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in: Insulins, Lente, Intermediate-acting,
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Changes: Monotard Pork

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{{Insulin|
⚫
#REDIRECT [[Lente]]
  
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bgcolor=#CCC|
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fgcolor=#0000|
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name=Monotard Pork|
  ⚫
generic=[[Lente]]|
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mfg=[[Novo Nordisk]]|
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action=[[intermediate-acting]]|
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origin=[[Porcine]]|
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strength=U100|
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suspension=[[Lente|Zinc]]|
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line=Novo|
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aliases=N/A|
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similar=:
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*[[Caninsulin]] U40,
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*[[Vetsulin]] U40,
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*[[Iletin II Lente]]|
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cataction= 
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*onset Xh,
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*peak Xh
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*duration: Xh|
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dogaction= 
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*onset <1h,
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*peak 4-8h,
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*duration 14-24h|
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cloudyorsoluble=cloudy|
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shelflife= 24 months|
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openedlife= 28 days |
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penlife= N/A|
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handlingnotes=&nbsp;
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*protect from light and heat
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*store at 2-8C
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*Do not use if product does not [[re-suspend]]
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*[[Rolling insulin|Roll]]
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*See [[Caninsulin]]/[[Vetsulin]] for current handling notes on pork lente insulin.
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}}
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Monotard Pork was a U100, 100% porcine insulin made by [[Novo Nordisk]]. It was an intermediate-acting, lente-type.
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[[Eli Lilly]] also made a comparable pork lente insulin, [[Iletin II Lente]]<ref>[http://www.drugs.com/cdi/lente-iletin-ii-suspension.html Drugs.com-Copy of Iletin II Lente Patient Information Leaflet]</ref><ref>[http://web.archive.org/web/20061011072938/http://www.fda.gov/cder/foi/appletter/2003/18347slr025ltr.pdf US-FDA Iletin II Lente Discontinuation Material 2003]</ref>.
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As the other Lente insulins<ref>[http://petdiabetes.wikia.com/images/1/17/205602en6_monotard.pdf EMEA Scientific Discussion-Monotard]</ref>, it was a suspension of crystalline (ultralente) and amorphous (semilente) insulin in a ratio of 7 crystalline parts to 3 amorphous parts.
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Monotard Pork was also identical to [[Caninsulin]]<ref>[http://web.archive.org/web/20070221145210/http://www.ava.com.au/avj/0012/00120831.pdf Horn Mitten Study-Refers to the Church Study Equating Caninsulin with Novo's old Pork Monotard]</ref><ref>[http://web.archive.org/web/20070221144552/http://www.ava.com.au/avj/0102/01020113.pdf Australian Veterinary Journal-More Re: Caninsulin Being Equivalent to Pork Monotard]</ref>/[[Vetsulin]] with the only exception being its strength: Pork Monotard was U100 strength, while [[Caninsulin]]/[[Vetsulin]] is U40.
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==What Lente Is Not==
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'''No''' Lente-type insulin regardless of species can contain any [[NPH]]/[[isophane]] insulin<ref>[http://www.nfb.org/Images/nfb/Publications/vod/VFAL0010.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]]<ref>[http://www.nfb.org/Images/nfb/Publications/vod/VFAL0010.HTM Lente-Type Insulins & NPH/Isophane Insulins-A Bad Combination]</ref>.
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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>.
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==Combining Lente Family Insulins==
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Insulin manufacturers<ref>[http://www.endotext.org/diabetes/diabetes17/diabetes17.htm Insulin Producers vs Doctors Re:Combining R/Neutral & Lente-type Insulins]</ref> 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<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=1863938&dopt=AbstractPlus Availability of Soluble (R/Neutral) Insulin in Mixed Preparations of Crystalline (Lente) & Ultralente GE Insulins-Clinical Therapeutics-1991]</ref><ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=3304896 Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin-Diabetes Care-1987]</ref><ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=3545725&dopt=AbstractPlus Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin Diabetes Research & Clinical Practice-1983]</ref><ref>[http://web.archive.org/web/20070820011317/http://www.rxed.org/rxtech/ce/tech-insulin.htm RxEd.org-Insulin Therapy-Mixing Precautions]</ref>.
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{|
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|-valign="top"
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|style="height:1px;border:0;" colspan="3"|
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|-valign="top"
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|style="padding:5px;border:2px solid #ffb6c1;background-color:#ffe4e1;" width="50%"|
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None of the Lente family of insulins ([[semilente]], [[Lente]], [[Ultralente]]) can be combined with<ref>[http://web.archive.org/web/20060427044732/http://www.nfb.org/vodold/vsum9809.htm Phenol Preservatives & Lente-type Insulins--A Bad Combination]</ref> [[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<ref>[http://web.archive.org/web/20070820011317/http://www.rxed.org/rxtech/ce/tech-insulin.htm RxEd.org-Insulin Therapy-Mixing Precautions]</ref>.
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Keeping the phenol [[preservatives]] in mind, all [[protamine]]-[[Suspension|suspended]] insulin mixes would be "off limits" regarding same syringe mixing with any [[Lente]]-type insulins<ref>[http://web.archive.org/web/20070820011317/http://www.rxed.org/rxtech/ce/tech-insulin.htm RxEd.org-Insulin Therapy-Mixing Precautions]</ref>.
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|}
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<br clear=both>
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==References==
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<references/>
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[[Category:Insulins]][[Category:Lente]][[Category:intermediate-acting]][[Category:porcine]][[Category:Novo Nordisk]][[Category:Intravenous use NO]][[Category:Methylparaben]][[Category:Zinc]][[Category:Acetate]]

