Novolin N Innolet
"Miriam E. Tucker
Medscape Medical News
The U.S. Food and Drug Administration (FDA) will now require a "for single patient use only" warning on all multidose pen devices used for injectable diabetes medications.
Novolin N Innolet
ANY CHANGE OF INSULIN SHOULD BE MADE CAUTIOUSLY AND ONLY UNDER MEDICAL SUPERVISION. CHANGES IN PURITY, STRENGTH, BRAND (MANUFACTURER), TYPE (REGULAR, NPH, LENTE®, ETC.), SPECIES (BEEF, PORK, BEEF-PORK, HUMAN), AND/OR METHOD OF MANUFACTURE (RECOMBINANT DNA VERSUS ANIMAL-SOURCE INSULIN) MAY RESULT IN THE NEED FOR A CHANGE IN DOSAGE.
SPECIAL CARE SHOULD BE TAKEN WHEN THE TRANSFER IS FROM A STANDARD BEEF OR MIXED SPECIES INSULIN TO A PURIFIED PORK OR HUMAN INSULIN. IF A DOSAGE ADJUSTMENT IS NEEDED, IT WILL USUALLY BECOME APPARENT EITHER IN THE FIRST FEW DAYS OR OVER A PERIOD OF SEVERAL WEEKS. ANY CHANGE IN TREATMENT SHOULD BE CAREFULLY MONITORED.
PLEASE READ THE SECTIONS "INSULIN REACTION AND SHOCK" AND "DIABETIC KETOACIDOSIS AND COMA" FOR SYMPTOMS OF HYPOGLYCEMIA (LOW BLOOD GLUCOSE) AND HYPERGLYCEMIA (HIGH BLOOD GLUCOSE).
Failure to comply with the following antiseptic measures may lead to infections at the injection site.
- Disposable needles are for single use; they should be used only once and destroyed.
- Clean your hands and the injection site with soap and water or with alcohol.
- Wipe the rubber stopper on the insulin cartridge with an alcohol swab.
Preparing The Injection
Never place a single-use disposable needle on your Novolin N InnoLet (nph, human insulin isophane suspension 3 ml disposable prefilled syringe) until you are ready to give an injection, and remove the needle immediately after each injection. Follow the directions for use of the Novolin N InnoLet (nph, human insulin isophane suspension 3 ml disposable prefilled syringe) on the reverse side of this insert.
Novolin N InnoLet (nph, human insulin isophane suspension 3 ml disposable prefilled syringe) may contain a small amount of air. To prevent an injection of air and make certain insulin is delivered, an air shot must be done before each injection. Directions for performing an air shot are provided on the reverse side of this insert.
Giving The Injection
- The following areas are suitable for subcutaneous insulin injection: thighs, upper arms, buttocks, abdomen. Do not change areas without consulting your physician. The actual point of injection should be changed each time; injection sites should be about an inch apart.
- The injection site should be clean and dry. Pinch up skin area to be injected and hold it firmly.
- Hold the device upright and push the needle quickly and firmly into the pinched-up area. Release the skin and push the push-button all the way in to inject insulin beneath the skin. After the injection, the needle should remain under the skin for at least 6 seconds. Keep the push-button fully depressed until the needle is withdrawn from the skin. This will ensure that the full dose has been delivered.
- Do not inject into a muscle unless your physician has advised it. You should never inject insulin into a vein.
- Remove the needle. If slight bleeding occurs, press lightly with a dry cotton swab for a few seconds - do not rub.
For additional information see Giving the injection on the reverse side of this insert.
Usage In Pregnancy
It is particularly important to maintain good control of your diabetes during pregnancy and special attention must be paid to your diet, exercise and insulin regimens. If you are pregnant or nursing a baby, consult your physician or nurse educator.
Insulin Reaction And Shock
Insulin reaction (hypoglycemia) occurs when the blood glucose falls very low. This can happen if you take too much insulin, miss or delay a meal, exercise more than usual or work too hard without eating, or become ill (especially with vomiting or fever).
Hypoglycemia can also happen if you combine insulin therapy and other medications that lower blood glucose, such as oral antidiabetic agents or other prescription and over-the-counter drugs. The first symptoms of an insulin reaction usually come on suddenly. They may include a cold sweat, fatigue, nervousness or shakiness, rapid heartbeat, or nausea.
Personality change or confusion may also occur. If you drink or eat something right away (a glass of milk or orange juice, or several sugar candies), you can often stop the progression of symptoms. If symptoms persist, call your physician - an insulin reaction can lead to unconsciousness. If a reaction results in loss of consciousness, emergency medical care should be obtained immediately. If you have had repeated reactions or if an insulin reaction has led to a loss of consciousness, contact your physician.
Severe hypoglycemia can result in temporary or permanent impairment of brain function and death.
In certain cases, the nature and intensity of the warning symptoms of hypoglycemia may change. A few patients have reported that after being transferred to human insulin, the early warning symptoms of hypoglycemia were less pronounced than they had been with animal-source insulin.
Diabetic Ketoacidosis And Coma
Diabetic ketoacidosis may develop if your body has too little insulin. The most common causes are acute illness or infection or failure to take enough insulin by injection. If you are ill you should check your urine for ketones. The symptoms of diabetic ketoacidosis usually come on gradually, over a period of hours or days, and include a drowsy feeling, flushed face, thirst and loss of appetite. Notify your physician right away if the urine test is positive for ketones (acetone) or if you have any of these symptoms. Fast, heavy breathing and rapid pulse are more severe symptoms and you should have medical attention right away. Severe, sustained hyperglycemia may result in diabetic coma and death.
- A change in the type, strength, species or purity of insulin could require a dosage adjustment. Any change in insulin should be made under medical supervision.
- To avoid possible transmission of disease, Novolin N InnoLet (nph, human insulin isophane suspension 3 ml disposable prefilled syringe) is for single-person use only.
- You may have learned how to test your urine or your blood for glucose. It is important to do these tests regularly and to record the results for review with your physician or nurse educator.
- If you have an acute illness, especially with vomiting or fever, continue taking your insulin. If possible, stay on your regular diet. If you have trouble eating, drink fruit juices, regular soft drinks, or clear soups; if you can, eat small amounts of bland foods. Test your urine for glucose and ketones and, if possible, test your blood glucose. Note the results and contact your physician for possible insulin dose adjustment. If you have severe and prolonged vomiting, seek emergency medical care.
- You should always carry identification which states that you have diabetes.
- Always ask your physician or pharmacist before taking any drug.
Always consult your physician if you have any questions about your condition or the use of insulin.This monograph has been modified to include the generic and brand name in many instances.
Last reviewed on RxList: 3/27/2009
Additional Novolin N Innolet Information
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