Insulin Aspart (30%) + Insulin Aspart Protamine (70%) is a biphasic premixed insulin analogue formulation. It consists of 30% rapid-acting insulin aspart and 70% intermediate-acting insulin aspart protamine suspension. This combination provides both a rapid onset for postprandial glucose control and a prolonged duration for basal insulin coverage, mimicking physiological insulin secretion. It is a cornerstone therapy for the management of both Type 1 and Type 2 Diabetes Mellitus in the Indian population, offering convenience with a single injection.
Adult: Highly individualized. Typically initiated at 0.2-0.5 units/kg/day, divided into 1-3 injections (usually before major meals). For Type 2 patients transitioning from oral drugs, a starting dose of 10 units or 0.1-0.2 units/kg once or twice daily is common. Dose is titrated based on self-monitored blood glucose (SMBG) profiles.
Note: For SUBCUTANEOUS use only. Inject into abdominal wall, thigh, upper arm, or buttocks. Rotate sites. Administer immediately (within 5-10 mins) BEFORE a meal. Gently roll the vial/pen 10 times before use to resuspend until it appears uniformly cloudy/milky. Do not shake. Use a new needle for each injection.
Insulin aspart is an analogue of human insulin where proline at position B28 is replaced by aspartic acid. This modification reduces the propensity for self-association into hexamers, allowing for faster absorption from subcutaneous tissue. The protamine-complexed insulin aspart forms a crystalline suspension that dissolves slowly, providing a prolonged duration of action. Insulin binds to the alpha-subunit of the insulin receptor, triggering autophosphorylation and activation of tyrosine kinase, leading to downstream signaling pathways.
Pregnancy: Pregnancy Category B. Insulin is the drug of choice for diabetes in pregnancy. Requirements may decrease in first trimester and increase significantly in second/third trimesters. Close monitoring of blood glucose and fetal well-being is mandatory.
Driving: Caution advised. Risk of hypoglycemia impairing concentration and motor skills. Patients should check blood glucose before driving and keep fast-acting carbohydrates in vehicle.
| Oral Hypoglycemics (Sulfonylureas, Meglitinides) | Additive hypoglycemic effect, increased risk of hypoglycemia | Major |
| Corticosteroids (e.g., Prednisolone) | Antagonize insulin effect, increase insulin requirement | Major |
| Beta-blockers (e.g., Propranolol) | Mask hypoglycemic symptoms (tachycardia), may potentiate hypoglycemia | Moderate |
| Thiazide Diuretics (e.g., Hydrochlorothiazide) | Hyperglycemia, increased insulin requirement | Moderate |
| ACE Inhibitors (e.g., Ramipril) | May enhance hypoglycemic effect | Moderate |
| Alcohol | Potentiates hypoglycemia, can cause delayed hypoglycemia | Major |
| MAO Inhibitors, Anabolic Steroids | Increase hypoglycemic effect | Moderate |
Same composition (Insulin Aspart (30%) + Insulin Aspart Protamine (70%)), different brands: