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Novolin N vs Lantus
Introduction
For patients with diabetes mellitus, insulin is a vital hormone that helps regulate blood sugar levels. Novolin N and Lantus are two types of insulins that are commonly prescribed for managing this chronic condition. These drugs each have different onset times, peak times, and durations of action but both help in maintaining stable blood glucose levels in diabetic patients. Novolin N or NPH (Neutral Protamine Hagedorn), an intermediate-acting insulin, has an onset time of 1 to 3 hours and a duration of roughly 18 to 24 hours post-injection. On the other hand, Lantus (Insulin Glargine) is classified as a long-acting insulin with no pronounced peak and has a consistent effect over 24 hours after injection. Its use can lead to less nocturnal hypoglycemia compared to intermediate acting insulins like Novolin N.
Novolin N vs Lantus Side By Side
| Attribute | Novolin n | Lantus |
|---|---|---|
| Brand Name | Novolin N | Lantus |
| Contraindications | Allergy to insulin or any of its inactive ingredients, hypoglycemia | Allergy to insulin glargine or any of its inactive ingredients, hypoglycemia |
| Cost | $150-$200 for a 10mL vial (100 units/mL) | $80-$130 for a single pen containing 3 mL (300 units) |
| Generic Name | Insulin NPH | Insulin Glargine |
| Most Serious Side Effect | Severe hypoglycemia, allergic reactions, changes at the injection site | Severe hypoglycemia, allergic reactions, heart failure |
| Severe Drug Interactions | Not specified in the article, but generally includes drugs that may increase the risk of hypoglycemia or hyperglycemia when taken with insulin | Not specified in the article, but generally includes drugs that may affect glucose metabolism |
| Typical Dose | Varies, typically given in divided doses between 1 and 4 times a day | 0.2 units/kg/day or up to 10 units once daily, adjusted based on blood glucose levels |
What is Novolin N?
Novolin N (the generic name for Insulin NPH) is a human insulin analogue that was developed as an improvement to the first generation of insulins, known as regular or short-acting insulins. Novolin N was first approved by the FDA in 1982. This intermediate-acting insulin works by mimicking your body's natural response to eating meals, thus controlling blood glucose levels over about half of the day or night. It is prescribed primarily for managing type 1 diabetes but can also be used in some cases of type 2 diabetes.
On the other hand, Lantus (also known as Insulin Glargine) is a long-acting basal insulin analog and represents another significant development in diabetic treatment since it lasts up to 24 hours with no pronounced peak. This offers patients a smoother profile compared to earlier insulins which may have peaks and troughs.
Comparatively, Novolin N has more fluctuations within its activity profile than Lantus does due to its shorter duration and distinct peak effect on blood glucose control. This might result in it having more side effects such as hypoglycemia when compared with Lantus whose longer duration provides steady-state low concentrations which mimic naturally occurring basal insulin secretion throughout the day without any significant peaks.
What conditions is Novolin N approved to treat?
Novolin N and Lantus are both used to manage blood sugar levels in patients with diabetes:
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Novolin N, an intermediate-acting insulin, is typically administered once or twice daily. It is often combined with other rapid or short-acting insulins.
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Lantus, a long-acting insulin analog that provides a slow and steady release of insulin over 24 hours, reduces the risk of nocturnal hypoglycemia. This medication requires only one injection per day.
How does Novolin N help with these illnesses?
Novolin N, an intermediate-acting insulin, helps to manage diabetes by mimicking the function of naturally occurring insulin in the body. It does this by promoting glucose uptake into cells and reducing the amount of glucose produced by the liver, thus helping to maintain blood sugar levels within a normal range for longer periods. Insulin is a hormone that acts as a key player in regulating blood sugar levels, having critical roles in metabolism and energy storage among other functions. People with diabetes either don't produce enough insulin or cannot use it effectively. Therefore, by supplementing natural insulin with Novolin N, diabetics can better control their blood sugar levels and manage their condition more effectively.
Lantus is another form of insulin but has long-lasting effects designed to work throughout the day similar to your body's own baseline level of insulin. This gives Lantus an advantage over Novolin N when it comes to controlling blood sugar levels around-the-clock without needing multiple injections.
