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Revision as of 03:19, 17 May 2012
Novolin 70/30 | |
---|---|
R/Neutral/NPH/Isophane Mix by Novo Nordisk | |
intermediate-acting | |
r-DNA/GE/GM | |
U100 | isophane |
Action in dogs:
| |
Line: Novolin | |
Also known as: Actraphane 30/70, Mixtard 30[1] Penmix 30,[2] Novolin 30R, ReliOn/Novolin 70/30 | |
Similar to: Huminsulin Profil III, Humulin 3/7 Humulin 30/70, Humulina 30/70, Humuline 30/70, Humulin M3, Profil 30, Umuline Profil 30 Humulin 70/30, Humulin Mix 30/70 Humulin ReliOn 70/30 Insuman Comb 30, Winthrop Comb 30 Names of Lilly r-DNA/GE/GM insulins worldwide | |
Use and Handling: | |
Shelf Life: 24 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 [3] |
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 [4][5] and Actraphane 30/70 [6][7] once you cross the Atlantic.
Other comparable insulins made by other companies are: Humulin M3, [8][9][10] Humulin 70/30, [11] 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. [12][13]
Why Lente doesn't equal 70/30
Let's look at the differences in the two insulins. Lente is comprised of 70 % long-acting Ultralente insulin and 30% short-acting Semilente insulin. So proportions of a long-acting and short-acting insulin are being combined to produce a intermediate-acting insulin. Both Ultralente and Semilente insulin are suspended by adding 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.[14]
70/30 insulin starts with 70% NPH/isophane insulin, an intermediate-acting insulin which is suspended by protamine. To that, 30% R/neutral/normal insulin, which is short-acting and 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 (Lente), made up of a long-acting and short-acting insulin, both with zinc suspensions, and a mixed insulin (70/30), made from an intermediate-acting 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. 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
- ↑ Patient Information Leaflet-Mixtard 30. Novo Nordisk.
- ↑ Penmix 40. Medsafe NZ.
- ↑ Maddison, Jill E.,Page, Stephen W.,Church, David B. (2008). Small Animal Clinical Pharmacology. Saunders Ltd..
- ↑ Prescribing Novo Insulins.
- ↑ Scientific Discussion-Mixtard. EMEA.
- ↑ Scientific Discussion-Actraphane. EMEA.
- ↑ Insulins & Mixtures. NHS.
- ↑ Patient Information Leaflet-Humulin M3. Eli Lilly.
- ↑ Humulin M3 Prescribing Information.
- ↑ Lilly EU/UK Product Sheet & Time Activity Profiles. Eli Lilly.
- ↑ Humulin 70/30-NPH;R Human Insulin
- ↑ Novo discontinuation notice for pens. Novo Nordisk.
- ↑ Novolin 70/30 cartridge Discontinuation Notice. US Food and Drug Administration.
- ↑ Greco, Deborah (2010). Treating Diabetes Mellitus in Dogs and Cats. Western Veterinary Conference.
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