Regular insulin

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Regular insulin
Actrapid vial.jpg
A vial of regular human insulin
Clinical data
Trade names Humulin R, Novolin R, Actrapid, others[2][1]
Synonyms insulin injection (soluble),[1] neutral insulin,[1] regular human insulin, human insulin (regular)
AHFS/Drugs.com Monograph
MedlinePlus a682611
Pregnancy
category
  • US: B (No risk in non-human studies)
Routes of
administration
subcutaneous, intramuscular, intravenous[1]
ATC code
Legal status
Legal status
Pharmacokinetic data
Onset of action 30 minutes
Duration of action 8 hours
Identifiers
CAS Number
ChemSpider
  • none

Regular insulin, also known as neutral insulin and soluble insulin is a type of short acting insulin.[1] It is used to treat diabetes mellitus type 1, diabetes mellitus type 2, gestational diabetes, and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states.[3] It is also used along with glucose to treat high blood potassium levels.[4] Typically it is given by injection under the skin, but may also be used by injection into a vein or muscle.[1] Onset of effect is typically in 30 minutes and they last for 8 hours.[3]

The common side effect is low blood sugar.[3] Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions.[3] Use during pregnancy is relatively safe for the baby.[3] Regular insulin can be made from the pancreas of pigs or cows.[1] Human versions can be made either by modifying pig versions or recombinant technology.[1]

Insulin was first used as a medication in Canada by Charles Best and Frederick Banting in 1922.[5] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[6] The wholesale cost in the developing world is about 2.39 to 10.61 USD per 1,000 iu of regular insulin.[7] In the United Kingdom 1,000 iu costs the NHS 7.48 pounds, while in the United States this amount is about 134.00 USD.[1][8] Versions are also available mixed with longer-acting versions of insulin, such as NPH insulin.[1]

Medical uses[edit]

It is used for the long term management of diabetes.[3] Regular insulin is the treatment of choice for the two diabetic emergencies diabetic ketoacidosis and hyperosmolar hyperglycemic states.[3] It may also be used in combination with glucose to lower potassium levels in those with hyperkalemia.[4]

Side effects[edit]

Side effects may include: low blood sugar levels, skin reactions at the site of injection and low potassium levels among others.[3]

Society and culture[edit]

Manufacture[edit]

Humulin, one brand name for a group of biosynthetic human insulin products, is synthesized in a laboratory strain of Escherichia coli bacteria which has been genetically altered with recombinant DNA to produce biosynthetic human insulin. Humulin R consists of zinc-insulin crystals dissolved in a clear fluid.

Formulations[edit]

It is currently sold by many manufacturers in a number of different forms.

By Eli Lilly these include:

  • Humulin R (REGULAR human insulin injection [rDNA origin]) is a short-acting insulin that has a relatively short duration of activity as compared with other insulins.
  • Humulin R Regular U-500 (Concentrated) insulin human injection, USP (rDNA Origin) is a stronger concentration (500 units/mL) of Humulin R.
  • Humulin 70/30 (70% human insulin isophane suspension, 30% human insulin injection [rDNA origin]) is a mixture insulin. It is an intermediate-acting insulin combined with the onset of action of Humulin
  • Humulin 50/50 (50% human insulin isophane suspension, 50% human insulin injection [rDNA origin]) is a mixture insulin. It is an intermediate-acting insulin combined with the onset of action of Humulin R.

In UK these include:[9]

  • Actrapid
  • Humulin S
  • Insuman Rapid

References[edit]

  1. ^ a b c d e f g h i j British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 464472. ISBN 9780857111562. 
  2. ^ "insulin regular human (OTC) – Humulin R, Novolin R". Archived from the original on 16 December 2014. Retrieved 1 December 2014. 
  3. ^ a b c d e f g h American Society of Health-System Pharmacists. "Insulin Human". www.drugs.com. Archived from the original on 22 October 2016. Retrieved 1 January 2017. 
  4. ^ a b Mahoney, BA; Smith, WA; Lo, DS; Tsoi, K; Tonelli, M; Clase, CM (18 April 2005). "Emergency interventions for hyperkalaemia". The Cochrane Database of Systematic Reviews (2): CD003235. doi:10.1002/14651858.CD003235.pub2. PMID 15846652. 
  5. ^ Fleishman JL, Kohler JS, Schindler S (2009). Casebook for The Foundation a Great American Secret. New York: PublicAffairs. p. 22. ISBN 978-0-7867-3425-2. Archived from the original on 18 January 2017. 
  6. ^ "WHO Model List of Essential Medicines (19th List)" (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016. 
  7. ^ "Insulin, Neutral Soluble". International Drug Price Indicator Guide. Retrieved 8 December 2016. 
  8. ^ "NADAC as of 2016-12-07 | Data.Medicaid.gov". Centers for Medicare and Medicaid Services. Archived from the original on 21 December 2016. Retrieved 17 January 2017. 
  9. ^ "Human Insulin - Types, Production, Action, History". Retrieved 2017-11-17.