Insulin Humulin NPH: instructions for use and price

Pharmacodynamics and pharmacokinetics

Humulin NPH is a DNA recombinant human insulin with an intermediate duration of action, the main effect of which is to regulate glucose metabolism . The drug also exhibits anabolic effectiveness.

In the tissues of the human body (except for brain tissue), insulin Humulin NPH activates the transport of amino acids and glucose , and also accelerates the processes of protein anabolism . In parallel, in the liver, the drug promotes the formation of glycogen from glucose , stimulates the transformation of excess glucose into fat , and inhibits gluconeogenesis .

The onset of action of Humulin NPH insulin is observed 60 minutes after administration, with maximum effectiveness achieved in the period from 2 to 8 hours and a duration of action within 18-20 hours.

Observed individual differences in insulin depend on the choice of dose, injection site, and physical activity of the patient.

Side effects

The main side effect is hypoglycemia , which in severe cases can cause loss of consciousness and even death (rarely).

Humulin NPH cartridge 100IU/ml 3ml No.5

A country

The country of production may vary depending on the batch of goods. Please check with the operator for detailed information when confirming your order.

Active substance

Insulin isophane [human genetically engineered]

Compound

Cartridge 3 ml
Neutral soluble biosynthetic human insulin 100 IU per 1 ml. Excipients: distilled m-cresol (2.5 mg/ml), glycerol, water, hydrochloric acid, sodium hydroxide.

pharmachologic effect

Humulin NPH is an intermediate-acting insulin preparation. The onset of action of the drug is 1 hour after administration, the maximum effect is between 2 and 8 hours, the duration of action is 18-20 hours. Individual differences in insulin activity depend on factors such as dose, choice of injection site, and physical activity of the patient.

Indications for use

— diabetes mellitus if there are indications for insulin therapy; — newly diagnosed diabetes mellitus; - pregnancy with type 2 diabetes mellitus (non-insulin dependent).

Mode of application

The doctor sets the dose individually depending on the glycemic level. The drug should be administered subcutaneously, possibly intramuscularly. IV administration of Humulin NPH is contraindicated! The drug is injected subcutaneously into the area of the shoulder, thigh, buttock or abdomen. The injection site must be alternated so that the same site is used no more than approximately 1 time per month. When administered subcutaneously, care must be taken to avoid entering a blood vessel. After the injection, do not massage the injection site. Patients should be trained in the correct use of insulin delivery devices. Rules for preparation and administration of the drug Vials of Humulin NPH before use should be rolled between the palms 10 times and rocked, turning 180° also 10 times to resuspend the insulin until it takes the form of a homogeneous cloudy liquid or milk. Do not shake vigorously as this may cause foam to appear, which may prevent the dose from being delivered correctly. Vials should be checked carefully. Do not use insulin if there are flakes in it after mixing, or if hard white particles have stuck to the bottom or walls of the bottle, creating a frosty pattern effect. The contents of the bottle should be drawn into an insulin syringe corresponding to the concentration of insulin administered, and the required dose of insulin should be administered as directed by the doctor. Using the outer needle cap, immediately after insertion, unscrew the needle and safely destroy it. Removing the needle immediately after injection ensures sterility and prevents leakage, air entrapment, and possible needle clogging. Needles should not be reused. Needles must not be used by others. The bottles are used until they are empty, after which they should be discarded. Humulin NPH can be administered in combination with Humulin Regular. To do this, short-acting insulin should be drawn into the syringe first to prevent longer-acting insulin from entering the vial. It is advisable to administer the prepared mixture immediately after mixing. To administer the exact amount of each type of insulin, you can use a separate syringe for Humulin Regular and Humulin NPH. You should always use an insulin syringe that matches the concentration of insulin being administered.

Interaction

The hypoglycemic effect is reduced by oral contraceptives, corticosteroids, thyroid hormone preparations, thiazide diuretics, diazoxide, tricyclic antidepressants. The hypoglycemic effect is enhanced by oral hypoglycemic drugs, salicylates (for example, acetylsalicylic acid), sulfonamides, MAO inhibitors, beta-blockers, ethanol and ethanol-containing drugs. Beta-blockers, clonidine, reserpine can mask the symptoms of hypoglycemia.

Side effect

Side effect associated with the main effect of the drug: hypoglycemia. Severe hypoglycemia can lead to loss of consciousness and (in exceptional cases) death. Allergic reactions: local allergic reactions are possible - hyperemia, swelling or itching at the injection site (usually disappear within a period of several days to several weeks); systemic allergic reactions (occur less frequently, but are more serious) - generalized itching, difficulty breathing, shortness of breath, decreased blood pressure, increased heart rate, increased sweating. Severe cases of systemic allergic reactions can be life-threatening. Other: the likelihood of developing lipodystrophy is minimal.

Contraindications

- Hypoglycemia.
- Hypersensitivity to insulin or to one of the components of the drug. Use during pregnancy and lactation During pregnancy, it is especially important to maintain good glycemic control in patients with diabetes mellitus. During pregnancy, the need for insulin usually decreases in the first trimester and increases in the second and third trimesters. Patients with diabetes are advised to inform their doctor about the onset or planning of pregnancy. In patients with diabetes mellitus during lactation (breastfeeding), adjustments in the dose of insulin, diet, or both may be required. In in vitro and in vivo genetic toxicity studies, human insulin did not have a mutagenic effect.

Overdose

Symptoms: hypoglycemia, accompanied by lethargy, increased sweating, tachycardia, pale skin, headache, trembling, vomiting, confusion. Under certain conditions, such as long-term diabetes or intensive control of diabetes, the warning symptoms of hypoglycemia may change. Treatment: Mild hypoglycemia can usually be treated with oral glucose (dextrose) or sugar. Adjustments to your insulin dose, diet, or physical activity may be necessary. Correction of moderate hypoglycemia can be carried out using intramuscular or subcutaneous administration of glucagon followed by oral carbohydrates. Severe conditions of hypoglycemia, accompanied by coma, convulsions or neurological disorders, are treated with intramuscular or subcutaneous administration of glucagon or intravenous administration of a concentrated solution of glucose (dextrose). After regaining consciousness, the patient must be given food rich in carbohydrates to avoid re-development of hypoglycemia.

special instructions

In case of damage or loss of the pen-injector or cartridge, it is recommended to have an insulin preparation with you (any replacement of insulin should be done with caution and only under the supervision of a physician) in a bottle and a syringe for administering the drug. Transferring a patient to another type of insulin or to an insulin preparation with a different trade name should occur under strict medical supervision. Changes in insulin activity, insulin type (eg, M3, NPH), type (porcine, human insulin, human insulin analog), or production method (DNA recombinant insulin or animal insulin) may require dosage adjustments. The need for dose adjustment may be required as early as the first administration of a human insulin product after an animal insulin product or gradually over several weeks or months after the transfer. The need for insulin may be reduced if there is insufficient function of the adrenal glands, pituitary gland or thyroid gland, or with renal or liver failure. With some illnesses or emotional stress, the need for insulin may increase. Dose adjustments may also be required if you increase physical activity or change your usual diet. Symptoms that are precursors of hypoglycemia during the administration of human insulin in some patients may be less pronounced or different from those observed during the administration of animal insulin. When blood glucose levels are normalized, for example as a result of intensive insulin therapy, all or some of the symptoms that are precursors of hypoglycemia may disappear, of which patients should be informed. Symptoms that predict hypoglycemia may change or be less pronounced with long-term diabetes mellitus, diabetic neuropathy, or with the simultaneous use of beta-blockers. In some cases, local allergic reactions may be caused by reasons unrelated to the action of the drug, for example, skin irritation by the cleansing agent or improper injection. In rare cases of systemic allergic reactions, immediate treatment is required. Sometimes it may be necessary to change insulin or carry out desensitization. Insulin requirements may be reduced in liver failure. Insulin requirements may be reduced in renal failure. Impact on the ability to drive vehicles and operate machinery: during hypoglycemia, the patient’s ability to concentrate may deteriorate and the speed of psychomotor reactions may decrease. This can be dangerous in situations where these abilities are especially needed (driving a car or operating machinery). Patients should be advised to take precautions to avoid hypoglycemia while driving. This is especially important for patients with mild or absent warning signs of hypoglycemia or who frequently develop hypoglycemia. In such cases, the doctor should evaluate the advisability of the patient driving a car.

