HUMULIN®R (regular insulin human) Injection, USP (rDNA Origin) 100 Units per ML (U-100) DESCRIPTION Humulin® R U-100 is a polypeptide hormone structurally identical to human insulin synthesized through rDNA technology in a special non-disease-producing laboratory strain of Escherichia coli bacteria. Humulin R (insulin human recombinant) U-100 has the empirical formula C257H383N65O77S6 and a molecular weight of 5808. Humulin R (insulin human recombinant) U-100 is a sterile, clear, aqueous, and colorless solution that contains human insulin (rDNA origin) 100 units/mL, glycerin 16 mg/mL and metacresol 2.5 mg/mL, endogenous zinc (approximately 0.015 mg/100 units) and water for injection. The pH is 7.0 to 7.8. Sodiumhydroxide and/or hydrochloric acid may be added during manufacture to adjust the pH. Adequate insulin dosage permits patients with diabetes to effectively utilize carbohydrates, proteins and fats. Regardless of dose strength, insulin enables carbohydrate metabolism to occur and thus to prevent the production of ketone bodies by the liver. Some patients develop severe insulin resistance such that daily doses of several hundred units of insulin or more are required. Continue reading >>
Feline Insulin Solutions: A Roundtable Discussion (sponsored By Boehringer Ingelheim Vetmedica, Inc.)
Previous 1234567891011Next Dr. Scott-Moncrieff: For cats being treated with glargine, the blood glucose concentration can be in the well-controlled range right before the next injection and that may not be a problem. It could be in the 80- to 120-mg/dl range right before the next injection and that could just reflect good control. Whereas with other insulins, the blood glucose concentration tends to be the highest right before you give the next dose. Dr. Norsworthy: If you are starting with a newly diagnosed diabetic cat, do you consider how high the blood glucose concentration is when choosing an insulin dose? Dr. Nelson: No, I start with one unit of PZI twice a day and go from there. I am trying to avoid having symptomatic hypoglycemia occur at home in the first week or two. The owner is dealing with handling the syringes, drawing up the insulin, understanding the treatment protocol, and more. The last thing I want is the animal to become hypoglycemic. So I always start conservatively. If I feel the diabetes is not controlled, I will adjust the dose within a week, usually at five to seven days. If the owner is reporting improvement and the cat is eating a high-protein, low-carbohydrate diet, then I will let it go a little longer. I tell most of my clients that it will take about a month, whether their cats are newly diagnosed or we're trying to regain control. Dr. Peterson: I think we are all saying one to two units of PZI twice a day and then we check them in the first week and make adjustments. We've agreed for 20 years that once a day is not going to do it. Dr. Ford: If you were going to change a cat from glargine to PZI, where would you start? Dr. Nelson: I usually start at one unit per cat twice a day. Dr. Scott-Moncrieff: In the original PZI study, there was no Continue reading >>
Static And Dynamic Light Scattering From Dilute Insulin Solutions
Abstract Static and dynamic light-scattering measurements are reported on zinc-insulin at room temperature (21 ± l°C) and pH = 6.88 in 0.1M NaCl aqueous solution. The experiments were performed at very low concentration, in the range 0.12 × 10−4 to 0.90 × 10−4 g cm−3. Within experimental error, we find no evidence for a critical micellar concentration in this system. The aggregation phenomenon starts immediately after preparation of the solutions, and takes several days to come to stable equilibrium. The concentration dependence of the diffusion coefficients, Dz, = Do (1 — kDC), is negative, and kD was observed to decrease as a function of time, while the aggregate size was found to increase. The equivalent concentration coefficient, −2BMW, obtained from static light scattering, showed a similar behavior, and, within experimental error, was found to be numerically equal to kD. From the relation found between the diffusion coefficient at infinite dilution and the molecular weight of the aggregates, log D0 = −0.240 log Mw − 5.077, we deduce that the insulin aggregates are compact structures with a characteristic radius of 0.71 Å/(dalton)1/3, surrounded by a hydration layer of a thickness of 8.0 Å. The equilibrium aggregation number is approximately 10. Continue reading >>
