BNF for Children 2011-2012

356 6.1.1 Insulins BNFC 2011–20126 Endocrine systemBIPHASIC INSULIN LISPRO(Intermediate-acting insulin)Cautions see section 6.1.1 and Insulin Lispro; 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 15 minutes before or soon after a meal,according to requirementsHumalog c Mix25 (Lilly) AInjection, biphasic insulin lispro (recombinant humaninsulin analogue), 25% insulin lispro, 75% insulinlispro protamine, 100 units/mL, net price 10-mL vial= £16.61; 5 3-mL cartridge (for Autopen c Classic orHumaPen c ) = £29.46; 5 3-mL Humalog c Mix25KwikPen prefilled disposable injection devices (range1–60 units allowing 1-unit dosage adjustment) =£30.98Counselling 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)Humalog c Mix50 (Lilly) AInjection, biphasic insulin lispro (recombinant humaninsulin analogue), 50% insulin lispro, 50% insulinlispro protamine, 100 units/mL, net price 5 3-mLcartridge (for Autopen c Classic or HumaPen c )=£29.46; 5 3-mL Humalog c Mix50 KwikPenprefilled disposable injection devices (range 1–60 units, allowing 1-unit dosage adjustment) = £30.98Counselling 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)BIPHASIC ISOPHANE INSULIN(Biphasic Isophane Insulin Injection—intermediateacting)A sterile buffered suspension of either porcine or human insulincomplexed with protamine sulphate (or another suitable protamine)in a solution of insulin of the same speciesCautions 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 dispensed; the proportions of the twocomponents should be checked carefully (the order in whichthe proportions are stated may not be the same in othercountries)Hypurin c Porcine 30/70 Mix (Wockhardt) AInjection, biphasic isophane insulin (porcine, highlypurified), 30% soluble, 70% isophane, 100 units/mL,net price 10-mL vial = £16.80; cartridges (for Autopenc Classic) 5 3 mL = £25.20Human sequenceCounselling 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)Humulin M3 c (Lilly) AInjection, biphasic isophane insulin (human, prb),30% soluble, 70% isophane, 100 units/mL, net price10-mL vial = £15.68; 5 3-mL cartridge (for Autopenc Classic or HumaPen c ) = £19.08; 5 3-mLHumulin M3 KwikPen c prefilled disposable injectiondevices (range 1–60 units, allowing 1-unit dosageadjustment) = £21.70Insuman c Comb 15 (Sanofi-Aventis) AInjection, biphasic isophane insulin (human, crb),15% soluble, 85% isophane, 100 units/mL, net price 5 3-mL cartridge (for ClikSTAR c , Optipen c Pro 1and Autopen c 24) = £17.50; 5 3-mL Insuman cComb 15 OptiSet c prefilled disposable injectiondevices (range 2–40 units, allowing 2-unit dosageadjustment) = £17.50Insuman c Comb 25 (Sanofi-Aventis) AInjection, biphasic isophane insulin (human, crb),25% soluble, 75% isophane, 100 units/mL, net price5-mL vial = £5.61; 5 3-mL cartridge (forClikSTAR c , OptiPen c Pro 1, and Autopen c 24) =£17.50; 5 3-mL Insuman c Comb 25 OptiSet cprefilled disposable injection devices (range 2–40 units, allowing 2-unit dosage adjustment) = £17.50;5 3-mL Insuman c Comb 25 SoloStar prefilleddisposable injection devices (range 1–80 units, allowing1-unit dosage adjustment) = £19.80Insuman c Comb 50 (Sanofi-Aventis) AInjection, biphasic isophane insulin (human, crb),50% soluble, 50% isophane, 100 units/mL, net price; 5 3-mL cartridge (for ClikSTAR c , OptiPen c Pro 1,and Autopen c 24) = £17.50; 5 3-mL Insuman cComb 50 OptiSet c prefilled disposable injectiondevices (range 2–40 units, allowing 2-unit dosageadjustment) = £17.506.1.1.3 Hypodermic equipmentCarers and children should be advised on the safedisposal of lancets, single-use syringes, and needles.Suitable arrangements for the safe disposal of contaminatedwaste must be made before these products areprescribed for patients who are carriers of infectiousdiseases.