Indication

Diabetes mellitus

Administration

Administer within 15 minutes before a meal or immediately after a meal. \r\nAdminister subcutaneously in the upper arm, thigh or abdominal wall. A subcutaneous injection into the abdominal wall results in a faster absorption than from other injection sites.\r\nNPH Insulin suspensions are never to be administered intravenously.

Adult Dose

$4e

Child Dose

Type 1 Diabetes Mellitus\r\n<12 years: Safety and efficacy not established\r\n\r\n>12 years: Suggested dose is 0.5-1 unit/kg/day SC; use adult dosing; \r\nusual daily maintenance range in adolescents is <1.2 units/kg/day during growth spurts

Renal Dose

Renal impairment: Dose adjustments may be needed.

Contraindication

Hypoglycaemia. Hypersensitivity to any of the components.

Mode of Action

$4f

Precaution

Pregnancy (insulin requirements tend to fall during the 1st trimester, increase during the 2nd and 3rd) and lactation. Caution with decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment\r\nHypokalemia may occur\r\nNot for IV or IM administration\r\nUse with caution in renal and hepatic impairment (dosage requirements may be reduced)\r\nCaution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery\r\n\r\nLactation: Safe to use while breastfeeding

Side Effect

Allergic reactions. Injection site reaction, lipodystrophy, pruritus, rash, lipoatrophy, hypokalaemia, blurred vision. Hypoglycaemia, insulin resistance

Interaction

Possible absence of hypoglycaemic warning symptoms with beta-blockers. Decreased hypoglycaemic effect with corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetic agents, thyroid hormones, oestrogens, progestins (e.g. in oral contraceptives), protease inhibitors and atypical antipsychotic (e.g. olanzapine and clozapine). Increased hypoglycaemic effect with oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates and sulfonamide antibiotics. Decreased insulin resistance with octreotide and lanreotide. Increased risk of wt gain and peripheral oedema with pioglitazone, rosiglitazone. Decreased effect of sermorelin.