Regular insulin
{{Short description|Short-acting insulin formulation}}
{{Use dmy dates|date=February 2023}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Infobox drug
| IUPAC_name =
| image = Actrapid vial.jpg
| alt =
| caption = A vial of regular human insulin
| pronounce =
| tradename = Humulin R, Novolin R, Actrapid, others{{cite web|title=insulin regular human (OTC) – Humulin R, Novolin R|url=http://reference.medscape.com/drug/humulin-r-novolin-r-insulin-regular-human-999007|access-date=1 December 2014|url-status=live|archive-url=https://web.archive.org/web/20141216210952/http://reference.medscape.com/drug/humulin-r-novolin-r-insulin-regular-human-999007|archive-date=16 December 2014}}
| Drugs.com = {{drugs.com|monograph|insulin_human}}
| MedlinePlus = a682611
| DailyMedID = Humulin
| pregnancy_AU =
| pregnancy_AU_comment =
| pregnancy_category=
| routes_of_administration = Subcutaneous, intramuscular, intravenous
| class =
| ATC_prefix = A10
| ATC_suffix = AB
| legal_AU =
| legal_AU_comment =
| legal_CA = Rx-only
| legal_CA_comment = /{{nbsp}}Schedule D{{cite web | title=Summary Basis of Decision - Myxredlin | website=Health Canada | date=23 October 2014 | url=https://hpr-rps.hres.ca/reg-content/summary-basis-decision-detailTwo.php?lang=en&linkID=SBD00622&lang=en | access-date=23 February 2023}}
| legal_DE =
| legal_NZ =
| legal_UK =
| legal_US = OTC
| legal_UN =
| legal_status =
| bioavailability =
| protein_bound =
| metabolism =
| metabolites =
| onset = 30 minutes
| elimination_half-life =
| duration_of_action = 8 hours
| excretion =
| CAS_number_Ref = {{cascite|correct|CAS}}
| CAS_number = 9004-10-8
| CAS_supplemental =
{{CAS|11061-68-0}} (insulin human)
| PubChem =
| DrugBank =
| ChemSpiderID = none
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 1Y17CTI5SR
| synonyms = insulin injection (soluble), neutral insulin, regular human insulin, human insulin (regular), Toronto insulin
}}
Regular insulin, also known as neutral insulin and soluble insulin, is a type of short-acting medical insulin. It is used to treat type 1 diabetes, type 2 diabetes, gestational diabetes, and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states.{{cite web|author1=American Society of Health-System Pharmacists|title=Insulin Human|url=https://www.drugs.com/monograph/insulin-human.html|website=drugs.com|access-date=1 January 2017|url-status=live|archive-url=https://web.archive.org/web/20161022221822/https://www.drugs.com/monograph/insulin-human.html|archive-date=22 October 2016}} It is also used along with glucose to treat high blood potassium levels.{{cite journal | vauthors = Mahoney BA, Smith WA, Lo DS, Tsoi K, Tonelli M, Clase CM | title = Emergency interventions for hyperkalaemia | journal = The Cochrane Database of Systematic Reviews | volume = 2005 | issue = 2 | pages = CD003235 | date = April 2005 | pmid = 15846652 | pmc = 6457842 | doi = 10.1002/14651858.CD003235.pub2 }} Typically it is given by injection under the skin, but may also be used by injection into a vein or muscle. Onset of effect is typically in 30 minutes and it typically lasts for 8 hours.
The common side effect is low blood sugar. Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions. Use during pregnancy is relatively safe for the baby. Regular insulin can be made from the pancreas of pigs or cows. Human versions can be made either by modifying pig versions or recombinant technology.{{cite book|title=British national formulary : BNF 69|date=2015|publisher=British Medical Association|isbn=9780857111562|page=464472|edition=69th}}
Insulin was first used as a medication in Canada by Charles Best and Frederick Banting in 1922.{{cite book | vauthors = Fleishman JL, Kohler JS, Schindler S | title = Casebook for The Foundation a Great American Secret. | date = 2009 | publisher = PublicAffairs | location = New York | isbn = 978-0-7867-3425-2 | page = 22 | url = https://books.google.com/books?id=5RmHA1SAoAgC&pg=PA22 | url-status = live | archive-url = https://web.archive.org/web/20170118063518/https://books.google.com/books?id=5RmHA1SAoAgC&pg=PA22 | archive-date = 18 January 2017}} It is on the World Health Organization's List of Essential Medicines.{{cite book | vauthors = ((World Health Organization)) | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }} In 2017, it was the 209th most commonly prescribed medication in the United States, with more than 2{{nbsp}}million prescriptions.{{cite web | title = Insulin Human - Drug Usage Statistics | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/InsulinHuman | access-date = 11 April 2020}} Versions are also available mixed with longer-acting versions of insulin, such as NPH insulin. In 2020, the combination of human insulin with insulin isophane was the 246th most commonly prescribed medication in the United States, with more than 2{{nbsp}}million prescriptions.{{cite web | title = The Top 300 of 2020 | url = https://clincalc.com/DrugStats/Top300Drugs.aspx | website = ClinCalc | access-date = 7 October 2022}}{{cite web | title = Insulin Human; Insulin Isophane Human - Drug Usage Statistics | website = ClinCalc | url = https://clincalc.com/DrugStats/Drugs/InsulinHumanInsulinIsophaneHuman | access-date = 7 October 2022}}
Medical uses
Side effects
Side effects may include: low blood sugar levels, skin reactions at the site of injection and low potassium levels among others.
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.{{cn|date=May 2022}}
Formulations
It is sold by many manufacturers in a number of different forms.
By Eli Lilly these include:{{cn|date=May 2022}}
- 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:{{Cite news|url=https://www.diabetes.co.uk/insulin/human-insulin.html|title=Human Insulin - Types, Production, Action, History|access-date=17 November 2017}}
- Actrapid
- Humulin S
- Insuman Rapid
References
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{{Oral hypoglycemics and insulin analogs}}
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Category:Insulin receptor agonists
Category:Drugs developed by Eli Lilly and Company