Equivalent Insulin to NovoLog 70/30
Humalog Mix75/25 (insulin lispro protamine/insulin lispro) is the direct equivalent to NovoLog 70/30 (insulin aspart protamine/insulin aspart), both providing comparable glycemic control with similar pharmacodynamic profiles as rapid-acting analogue premixed insulins. 1, 2
Direct Equivalents
NovoLog 70/30 (also called BIAsp 30 internationally) contains 30% soluble insulin aspart and 70% protaminated insulin aspart, while Humalog Mix75/25 contains 25% insulin lispro and 75% protaminated lispro—both are rapid-acting analogue premixes that function equivalently in clinical practice. 1, 2
Head-to-head comparison demonstrated noninferior glycemic control between these two formulations, with comparable HbA1c reduction and similar hypoglycemia rates (0.69 episodes/month with BIAsp 30 vs 0.62 episodes/month with Mix25). 2
Both formulations provide superior postprandial glucose control compared to human insulin 70/30, with peak activity occurring approximately 2-3 hours after injection. 1, 3
Dosing is interchangeable on a unit-for-unit basis when switching between NovoLog 70/30 and Humalog Mix75/25, as both are equipotent rapid-acting analogue premixes. 1, 2
Alternative Human Insulin Equivalents (Lower Cost Options)
If cost is a primary concern, human insulin 70/30 formulations (Novolin 70/30 or Humulin 70/30) are less expensive alternatives, though they have inferior postprandial glucose control and require dosing 30-60 minutes before meals instead of immediately before eating. 4, 1
Human insulin 70/30 contains 30% regular insulin and 70% NPH, with peak activity occurring at 4.4 hours compared to 2.6 hours for analogue premixes. 1
The American Diabetes Association notes that human insulin formulations are appropriate for patients with cost concerns, relaxed A1C goals, or prominent insulin resistance. 4
Dosing Considerations When Switching
Administer either NovoLog 70/30 or Humalog Mix75/25 twice daily, 5-15 minutes before breakfast and dinner, with typical starting doses of 0.3-0.5 units/kg/day divided between morning and evening doses. 5
The morning dose should be approximately 2/3 of total daily dose, with the evening dose comprising 1/3—never use equal doses for both injections. 5, 4
When transitioning from basal insulin, maintain the same total daily dose initially but redistribute to the 2/3 morning and 1/3 evening split. 5
Critical Timing Differences
Analogue premixes (NovoLog 70/30, Humalog Mix75/25): dose within 15 minutes before meals 5, 1
Human insulin 70/30: must dose 30-60 minutes before meals 1
Common Pitfalls to Avoid
Never mix any premixed insulin formulation with other insulins in the same syringe, particularly avoiding mixing with glargine. 5
Do not use premixed insulins in hospitalized patients due to higher hypoglycemia risk in that setting. 5, 4
Ensure consistent meal timing when using any premixed formulation, as the fixed ratio of rapid-acting to intermediate-acting insulin cannot be adjusted for variable carbohydrate intake. 5, 4
Discontinue sulfonylureas and DPP-4 inhibitors when initiating multiple-dose premixed insulin regimens to reduce hypoglycemia risk, but continue metformin. 4, 6