middellangwerkende

Middellangwerkende, in pharmacologie often translated as intermediate-acting, is a term used to describe medicines whose effects begin after a short delay and persist longer than short-acting formulations but shorter than long-acting ones. The exact duration of action varies by substance and formulation, but the designation typically characterizes effects that last roughly from several hours up to about a day. The onset is usually slower than that of short-acting preparations, reflecting formulation properties that delay absorption or slow release.

In diabetes management, middellangwerkende insulines are a common example. They are designed to provide basal insulin coverage between meals. For insulin NPH (neutral protamine Hagedorn), the classic middellangwerkende preparation, the onset is about 1 to 2 hours, with a peak around 4 to 12 hours, and a duration of roughly 12 to 18 hours (in practice, up to about 24 hours for some patients). Such formulations are frequently used in combination regimens with rapid- or short-acting insulins and may be administered once or twice daily, depending on the treatment plan and individual needs.

The exact pharmacokinetic profile of middellangwerkende drugs depends on the substance, its formulation, route of administration, and patient factors such as age, injection site, and activity level. They are associated with risks similar to other long-acting agents, notably hypoglycemia in the case of insulin, and require careful dosing, monitoring of therapeutic response, and adjustments for meals and activity. The term is used across multiple drug classes to indicate an intermediate duration of action relative to short- and long-acting formulations.