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 | ||
---|---|---|
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.