Insulin Aspart (rdna Origin) Injection
Insulin aspart is used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). It is also used to treat people with type 2 diabetes (condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood) who need insulin to control their diabetes. In patients with type 1 diabetes, insulin aspart is usually used with another type of insulin, unless it is used in an external insulin pump. In patients with type 2 diabetes, insulin aspart also may be used with another type of insulin or with oral medication(s) for diabetes. Insulin aspart is a short-acting, manmade version of human insulin. Insulin aspart works by replacing the insulin that is normally produced by the body and by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Insulin aspart comes as a solution (liquid; Fiasp, NovoLog) and Continue reading >>
Insulin Detemir, Injectable Solution
Low blood sugar warning: Insulin detemir can cause hypoglycemia (very low blood sugar levels). Severe low blood sugar can be dangerous. It can harm your heart or brain, cause unconsciousness or seizures, and even be fatal. Low blood sugar can happen very quickly and come on without symptoms. This is why it’s important to check your blood sugar as often as your doctor says to do so. Low blood sugar symptoms occur most frequently when your blood sugar level is less than 70 mg/dL. Allergic reaction warning: Insulin detemir can cause a severe allergic reaction. Don’t take insulin detemir if you’ve ever had an allergic reaction to it or any ingredients in the injection. Taking it a second time after an allergic reaction could be fatal. Proper usage warning: Insulin detemir shouldn’t be used to treat diabetic ketoacidosis, a condition that can occur in people with type 1 diabetes. If you have type 1 diabetes and your blood sugar levels are high, your body may try to break down fat to get energy. In this process, chemicals called ketones are produced. High levels of ketones can poison your body and cause diabetic ketoacidosis. Seek medical help right away if you have symptoms of diabetic ketoacidosis. Heart failure warning: Taking diabetes pills called thiazolidinediones (TZDs) with insulin may cause heart failure. Tell your doctor if you have any new or worse symptoms of heart failure, including shortness of breath, swelling of your ankles or feet, orsudden weight gain. If you have these symptoms, your doctor may adjust your TZD dosage. Infection warning: Insulin vials, syringes, or prefilled pens must never be shared between patients. Sharing or reusing needles or syringes with another person puts you at risk for various infections. Insulin detemir is a prescription Continue reading >>
Our Next Step In Addressing Insulin Affordability
Over the last several months, Lilly has engaged the diabetes community, including people impacted by diabetes, advocacy organizations and the business community, on the topic of insulin prices. We recognize the burden many people with diabetes are feeling due to increased out-of-pocket expenses, and we’re committed to seeking additional solutions so everyone who uses insulin has affordable access. As you may have heard, Express Scripts has introduced a new prescription drug discount program – Inside Rx – and Lilly is one of several pharmaceutical companies participating. We continue looking for ways to help provide options for people who pay full price at the pharmacy – including those who don’t have insurance or who are in the deductible phase of a high-deductible commercial insurance plan. Joining Inside Rx is a next natural step. Through this program, most Lilly insulins can be accessed at a discount of approximately 40 percent – a savings that can be realized immediately at the pharmacy. When it comes to providing access to insulin, more options are better. While the current system works for many people, some pay full retail price at the pharmacy, forcing difficult trade-offs. We all need to work together to address patient affordability. With this program, Express Scripts is providing an important option for many people with diabetes. We also know that longer-term solutions are needed, and we are working on more ways to help people who have trouble affording their treatment. In the meantime, Inside RX can provide relief to people who typically pay all-cash for their medicines. You can find more information about the program at InsideRx.com. Mike Mason Vice President, US, Lilly Diabetes Continue reading >>
