Regular insulin

Regular insulin
A vial of regular human insulin
Names
Trade namesHumulin R, Novolin R, Actrapid, others[1][2]
Other namesinsulin injection (soluble),[2] neutral insulin,[2] regular human insulin, human insulin (regular)
Clinical data
Pregnancy
category
  • US: B (No risk in non-human studies)
    Routes of
    use    		subcutaneous, intramuscular, intravenous[2]
    Onset of action30 minutes
    Duration of action8 hours
    Defined daily dose40 U[3]
    External links
    AHFS/Drugs.comMonograph
    US NLMRegular insulin
    MedlinePlusa682611
    Legal
    License data
    Legal status

    Regular insulin, also known as neutral insulin and soluble insulin is a type of short acting insulin.[2] 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.[4] It is also used along with glucose to treat high blood potassium levels.[5] Typically it is given by injection under the skin, but may also be used by injection into a vein or muscle.[2] Onset of effect is typically in 30 minutes and they last for 8 hours.[4]

    The common side effect is low blood sugar.[4] Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions.[4] Use during pregnancy is relatively safe for the baby.[4] Regular insulin can be made from the pancreas of pigs or cows.[2] Human versions can be made either by modifying pig versions or recombinant technology.[2]

    Insulin was first used as a medication in Canada by Charles Best and Frederick Banting in 1922.[6] It is on the World Health Organization's List of Essential Medicines.[7] The wholesale cost in the developing world is about US$2.39–10.61 per 1,000 iu of regular insulin.[8] In the United Kingdom 1,000 iu costs the NHS £7.48, while in the United States this amount is about $134.00.[2][9] In 2017, it was the 73rd most commonly prescribed medication in the United States, with more than ten million prescriptions.[10][11] Versions are also available mixed with longer-acting versions of insulin, such as NPH insulin.[2]

    Medical uses

    Regular insulin is used for the long-term management of diabetes.[4] It is the treatment of choice for the two diabetic emergencies diabetic ketoacidosis and hyperosmolar hyperglycemic states.[4] It may also be used in combination with glucose to lower potassium levels in those with hyperkalemia.[5]

    Dosage

    The defined daily dose is 40 U (by injection).[3]

    Side effects

    Side effects may include: low blood sugar levels, skin reactions at the site of injection and low potassium levels among others.[4]

    Manufacture

    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

    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:[12]

    • Actrapid
    • Humulin S
    • Insuman Rapid

    References

    1. ↑ "insulin regular human (OTC) – Humulin R, Novolin R". Archived from the original on 16 December 2014. Retrieved 1 December 2014.
    2. 1 2 3 4 5 6 7 8 9 10 British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 464472. ISBN 9780857111562.
    3. 1 2 "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 5 March 2021. Retrieved 12 September 2020.
    4. 1 2 3 4 5 6 7 8 American Society of Health-System Pharmacists. "Insulin Human". www.drugs.com. Archived from the original on 22 October 2016. Retrieved 1 January 2017.
    5. 1 2 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. PMC 6457842. PMID 15846652.
    6. ↑ Fleishman, Joel L.; Kohler, J. Scott; Schindler, Steven (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.
    7. ↑ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
    8. ↑ "Insulin, Neutral Soluble". International Drug Price Indicator Guide. Archived from the original on 7 July 2018. Retrieved 8 December 2016.
    9. ↑ "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.
    10. ↑ "The Top 300 of 2020". ClinCalc. Archived from the original on 18 March 2020. Retrieved 11 April 2020.
    11. ↑ "Insulin Human - Drug Usage Statistics". ClinCalc. Archived from the original on 28 August 2021. Retrieved 11 April 2020.
    12. ↑ "Human Insulin - Types, Production, Action, History". Archived from the original on 2017-11-27. Retrieved 2017-11-17.
    Identifiers:
    • "Insulin regular". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 2020-08-02. Retrieved 2020-01-08.
    • "Insulin". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 2019-12-11. Retrieved 2020-01-08.
    • "Insulin [Injection], biphasic". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 2019-06-28. Retrieved 2020-01-08.
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