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Insulin  (Systemic)

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Brand Names

Some commonly used brand names are:

In the U.S.—

  • Humulin 50/5010
  • Humulin 70/3010
  • Humulin 70/30 Pen10
  • Humulin L7
  • Humulin N9
  • Humulin N Pen9
  • Humulin R5
  • Humulin R, Regular U-500 (Concentrated)5
  • Humulin U3
  • Lente Iletin II6
  • Lente6
  • Novolin 70/3010
  • Novolin L7
  • Novolin N9
  • Novolin N PenFill9
  • Novolin N Prefilled9
  • Novolin 70/30 PenFill10
  • Novolin 70/30 Prefilled10
  • Novolin R5
  • Novolin R PenFill5
  • Novolin R Prefilled5
  • NPH Iletin II8
  • NPH Purified Insulin8
  • Regular (Concentrated) Iletin II, U-5004
  • Regular Iletin II4
  • Regular Insulin4
  • Velosulin BR1

In Canada—

  • Humulin 10/9010
  • Humulin 20/8010
  • Humulin 30/7010
  • Humulin 40/6010
  • Humulin 50/5010
  • Humulin-L7
  • Humulin-N9
  • Humulin-R5
  • Humulin-U3
  • Lente Iletin6
  • Lente Iletin II6
  • Novolin ge 30/7010
  • Novolin ge Lente7
  • Novolin ge NPH9
  • Novolin ge NPH Penfill9
  • Novolin ge 10/90 Penfill10
  • Novolin ge 20/80 Penfill10
  • Novolin ge 30/70 Penfill10
  • Novolin ge 40/60 Penfill10
  • Novolin ge 50/50 Penfill10
  • Novolin ge Toronto5
  • Novolin ge Toronto Penfill5
  • Novolin ge Ultralente3
  • NPH Iletin8
  • NPH Iletin II8
  • Regular Iletin II4
  • Velosulin Human1

Note:

For quick reference, the following insulins are numbered to match the corresponding brand names.

Other commonly used names are: Lente insulin, L NPH insulin, NPH Regular insulin, R Semilente insulin, S Ultralente insulin, U

This information applies to the following medicines:
1.  Buffered Insulin Human (R) (IN-su-lin)
1A.  Buffered Insulin Human (R) or Insulin (R) or Insulin Human (R)
2.  Extended Insulin Zinc (U)*
2A.  Extended Insulin Zinc (U) or Extended Insulin Human Zinc (U)*
3.  Extended Insulin Human Zinc (U)
4.  Insulin (R)
5.  Insulin Human (R)
6.  Insulin Zinc (L)
6A.  Insulin Zinc (L) or Insulin Human Zinc (L)
7.  Insulin Human Zinc (L)
8.  Isophane Insulin (NPH) (EYE-so-fayn)
8A.  Isophane Insulin (NPH) or Isophane Insulin Human (NPH)
9.  Isophane Insulin Human (NPH)
10.  Isophane Insulin Human and Insulin Human (NPH and R)
11.  Prompt Insulin Zinc (S)*
‡  Generic name product may be available in the U.S.
§  Generic name product may be available in Canada
*  Not commercially available in the U.S.
†  Not commercially available in Canada

Category


Description

Insulin (IN-su-lin) is one of many hormones that helps the body turn the food we eat into energy. Also, insulin helps us store energy that we can use later. After we eat, insulin works by causing sugar (glucose) to go from the blood into our body's cells to make fat, sugar, and protein. When we need more energy between meals, insulin will help us use the fat, sugar, and protein that we have stored. This occurs whether we make our own insulin in the pancreas gland or take it by injection.

Diabetes mellitus (sugar diabetes) is a condition in which the body does not make enough insulin to meet its needs or does not properly use the insulin it makes. Without insulin, glucose cannot get into the body's cells. Without glucose, the cells will not work properly.

To work properly, the amount of insulin you use must be balanced against the amount and type of food you eat and the amount of exercise you do. If you change your diet, your exercise, or both without changing your insulin dose, your blood glucose level can drop too low or rise too high. A prescription is not necessary to purchase most insulin. However, your doctor must first determine your insulin needs and provide you with special instructions for control of your diabetes.

Insulin can be obtained from beef or pork pancreas glands. Another type of insulin that you may use is called human insulin. It is just like the insulin made by humans but it is made by methods called semi-synthetic or recombinant DNA. All types of insulin must be injected because, if taken by mouth, insulin is destroyed in the stomach.

Insulin is available in the following dosage forms:



Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For insulin, the following should be considered:

Allergies—Tell your doctor if you have ever had any reactions to insulin, especially in the skin area where you injected the insulin. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—The amount of insulin you need changes during and after pregnancy. It is especially important for your health and your baby's health that your blood sugar be closely controlled. Close control of your blood sugar can reduce the chance of your baby gaining too much weight, having birth defects, or having high or low blood sugar. Be sure to tell your doctor if you plan to become pregnant or if you think you are pregnant.

