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NPH

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Novolin N

Novolin NPH/isophane insulin.

NPH Insulins, or "Neutral Protamine Hagedorn", now describes the set of insulins using Isophane / Protamine as their suspension. In North America, Humulin N and Novolin N are the most common brands of NPH insulin. Another term for this type of insulin is Isophane; it's commonly used to describe this insulin type outside of North America.

NPH was first launched in 1946 in Denmark by Novo Nordisk as the first longer-lasting neutral pH insulin for human use. "Hagedorn", was the chief scientist who invented it.

The difference between NPH/isophane insulin and PZI insulin is the amount of protamine in the suspension. PZI has more of it and this is what makes it a slow-acting insulin, in contrast to NPH/isophane being an intermediate-acting (or in some cats, short-acting) one[1], as the additional protamine extends the duration.

Specifications of NPH/isophane insulinEdit

A101303

letin II NPH--pork isophane insulin--Canadian packaging.

British National Formulary[2]defines this type as: A sterile suspension bovine or porcine or of human insulin in the form of a complex obtained by the addition of protamine sulphate or another suitable protamine.

British Pharmacoepia and United States Pharmacopia definitions:[3]

Isophane Insulin

Sterile buffered suspension of insulin in the form of a complex obtained by addition of suitable protamine. Prepared from crystalline insulin. pH 6.9 - 7.5 iso-osmotic with blood. Contains for each 100 units of insulin, 300 - 600 g protamine sulphate and not more than 40 g zinc, a suitable bactericide and sodium phosphate as buffering agent.

USP specification: Sterile suspension of zinc insulin crystalline and protamine sulphate in buffered water for injection. Solid phase contain crystals of insulin protamine and zinc; 40, 80, 100 units/ml. Contains glycerol, metacresol, phenol sodium phosphate and zinc.

Additional detailsEdit

NPHtap

Human time activity profile for r-DNA/GE/GM NPH/isophane insulin.

NPH is the most widely used type of insulin for treatment of diabetic dogs, but is shorter-acting and less predictable in cats[4][5][6]. With a peak of 1.5-6 hours and duration of 4-10 hours, if it is successfully used, twice-daily dosing is a must[7]. See also Humulin N 101 for Cats at link below[8].

This 1987 study[9] of direct comparisons between R and NPH insulins in dogs, found R insulin to be absorbed better than NPH and suggests that NPH insulin may have an earlier peak and shorter duration than previously thought.

Novo Nordisk's and Lilly's analog insulin mixes NovoLog and Humalog employ protamine/isophane suspension; non-mix Novolog and Humalog do not.

NPH/isophane insulinsEdit

The following commercial insulins are all generically NPH insulins:

NPH/Isophane Insulins

All Intermediate acting

Bovine/Beef

Hypurin Bovine Isophane

Bovine/Beef

Iletin I NPH
(No longer produced.)

Porcine/Pork

Hypurin Porcine Isophane
Hypurin Pork NPH

Porcine/Pork

Pork Insulatard

Porcine/Pork

Iletin II NPH
(No longer produced.)

R-DNA

Humulin N, Humulin I

R-DNA

Insuman Basal

R-DNA

Novolin N, Insulatard
ReliOn/Novolin NPH, Protaphane


Other commonly used names are:

  • NPH insulin, NPH
  • isophane insulin

Further ReadingEdit

Wikicat3


Wikidog3


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ReferencesEdit

  1. Selecting an Insulin for Treatment of Diabetes Mellitus in Dogs 7 Cats-Nelson-Page 41
  2. British National Formulary-Isophane/NPH Insulin Definition
  3. British Pharmacoepia (BP) & United States Pharmacoepia (USP)-Isophane/NPH Insulin Defined
  4. BD Diabetes-Insulin Choices for Cats
  5. BD Diabetes-Insulin Choice for Dogs
  6. Ask the D Team-2002- Some People Find it Inconsistent Also
  7. International Journal of Pharmaceutical Compounding-Page 3
  8. Humulin N 101 For Cats-Gorbzilla.com
  9. Absorption Kinetics of Regular (R)/(Neutral) & Isophane (NPH) Insulin in the Normal Dog-Domestic Animal Endocrinology-1987

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