Brand Names of Intermediate-Acting Insulin
Intermediate-acting insulins include NPH (Neutral Protamine Hagedorn) insulin, also known by brand names Humulin N and Insulatard HM, and Lente insulin. 1
Types of Intermediate-Acting Insulin
Intermediate-acting insulins are characterized by their pharmacokinetic profile that positions them between short-acting and long-acting insulins:
NPH insulin (Neutral Protamine Hagedorn)
- Brand names: Humulin N, Insulatard HM, Novolin N
- Onset: Approximately 1 hour
- Peak action: 6-8 hours
- Duration: Approximately 12 hours 1
Lente insulin
- Brand name: Insulin zinc suspension (Lente)
- Onset: Approximately 1 hour
- Peak action: 6-8 hours
- Duration: Approximately 12 hours 1
Clinical Characteristics of Intermediate-Acting Insulin
Intermediate-acting insulins have distinct pharmacokinetic properties that affect their clinical use:
- They have a slower onset of action compared to rapid-acting and short-acting insulins
- They peak several hours after administration (6-8 hours)
- Their duration of action is approximately 12 hours 1
- They appear uniformly cloudy upon visual inspection (unlike rapid-acting and short-acting insulins which should be clear) 1
Comparison with Other Insulin Types
Rapid-Acting Insulins
- Examples: Aspart (NovoLog/NovoRapid), Lispro (Humalog)
- Onset: 5 minutes
- Peak: 1-2 hours
- Duration: 3-4 hours 1
Short-Acting Insulins
- Example: Regular insulin
- Onset: 15 minutes
- Peak: 3-4 hours
- Duration: 6-8 hours 1
Long-Acting Insulins
- Examples: Glargine (Lantus), Detemir (Levemir), Degludec (Tresiba)
- Onset: 1 hour
- Peak: None or minimal
- Duration: 24 hours or more 1, 2
Clinical Considerations
When using intermediate-acting insulin:
- Due to their pronounced peak action, intermediate-acting insulins like NPH carry a higher risk of hypoglycemia compared to long-acting insulin analogs like glargine or detemir 2
- Patients must eat meals at set intervals to avoid hypoglycemia when using intermediate-acting insulin 1
- NPH insulin can be mixed with short-acting or rapid-acting insulins in the same syringe for convenience 1
- Pre-mixed formulations containing fixed ratios of intermediate-acting and short/rapid-acting insulins are available (e.g., 70% NPH/30% regular, 50% NPH/50% regular, 75% NPL/25% insulin lispro) 1
Cost Considerations
Intermediate-acting insulins like NPH may be more affordable options compared to newer long-acting insulin analogs, which is an important consideration for patients with cost constraints 1. According to 2023 pricing data, NPH insulin is generally less expensive than long-acting insulin analogs 1.