Crystallographic And Solution Studies Of N-lithocholyl Insulin: A New Generation Of Prolonged-acting Human Insulins†
Abstract The addition of specific bulky hydrophobic groups to the insulin molecule provides it with affinity for circulating serum albumin and enables it to form soluble macromolecular complexes at the site of subcutaneous injection, thereby securing slow absorption of the insulin analogue into the blood stream and prolonging its half-life once there. N-Lithocholic acid acylated insulin [LysB29-lithocholyl des-(B30) human insulin] has been crystallized and the structure determined by X-ray crystallography at 1.6 Å resolution to explore the molecular basis of its assembly. The unit cell in the crystal consists of an insulin hexamer containing two zinc ions, with two m-cresol molecules bound at each dimer−dimer interface stabilizing an R6 conformation. Six covalently bound lithocholyl groups are arranged symmetrically around the outside of the hexamer. These form specific van der Waals and hydrogen-bonding interactions at the interfaces between neighboring hexamers, possibly representing the kinds of interactions which occur in the soluble aggregates at the site of injection. Comparison with an equivalent nonderivatized native insulin hexamer shows that the addition of the lithocholyl group disrupts neither the important conformational features of the insulin molecule nor its hexamer-forming ability. Indeed, binding studies show that the affinity of N-lithocholyl insulin for the human insulin receptor is not significantly diminished. Continue reading >>
Insulin: How To Give A Mixed Dose
Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful because the needles are short and thin and the insulin shots are placed into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection. In some cases, the doctor prescribes a mixed dose of insulin. This means taking more than one type of insulin at the same time. A mixed dose allows you to have the benefits of both short-acting insulin along with a longer acting insulin — without having to give 2 separate shots. Usually, one of the insulins will be cloudy and the other clear. Some insulins cannot be mixed in the same syringe. For instance, never mix Lantus or Levemir with any other solution. Be sure to check with your doctor, pharmacist, or diabetes educator before mixing. These instructions explain how to mix two different types of insulin into one shot. If you are giving or getting just one type of insulin, refer to the patient education sheet Insulin: How to Give a Shot. What You Will Need Bottles of insulin Alcohol swab, or cotton ball moistened with alcohol Syringe with needle (You will need a prescription to buy syringes from a pharmacy. Check with your pharmacist to be sure the syringe size you are using is correct for your total dose of insulin.) Hard plastic or metal container with a screw-on or tightly-secured lid Parts of a Syringe and Needle You will use a syringe and needle to give the shot. The parts are labeled below. Wash the work area (where you will set the insulin and syringe) well with soap and water. Wash your hands. Check the drug labels to be sure they are what your doctor prescribed. Check the expiration date o Continue reading >>
How Long Should Insulin Be Used Once A Vial Is Started?
