Notes for: Short-Acting InsulinsLast edited [11/05/2012 09:10:59]
NOTE: Insulin aspart, lispro and glulisine are shorter acting than ordinary soluble insulin and may be advantageous as they can be injected at the start of a meal (see also biphasic lispro insulins). They may be used in patients whose mealtimes are unpredictable, who eat late in the evening or if they are prone to early nocturnal hypoglycaemia.
Last edited [11/05/2012 09:13:17]1. The insulin preparations contained within this formulary are proposed as suggestions for newly diagnosed patients or when a clear clinical need indicates a change in therapy. It is recognised that prescribing of insulins not included (eg porcine / bovine) will continue for some existing patients. There may be rare occasions when these particular insulins will be initiated (by the specialist) as new therapy. Prescribers and patients need to be aware that porcine / bovine and human insulins are not directly interchangeable.
2. For a full list of insulin preparations please refer to the ‘Joint Formulary Summary of Insulins’ (p 6:2). This chart also indicates formulary inclusion and suitable pens.
3. The choice of insulin often depends upon the delivery device as much as the insulin itself. Patient’s choice is important.
4. It is important to prescribe the correct type of pen for the insulin.
5. SoloStar is the preferred device for insulin glulisine (Apidra) and insulin glargine (Lantus).
6. Animal insulins (pork and bovine) are still available as cartridges and 10 mL vials and some patients will wish to continue on these products.
10ml vial
3ml cartridge
Preloaded device
Device names
Short acting analogues
These are licensed to be given immediately before or just after a meal and have a duration of about 4.5 hours
NovoRapid® (Aspart) [g]
a
a
a
NovoPen 4, FlexPen
Humalog® (Lispro) [g]
a
a
a
HumaPen Luxura, KwikPen,
Apidra® (Glulisine) [g]
a
a
a
SoloStar, ClikSTAR
Short-acting insulins
These should be given 20 - 30 minutes before food, and have a duration of about 8 hours
Humulin S® [g]
a
a
a
HumaPen Luxura, KwikPen
Actrapid® [o] Usually used in i/v sliding scale regimen
a
Intermediate-acting insulins
These isophane insulins have an onset of 1 - 2 hours, duration of 15 hours or more
Insuman basal®
5ml vial
a
a
ClikSTAR, SoloStar
Insulatard® [b]
a
a
NovoPen 4, InnoLet
Humulin I® [b]
a
a
a
HumaPen Luxura, KwikPen
Long-lasting analogues
These have a prolonged action of 16 - 22 hours with little or no peak
Lantus® (Glargine) [g]
Generally given once daily
a
a
a
SoloStar, ClikSTAR
Levemir® (Detemir) [g]
Given once or twice daily
a
a
NovoPen 4, Innolet, FlexPen ,
Biphasic insulin analogues
These have activity that reflects the component insulins and are given immediately before or after a meal
NovoMix® 30 [g]
a
a
NovoPen 4, FlexPen
Humalog® Mix 25 [g]
a
a
HumaPen Luxura, KwikPen
Humalog® Mix 50 [o]
a
a
HumaPen Luxura, KwikPen
Biphasic insulins
These have activity that reflects the component insulins
Insuman Comb 25 [g]
5ml vial
a
a
SoloStar, ClikSTAR
Insuman Comb 50 [g]
a
a
ClikSTAR
Humulin M3® [b]
a
a
a
HumaPen Luxura, KwikPen