Breast-feeding—Insulin does not pass into breast milk and will not affect the nursing infant. However, most women need less insulin while breast-feeding than they needed before. You will need to test your blood sugar often for several months in case your insulin dose needs to be changed.

Children—Children are especially sensitive to the effects of insulin before puberty (the time when sexual changes occur). Therefore, low blood sugar may be especially likely to occur.

Teenagers—Use in teenagers is similar to use in older age groups. The insulin need may be higher during puberty and lower after puberty.

Older adults—Use in older adults is similar to use in other age groups. However, sometimes the first signs of low or high blood sugar are missing or not easily seen in older patients. This may increase the chance of low blood sugar during treatment. Also, some older people may have vision problems or other medical problems that make it harder for them to measure and inject the medicine. Special training and equipment may be needed.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Do not take any other medicine, unless prescribed or approved by your doctor. When you are using insulin, it is especially important that your health care professional know if you are taking any of the following:

Other medical problems—The presence of other medical problems may affect the dose of insulin you need. Be sure to tell your doctor if you have any other medical problems, especially:


Proper Use of This Medicine

Make sure you have the type (beef and pork, pork, or human) and the strength of insulin that your doctor ordered for you. You may find that keeping an insulin label with you is helpful when buying insulin supplies.

The concentration (strength) of insulin is measured in USP Insulin Units and USP Insulin Human Units and is usually expressed in terms such as U-100 insulin. Insulin doses are measured and injected with specially marked insulin syringes. The appropriate syringe is chosen based on your insulin dose to make measuring the dose easy to read. This helps you measure your dose accurately. These syringes come in three sizes: 3/10 cubic centimeters (cc) measuring up to 30 USP Units of insulin, ½ cc measuring up to 50 USP Units of insulin, and 1 cc measuring up to 100 USP Units of insulin.

It is important to follow any instructions from your doctor about the careful selection and rotation of injection sites on your body.

There are several important steps that will help you successfully prepare your insulin injection. To draw the insulin up into the syringe correctly, you need to follow these steps:

How to prepare your insulin dose if you are using one type of insulin:

How to prepare your insulin dose if you are using two types of insulin:

How to inject your insulin dose:

How to use special injection devices:

For patients using an automatic injector (with a disposable syringe):

For patients using a continuous subcutaneous infusion insulin pump:

For patients using disposable syringes:

For patients using an insulin pen device (cartridge and disposable needles):

For patients using nondisposable syringes (glass syringe and metal needle):

For patients using a spray injector (device without needles):

Laws in some states require that used insulin syringes and needles be destroyed. Be careful when you recap, bend, or break a needle, because these actions increase the chances of a needle-stick injury. It is best to put used syringes and needles in a disposable container that is puncture-resistant (such as an empty plastic liquid laundry detergent or bleach bottle) or to use a needle-clipping device. The chance of a syringe being reused by someone else is smaller if the plunger is taken out of the barrel and broken in half when you dispose of a syringe.

Use this medicine only as directed. Do not use more or less insulin than recommended by your doctor. To do so may increase the chance of serious side effects.

Your doctor will give you instructions about diet, exercise, how to test your blood sugar levels, and how to adjust your dose when you are sick.

Dosing—

The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label. The following information applies to the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The number of injections that you receive each day depends on the strength or type of the medicine. Also, the number of doses you receive each day, the time allowed between doses, and the length of time you receive the medicine depend on the amount of sugar in your blood or urine .

For regular insulin (R)—Crystalline zinc, human buffered, and human regular insulins

For isophane insulin (NPH)—Isophane and human isophane insulins

For isophane insulin human/insulin human (NPH/R)—Human isophane/human regular insulin

For insulin zinc (L)—Lente and human lente insulins

For insulin zinc extended (U)—Ultralente and human ultralente insulins

For prompt insulin zinc (S)—Semilente insulin

Storage—

To store this medicine:


Precautions While Using This Medicine

It is very important that your doctor check your progress at regular visits, especially during the first few weeks of insulin treatment.

It is very important to follow carefully any instructions from your health care team about:

In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to:

Too much insulin can cause low blood sugar (also called hypoglycemia or insulin reaction). Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn what symptoms of low blood sugar you usually have so that you can treat it quickly.

High blood sugar (hyperglycemia) is another problem related to uncontrolled diabetes. If you have any symptoms of high blood sugar, contact your health care team right away. If high blood sugar is not treated, severe hyperglycemia can occur, leading to ketoacidosis (diabetic coma) and death.


Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Also, check with your doctor as soon as possible if any of the following side effects occur:

Not all of the side effects listed above have been reported for each of these medicines, but they have been reported for at least one of them. All of the insulins are similar, so any of the above side effects may occur with any of these medicines.

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.


Additional Information

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although this use is not included in product labeling, regular insulin is used in certain patients:

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for this use.

Revised: 04/03/2002

Micromedex, Inc. Disclaimer

Copyright© 2003 Thomson MICROMEDEX. All rights reserved. USP DI® and Advice for the Patient® are registered trademarks of USP used under license to Micromedex, a business of Thomson Healthcare Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.