Insulin Aspart (50%) + Insulin Aspart Protamine (50%) is a biphasic premixed insulin analogue formulation. It consists of 50% rapid-acting insulin aspart (a rapid-acting insulin analogue) and 50% intermediate-acting insulin aspart protamine (a complex of insulin aspart with protamine). This combination provides both a rapid onset of action to control postprandial glucose excursions and a prolonged duration of action to provide basal insulin coverage. It is designed to mimic the physiological insulin profile more closely than human premixed insulins, offering improved postprandial glycemic control and flexibility in timing of meals.
Adult: Highly individualized. Typically initiated at 0.2-0.4 units/kg/day or 10 units/day, divided into 2-3 injections (usually before major meals). The total daily dose is often split, with approximately 50-70% given before breakfast and the remainder before the evening meal. Dose adjustments are based on self-monitored blood glucose (SMBG) profiles.
Note: For subcutaneous injection only. Administer immediately (within 5-10 minutes) before a meal. Rotate injection sites (abdomen, thigh, buttock, upper arm) to prevent lipodystrophy. The abdomen provides the fastest absorption. Do not shake vigorously; roll gently before use. Use a new needle for each injection. Do not mix with any other insulin.
Insulin aspart is an insulin analogue where the amino acid proline at position B28 is replaced with aspartic acid. This modification reduces the propensity for self-association into hexamers, allowing for faster absorption from the subcutaneous tissue compared to regular human insulin. The insulin aspart protamine component is a complex where insulin aspart is bound to protamine, forming crystals that dissolve slowly, providing an intermediate duration of action. The combined formulation mimics both prandial and basal insulin secretion.
Pregnancy: Pregnancy Category B (as per some regulatory bodies; Indian labels often state 'Use if clearly needed'). Insulin requirements typically decrease in first trimester and increase significantly in second/third trimesters. Close monitoring of blood glucose is mandatory. Preferred over oral anti-diabetics in pregnancy.
Driving: Hypoglycemia can impair cognitive and motor functions. Patients should check blood glucose before driving and avoid driving if hypoglycemic or if warning signs are present. Always carry a fast-acting carbohydrate source in the vehicle.
| Corticosteroids (e.g., Prednisolone) | Decreased hypoglycemic effect; increases insulin requirement. | Major |
| Beta-blockers (e.g., Propranolol) | May mask tachycardia as a warning sign of hypoglycemia and impair counter-regulatory response. | Moderate |
| Thiazide Diuretics (e.g., Hydrochlorothiazide) | May cause hyperglycemia, increasing insulin requirement. | Moderate |
| ACE Inhibitors (e.g., Ramipril) | May enhance hypoglycemic effect. | Moderate |
| Alcohol | Increases risk of hypoglycemia, especially if consumed without food. Can impair gluconeogenesis. | Major |
| MAO Inhibitors, SSRIs | May increase or decrease hypoglycemic effect. | Moderate |
| Octreotide, Lanreotide | Alters glucose metabolism; may increase or decrease insulin requirement. | Moderate |
| Pioglitazone, other TZDs | May increase risk of fluid retention and edema when combined with insulin. | Moderate |
Same composition (Insulin Aspart (50%) + Insulin Aspart Protamine (50%)), different brands: