Three presentations of Insuman Basal and Insuman Comb are to be discontinued owing to limited capacity at the manufacturing site. The manufacturer says the discontinuations are not due to any safety issue.
The presentations being discontinued are:
- Insuman Comb 15 100IU/mL suspension for injection in a cartridge (expected end of supply June 2020). This is the only presentation of Insuman Comb 15.
- Insuman Basal 100IU/mL suspension for injection in a vial (expected end of supply May 2020).
- Insuman Comb 25 100IU/mL suspension for injection in a vial (expected end of supply June 2020).
No new patients should be started on these presentations, and existing patients should be switched to a suitable alternative.
Switching should be supervised by a healthcare professional who must provide training on how to use the new delivery device. While patients become familiar with the new device their blood glucose levels should be closely monitored.
Alternative human insulins
Alternative human insulins recommended by the manufacturer are as follows:
|Insuman||Alternative human insulin|
|Basal vial||Insuman Basal cartridge|
Insuman Basal SoloStar
Humulin I vial
|Comb 25 vial||Insuman Comb 25 cartridge|
Insuman Comb 25 SoloStar
Humulin M3 vial
|Comb 15 cartridge||Insuman Comb 25 cartridge|
Humulin M3 cartridge
Switching from Insuman Basal to another basal human insulin may require minimal or no dose adjustment.
However, switching from Insuman Comb 15 to an alternative insulin requires close supervision. The differences in proportions of the soluble and isophane insulins are likely to be clinically significant and a dose adjustment would be anticipated. Insuman Comb 15 has a ratio of 15% dissolved insulin and 85% crystalline protamine insulin, Insuman Comb 25 has a ratio of 25% dissolved insulin and 75% crystalline protamine insulin, and Humulin M3 has a ratio of 30% soluble insulin/70% isophane insulin.
Any switch to insulin analogues should be done under careful supervision as the pharmacokinetic and pharmacodynamic profiles of insulin analogues are different from human insulins, as are the international units used for human insulins and the analogue-specific units. As a result, adjustments may be required in the dose and/or dosing regimen.