Diabetes in Pets
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Novolin U
Ultralente by Novo Nordisk
long-acting r-DNA/GE/GM
U100 Zinc
Line Novolin
Also known as Ultratard
Similar to  
Action in cats  
  • onset Xh,
  • peak Xh
  • duration: Xh
Action in dogs  
  • onset 1-8h,
  • peak 4-16h,
  • duration 8-28h
Use and Handling
Type cloudy
Shelf Life 24 months
When opened 28 days
In pen N/A
Notes  

The name for Novo Nordisk's Ultralente insulin sold in North America. It was a U100, lente-type, long-acting insulin, now discontinued.

Novo's Euro name for the same insulin was Ultratard[1][2]. Both were crystalline-suspended insulins[3] were crystalline-suspended insulins.

It is comparable to Humulin U[4][5] and Humulin Zn[6][7].

What Ultralente Is Not[]

No Lente-type insulin regardless of species can contain any NPH/isophane insulin[8] or any R/Neutral insulin[9][10].

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[11].

The zinc suspension of Lente-type insulin binds R/Neutral, causing the short-acting insulin to slow, losing its short-acting effect[12][13][14][15].

Combining Lente Family Insulins[]

Insulin manufacturers[16] 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[17][18][19][20][21].

None of the Lente family of insulins (semilente, Lente, Ultralente) can be combined with[22] 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[23].

Keeping the phenol preservatives in mind, all protamine-suspended insulin mixes would be "off limits" regarding same syringe mixing with any Lente-type insulins[24].

The Novo insulins,Ultratard and Monotard, 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.

See also Substitutes_for_Humulin_U_and_L.

Further Reading[]

Wikicat3

References[]

  1. Prescribing Novo Insulins
  2. Ultratard/Monotard Discontinuation-July 2005
  3. EMEA Scientific Discussion-Ultratard
  4. U etc.-Ultralente Human Insulin Remedyfind.com
  5. US-FDA-Humulin U Discontinuation Notice July 2005
  6. Discontinuation of Humulin Zn July 2004
  7. Lilly EU/UK Product Sheet & Time Activity Profiles
  8. Combining Lente-type Insulins with Phenol-Preserved Insulins
  9. Lente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect
  10. Availability of Soluble (R/Neutral) Insulin in Mixed preparations of Crystalline (Lente) & Ultralente GE Insulins-Clinical Therapeutics-1991
  11. Lente-Type Insulins & NPH/Isophane Insulins-A Bad Combination
  12. 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
  13. Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin-Diabetes Care-1987
  14. Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin Diabetes Research & Clinical Practice-1983
  15. Resource Guide 2005-American Diabetes Association
  16. Insulin Producers vs Doctors Re:Combining R/Neutral & Lente-type Insulins
  17. Availability of Soluble (R/Neutral) Insulin in Mixed Preparations of Crystalline (Lente) & Ultralente GE Insulins-Clinical Therapeutics-1991
  18. Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin-Diabetes Care-1987
  19. Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin Diabetes Research & Clinical Practice-1983
  20. Therapy-Mixing Precautions
  21. RxEd.org-Insulin Therapy-Mixing Precautions
  22. Phenol Preservatives & Lente-type Insulins--A Bad Combination
  23. RxEd.org-Insulin Therapy-Mixing Precautions
  24. RxEd.org-Insulin Therapy-Mixing Precautions
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