Humulin L

Use and Handling
Humulin L
Lente by Eli Lilly
intermediate-acting	r-DNA/GE/GM
U100	Zinc
Line	Humulin
Also known as	N/A
Similar to	Novolin L, Monotard
Action in cats	onset 2-5h, peak 8-10h^[1] duration: 10-16h
Action in dogs	onset 2-10h, peak 6-24h, duration 14-24h
Type	cloudy
Shelf Life	24 months
When opened	28 days
In pen	N/A
Notes	protect from light and heat store at 2-8C Do not use if product does not re-suspend Roll Do not use intravenously

Humulin L^[2] was a U100 r-DNA/GE/GM intermediate-acting, lente insulin^[3]^[4]^[5]. Novo Nordisk also made similar insulins, calling them Novolin L^[6] and Monotard^[7]^[8].

"L" came to an end when Eli Lilly announced in July, 2005 that it would no longer be produced^[9]^[10]. The UK & Euro production of Humulin L stopped a year prior to this, in July 2004^[11]^[12].

What Lente Is Not[]

No Lente-type insulin regardless of species can contain any NPH/isophane insulin^[13] or any R/Neutral insulin^[14]^[15].

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^[16].

The zinc suspension of Lente-type insulin binds R/Neutral, causing the short-acting insulin to slow, losing its short-acting effect^[17]^[18].

Lente-type insulins cannot be dispensed in pen or cartridge form because the glass ball used to mix the insulin in these devices will shatter the Lente crystals^[19].

Combining Lente Family Insulins[]

None of the Lente family of insulins (semilente, Lente, Ultralente) can be combined with^[20] 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^[21].

Keeping the phenol preservatives in mind, all protamine-suspended insulin mixes would be "off limits" regarding same syringe mixing with any Lente-type insulins^[22].

Insulin manufacturers^[23] 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^[24]^[25]^[26]^[27].

The Novo insulins,Monotard and Ultratard, were available slightly longer in Europe.

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.

Compared to Humulin N[]

Humulin L/Monotard and Humulin N are both U100 strength insulins of r-DNA/GE/GM species. They differ in their suspension. Humulin L and Monotard were Zinc suspended, from the Lente type family, while Humulin N/NPH insulins are isophane suspended.

References[]

[1] Insulins-North American Veterinary Conference-2005

[2] Humulin L carton photo.

[3] Humulin L, etc.-Lente Human Insulin Remedyfind.com

[4] Humulin L Patient Leaflet

[5] Humulin L Carton Photo

[6] US-FDA-Novolin L Discontinuation Notice-2003

[7] EMEA Scientific Discussion-Monotard

[8] Monotard Discontinuation Notice July 2005

[9] US-FDA-Humulin L Discontinuation Notice

[10] Lilly US Humulin L/Humulin U Discontinuation Sheet

[11] Withdrawal of EU/UK Humulin L July 2004

[12] Lilly EU/UK Product Sheet & Time Activity Profiles

[13] Combining Lente-type Insulins with Phenol-Preserved Insulins

[14] Lente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect

[15] Availability of Soluble (R/Neutral) Insulin in Mixed Preparations With Crystalline (Lente) & Ultralente GE Insulin-Clinical Therapeutics-1991

[16] Lente-Type Insulins & NPH/Isophane Insulins-A Bad Combination

[17] Intermediate-Acting Insulin Preparations: NPH (Isophane) & Lente Diabetes Care-1980
Note--in 1980, there was only beef Lente-type insulin--no pork or r-DNA/GE/GM Lente insulins

[18] Resource Guide 2005-American Diabetes Association

[19] Insulin-Dependent Diabetes--Page 10--Dr. Ragnar Hanas

[20] Phenol Preservatives & Lente-type Insulins--A Bad Combination

[21] RxEd.org-Insulin Therapy-Mixing Precautions

[22] RxEd.org-Insulin Therapy-Mixing Precautions

[23] Insulin Producers vs Doctors Re:Combining R/Neutral & Lente-type Insulins

[24] Availability of Soluble (R/Neutral) Insulin in Mixed Preparations of Crystalline (Lente) & Ultralente GE Insulins-Clinical Therapeutics-1991

[25] Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin-Diabetes Care-1987

[26] Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin Diabetes Research & Clinical Practice-1983

[27] RxEd.org-Insulin Therapy-Mixing Precautions

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Humulin L

Contents

What Lente Is Not[]

Combining Lente Family Insulins[]

Compared to Humulin N[]

Further Reading[]

References[]