop Comb 30]].

As of January 1, 2010, Novo has discontinued offering Novolin 70/30 in cartridges for refillable insulin pens. <ref>{{cite web|url=http://www.novonordiskcare.com/novolog-novolin-pens/ |title=Novo discontinuation notice for pens|publisher=Novo Nordisk}}</ref><ref>{{cite web|url=http://www.fda.gov/downloads/Drugs/DrugSafety/DrugShortages/UCM177159.pdf |title=Novolin 70/30 cartridge Discontinuation Notice|publisher= US Food and Drug Administration}}</ref>

==Why Lente doesn't equal 70/30==
[[Image:Lente-70 30.jpg|thumb|300px|left|Direct comparison of insulin activity profiles for Lente and 70/30 insulins. The early strong action from the non-suspended R/neutral/normal insulin is seen at the "bump" from hours 0-6.]]
<br><br><br>
Let's look at the differences in the two insulins.  Lente is comprised of 70 % [[:Category:Long-acting|long-acting]] [[Ultralente]] insulin and 30% [[:Category:Short-acting|short-acting]] [[Semilente]] insulin. So proportions of a long-acting and short-acting insulin are being combined to produce a [[:Category:Intermediate-acting|intermediate-acting]] insulin.  Both Ultralente and Semilente insulin are [[suspension|suspended]] by adding [[:Category:Zinc|zinc]] and the size of their respective insulin crystals. The largest insulin crystals are those of Ultralente, while Semilente contains the smallest, or microcrystals.  Simply put, you're combining a long insulin and a short insulin to make an intermediate-acting one.<ref>{{cite web|url=http://images1.wikia.nocookie.net/diabetesindogs/images/4/42/2010_T35-greco-western-2010.pdf|title=Treating Diabetes Mellitus in Dogs and Cats|author=Greco, Deborah|publisher=Western Veterinary Conference|year=2010}}</ref> 

70/30 insulin starts with 70% [[NPH]]/isophane insulin, an [[:Category:Intermediate-acting|intermediate-acting]] insulin which is suspended by [[Protamine|protamine]]. To that, 30% [[R]]/neutral/normal insulin, which is [[:Category:Short-acting|short-acting]] and [[Soluble insulin|soluble]], meaning there is no suspension; nothing is added to this insulin to delay its action. In this case, you are taking an intermediate-acting insulin with a suspension and adding to it a short-acting one with no suspension to create an intermediate-acting insulin.

So we have an insulin ([[:Category:Lente|Lente]]), made up of a long-acting and short-acting insulin, both with [[:Category:Zinc|zinc]] suspensions, and a [[:Category:Mixed|mixed]] insulin (70/30), made from an intermediate-acting [[:Category:Isophane|protamine]] suspended insulin and a short-acting one without any suspension.  Because of these differences, the insulin action profile for these two insulins is going to be quite different, even though both insulins are classed as intermediate-acting.

[[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. 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:

{| class="collapsible collapsed"  align="center" width="500" border="1" bgcolor="powderblue"|
! bgcolor="BCD2EE" colspan="3" |Non-Analog Mixed Insulins
|-
! bgcolor="lightcyan" width="200" |[[Image:Intermediate_acting.jpg|200px]]
! 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
|-
! 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% [[R|R/Neutral Insulin]]<br />80% [[NPH|NPH/Isophane Insulin]]
!colspan="1" bgcolor="ivory"|80/20
! colspan="1" bgcolor="ivory"|20/80
|-
! 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"|30/70
|-
! 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"|40/60
|-
! 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==
{{Reflist|colwidth=30em}}

==More Information==

*[http://images2.wikia.nocookie.net/__cb20100821055615/diabetesindogs/images/0/0a/NACDS_insulin_chart.pdf NACDS-Insulin Chart-Page 2]
*[http://www.leedsth.nhs.uk/sites/diabetes/insular/InsulinGuide.php Leeds NHS UK Insulin Guide]


<center>'''Related pages'''</center>
{|align="center" width="600"

|<center>[[Image:30 70.jpg|100px]]</center>
|<center>[[Image:Mixtard30.jpg|100px]]</center>
|<center>[[Image:HumilinLILLY.jpg|100px]]</center>
|<center>[[Image:21941f.png|100px]]</center>
|<center>[[Image:30 70.jpg|100px]]</center>

|-
|<center>[[Penmix 30]]</center>
|<center>[[Mixtard 30]]</center>
|<center>[[Humulin 70/30]]</center>
|<center>[[Humulin M3]]</center>
|<center>[[Insuman Comb 30]]</center>
|}
[[Category:30-70]]
[[Category:Insulins]]
[[Category:Mixed]]
[[Category:intermediate-acting]]
[[Category:Novo Nordisk]]
[[Category:r-DNA/GE/GM]]
[[Category:OTC Status]]
[[Category:Intravenous use NO]]
[[Category:Meta-cresol]]
[[Category:Phenol]]
[[Category:Isophane]]
[[Category:Phosphate]]
[[Category:Content]]
[[Category:Currently marketed insulins]]
[[Category:Currently marketed insulins]]