Dispensing conditions in pharmacies

On prescription

Instructions for use Humulin NPH

The dosage of Humulin NPH is selected individually, depending on glycemic .

IV injections of Humulin NPH are prohibited!

The emulsion should be administered subcutaneously; in some cases, intramuscular injections are allowed. Subcutaneous injection is carried out in the abdomen, shoulder, buttock or thigh. The injection sites should be alternated so that no more than one injection is given at one site over a 30-day period.

Subcutaneous injections require certain administration skills and precautions. It is necessary to avoid getting the needle into the blood vessels, not to massage the injection site, and also to handle the devices for administering the drug correctly.

Preparation and administration of Humulin NPH

In order to resuspend insulin , before use, it is recommended to roll the vials and cartridges of the drug Humulin NPH 10 times in the palms and shake the same number of times (rotating 180°) until the drug acquires a state close to milk or a homogeneous liquid of a turbid shade. The drug should not be shaken vigorously, as the foam formed in this way may interfere with the exact dose.

Vials and cartridges must be checked with special care. Avoid using insulin with flakes of sediment or white particles adhering to the sides or bottom of the vial, giving the appearance of a frosty pattern.

The design of the cartridge does not allow its contents to be mixed with other insulins , as well as the cartridge itself not to be refilled.

When using vials, the emulsion is drawn into an insulin syringe that corresponds in volume to the insulin (for example, 100 IU/1 ml of insulin = 1 ml syringe) and administered in accordance with the doctor’s recommendations.

When using cartridges, you must follow the instructions of the pen manufacturer for installing them, attaching the needle, and administering insulin, for example, instructions for Humulin NPH in the KwikPen syringe pen.

Immediately after the injection, you should use the outer needle cap to remove the needle itself and destroy it in a safe manner, then close the pen with the cap. This procedure ensures further sterility, prevents the entry of air, and prevents leakage of the drug and its possible clogging.

Needles and syringe pens cannot be reused or used by others. Vials and cartridges are used once until the drug is completed, and then discarded.

It is possible to administer Humulin NPH in combination with Humulin Regular . For this purpose, in order to prevent longer-acting insulin insulin . This mixture is recommended to be administered immediately after mixing. To accurately dose the two insulins, different syringes may be used.

Humulin NPH, 100 IU/ml, suspension for subcutaneous administration, 3 ml, 5 pcs.

PC,

in the area of the shoulder, thigh, buttock or abdomen. IM administration is allowed.

The dose of Humulin® NPH is determined by the doctor individually, depending on the concentration of glucose in the blood. IV administration of Humulin® NPH is contraindicated.

The temperature of the administered drug should be at room temperature. Injection sites should be rotated so that the same site is used no more than approximately once a month. When administering insulin subcutaneously, care must be taken not to enter a blood vessel. After the injection, do not massage the injection site.

Patients should be trained in the correct use of the insulin delivery device. The insulin administration regimen is individual.

Preparing for the introduction

For the drug Humulin® NPH in vials.

Immediately before use, vials of Humulin® NPH must be rolled between the palms several times until the insulin is completely resuspended until it takes the form of a homogeneous cloudy liquid or milk. Do not shake vigorously as this may cause foam to appear, which may prevent the dose from being delivered correctly. Do not use insulin if, after mixing, there are flakes or hard white particles stuck to the bottom or walls of the bottle, creating a frosty pattern effect. Use an insulin syringe that matches the concentration of insulin injected.

For the drug Humulin® NPH in cartridges.

Immediately before use, Humulin® NPH cartridges should be rolled between the palms 10 times and rocked, turning 180° also 10 times until the insulin is completely resuspended until it takes the form of a homogeneous cloudy liquid or milk. Do not shake vigorously as this may cause foam to appear, which may prevent the dose from being delivered correctly. Inside each cartridge there is a small glass ball that makes it easier to mix the insulin. Do not use insulin if there are flakes in it after mixing. The design of the cartridges does not allow mixing their contents with other insulins directly in the cartridge itself. Cartridges are not intended to be refilled. Before giving the injection, you must read the manufacturer's instructions for using a syringe pen for administering insulin.

