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ReliOn/Novolin 70/30

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ReliOn/Novolin 70/30
R/Neutral/NPH/Isophane Mix by Novo Nordisk
intermediate-acting
r-DNA/GE/GM
U100 isophane
Action in dogs:
  • onset 0.5-3h,
  • peak 2-10h,
  • duration 4-24h
Line: Novolin
Also known as: Actraphane 30/70, Mixtard 30 [1]
Penmix 30,[2] Novolin 70/30, Novolin 30R
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]
70 30insulin

ReliOn Novolin 70/30


A mixed insulin, containing 30% R neutral and 70% NPH isophane  crystal insulin. [4]

All ReliOn insulins were made by Novo Nordisk and were identical to those in their Novolin line. [5][6] After October 2010, ReliOn brand insulin was no longer made by Novo Nordisk, who had been responsible for producing the ReliOn insulins since 2000. [7][8] The ReliOn insulins are still offered in the same types, R, NPH, and 70/30 mix, but they are now produced by Eli Lilly and branded as Humulin/ReliOn insulins. [9][10][11] Novolin insulins have NOT been discontinued; these insulins are available as Novolin N, Novolin R, and Novolin 70/30. Only the ReliOn/Novolin branded insulins have been phased out.

The difference between Novolin 70/30, Actraphane 30/70, Mixtard 30 [12][13][14][15] was only the ReliOn name added to the label and the less expensive price; they all came from Novo.

Other comparable insulins made by others are: Insuman Comb 30, Winthrop Comb 30, Humulin 70/30, [16] Umuline Profil 30, Huminsulin Profil III, Humulina 30/70, Humuline 30/70, and Humulin M3. [17][18][19]

Why Lente doesn't equal 70/30Edit

Lente-70 30

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.

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.[20]

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:

ReferencesEdit

  1. Patient Information Leaflet-Mixtard 30. Novo Nordisk.
  2. Penmix 40. Medsafe NZ.
  3. Maddison, Jill E.,Page, Stephen W.,Church, David B. (2008). Small Animal Clinical Pharmacology. Saunders Ltd..
  4. Scientific Discussion-Actraphane. EMEA.
  5. ReliOn/Novolin insulins.
  6. ReliOn/Novolin 70/30.
  7. A Change to ReliOn Insulin. ReliOn.
  8. Low Cost Insulin Available through major retailer. Diabetes Health (1 December 2000).
  9. Wal-Mart Changes Insulin Partners. Wall Street Journal (22 June 2010).
  10. Wal-Mart Press Release (22 June 2010).
  11. ReliOn insulins. ReliOn.
  12. Scientific Discussion-Mixtard. EMEA.
  13. Insulins & Mixtures. NHS.
  14. Patient Information Leaflet-Mixtard 30. Novo Nordisk.
  15. Prescribing Novo Insulins.
  16. Humulin 70/30-NPH;R Human Insulin. Revolution Health.
  17. Patient Information Leaflet-Humulin M3. Eli Lilly.
  18. Humulin M3 Prescribing Information.
  19. Lilly EU/UK Product Sheet & Time Activity Profiles. Eli Lilly.
  20. Greco, Deborah (2010). Treating Diabetes Mellitus in Dogs and Cats. Western Veterinary Conference.


More InformationEdit


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