PZI

Various types of veterinary insulins are known as PZI, "protamine zinc insulin". The ones we use most often for animals are a combination pork/beef-derived insulin or a beef-derived insulin. Because they are veterinary insulins, PZIs are not available at normal human pharmacies.

British National Formulary defines protamine zinc insulin as a sterile suspension of insulin in the form of a complex obtained by the addition of a suitable protamine and zinc chloride. PZI contains more zinc and protamine than NPH/isophane insulin and it is primarily the extra protamine which givies it its long-acting duration. NPH/isophane insulin contains less protamine than PZI does and because there's less, it is an intermediate-acting insulin.

PZI veterinary insulins are intermediate-acting to long-acting, and can be closer in molecular structure to a cat or dog's own insulin than human-type or analog insulins.

Types of Veterinary PZI

BCP PZI

BCP PZI
PZI by BCP Veterinary Pharmacy
long-acting	Bovine
U100/U50/U40	protamine
Line	N/A
Also known as	beef PZI
Similar to	Hypurin Vet Protamine Zinc, Hypurin Bovine Protamine Zinc, Insuvet Protamine Zinc
Action in cats	onset 2-5h, peak 12-24h duration: maximum 36h
Action in dogs	onset 8-20h, peak Xh, duration Xh
Use and Handling
Type	cloudy
Shelf Life	6 months
When opened	XX days
In pen	N/A
Notes	protect from light and heat store at 2-8C Do Not Freeze Do not use if product does not re-suspend Roll Do not use intravenously

What it is. BCP PZI is a bovine-origin PZI-based insulin. Because it's beef based, its amino acid chain is almost the same as that of a cat, so it's especially well-matched to cats. BCP Veterinary Pharmacy in Houston, TX, USA, manufactures and is the sole source supplier for BCP PZI. BCP PZI is commonly used in diabetic cats in the U.S. Generally, depending on an individual cat’s reaction to the insulin and the dosage, BCP PZI will lower blood glucose levels for 10 to 14 hours with a peak in the +6 to +8 timeframe. However, some cats experience shorter or longer duration and earlier or later peaks. Like other insulins, BCP PZI is normally administered twice a day.

How to get it. To obtain BCP PZI, your veterinarian calls or faxes a prescription (a script) to the phone numbers shown on the BCP Internet site (see the source information below). After the script is placed, you call BCP with a credit card number and BCP ships the insulin to you overnight for delivery Tuesday through Friday. If you want the insulin left without a delivery signature, you should ask BCP for that.

Strength and cost: Your vet can order BCP PZI in a U40, U50, or U100 formulation. Some BCP PZI users have their vets order the U40 or U50 strengths and they administer it in a U100 syringe. This link gives you instructions on how to use a U40 insulin in a U100 syringe.

BCP PZI is available in 5ml and 10ml vials. A recent price of a 10ml 40U bottle was $29, plus $11 shipping ($40 total). A 5ml bottle costs... to be completed.

Shelf life: 6 months.

Handling: You should refrigerate BCP PZI when it is not in use. If you happen to leave it out ...to be completed.

PZI Vet
PZI by IDEXX
long-acting	Bovine 90% Porcine 10%
U40	protamine
Line	IDEXX
Also known as	none
Similar to	*  No other Bovine/Porcine insulins currently marketed
Action in cats	onset Xh, peak Xh duration Xh
Action in dogs	onset 1-4h, peak 4-14h, duration 6-28h
Use and Handling
Type	cloudy
Shelf Life	36 months
When opened	XX days
In pen	N/A
Notes	protect from light and heat store at 2-8C Do Not Freeze Do not use if product does not re-suspend Roll Do not use intravenously

PZI Vet (IDEXX)

IDEXX Laboratories manufactures a PZI insulin under the trademarked name PZI Vet. PZI Vet is commonly used in diabetic cats in the U.S. Some compounding pharmacies may refer to their PZI insulins as PZI Vet, but you aren't using PZI Vet unless it is made by IDEXX Labs.

What it is: PZI Vet is a 90% beef, 10% pork insulin. It's duration is similar to that of BCP PZI.

How to get it: You get PZI Vet from your vet, or with a prescription from your vet, you can order from an online pet pharmacy such as this one.

Strength and cost: PZI Vet comes in U40 strength only. You should use U40 syringes or use U100 syringes and the conversion table.

Some vets mark up the cost of PZI Vet to make a large profit. A reasonable price would be around $90 US.

Shelf life: The IDEXX Internet site says PZI Vet is good for three years after date of manufacture. You may find that you will use your vial in much less than three years.

Handling: You should refrigerate PZI Vet when not in use. It should not lose effectiveness if accidentally left out as long as not in direct sunlight or heat. However, watch for signs of decreased effectiveness (higher blood glucose levels) just in case.

It is not advised to dilute or combine PZI Vet with other insulins.

PZI Vet package insert.

Before IDEXX purchased Blue Ridge Pharmaceuticals and re-named the insulin as PZI Vet, this study showing efficacy was done.

Insuvet PZI

Insuvet makes a PZI called Insuvet Protamine Zinc or Insuvet PZI, similar to BCP's PZI above. It also makes two other veterinary insulins, see Insuvet for more.

CP Pharma

CP Pharma manufactures a U100 100% bovine PZI, Hypurin Bovine Protamine Zinc, which is approved for use in humans and which can be imported into the US and other countries. CP Pharma also produces Hypurin Vet Protamine Zinc, which is pure beef but not offered outside of the UK. Those CP Pharma insulins are comparable to Insuvet Protamine Zinc, made by Schering-Plough Animal Health, a U100, 100% bovine PZI for veterinary use that is only available in the UK.

UK and US Compounded PZIs

The above are manufactured, not compounded, insulins. This means the insulin keeps longer, and is less likely to vary, as compounded insulins can, from batch to batch. The manufactured insulins have a shelf life of three years (unopened).

There are also pharmacies in the US and UK that compound PZI based on human ("regular") or animal-source insulins. This link lists some of those compounding pharmacies, their contact information, and prices for their insulins.

Handling and use

According to Merck, in cases where a shorter-acting insulin is needed in addition to the PZI, the protamine zinc insulin must always be injected separately--NO mixing--due to the excess of protamine in the insulin formula.

External Links

• List of sources and prices for PZI insulins worldwide
• BCP Contact information
• British National FormularyAccess to BNF is free but you must register and log in to use it.
• Characteristics of Animal Insulins
• Protamine Zinc insulin information from FRED--Penn State's Faculty Research Expertise Database.