Editor’s comment: The commentary by Dr. Grajower has such important clinical relevance that responses were invited from the three pharmaceutical companies that supply insulin in the U.S. and the American Diabetes Association, and all of these combined in this commentary. The commenting letter and individual responses were authored separately and are completely independent of each other. Diabetic patients treated with insulin, whether for type 1 or type 2 diabetes, are prone to often unexplained swings in their blood glucose. These swings can vary from dangerously low to persistently high levels. Most diabetic patients, and most physicians, will adjust insulin regimens so as to avoid hypoglycemia at the expense of hyperglycemia. Among the “textbook” reasons for variable glucose responses to any given insulin regimen are 1) site of administration, 2) exercise, 3) bottles not adequately mixed before drawing the insulin (for NPH, Lente, or Ultralente), and 4) duration of treatment with insulin (1). A new insulin was marketed by Aventis Pharmaceuticals about 1 year ago, insulin glargine (Lantus). The manufacturer seemed to stress that patients not use a started bottle of this insulin for >28 days (2). Two patients of mine highlighted this point. L.K. is a 76-year-old woman with type 2 diabetes, diagnosed at 55 years of age, and treated with insulin since age 56. Her insulin regimen was changed to Lantus at night together with Novolog before meals. She monitors her blood glucose four times a day. She used a bottle of Lantus until it ran out; therefore, a bottle lasted for 2 months. Her recent HbA1c was 7.6%. I retrospectively analyzed her home glucose readings by averaging her fasting blood glucose levels for the first 15 days of a new bottle and the last 15 days of tha Continue reading >>
Insuman Rapid 100 Iu/ml Solution For Injection In A Cartridge
Insuman Rapid 100 IU/ml solution for injection in a cartridge Insuman Rapid 100 IU/ml in a cartridge Each ml contains 100 IU insulin human (equivalent to 3.5 mg). Each cartridge contains 3 ml of solution for injection, equivalent to 300 IU insulin. One IU (International Unit) corresponds to 0.035 mg of anhydrous human insulin*. Insuman Rapid is a neutral insulin solution (regular insulin). *Human insulin is produced by recombinant DNA technology in Escherichia coli. For the full list of excipients, see section 6.1. Diabetes mellitus where treatment with insulin is required. Insuman Rapid is also suitable for the treatment of hyperglycaemic coma and ketoacidosis, as well as for achieving pre-, intra- and post-operative stabilisation in patients with diabetes mellitus. Posology The desired blood glucose levels, the insulin preparations to be used and the insulin dose regimen (doses and timings) must be determined individually and adjusted to suit the patient's diet, physical activity and life-style. Daily doses and timing of administration There are no fixed rules for insulin dose regimen. However, the average insulin requirement is often 0.5 to 1.0 IU per kg body weight per day. The basal metabolic requirement is 40% to 60% of the total daily requirement. Insuman Rapid is injected subcutaneously 15 to 20 minutes before a meal. Insuman Rapid 100 IU/ml in a cartridge In the treatment of severe hyperglycaemia or ketoacidosis in particular, insulin administration is part of a complex therapeutic regimen which includes measures to protect patients from possible severe complications of a relatively rapid lowering of blood glucose. This regimen requires close monitoring (metabolic status, acid-base and electrolyte status, vital parameters etc.) in an intensive care unit or simi Continue reading >>
Insulin Association In Neutral Solutions Studied By Light Scattering.
Abstract Molecular weights and weight distributions of sulfated, Zn-free, and 2Zn insulins have been measured at pH 7.3 as a function of concentration from 0.1 to 2 mg/ml by use of a combination of light scattering, refractometry, and size-exclusion chromatography. Results show that sulfated insulin is monomeric over the studied concentration range. Weight average molecular weights between those of a monomer and a hexamer were found for both zinc-free and 2Zn insulins. Zinc stabilizes the hexamer, and the dimer-hexamer equilibrium constant is approx. 400-times higher in the presence of zinc than in its absence. An average hydrodynamic radius of 5.6 nm, close to the crystallographic size of the insulin hexamer, was determined from dynamic light scattering of 2Zn insulin solutions. Continue reading >>
Get Unlimited Access On Medscape.
