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Question:

From Illinois, USA:

My 13-year-old daughter was diagnosed as Type 1 seven months ago. Since then she has been using Humalog and Lente (Humulin L), both by Lilly. Our HMO (which has been very good and helpful throughout all this) now wants to change her prescription to Humalog and Lente by Novolin. My pharmacist insists that Humalog must be used with Humulin L. My pediatrician checked with a research internist who said that Humalog can be mixed with Novolin Lente. I can't reach my endo until Monday, and I will definitely do whatever he says, but I am interested in hearing any of your thoughts on this. My feeling is that Lente is Lente, but, obviously, I'm not a pharmacist. Do you know of any reason why the insulins from different companies could not be mixed?

Answer:

The use of insulins by one company mixed into the same syringe with insulins by the other company hasn't been well-studied, probably because the companies don't want to take the responsibility of whatever might happen in terms of chemical interactions between the different products. I've heard of cases where one product is used with another product from the other company, successfully, but I don't have any details; I would suspect it's probably safe, but just don't know.

You could, of course, give the two products safely, as two different shots, since the concern is what happens in the syringe, not what happens in the body (the Lente products from Lilly and Novo/Nordisk are interchangeable for all practical purposes in how they work in the body).

I assume that your HMO now has a contract with Novo/Nordisk for their insulin products. Your doctors probably can get an exception from the HMO for use of Lilly's Humulin brand of Lente (Humulin L), since your daughter's lispro insulin (Humalog brand name) is only made by Lilly.

My advice: Don't switch insulins until you get this sorted out, unless your daughter is willing to give the insulins as separate shots. Buy your present products out of your own pocket if you must (and save the receipts, to argue with the HMO's Medical Director later).

WWQ

Original posting 6 May 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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