For the drug Humulin® NPH in the KwikPen™ syringe pen.

Before performing an injection, you must read the Instructions for Use of the KwikPen™ syringe pen.

Instructions for using the KwikPen™ syringe pen

The KwikPen™ syringe pen is easy to use. It is a device for administering insulin (insulin syringe pen) containing 3 ml (300 units) of an insulin preparation with an activity of 100 IU/ml. You can administer from 1 to 60 units of insulin per injection. You can set the dose with an accuracy of one unit. If too many units are set, the dose can be adjusted without losing insulin. The QuickPen™ syringe pen is recommended for use with needles manufactured by Becton, Dickinson and Company (BD)

for syringe pens. Before using the pen, you must ensure that the needle is completely attached to the pen.

In the future, the following rules should be followed.

1. Follow the rules of asepsis and antisepsis recommended by the attending physician.

2. Wash your hands.

3. Select the injection site.

4. Wipe the skin at the injection site.

5. Rotate injection sites so that the same site is used no more than approximately once a month.

Preparation of the KwikPen™ syringe pen and administration

1. Pull the pen cap to remove it. Do not rotate the cap. Do not remove the label from the syringe pen. Make sure the insulin is checked for insulin type; expiration date; appearance. Carefully roll the pen 10 times between your palms and turn the pen over 10 times.

2. Take a new needle. Remove the paper sticker from the outer needle cap. Use an alcohol swab to wipe the rubber disc at the end of the cartridge holder. Place the needle in the cap straight along the axis onto the syringe pen. Screw the needle until completely connected.

3. Remove the outer cap from the needle. Don't throw it away. Remove the inner needle cap and discard it.

4. Check the KwikPen™ syringe pen for insulin supply. You should check your insulin supply every time. Checking the delivery of insulin from the pen should be performed before each injection until a stream of insulin appears to ensure that the pen is ready to administer a dose.

If you do not check your insulin before the trickle appears, you may receive too little or too much insulin.

5. Fix the skin by stretching it or gathering it into a large fold. Insert the needle subcutaneously using the injection technique recommended by the attending physician. Place your thumb on the dose button and press firmly until it stops completely. To administer a full dose, hold the dose button and slowly count to 5.

6. Remove the needle and gently press the injection site with a cotton swab for a few seconds. Do not rub the injection site. If insulin drips from the needle, the patient most likely did not hold the needle under the skin long enough. It is normal to have a drop of insulin at the tip of the needle and will not affect your dose.

7. Using the needle protective cap, unscrew the needle and discard it.

Even numbers are printed in the dose indicator window as numbers, odd numbers are printed as straight lines between even numbers.

If the dose required to deliver exceeds the number of units remaining in the cartridge, you can inject the remaining amount of insulin in the pen and then use a new pen to complete the required dose, or administer the entire dose required using a new pen.

Do not attempt to inject insulin by rotating the dose button. The patient will not receive insulin if he rotates the dose button. It is necessary to press the dose button along a straight axis in order to receive a dose of insulin.

Do not try to change the insulin dose during the injection.

Note.

The pen will not allow the patient to set an insulin dose greater than the number of units remaining in the pen. If you are not sure that the full dose has been administered, do not administer another one. You should read and follow the instructions contained in the instructions for use of the drug. The label on the pen should be checked before each injection to ensure that the drug has not expired and that the patient is using the correct type of insulin; Do not remove the label from the syringe pen.

The color of the dose button of the QuickPen™ syringe pen corresponds to the color of the stripe on the label of the syringe pen and depends on the type of insulin. In this manual, the dose button is shown in gray. The beige color of the body of the QuickPen™ syringe pen indicates that it is intended for use with the Humulin® line of drugs.

Storage and disposal

The syringe pen cannot be used if it has been out of the refrigerator for more than the time specified in the instructions for use.

