What it means
Neutral protamine Hagedorn insulin, also called isophane insulin. A protein added to it slows absorption, so it starts working in about 1 to 2 hours, peaks in about 4 to 12 hours and lasts up to about 18 hours. It is the only cloudy human insulin and is often mixed with regular insulin in one syringe or bought premixed (70/30).
For the nurse
Roll the vial or pen gently between the hands to mix it; do not shake. When mixing with regular insulin, draw up the clear regular insulin first, then the cloudy NPH. Watch for low blood glucose at the peak, which can be in the afternoon or overnight. It is never given IV.
Remember it
Mixing insulins: "clear before cloudy".
At a glance
| Drug class | intermediate-acting insulin |
|---|---|
| Brand names | Humulin N, Novolin N |
| Spanish | insulina NPH |
| Also written | isophane insulin |
Related terms
insulin
A hormone made by the pancreas that lets the body's cells take in glucose, also made as a medicine.
insulin glargine
A long-acting insulin, injected once a day, that gives a steady background level of insulin for about 24 hours.
insulin lispro
A rapid-acting insulin given just before or right after a meal to handle the rise in blood glucose from eating.
protamine
An IV drug that binds heparin and reverses its blood-thinning effect.