 | This article needs additional citations for verification. (November 2020) |
 A vial of NPH insulin with insulin syringe | |
| Clinical data | |
|---|---|
| Trade names | Novolin N, Humulin N, Insulatard, others |
| Other names | Neutral protamine Hagedorn insulin,[1] protamine zinc insulin (slightly different),[2] isophane insulin,[2] compound insulin zinc suspension (slightly different),[2] intermediate-acting insulin |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a682611 |
| Routes of administration | Subcutaneous |
| ATC code | |
| Legal status | |
| Legal status |
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| Pharmacokinetic data | |
| Onset of action | 90 minutes[3] |
| Duration of action | 24 hours[3] |
| Identifiers | |
| CAS Number | |
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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. The words refer to neutral pH (pH = 7), protamine a protein, and Hans Christian Hagedorn, the insulin researcher who invented this formulation. It is designed to improve the delivery of insulin, and is one of the earliest examples of engineered drug delivery.[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 2 million 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 1 million prescriptions.[7][8]
- ^ a b c d e f Owens 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.
- ^ a b c d British national formulary: BNF 69 (69 ed.). British Medical Association. 2015. pp. 464–472. ISBN 9780857111562.
- ^ a b c d e f g "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.