BNF for Children 2011-2012

BNFC 2011–2012 6.1.1 Insulins 355Highly purified animalHypurin c Bovine Lente (Wockhardt) AInjection, insulin zinc suspension (bovine, highlypurified) 100 units/mL. Net price 10-mL vial = £27.72Counselling Show container to child or carer and confirmthe expected version is dispensedISOPHANE INSULIN(Isophane Insulin Injection; Isophane ProtamineInsulin Injection; Isophane Insulin(NPH)—intermediate acting)A sterile suspension of bovine or porcine insulin or of humaninsulin in the form of a complex obtained by the addition ofprotamine sulphate or another suitable protamineCautions section 6.1.1; interactions: Appendix 1(antidiabetics)Hepatic impairment section 6.1.1Renal impairment section 6.1.1Pregnancy section 6.1.1Breast-feeding section 6.1.1Side-effects see under Insulin (section 6.1.1.1); protaminemay cause allergic reactionsIndication and doseDiabetes mellitus. By subcutaneous injectionAccording to requirementsHighly purified animalCounselling Show container to child or carer and confirmthe expected version is dispensedHypurin c Bovine Isophane (Wockhardt) AInjection, isophane insulin (bovine, highly purified)100 units/mL. Net price 10-mL vial = £27.72; cartridges(for Autopen c Classic) 5 3 mL = £41.58Hypurin c Porcine Isophane (Wockhardt) AInjection, isophane insulin (porcine, highly purified)100 units/mL. Net price 10-mL vial = £25.20; cartridges(for Autopen c Classic) 5 3 mL = £37.80Human sequenceCounselling Show container to child or carer and confirmthe expected version is dispensedInsulatard c (Novo Nordisk) AInjection, isophane insulin (human, pyr) 100 units/mL. Net price 10-mL vial = £7.48; Insulatard Penfill ccartridge (for Innovo c , or Novopen c devices) 5 3 mL = £22.90; 5 3-mL Insulatard InnoLet cprefilled disposable injection devices (range 1–50 units, allowing 1-unit dosage adjustment) = £20.40Humulin I c (Lilly) AInjection, isophane insulin (human, prb) 100nits/mL,net price 10-mL vial = £15.68; 5 3-mL cartridge (forAutopen c Classic or HumaPen c ) = £19.08; 5 3-mLHumulin 1 KwikPen c prefilled disposable injectiondevices (range 1–60 units, allowing 1-unit dosageadjustment) = £21.70Insuman c Basal (Sanofi-Aventis) AInjection, isophane insulin (human, crb) 100 units/mL, net price 5-mL vial = £5.61; 5 3-mL cartridge(for ClikSTAR c and OptiPen c Pro 1, and Autopen c24) = £17.50; 5 3-mL Insuman c Basal OptiSet cprefilled disposable injection devices (range 2–40 units, allowing 2-unit dosage adjustment) = £17.50Mixed preparationsSee Biphasic Isophane Insulin (p. 356)PROTAMINE ZINC INSULIN(Protamine Zinc Insulin Injection—long acting)A sterile suspension of insulin in the form of a complexobtained by the addition of a suitable protamine and zincchloride; this preparation was included in BP 1980 but is notincluded in BP 1988Cautions section 6.1.1; see also notes above; interactions:Appendix 1 (antidiabetics)Hepatic impairment section 6.1.1Renal impairment section 6.1.1Pregnancy section 6.1.1Breast-feeding section 6.1.1Side-effects see under Insulin (section 6.1.1.1); protaminemay cause allergic reactionsIndication and doseDiabetes mellitus. By subcutaneous injectionAccording to requirementsHypurin c Bovine Protamine Zinc (Wockhardt) AInjection, protamine zinc insulin (bovine, highly purified)100 units/mL. Net price 10-mL vial = £27.72Counselling Show container to child or carer and confirmthe expected version is dispensedBiphasic insulinsBiphasic insulins are pre-mixed insulin preparationscontaining various combinations of short-acting (soluble)or rapid-acting (analogue) insulin and an intermediate-actinginsulin.The percentage of short-acting insulin varies from 10%to 50%. These preparations should be administered bysubcutaneous injection up to 15 minutes before or soonafter a meal.BIPHASIC INSULIN ASPART(Intermediate-acting insulin)Cautions section 6.1.1; interactions: Appendix 1(antidiabetics)Hepatic impairment section 6.1.1Renal impairment section 6.1.1Pregnancy section 6.1.1Breast-feeding section 6.1.1Side-effects see under Insulin (section 6.1.1.1); protaminemay cause allergic reactionsIndication and doseDiabetes mellitus. By subcutaneous injectionUp to 10 minutes before or soon after a meal,according to requirementsNovoMix c 30 (Novo Nordisk) AInjection, biphasic insulin aspart (recombinanthuman insulin analogue), 30% insulin aspart, 70%insulin aspart protamine, 100 units/mL, net price 5 3-mL Penfill c cartridges (for Innovo c and NovoPen cdevices) = £28.84; 5 3-mL FlexPen c prefilleddisposable injection devices (range 1–60 units, allowing1-unit dosage adjustment) = £32.00Counselling Show container to child or carer and confirmthe expected version is dispensed; the proportions of the twocomponents should be checked carefully (the order in whichthe proportions are stated may not be the same in othercountries)6 Endocrine system