You’ve become the New York Times and the Wall Street Journal of medicine. A must-read every morning. ” Continue reading >>
Humulin R By A-s Medication Solutions
DESCRIPTION Humulin® R U-100 is a polypeptide hormone structurally identical to human insulin synthesized through rDNA technology in a special non-disease-producing laboratory strain of Escherichia coli bacteria. Humulin R U-100 has the empirical formula C257H383N65O77S6 and a molecular weight of 5808. Humulin R U-100 is a sterile, clear, aqueous, and colorless solution that contains human insulin (rDNA origin) 100 units/mL, glycerin 16 mg/mL and metacresol 2.5 mg/mL, endogenous zinc (approximately 0.015 mg/100 units) and water for injection. The pH is 7.0 to 7.8. Sodium hydroxide and/or hydrochloric acid may be added during manufacture to adjust the pH. Adequate insulin dosage permits patients with diabetes to effectively utilize carbohydrates, proteins and fats. Regardless of dose strength, insulin enables carbohydrate metabolism to occur and thus to prevent the production of ketone bodies by the liver. Some patients develop severe insulin resistance such that daily doses of several hundred units of insulin or more are required. CLINICAL PHARMACOLOGY Regulation of glucose metabolism is the primary activity of insulin. Insulin lowers blood glucose by stimulating peripheral glucose uptake by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulins inhibit lipolysis, proteolysis, and gluconeogenesis, and enhance protein synthesis and conversion of excess glucose into fat. Administered insulin, including Humulin R U-100, substitutes for inadequate endogenous insulin secretion and partially corrects the disordered metabolism and inappropriate hyperglycemia of diabetes mellitus, which are caused by either a deficiency or a reduction in the biologic effectiveness of insulin. When administered in appropriate doses at prescribed intervals to patients wi Continue reading >>
Types Of Insulin
Insulin analogs are now replacing human insulin in the US. Insulins are categorized by differences in onset, peak, duration, concentration, and route of delivery. Human Insulin and Insulin Analogs are available for insulin replacement therapy. Insulins also are classified by the timing of their action in your body – specifically, how quickly they start to act, when they have a maximal effect and how long they act.Insulin analogs have been developed because human insulins have limitations when injected under the skin. In high concentrations, such as in a vial or cartridge, human (and also animal insulin) clumps together. This clumping causes slow and unpredictable absorption from the subcutaneous tissue and a dose-dependent duration of action (i.e. the larger dose, the longer the effect or duration). In contrast, insulin analogs have a more predictable duration of action. The rapid acting insulin analogs work more quickly, and the long acting insulin analogs last longer and have a more even, “peakless” effect. Background Insulin has been available since 1925. It was initially extracted from beef and pork pancreases. In the early 1980’s, technology became available to produce human insulin synthetically. Synthetic human insulin has replaced beef and pork insulin in the US. And now, insulin analogs are replacing human insulin. Characteristics of Insulin Insulins are categorized by differences in: Onset (how quickly they act) Peak (how long it takes to achieve maximum impact) Duration (how long they last before they wear off) Concentration (Insulins sold in the U.S. have a concentration of 100 units per ml or U100. In other countries, additional concentrations are available. Note: If you purchase insulin abroad, be sure it is U100.) Route of delivery (whether they a Continue reading >>
All About Insulin!
All About Insulin Health-e-Solutions comment: This excerpt from an excellent article writer Michelle A. Cissell, Ph.D., All About Insulin gives a brief history of the discovery and development of insulin in its current multi-varied forms. We agree with her comment, “Like any drug, all forms of insulin have the potential for side effects. Each person should choose the appropriate types, dosages, and combinations of insulins for himself or herself in consultation with a qualified diabetes healthcare team.” (Source) In 1921, a team of Canadian researchers including Frederick G. Banting, M.D., Charles H. Best, J.J.R. Macleod, Ph.D., and James B. Collip, Ph.D., isolated a newly discovered hormone they named “insulin” from calf pancreases (pancreata). They injected it into a teenage boy who had type 1 diabetes (T1D). The young man, Leonard Thompson, was confined to a bed in a diabetes ward of Toronto General Hospital and not expected to live long—like all people diagnosed with T1D at that time. Prior to the discovery of insulin, a diagnosis of T1D was a death sentence; without an effective treatment, the disease was always fatal. That first insulin injection failed. The preparation was too impure and caused an allergic reaction. Rather than give up, the researchers went back to the laboratory to hone their purification process. Less than two weeks later, the team tried again. This time, the more refined insulin formulation was a success. Glucose levels in the boy’s blood and urine began dropping. Leonard, who had been weak and listless, became more active and mentally alert almost immediately. The new formulation was soon tested on other patients, who all showed dramatic improvements in their appearance, energy level, sense of well-being, and clinical measures. Th Continue reading >>