Humulin U

Use and Handling
Humulin U
Ultralente by Eli Lilly
long-acting	r-DNA/GE/GM
U100	Zinc
Line	Humulin
Also known as	Humulin Zn
Similar to	Novolin U, Ultratard
Action in cats	onset Xh peak Xh duration: Xh
Action in dogs	onset 1-8h, peak 4-16h, duration 8-28h
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 U^[1] is a long-acting, Ultralente insulin formerly produced by Eli Lilly^[2], who stopped producing it in July 2005^[3]^[4]^[5]^[6].

Lilly called it Humulin Zn^[7]^[8] in the UK.

Comparable to Novo Nordisk's Ultratard^[9]^[10] and Novolin U. All of them were crystalline-suspended insulins^[11].

What Ultralente Is Not[]

No Lente-type insulin regardless of species can contain any NPH/isophane insulin^[12] or any R/Neutral insulin^[13]^[14].

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^[15].

The zinc suspension of Lente-type insulin binds R/Neutral, causing the short-acting insulin to slow, losing its short-acting effect^[16]^[17].

Combining Lente Family Insulins[]

Insulin manufacturers^[18] 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^[19]^[20]^[21]^[22].

None of the Lente family of insulins (semilente, Lente, Ultralente) can be combined with^[23] 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^[24].

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.

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.

References[]

[1] Humulin U carton photo.

[2] Humulin U, etc.-Ultralente Human Insulin Remedyfind.com

[3] Humulin U Patient Leaflet

[4] Humulin U Carton Photo

[5] US-FDA Humulin U Discontinuation Notice

[6] Lilly US-Humulin U/Humulin L Discontinuation Sheet

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

[8] Humulin Zn Discontinuation Notice 2004

[9] Prescribing Novo Insulins

[10] Ultratard Discontinuation Notice July 2005

[11] EMEA Scientific Discussion-Ultratard

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

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

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

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

[16] 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

[17] Resource Guide 2005-American Diabetes Association

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

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

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

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

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

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

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

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

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Humulin U

Contents

What Ultralente Is Not[]

Combining Lente Family Insulins[]

Further Reading[]

References[]