What is Lantus?
Lantus, a long-acting insulin formulation also known as insulin glargine, helps control the blood sugar levels in people with diabetes mellitus. It's designed to provide consistent, all-day sugar level control and works by mimicking your body's natural release of insulin throughout the day. First approved by FDA in 2000, Lantus provides a steady stream of insulin over a 24-hour period that aids in keeping glucose levels stable and predictable. Unlike Novolin N which is an intermediate-acting form of insulin providing coverage for half the day or overnight, Lantus does not have peak times where it might lead to hypoglycemia (low blood sugar). This feature makes Lantus particularly helpful for patients who need consistent blood sugar control with fewer fluctuations throughout their daily activities. As with any medication though, it may have side effects such as weight gain and allergic reactions but compared to other insulins like Novolin N, it offers better predictability and ease of use due to its once-a-day dosing schedule.
What conditions is Lantus approved to treat?
Lantus is an FDA approved insulin for the long-term treatment of:
- Type 1 diabetes mellitus in adults and pediatric patients
- Type 2 diabetes mellitus in adults who require a long-acting (basal) insulin for the control of hyperglycemia.
How does Lantus help with these illnesses?
Insulin is a hormone essential for regulating blood glucose levels, playing a vital role in many bodily processes such as metabolism and energy production. In the case of diabetes, insulin production or utilization may be impaired. Lantus works by slowly releasing insulin throughout the day, mimicking the action of naturally occurring basal insulin to maintain optimal blood glucose levels over an extended period. This differs from Novolin N which has intermediate-acting characteristics with a quicker onset but shorter duration compared to Lantus. The steady release mechanism of Lantus minimizes peaks and troughs seen with other insulins like Novolin N, making it more suitable for maintaining stable overnight and between-meal sugar control. As such, patients who experience hypoglycemia or inconsistent control with "typical" insulins (such as Novolin N) may respond better to Lantus or it can be combined with faster-acting mealtime insulins.
How effective are both Novolin N and Lantus?
Both Novolin N (NPH insulin) and Lantus (insulin glargine) have a well-established history in managing blood sugar levels for patients with diabetes. They were initially approved by the FDA only 1 year apart, but they differ in their pharmacokinetics and can be prescribed under different circumstances.
Novolin N is an intermediate-acting insulin that starts to work within 2 to 4 hours after injection, has a peak effect between 4 to 12 hours, and lasts up to 18 hours. It requires twice-daily injections due to its shorter duration of action. On the other hand, Lantus is a long-acting basal insulin analogue that begins working one hour after injection and works evenly over the next twenty-four hours without any peak effects making it suitable for once daily dosing at any time of day but preferably at the same time each day.
A double-blind clinical trial conducted in 2000 compared Novolin N with Lantus as part of a multiple daily injection regimen along with mealtime regular human insulin or rapid acting analogues. The study found no significant differences between groups concerning HbA1C values; however, fasting plasma glucose was significantly lower with Lantus use than Novolin N use.
It's worth noting that individual preference may play into choosing between these two insulins since ease of administration may affect adherence rates especially among elderly patients who might face challenges using syringes which could favor use of pen devices available for Insulin Glargine(Lantus). Moreover, both have been shown generally safe during pregnancy although more studies are needed particularly on safety profile of Insulin Glargine(Lantus).
Analyses from multiple studies point towards better nocturnal glycemic control with reduced hypoglycemia risk when using Insulin Glargine(Lantus), suggesting it might be preferred choice if cost isn't prohibitive factor given its higher price compared to Novolin N(NPH Insulin).
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At what dose is Novolin N typically prescribed?
Dosage of Novolin N (NPH, Human Insulin Isophane Suspension) varies significantly based on the individual's needs but is typically given in divided doses between 1 and 4 times a day. Lantus (Insulin Glargine), on the other hand, is usually administered once daily at any time during the day but at the same time every day. The dosage of both insulins will depend upon patient-specific factors such as blood glucose control target, lifestyle, diet and exercise habits. Both medications' dosages can be adjusted over time based on blood sugar response; however, these adjustments should always be made under medical supervision. There isn't an absolute maximum dose for either insulin; it truly depends on individual requirements.
