Pre-Mixed Insulin Combinations 1st number = percentage of intermediate-acting insulin 2nd number = percentage of short/rapid-acting insulin Novolog 70/30 Aspart protamine / Aspart Humalog 75/25 - Lispro protamine / Lispro Humalog 50/50 - Lispro protamine / Lispro Humulin 70/30 - NPH / Regular Novolin 70/30 - NPH / Regular Pre-mixed insulins have been around for a long time, so let’s review them! These products have a protamine component that is intermediate-acting and serves as the basal insulin, combined with a regular version that is shorter-acting and serves as the prandial insulin. They are normally dosed twice per day. When looking at the ratio, always remember that the first number is the basal percentage and second number is the prandial percentage. The main benefits of these products is that it cuts down on the number of injections per day (2 per day, compared to 4 per day with a basal daily + prandial TID). This can also make it cheaper for patients since they pay 1 copayment instead of having 2 different prescriptions. The major downside is that there is very little flexibility in dosing. The ratios are set so you can’t increase the basal without increasing the prandial (& vice versa), and most patients will not fit perfectly into those ratios since everyone’s insulin requirements are different. This can make it difficult to get optimal glycemic control. I generally do not use these products with my patients, but again it is patient-specific so there may be some instances that these would be the ideal fit for a patient. Jarred Prudencio, PharmD - https://www.instagram.com/ambcarerx #Insulin #Combinations #PreMixed #Pharmacology #BrandNames
