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Novolin L
Lente by Novo Nordisk
intermediate-acting r-DNA/GE/GM
U100 Zinc
Line Novolin
Also known as Monotard
Similar to  
Action in cats  
  • onset 2-5h,
  • peak 8-10h[1]
  • duration: 10-16h
Action in dogs  
  • onset 2-10h,
  • peak 6-24h,
  • duration 14-24h
Use and Handling
Type cloudy
Shelf Life 24 months
When opened 28 days
In pen N/A
Notes  

A U100 r-DNA/GE/GM lente, intermediate-length, lente insulin made by Novo Nordisk and sold by this brand name in North America until the end of 2003[2][3]. Novo's name for the same insulin elsewhere was Monotard[4][5][6][7].

The insulin was also comparable to Eli Lilly's Humulin L[8][9][10].

What Lente Is NotEdit

No Lente-type insulin regardless of species can contain any NPH/isophane insulin[11] or any R/Neutral insulin[12][13].

Both are chemically impossible: the phenol preservative present in NPH/isophane alters the action of Lente-type insulins, creating a mixture with an approximate action of R/Neutral[14].

The zinc suspension of Lente-type insulin binds R/Neutral, causing the short-acting insulin to slow, losing its short-acting effect[15][16][17][18].

Combining Lente Family InsulinsEdit

Insulin manufacturers[19] indicate that R/neutral and semilente, Lente, ultralente insulins are able to be combined in the same syringe, but only just before injection. In pre-filled syringes, the zinc suspension of the Lente-type insulins binds the R/neutral, causing it to lose its short-acting effect. Various studies have documented this, and some doctors advise against using R/neutral in the same syringe with the Lente family of insulins[20][21][22][23].

None of the Lente family of insulins (semilente, Lente, Ultralente) can be combined with[24] NPH/isophane insulins. The phenol preservatives present in NPH-type insulins alters the Lente-types to the point where they become a close approximation of R/neutral, with regard to action[25].

Keeping the phenol preservatives in mind, all protamine-suspended insulin mixes would be "off limits" regarding same syringe mixing with any Lente-type insulins[26].

The Novo insulins, Monotard and Ultratard, were available slightly longer in Europe.

From the announcement: Monotard and Ultratard will not be available in the UK after February 2006. The discontinuation of these insulins was initially announced in September 2004. Initially the discontinuation was scheduled for February 2006, however this date has now been brought forward to October 2005.

Further ReadingEdit

Wikicat3Wikidog3

See also Substitutes_for_Humulin_U_and_L.

ReferencesEdit

  1. Insulins-North American Veterinary Conference-2005
  2. Photo of Novolin L vial and carton
  3. US-FDA Novolin L Discontinuation Notice October 2003
  4. Prescribing Novo Insulins
  5. EMEA Scientific Discussion-Monotard
  6. Lilly EU/UK Product Sheet & Time Activity Profiles
  7. Monotard/Ultratard Discontinuation Notice July 2005
  8. Humulin L, etc.-Lente Human Insulin Remedyfind.com
  9. US-FDA-Humulin L Discontinuation Notice-July 2005
  10. Humulin L Discontinuation Notice-July 2004
  11. Combining Lente-type Insulins with Phenol-Preserved Insulins
  12. Lente Zinc Suspension Causes Loss Of R/Neutral Short-Acting Effect
  13. Availability of Soluble (R/Neutral) Insulin in Mixed Preparations of Crystalline (Lente) & Ultralente GE Insulins-Clinical Therapeutics-1991
  14. Lente-Type Insulins & NPH/Isophane Insulins-A Bad Combination
  15. Intermediate-Acting Insulin Preparations: NPH (Isophane) & Lente Diabetes Care-1980
    Note: in 1980 there was only beef Lente-type insulin-no pork or R-DNA/GE/GM Lente insulins
  16. Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin-Diabetes Care-1987
  17. Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin Diabetes Research & Clinical Practice-1983
  18. Resource Guide 2005-American Diabetes Association
  19. Insulin Producers vs Doctors Re:Combining R/Neutral & Lente-type Insulins
  20. Availability of Soluble (R/Neutral) Insulin in Mixed Preparations of Crystalline (Lente) & Ultralente GE Insulins-Clinical Therapeutics-1991
  21. Absorption Kinetics & Action Profiles-Single Subcutaneous Administration of Human Soluble (R/Neutral) & Lente Insulin-Diabetes Care-1987
  22. Delayed Onset of Action of Soluble (R/Neutral) Insulin After Premixing With Lente Insulin Diabetes Research & Clinical Practice-1983
  23. RxEd.org-Insulin Therapy-Mixing Precautions
  24. Phenol Preservatives & Lente-type Insulins--A Bad Combination
  25. RxEd.org-Insulin Therapy-Mixing Precautions
  26. RxEd.org-Insulin Therapy-Mixing Precautions

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