At what dose is Lantus typically prescribed?
Lantus therapy typically begins with a dosage of 0.2 units/kg/day or up to 10 units once daily, administered via subcutaneous injection. The dose can then be adjusted based on blood glucose levels and individual patient needs. However, it's essential to remember that the maximum daily dose may not exceed more than a third of the total insulin requirements per day and should be spaced out by at least 24 hours apart due to its long-acting nature. If there is no significant improvement in controlling glucose levels after several weeks, your healthcare provider might consider testing an increase in dosage while keeping within safe limits.
What are the most common side effects for Novolin N?
Common side effects of Novolin N and Lantus may include:
- Hypoglycemia (low blood sugar)
- Hyperglycemia (high blood sugar)
- Injection site reactions such as redness, swelling or itching
- Weight gain
- Skin rash, itching
- Swelling in your hands or feet
- Mild nausea, diarrhea
- Thinning or thickening of the fatty tissue where you inject the insulin.
Remember that each individual's reaction to medication can be different, it is important to communicate with your healthcare provider about any unusual symptoms after starting a new medication.
Are there any potential serious side effects for Novolin N?
Both Novolin N and Lantus are types of insulin used to manage blood sugar levels in people with diabetes. However, they can cause some serious side effects in rare cases:
- Hypoglycemia (low blood sugar), which may cause symptoms such as sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness or tingling hands/feet
- Allergic reactions: hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Serious allergic reaction known as insulin allergy: rash all over the body; shortness of breath; wheezing; decrease in blood pressure; fast pulse rate
- Changes at the injection site (lipodystrophy or localized cutaneous amyloidosis). The fatty tissue under the skin at the injection site may shrink (lipoatrophy) or thicken (lipohypertrophy)
- Potassium level changes - muscle weakness/cramping/twitching
- Symptoms indicating a heart failure like shortness of breath/swelling ankles/feet/unusual tiredness/unusual/sudden weight gain
It's important that you seek medical help immediately if you experience any of these symptoms while taking either Novolin N or Lantus.
What are the most common side effects for Lantus?
Common side effects of Lantus may include:
- Hypoglycemia, or low blood sugar
- Allergic reactions causing itching and rash
- Injection site reactions such as redness, swelling, and irritation
- Weight gain
- Swelling in your hands or feet due to fluid retention
- Shortness of breath
- Rapid heart rate
- Muscle pain or joint discomfort.
If you experience severe symptoms like difficulty breathing or a rapid heartbeat, it's essential to seek medical attention promptly.
Are there any potential serious side effects for Lantus?
If you are using Lantus, be aware that while it's generally safe and effective for managing diabetes, there can be serious side effects in rare cases. Watch out for:
- Signs of an allergic reaction such as hives, itching, difficulty breathing or swallowing, swelling in your face or throat
- Low blood sugar (hypoglycemia) symptoms which include dizziness, confusion, shaking or fast heartbeat
- Potassium levels dropping too low (hypokalemia), with symptoms like muscle cramps or weakness and irregular heartbeats
- Severe pain in your upper stomach spreading to your back with nausea and vomiting; this could point towards pancreatitis
- Swelling, weight gain, feeling short of breath; these may indicate heart failure.
Should any of the above occur while taking Lantus insulin glargine stop using it immediately and seek medical attention at once.
Contraindications for Novolin N and Lantus?
Both Novolin N and Lantus, along with most other insulin medications, may cause low blood sugar (hypoglycemia) in some people. If you experience symptoms such as dizziness, shaking, sweating or rapid heartbeat, it's an indication of a possible hypoglycemic condition. In this case immediate action should be taken to increase your blood glucose levels.
Neither Novolin N nor Lantus can be used if you are allergic to insulin or any of the inactive ingredients present in these drugs. Furthermore, inform your doctor about all the medications you are currently taking; certain medicines can interact adversely with insulin causing harmful effects.
