Insulin (Human) N
Indications
Insulin (Human) N, also called NPH or isophane insulin, is an intermediate-acting insulin used to control blood sugar in people with diabetes mellitus, both type 1 and type 2, when insulin is needed. It is often combined with a short-acting (regular) insulin or with diabetes tablets.
How It Works
Insulin is the hormone that moves sugar (glucose) from the blood into the body's cells to be used for energy, and stops the liver from releasing too much sugar. NPH insulin is human insulin combined with a protein called protamine, which slows its absorption. It usually starts working in 1 to 2 hours, has its strongest effect at about 4 to 12 hours, and lasts up to about 18 to 24 hours.
Dosage and Administration
The dose is worked out by your doctor for you and is adjusted according to your blood sugar readings, diet and activity; use exactly as prescribed. It is injected under the skin (subcutaneously) of the abdomen, thigh, upper arm or buttock, usually once or twice a day. Before use, gently roll and tip the vial or pen about 10 to 20 times until the liquid is evenly cloudy; do not shake hard. Change the injection spot each time. Never inject it into a vein. Your nurse or doctor will teach you how to inject and check your blood sugar.
Interactions
Many medicines change blood sugar. Other diabetes medicines, alcohol, some antibiotics and ACE inhibitors can lower it further. Steroids such as Prednisolone, thiazide diuretics, thyroid hormones, some antipsychotics and the oral contraceptive pill can raise it, so more insulin may be needed. Beta blockers such as Propranolol can hide the warning signs of low blood sugar. Pioglitazone with insulin can increase fluid retention. Tell your doctor about all medicines you take.
Contraindications
Do not inject insulin when your blood sugar is low (hypoglycaemia), or if you are allergic to human insulin or any ingredient in the product.
Side Effects
The most common side effect is low blood sugar, with sweating, shaking, hunger, fast heartbeat, headache, confusion or irritability. Others include redness, swelling or itching at the injection site, lumps or dents under the skin from injecting in the same spot, weight gain and mild swelling of the ankles. Low potassium can occur rarely.
Get urgent medical help for severe low blood sugar (confusion, fits, unconsciousness), or for signs of a serious allergic reaction such as rash all over the body, swelling of the face or trouble breathing. If you have low blood sugar symptoms, take sugar, glucose tablets or a sweet drink at once, then eat a snack.
Pregnancy and Lactation
Human insulin is a preferred treatment for diabetes during pregnancy and is safe while breastfeeding. Insulin needs usually change during pregnancy and after delivery, so blood sugar must be checked closely with your doctor.
Precautions and Warnings
Check your blood sugar regularly. Skipping meals, extra exercise, alcohol, illness, vomiting or kidney and liver problems can change how much insulin you need. Always carry sugar or glucose. Never share insulin pens or needles. Do not switch insulin type or brand without medical advice. Be careful when driving if you are prone to low blood sugar.
Overdose
Too much insulin causes low blood sugar, which can be severe and lead to fits or unconsciousness. For mild symptoms, take sugar straight away. If the person is unconscious, do not give food or drink by mouth; get emergency help, where glucose injection or glucagon may be given.
Therapeutic Class
Antidiabetic agent, intermediate-acting human insulin (NPH).
Storage
Store unopened vials, cartridges and pens in a refrigerator at 2 to 8°C; do not freeze. The vial or pen in use can be kept below 25 to 30°C for up to 4 to 6 weeks as stated on the pack, away from heat and direct light. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.
All brands of Insulin (Human) N