Do not store a pen with a needle attached to it. If the needle is left attached, insulin may leak out of the pen, the insulin may dry out inside the needle, causing the needle to become clogged, or air bubbles may form inside the cartridge.

Syringe pens that are not in use should be stored in the refrigerator at a temperature of 2 to 8 °C. Do not use the pen if it has been frozen.

The pen currently in use should be stored at room temperature, away from heat and light, and out of the reach of children.

Dispose of used needles in a puncture-resistant, lockable container (such as a biohazard or waste container), or as directed by your healthcare provider.

The needle must be removed after each injection.

Dispose of used pens without needles attached as directed by your healthcare provider and in accordance with local medical waste disposal regulations.

Do not recycle a filled sharps container.

Overdose

As such, there is no specific overdose of Humulin NPH. Symptoms are considered to be manifestations of hypoglycemia , accompanied by increased sweating , lethargy, tachycardia , headache, pale skin, trembling , confusion , and vomiting.

In some cases, the symptoms that precede hypoglycemia ( long-term diabetes or its intensive control) may change.

Manifestations hypoglycemia are usually relieved by oral intake of sugar or glucose ( dextrose ). In the future, you may need to adjust your diet, insulin , or physical activity.

Correction of hypoglycemia is carried out by subcutaneous or intramuscular injection of glucagon , followed by oral intake of carbohydrates .

Manifestations of severe hypoglycemia may be accompanied by coma , neurological disorders or seizures , which are localized by intravenous injection of concentrated glucose ( dextrose ) or subcutaneous or intramuscular administration of glucagon . In the future, in order to prevent recurrence of symptoms, it is necessary to eat foods rich in carbohydrates .

Instructions for use HUMULIN REGULAR

Transferring a patient to another type or insulin preparation with a different trade name should occur under strict medical supervision. A change in insulin activity, brand (manufacturer), type (Regular, NPH, M3, etc.), species (animal, human, analogue of human insulin) and/or production method (DNA recombinant insulin or insulin of animal origin) can lead to to the need for dose adjustment.

For some patients, when switching from animal insulin to human insulin, it may be necessary to adjust the dose. This may occur as early as the first time a human insulin product is administered, or gradually over several weeks or months after the transfer.

Symptoms that are precursors of hypoglycemia during the administration of human insulin in some patients may be less pronounced or different from those observed during the administration of animal insulin. When blood glucose levels are normalized, for example, as a result of intensive insulin therapy, all or some of the symptoms that are precursors of hypoglycemia may disappear, about which patients should be informed. Symptoms that are warning signs of hypoglycemia may change or be less pronounced with prolonged diabetes mellitus, diabetic neuropathy, or treatment with drugs such as beta-blockers. Failure to promptly correct hypoglycemic or hyperglycemic reactions can lead to loss of consciousness, coma or death.

The use of inadequate doses or discontinuation of treatment, especially in patients with insulin-dependent diabetes mellitus, can lead to hyperglycemia and diabetic ketoacidosis (conditions that are potentially life-threatening to the patient).

Treatment with Humulin Regular can cause the formation of antibodies, but antibody titers to human insulin are lower than to purified animal insulin. The need for insulin may be reduced if there is insufficiency of the adrenal glands, pituitary gland or thyroid gland, or with renal or liver failure.

With some illnesses or emotional stress, the need for insulin may increase.

Insulin dosage adjustments may also be necessary if you increase your physical activity or change your usual diet.

Combined use with pioglitazone

Cases of heart failure have been reported when pioglitazone was used in combination with insulin, especially in patients with risk factors for heart failure. If insulin is used in combination with pioglitazone, patients should be monitored for signs and symptoms of heart failure, weight gain, and edema. Treatment with pioglitazone should be discontinued if there is any worsening of cardiac symptoms.

Children

The dose, administration schedule and number of injections for children are determined by the doctor, based on individual needs and in accordance with the specific case.

Effect on the ability to drive a car and other mechanical means

During hypoglycemia, the patient's concentration and speed of psychomotor reactions may decrease. This can be dangerous in situations where these abilities are particularly needed (for example, driving a car or operating machinery).

