(→What Lente Is Not: ref re: not mixing NPH & Lente types) |
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'''No''' Lente-type insulin regardless of species can contain any [[NPH]]/[[isophane]] insulin<ref>[http://www.nfb.org/vodold/vsum9809.htm Combining Lente-type Insulins with Phenol-Preserved Insulins]</ref> '''or''' any [[R]]/[[Neutral]] insulin<ref>[http://www.endotext.org/diabetes/diabetes17/diabetes17.htm Lente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect]</ref>. |
'''No''' Lente-type insulin regardless of species can contain any [[NPH]]/[[isophane]] insulin<ref>[http://www.nfb.org/vodold/vsum9809.htm Combining Lente-type Insulins with Phenol-Preserved Insulins]</ref> '''or''' any [[R]]/[[Neutral]] insulin<ref>[http://www.endotext.org/diabetes/diabetes17/diabetes17.htm Lente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect]</ref>. |
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− | Both are chemically impossible: the phenol [[preservatives|preservative]] present in [[NPH]]/[[isophane]] alters the action of Lente-type insulins, creating a mixture with an approximate action of [[R]]/[[Neutral]]. |
+ | Both are chemically impossible: the phenol [[preservatives|preservative]] present in [[NPH]]/[[isophane]] alters the action of Lente-type insulins, creating a mixture with an approximate action of [[R]]/[[Neutral]]<ref>[http://www.nfb.org/Images/nfb/Publications/vod/VFAL0010.HTM Lente-Type Insulins & NPH/Isophane Insulins-A Bad Combination]</ref>. |
The zinc [[suspension]] of Lente-type insulin binds [[R]]/[[Neutral]], causing the [[short-acting]] insulin to slow, losing its short-acting effect<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=7192205 Intermediate-Acting Insulin Preparations: NPH (Isophane) & Lente Diabetes Care-1980]<br>Note--in 1980, there was only [[bovine|beef]] Lente-type insulin--no [[porcine|pork]] or [[r-DNA/GE/GM]][[Lente]] insulins</ref><ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3281288&dopt=Abstract Solubility Changes on Mixing Short- and Long-acting Insulin Preparations-South African Medical Journal-1988]</ref><ref>[http://www.diabetes.org/rg2005/insulin.jsp Resource Guide 2005-American Diabetes Association]</ref>. |
The zinc [[suspension]] of Lente-type insulin binds [[R]]/[[Neutral]], causing the [[short-acting]] insulin to slow, losing its short-acting effect<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=7192205 Intermediate-Acting Insulin Preparations: NPH (Isophane) & Lente Diabetes Care-1980]<br>Note--in 1980, there was only [[bovine|beef]] Lente-type insulin--no [[porcine|pork]] or [[r-DNA/GE/GM]][[Lente]] insulins</ref><ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3281288&dopt=Abstract Solubility Changes on Mixing Short- and Long-acting Insulin Preparations-South African Medical Journal-1988]</ref><ref>[http://www.diabetes.org/rg2005/insulin.jsp Resource Guide 2005-American Diabetes Association]</ref>. |
Revision as of 19:36, 30 November 2006
Monotard Pork | |
Lente by Novo Nordisk | |
intermediate-acting | Porcine |
U100 | Zinc |
Line | Novo |
Also known as | N/A |
Similar to | :
|
Action in cats |
|
Action in dogs |
|
Use and Handling | |
---|---|
Type | cloudy |
Shelf Life | 24 months |
When opened | 28 days |
In pen | N/A |
Notes |
|
Monotard Pork was a U100, 100% porcine insulin made by Novo Nordisk. It was an intermediate-acting, lente-type.
Eli Lilly also made a comparable pork lente insulin, Iletin II Lente[1][2].
As the other Lente insulins[3], it was a suspension of crystalline (ultralente) and amorphous (semilente) insulin in a ratio of 7 crystalline parts to 3 amorphous parts.
Monotard Pork was also identical to Caninsulin[4][5]/Vetsulin with the only exception being its strength: Pork Monotard was U100 strength, while Caninsulin/Vetsulin is U40.
What Lente Is Not
No Lente-type insulin regardless of species can contain any NPH/isophane insulin[6] or any R/Neutral insulin[7].
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[8].
The zinc suspension of Lente-type insulin binds R/Neutral, causing the short-acting insulin to slow, losing its short-acting effect[9][10][11].
Combining Lente Family Insulins
Insulin manufacturers[12] 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[13][14][15].
None of the Lente family of insulins (semilente, Lente, Ultralente) can be combined with[16] 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. Keeping the phenol preservatives in mind, all protamine-suspended insulin mixes would be "off limits" regarding same syringe mixing with any Lente-type insulins. |
References
- ↑ Drugs.com-Copy of Iletin II Lente Patient Information Leaflet
- ↑ US-FDA Iletin II Lente Discontinuation Material 2003
- ↑ EMEA Scientific Discussion-Monotard
- ↑ Horn Mitten Study-Refers to the Church Study Equating Caninsulin with Novo's old Pork Monotard
- ↑ Australian Veterinary Journal-More Re: Caninsulin Being Equivalent to Pork Monotard
- ↑ Combining Lente-type Insulins with Phenol-Preserved Insulins
- ↑ Lente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect
- ↑ Lente-Type Insulins & NPH/Isophane Insulins-A Bad Combination
- ↑ 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/GMLente insulins - ↑ Solubility Changes on Mixing Short- and Long-acting Insulin Preparations-South African Medical Journal-1988
- ↑ Resource Guide 2005-American Diabetes Association
- ↑ Insulin Producers vs Doctors Re:Combining R/Neutral & Lente-type Insulins
- ↑ Availability of Soluble (R/Neutral) Insulin in Mixed Preparations of Crystalline (Lente) & Ultralente GE Insulins-Clinical Therapeutics-1991
- ↑ Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin-Diabetes Care-1987
- ↑ Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin Diabetes Research & Clinical Practice-1983
- ↑ Phenol Preservatives & Lente-type Insulins--A Bad Combination