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Humulin Ultralenta
Ultralente by Eli Lilly
long-acting
r-DNA/GE/GM
U40, U100 Zinc
Action in dogs:
  • onset 2-10h,
  • peak 6-24h,
  • duration 14-24h
Line: Humulin
Also known as: Huminsulin Ultralong, Humulin U
Humulin UL, Humulin Ultralente
Humulin Zn, Humuline Ultralong
Humulina Ultralenta, Umuline Zinc
Similar to: Novolin U, Ultratard

Names of Lilly r-DNA/GE/GM insulins worldwide
Use and Handling:
Shelf Life: 24 months Type: cloudy
When Opened: 28 days room temp.
In Pen: N/A
Notes: Protect from light and heat
Do Not Freeze, Resuspend
Do not use if product does not re-suspend
Do not use intravenously [1]
store at 2-8C
Ultralentetap

Time activity profile for Ultralente insulins.


Humulin Ultralenta [2] was a long-acting, Ultralente [3][4] insulin formerly produced by Eli Lilly. They stopped producing their US version, Humulin U, in July 2005. [5][2][6][7]

Lilly called it Humulin Zn [8][9] in the UK, Umuline Zinc, and Humuline Ultralong elsewhere.

Comparable to Novo Nordisk's Ultratard [10][11] and Novolin U, [12] all of them were crystalline-suspended insulins. [13]

What Ultralente Is NotEdit

No Lente-type insulin regardless of species can contain any NPH/isophane insulin [14] or any R/Neutral insulin. [15][16]

Both are chemically impossible: the phenol preservative present in NPH/isophane alters the action of Lente-type insulins, creating a mixture with an approximate action of R/Neutral. [17][18]

The zinc suspension of Lente-type insulin binds R/Neutral, causing the short-acting insulin to slow, losing its short-acting effect. [19][20]

Before the invention of VetPen, Lente-type insulins could not be dispensed in pen or cartridge form because the glass ball formerly used to mix the insulin in these devices shattered the Lente crystals.[21]

Combining Lente Family InsulinsEdit

Insulin manufacturers [22] indicate that R/neutral and semilente, Lente, ultralente insulins are able to be combined in the same syringe, but only just before injection. In pre-filled syringes, the zinc suspension of the Lente-type insulins binds the R/neutral, causing it to lose its short-acting effect. Various studies have documented this, and some doctors advise against using R/neutral in the same syringe with the Lente family of insulins. [16][23][24][25]

None of the Lente family of insulins (semilente, Lente, Ultralente) can be combined with [26] NPH/isophane insulins. The phenol preservatives present in NPH-type insulins alters the Lente-types to the point where they become a close approximation of R/neutral, with regard to action. [25]

Keeping the phenol preservatives in mind, all protamine-suspended insulin mixes would be "off limits" regarding same syringe mixing with any Lente-type insulins. [25]



The Novo insulins, Novolin U and Ultratard, were available slightly longer in Europe. [11]

From the announcement: Monotard and Ultratard will not be available in the UK after February 2006. The discontinuation of these insulins was initially announced in September 2004. Initially the discontinuation was scheduled for February 2006, however this date has now been brought forward to October 2005.

ReferencesEdit

  1. Maddison, Jill E.,Page, Stephen W.,Church, David B. (2008). Small Animal Clinical Pharmacology. Saunders Ltd..
  2. 2.0 2.1 Humulin U carton photo..
  3. Definition of Ultralente Insulin. Merck Manual.
  4. Dumitriu, Severian (2001). Polymeric Biomaterials, Revised and Expanded 1104. CRC Press.
  5. Humulin U Patient Leaflet. Eli Lilly.
  6. Humulin U Discontinuation Notice. US Food and Drug Administration.
  7. Humulin U/Humulin L Discontinuation Sheet. Eli Lilly.
  8. Lilly EU/UK Product Sheet & Time Activity Profiles. Eli Lilly.
  9. Humulin Zn Discontinuation Notice. Diabetes UK (2004).
  10. Prescribing Novo Insulins.
  11. 11.0 11.1 Ultratard Discontinuation Notice. Diabetes UK (July 2005]).
  12. Discontinuation of Novolin U. IDDT International (2003).
  13. Scientific Discussion-Ultratard. EMEA.
  14. Combining Lente-type Insulins with Phenol-Preserved Insulins. National Federation for the Blind.
  15. Lente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect. Endotext.org.
  16. 16.0 16.1 Huffman DM, Garber AJ. (1991). Availability of Soluble (R/Neutral) Insulin in Mixed Preparations With Crystalline (Lente) & Ultralente GE Insulin. Clinical Therapeutics.
  17. Lente-Type Insulins & NPH/Isophane Insulins-A Bad Combination. National Federation for the Blind.
  18. Havlik I, Galasko G, Alberts E, Furman KI, Seftel HC. (1988). Solubility Changes on Mixing Short- and Long-acting Insulin Preparations. South African Medical Journal.
  19. Deckert T. (1980). Intermediate-Acting Insulin Preparations: NPH (Isophane) & Lente. Diabetes Care.
    Note--in 1980, there were no r-DNA/GE/GM insulins
  20. Resource Guide. American Diabetes Association (2005).
  21. Hanas, Ragnar (1999). Insulin-Dependent Diabetes--Page 10. Children With Diabetes.
  22. Insulin Producers vs Doctors Re:Combining R/Neutral & Lente-type Insulins. Endotext.org.
  23. Bilo HJ, Heine RJ, Sikkenk AC, van der Meer J, van der Veen EA. (1987). Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin. Diabetes Care.
  24. Heine RJ, Sikkenk AC, Eizenga WH, van der Veen EA. (1983). Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin. Diabetes Research & Clinical Practice.
  25. 25.0 25.1 25.2 Insulin Therapy-Mixing Precautions. RxEd.org.
  26. Phenol Preservatives & Lente-type Insulins--A Bad Combination. National Federation for the Blind.
  27. Discussion of differences between r-DNA Ultralente and beef Ultralente insulins. Free Patents Online.
  28. Insulin Preparations. Committee on Safety in Medicines-UK (1976).


More InformationEdit


Related pages
Ultratardhm
Human Activity Profiles Various Insulins
Humu00ut
Zn
Ultratard
Novolin U
Humulin U
Humulin Zn

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