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Neutral Protamine Hagedorn (NPH) insulin, also known as isophane insulin, is an intermediate-acting insulin given to help control blood sugar levels in people with diabetes.[3] It is used by injection under the skin once to twice a day.[1] Onset of effects is typically in 90 minutes and they last for 24 hours.[3] Versions are available that come premixed with a short-acting insulin, such as regular insulin.[2]
The common side effect is low blood sugar.[3] Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions.[3] Use during pregnancy is relatively safe for the fetus.[3] NPH insulin is made by mixing regular insulin and protamine in exact proportions with zinc and phenol such that a neutral-pH is maintained and crystals form.[1] There are human and pig insulin based versions.[1]
Protamine insulin was first created in 1936 and NPH insulin in 1946.[1] It is on the World Health Organization's List of Essential Medicines.[4] NPH is an abbreviation for "neutral protamine Hagedorn".[1] In 2020, insulin isophane was the 221st most commonly prescribed medication in the United States, with more than 2million prescriptions.[5][6] In 2020, the combination of human insulin with insulin isophane was the 246th most commonly prescribed medication in the United States, with more than 1million prescriptions.[7][8]
^ abcdefOwens DR (1986). Human Insulin: Clinical Pharmacological Studies in Normal Man. Springer Science & Business Media. pp. 134–136. ISBN 9789400941618. Archived from the original on 2017-01-18.
^ abcdBritish national formulary: BNF 69 (69 ed.). British Medical Association. 2015. pp. 464–472. ISBN 9780857111562.
^ abcdefg"Insulin Human". The American Society of Health-System Pharmacists. Archived from the original on 22 October 2016. Retrieved 8 January 2017.
^World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^"The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
^"InsulinIsophane - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
^"The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
^"Insulin Human; Insulin Isophane Human - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
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