Patients should be advised to take precautions to avoid hypoglycemia while driving. This is especially important for patients with mild or absent symptoms that are precursors to hypoglycemia or with frequent occurrence of hypoglycemia. In such cases, the doctor should evaluate the advisability of the patient driving a car.

Interaction

The hypoglycemic effectiveness of Humulin NPH decreases with concomitant use oral contraceptives , thyroid hormones, glucocorticoids , thiazide diuretics , tricyclic antidepressants , Diazoxide .

The combined use of ethanol , hypoglycemic drugs (oral), salicylates , MAO inhibitors, sulfonamides , beta-blockers enhance the hypoglycemic effects of Humulin NPH.

Reserpine , clonidine and beta-blockers can alleviate the symptoms of hypoglycemia.

special instructions

decide whether to switch the patient to another drug or type of insulin . This change must take place under strict control of the patient's condition.

A change in the type of insulin activity (Regular , M3 , etc.), its type ( human , porcine , analogue ) or production method ( animal origin or DNA recombinant ) may require dose adjustments, both at the first administration and during therapy , gradually over weeks or months.

Insulin dependence may decrease with insufficiency of kidney , pituitary, adrenal , thyroid, and liver .

With emotional stress and certain pathologies, there may be an increased need for insulin .

Sometimes dosage adjustments are appropriate when changing your diet or increasing your physical activity .

In some patients, when using human insulin , the symptoms preceding hypoglycemia may differ from those when using animal insulin or be less severe.

Normalization of plasma glucose levels , due to intensive insulin therapy , leads to the disappearance of all or some manifestations of hypoglycemia , about which the patient must be informed.

Symptoms of advancing hypoglycemia may be smoothed out or changed in the case of concurrent use of beta-blockers , diabetic neuropathy or prolonged diabetes mellitus .

In some cases, local allergic manifestations may develop for reasons unrelated to the effects of the drug (for example, skin irritations due to the use of a cleansing agent or improper injection).

Rarely, systemic allergic reactions may require immediate therapy ( desensitization or insulin replacement ).

Due to the potential for symptoms of hypoglycemia , every precaution should be taken when performing hazardous work or driving a vehicle.

Description of the drug HUMULIN® NPH (HUMULIN® NPH)

Transferring a patient to another type of insulin or to an insulin preparation with a different trade name should occur under strict medical supervision.

Changes in insulin activity, insulin type, species (porcine, human insulin, human insulin analogue) or production method (DNA recombinant insulin or animal insulin) may require dose adjustment.

The need for dose adjustment may be required as early as the first administration of a human insulin product after an animal insulin product or gradually over several weeks or months after the transfer.

The need for insulin may be reduced if there is insufficient function of the adrenal glands, pituitary gland or thyroid gland, or with renal or liver failure.

With some illnesses or emotional stress, the need for insulin may increase.

Dose adjustments may also be necessary if you increase your physical activity or change your usual diet.

Symptoms that predict hypoglycemia may change or be less pronounced with long-term diabetes mellitus, diabetic neuropathy, or with the simultaneous use of beta-blockers.

In some cases, local allergic reactions may be caused by reasons unrelated to the action of the drug, for example, skin irritation by the cleansing agent or improper injection.

In rare cases of systemic allergic reactions, immediate treatment is required. Sometimes it may be necessary to change insulin or carry out desensitization.

Impact on the ability to drive vehicles and operate machinery

During hypoglycemia, the patient's ability to concentrate may deteriorate and the speed of psychomotor reactions may decrease. This can be dangerous in situations where these abilities are especially needed (driving a car or operating machinery). Patients should be advised to take precautions to avoid hypoglycemia while driving. This is especially important for patients with mild or absent warning signs of hypoglycemia or who frequently develop hypoglycemia. In such cases, the doctor should evaluate the advisability of the patient driving a car.

Humulin NPH price, where to buy

You can buy Humulin NPH on average: 10 ml bottle No. 1 – 550 rubles; cartridges 3 ml No. 5 – 1500 rubles.

Online pharmacies in RussiaRussia
Online pharmacies in UkraineUkraine

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