Latest revision as of 20:11, 22 June 2009

Monotard Pork
Lente by Novo Nordisk
intermediate-acting Porcine
U100 Zinc
Line Novo
Also known as N/A
Similar to :
Action in cats  
  • onset Xh,
  • peak Xh
  • duration: Xh
Action in dogs  
  • onset <1h,
  • peak 4-8h,
  • duration 14-24h
Use and Handling
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
  • See Caninsulin/Vetsulin for current handling notes on pork lente insulin.

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][16].

None of the Lente family of insulins (semilente, Lente, Ultralente) can be combined with[17] 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[18].

Keeping the phenol preservatives in mind, all protamine-suspended insulin mixes would be "off limits" regarding same syringe mixing with any Lente-type insulins[19].


References

  1. ↑ Drugs.com-Copy of Iletin II Lente Patient Information Leaflet
  2. ↑ US-FDA Iletin II Lente Discontinuation Material 2003
  3. ↑ EMEA Scientific Discussion-Monotard
  4. ↑ Horn Mitten Study-Refers to the Church Study Equating Caninsulin with Novo's old Pork Monotard
  5. ↑ Australian Veterinary Journal-More Re: Caninsulin Being Equivalent to Pork Monotard
  6. ↑ Combining Lente-type Insulins with Phenol-Preserved Insulins
  7. ↑ Lente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect
  8. ↑ Lente-Type Insulins & NPH/Isophane Insulins-A Bad Combination
  9. ↑ 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
  10. ↑ Solubility Changes on Mixing Short- and Long-acting Insulin Preparations-South African Medical Journal-1988
  11. ↑ Resource Guide 2005-American Diabetes Association
  12. ↑ Insulin Producers vs Doctors Re:Combining R/Neutral & Lente-type Insulins
  13. ↑ Availability of Soluble (R/Neutral) Insulin in Mixed Preparations of Crystalline (Lente) & Ultralente GE Insulins-Clinical Therapeutics-1991
  14. ↑ Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin-Diabetes Care-1987
  15. ↑ Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin Diabetes Research & Clinical Practice-1983
  16. ↑ RxEd.org-Insulin Therapy-Mixing Precautions
  17. ↑ Phenol Preservatives & Lente-type Insulins--A Bad Combination
  18. ↑ RxEd.org-Insulin Therapy-Mixing Precautions
  19. ↑ RxEd.org-Insulin Therapy-Mixing Precautions
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