Is it ok to use different brands for basal and bolus injections?

[MonkeyMoon]

Hello All: New to the Forum. I was recently diagnosed with T2 Diabetes and put on a basal-bolus injection regimen. The Dr. prescribed Novalog and Levemir. Both are expensive. Are there any of you who have switched the brand of the long-acting insulin while maintaining the meal-time insulin brand with success? In the US, some insulins like Novalin, are available OTC and are substantially cheaper. Any help is appreciated!!

 

[Engineer88]

Where are you based that you pay for insulin?

 

[MonkeyMoon]

I'm in the US. The meds are between $140 and $150 per vile (10 ml), while the OTC Novalin is under $25.

 

[Daibell]

Mixing insulin brands isn't normally a problem, but obviously the type needs to suit you. Levemir is very popular in the UK and I'm on it. In the UK NovoRapid is the commonly prescribed rapid but there are others

 

[phoenix]

It's perfectly possible to use Novolin N as a basal
As you can see it is an intermediate insulin so differs from Levemir. in that it has a marked peak and may last less time in the body.
http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_C.aspx
Here is a page that shows a graph of it's action (under NPH)
http://dtc.ucsf.edu/types-of-diabet...pies/type-1-insulin-therapy/types-of-insulin/

However, many people do use it and the first people to use basal/bolus regimes used it as lantus and and levemir weren't on the market.

I've never used it so I can't really give any advice on how to use it (I think that you may need to split the dose and use it twice a day, timing it to make the peak work for you but it is something that you really need to talk to a doctor about)

 

[smidge]

Well, I'm on different brands of basal and bolus; basal is Levemir by Novo Nordisk and bolus is Apidra by Sanofi Aventis. It's absolutely fine, but the consultants usually prescribe the same brand by default.

I'm not an expert in US insulins, so don't take wat I'm about to say for granted, but I think Novalog and novalin are different types of insulin, Novalog is the same as UK Novorapid under a different name, so a rapid-acting insulin that you take immediately before your meal; Novalin is a regular or short-acting insulin which is a slower onset and longer duration than the rapid-actings so you have to take it 30 - 45 minutes before your meal.

If you're going to change insulin type, you need to discuss it with a consultant really.

Smidge

 

[smidge]

Tanks phoenix - our posts must have crossed. I was talking about Novalin-R, so I assume people would usually use Novalin-S in conjunction with Novalin-R?

Smidge

 

[phoenix]

It really doesn't help that they have different names and letters in the US and the UK. I've given a US Gov website so it should be right.

 

[robert72]

If you are using Novolin N as a basal, it does not have the flat action of Levemir or Lantus. You would normally take one dose in the Morning and use it's peak to cover your lunch carbs and take another dose at bedtime and use it's peak to cover 'dawn phenomenon' which occurs around 3-6am. You would also take Novolin R at breakfast and dinner to cover the carbs for those meals.

It's not really as flexible as the NovoLog and Levemir you are using now, as you'll need to eat at preset times.

 

[MonkeyMoon]

Thanks All for the reponses.

 

[AlexMBrennan]

(Sorry for any mistakes - I had to retype this from memory becauseiPad is bloody useless and lost everything while I looked up that image at the end)

Is it ok to use different brands for basal and bolus injections?

Yes - in the sense that there is no reason you need to take NovoNordisk branded insulin aspart (brand name NovoRapid, also known as Novolog which you misspelled Novalog) with your NovoNordisk branded insulin determir (brand name Levemir); you could take another fast acting analogue like Humalog (manufactured by Eli Lilly) instead. However...

In the US, some insulins like Novalin, are available OTC and are substantially cheaper

The cheap insulin you are looking at is another KIND of insulin - human-identical insulin. The insulin you have been prescribed is newer (and still in patent) and thus more expensive - but it also works faster, and is considered better (e.g. The insulin you have been prescribed can be taken with food whereas the cheap insulin you saw has to be taken half an hour before food... which could problematic if you were eating dinner at a restaurant and the meal was delayed)

Aspart/Novolog/Novorapid has been altered to work faster and is not identical to human insulin; novalin (assuming you meant "Novololin") is human insulin but here details matter:

Novolin R is comparable to Novorapid/Novolog but slower acting (as mentioned above).
Novolin N/NPH is a suspension/preparation of human insulin comparable to Levemir but with less even profile (I.e. greater risk of nocturnal hypos).