Am Fam Physician. 2004;70(11):2081
| Insulin | Onset | Peak (hours) | Usual effective duration (hours) | Usual maximum duration (hours) | Cost* | |
|---|---|---|---|---|---|---|
| Bolus or mealtime insulin | ||||||
| Aspart (NovoLog) | 5 to 10 minutes | 1 to 3 | 3 to 5 | 4 to 6 | $59 | |
| Lispro (Humalog) | < 15 minutes | 0.5 to 1.5 | 2 to 4 | 4 to 6 | 59 | |
| Regular (Humulin R, Novolin R) | 30 to 60 minutes | 2 to 3 | 3 to 6 | 6 to 10 | 28 | |
| Basal insulin | ||||||
| NPH (Humulin N, Novolin N) | 2 to 4 hours | 4 to 10 | 10 to 16 | 14 to 18 | 28 | |
| Lente (insulin zinc suspension) | 3 to 4 hours | 4 to 12 | 12 to 18 | 16 to 20 | ||
| Ultralente (extended insulin zinc suspension) | 6 to 10 hours | Peakless | 18 to 20 | 20 to 24 | 28 | |
| Glargine (Lantus) | 1 hour, 6 minutes | Peakless | 24 | 24 | 51 | |
| Combinations | ||||||
| 50% NPH/50% regular | 30 to 60 minutes | Dual | 10 to 16 | 14 to 18 | ||
| 70% NPH/30% regular (Humulin R 70/30, Novolin R 70/30) | 30 to 60 minutes | Dual | 10 to 16 | 14 to 18 | 28 | |
| 75% NPL/25% lispro (Humalog 75/25) | < 15 minutes | Dual | 10 to 16 | 14 to 18 | 59† | |
| 70% APS/30% aspart (NovoLog Mix 70/30) | 10 to 20 minutes | 2.4 ± 0.80 | 24 | 24 | 59 | |
NovoLog Mix 70/30 is incorrectly identified as “NovoLog 70/30” and is incorrectly described as 70 percent neutral protamine Hagedorn (NPH) insulin and 30 percent aspart. NovoLog Mix 70/30 does not contain NPH insulin, but rather 70 percent insulin aspart (rDNA origin) protamine suspension and 30 percent insulin aspart (rDNA origin) injection. NovoLog Mix 70/30 is a single solution containing a premixed formulation of 70 percent insulin aspart in the crystalline protamine form and 30 percent insulin aspart in the soluble form.
The table states that NovoLog Mix 70/30 has a dual peak. The glucose-lowering effects for this insulin begin as early as 10 to 20 minutes after subcutaneous injection and are maximal at 2.4 ± 0.80 hours; the duration of action may be as long as 24 hours because of the protaminated insulin aspart. However, examination of the pharmacokinetic profile of NovoLog Mix 70/30 reveals only one peak.
editor’s note: The online version of this article has been corrected, and the corrected table is reprinted above.