It's also crucial to note that changes between different types or brands of insulin should only be made under medical supervision because dosage adjustment might be necessary when switching over. Remember not to mix Lantus with other insulins as it can change its time-action profile leading to undesirable consequences.
How much do Novolin N and Lantus cost?
For the brand name versions of these insulins:
- The price of a 10mL vial of Novolin N (100 units/mL) averages around $150-$200, which works out to about $15–20/day based on an average dose of 50 units per day.
- The price for Lantus (also known as insulin glargine), is generally higher. A single pen containing 3 mL (300 units) can cost between $80 and $130. If you use an average daily dose of 30 units, this equates approximately to a cost range from $8 to nearly $13 per day.
As such, if your dosage requirement is high, then brand-name Novolin N may be more economical compared to Lantus on a daily treatment basis. However, it's important that pricing should not be the only factor in deciding which medication might suit you better.
In terms of generic options:
- There isn't currently a generic form available for either Novolin N or Lantus in the United States at this time. Therefore costs as outlined above would apply irrespective whether branded or 'generics' were sought after.
Popularity of Novolin N and Lantus
Insulin NPH, under brand names such as Novolin N, was prescribed to approximately 2.3 million people in the USA in 2020. This intermediate-acting insulin accounted for about 10% of overall insulin prescriptions in the US. Insulin NPH has been a mainstay treatment for diabetes over several decades and its usage remained relatively constant from 2013.
On the other hand, Insulin glargine, known by its brand name Lantus among others, was prescribed to almost 5 million people in the USA during 2020. Representing around 30% of long-acting insulin prescriptions and nearly a quarter of all insulin prescriptions nationwide, it's clear that Lantus has become one of the most preferred options for managing blood glucose levels in patients with diabetes since its introduction to market at start of this century.
Conclusion
Both Novolin N (NPH insulin) and Lantus (insulin glargine) have been extensively used in the management of diabetes, with numerous clinical trials indicating their effectiveness over placebo treatments. Both medications can be used alone or combined with short-acting insulin or oral hypoglycemic agents. However, they differ in onset and duration of action; Novolin N is an intermediate-acting insulin while Lantus is a long-acting insulin.
Given these differences, they are often prescribed under varying circumstances: Novolin N might be administered once or twice daily to provide basal glucose control whereas Lantus typically requires just one daily injection due to its longer duration of action.
Both insulins are available as generic formulations providing cost savings for patients who must pay out-of-pocket expenses. Also note that starting on either medication may require a period of dose adjustment in order to determine the most effective amount needed for each individual patient.
In terms of side effects, both drugs carry similar risks such as hypoglycemia, weight gain and injection site reactions; however these usually decrease over time with regular monitoring and use. Patients need to watch closely their blood sugar levels when initiating therapy on either drug, adjusting dosage as necessary under medical supervision.
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Refrences
- Yki‐Järvinen, H. (2004, June). Insulin therapy in type 2 diabetes: role of the long‐acting insulin glargine analogue. European Journal of Clinical Investigation. Wiley.http://doi.org/10.1111/j.1365-2362.2004.01356.x
- Rosenstock, J., Dailey, G., Massi-Benedetti, M., Fritsche, A., Lin, Z., & Salzman, A. (2005, April 1). Reduced Hypoglycemia Risk With Insulin Glargine. Diabetes Care. American Diabetes Association.http://doi.org/10.2337/diacare.28.4.950
- Elrishi, M., Jarvis, J., Khunti, K., & Davies, M. (2008, August). Insulin glargine and its role in glycaemic management of Type 2 diabetes. Expert Opinion on Drug Metabolism & Toxicology. Informa Healthcare.http://doi.org/10.1517/17425255.4.8.1099
- Pesic, M., Zivic, S., Radenkovic, S., Velojic, M., Dimic, D., & Antic, S. (2007). Comparison between basal insulin glargine and NPH insulin in patients with diabetes type 1 on conventional intensive insulin therapy. Vojnosanitetski pregled. National Library of Serbia.http://doi.org/10.2298/vsp0704247p