Drug Classes: Insulins

Contains information about:

• Rapid-Acting Insulins
• Short-Acting Insulins
• Intermediate-Acting Insulins
• Long-Acting Insulins

The following image shows the time of onset and duration of action for the various types of insulins. Source below. And if you have trouble calculating day supply when working with insulin, be sure to check out the post explaining how to calculate day supply.

Rapid-Acting Insulin

Use: Control of hyperglycemia in patients with diabetes mellitus 1 or 2
Mechanism of Action: Stimulates glucose uptake by skeletal muscle and fat cells
Contraindications: Hypersensitivity to active ingredient or preservatives
Pregnancy Category:

• C (Insulin Glulisine) - Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
• B (Insulins Aspart and Lispro) - Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

Availability:

• Novolog - Insulin Aspart
  
  • 10mL Vials - 100u/mL
  • 3mL Pens - 100u/mL (Pack of 5 pens)
• Humalog - Insulin Lispro
  
  • 10mL Vials - 100u/mL
  • 3mL Pens - 100u/mL (Pack of 5 pens)
• Apidra - Insulin Glulisine
  
  • 10mL Vials - 100u/mL
  • 3mL Pens - 100u/mL (Pack of 5 pens)

Common Side Effects:

• None frequently

Combination Drugs:

• Humalog 50/50
• Humalog 75/25

Miscellaneous: Rapid-acting insulins are intended for use with intermediate to long-acting insulins

Short-Acting Insulins

Use: DM1 or 2, diabetic ketoacidosis
Mechanism of Action: Stimulates glucose uptake by skeletal muscle and fat cells
Contraindications: Hypersensitivity to active ingredient or preservatives
Pregnancy Category: B - Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Availability:

• Humulin R, Novolin R
  
  • 10mL vial - 100units/mL
    
• Humulin R Concentrated
• 20mL vial - 500u/mL

Common Side Effects:

• None Frequently

Combination Drugs:

• Humulin 70/30 OR Novolin 70/30 - NPH Insulin/Regular Insulin

Miscellaneous:

• Concentrated insulin only for use in patients with insulin requirements exceeding 200units/day
• Nonconcentrated insulins available for purchase over the counter

Intermediate-Acting Insulins

Use: DM1 or 2
Mechanism of Action: Stimulates glucose uptake by skeletal muscle and fat cells
Contraindications: Hypersensitivity to active ingredient or preservatives
Pregnancy Category: B - Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Availability:

• Humulin N, Novolin N - NPH (Isophane Insulin Suspension) Insulin
  
  • 10mL vial - 100u/mL
  • 3mL Pen - 100u/mL (5 pens)
    

Common Side Effects:

• None Frequently

Combination Drugs:

• Humulin 70/30 OR Novolin 70/30 - NPH Insulin/Regular Insulin

Long-Acting Insulins

Use: DM1 or 2
Mechanism of Action: Stimulates glucose uptake by skeletal muscle and fat cells
Contraindications: Hypersensitivity to active ingredient or preservatives
Pregnancy Category: C - Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Availability:

• Levemir - Insulin Detemir
  
  • 10mL Vial - 100u/mL
  • 3mL Pen - 100u/mL (Five Pens)
• Lantus - Insulin Glargine
  
  • 10mL Vial - 100u/mL
  • 3mL Pen - 100u/mL (Five Pens)

Common Side Effects:

• None Frequently

Combination Drugs: None

Resources
Finkel, Richard, Michelle Alexia, Pamela C., and Luigi X. Pharmacology. 4th. Philadelphia: Lippincott Williams & Wilkins, 2008. Pg 289. Print.