INSULIN

Brand & Generic Names

Humulin BR	NPH Insulin
Humulin L	Protamine Zinc & Iletin
Humulin N	Protamine Zinc & Iletin I
Humulin R	Protamine Zinc & Iletin II
Humulin U	PZI
Insulatard NPH	Regular
Insulatard NPH Human	Regular (Concentrated)
Lente	Iletin
Lente Iletin I	Regular (Concentrated)
Lente Iletin II	Iletin II, U-500
Lente Insulin	Regular Iletin I
Mixtard	Regular Iletin II
Mixtard Human	Regular Insulin
Novolin 70/30	Semilente
Novolin L	Semilente Iletin
Novolin N	Semilente Iletin I
Novolin R	Ultralente
NPH	Ultralente Iletin I
NPH Iletin I	Velosulin
NPH Iletin II	Velosulin Human

Basic Information

• Habit forming? No
• Prescription needed? No
• Available as generic? No
• Drug class: Antidiabetic

Uses

Controls diabetes, a complex metabolic disorder, in which the body does not manufacture insulin.

Dosage & Usage Information

How to take:
Must be taken by injection under the skin. Use disposable, sterile needles. Rotate injection sites.

When to take:
At the same time each day.

If you forget a dose:
Take as soon as you remember. Wait at least 4 hours for next dose. Resume regular schedule.

What drug does:
Facilitates passage of blood sugar through cell membranes so sugar is usable.

Time lapse before drug works:
30 minutes to 8 hours, depending on type of insulin used.

Don't take with:
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Low blood sugar (hypoglycemia)--Anxiety; chills, cold sweats, pale skin; drowsiness; excess hunger; headache; nausea; nervousness; fast heartbeat; shakiness; unusual tiredness or weakness.

WHAT TO DO:

• Eat some type of sugar immediately, such as orange juice, honey, sugar cubes, crackers, sandwich.
• If patient loses consciousness, give glucagon if you have it and know how to use it.
• Otherwise, dial 0 (operator) or 911 (emergency) for an ambulance or medical help. Then give first aid immediately.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Hives, rash, intense Seek emergency itching, faintness treatment immediately. soon after a dose (anaphylaxis).

Common:

Symptoms of low blood sugar--Nervousness, hunger (excessive), cold sweats, rapid pulse, anxiety, cold skin, chills, confusion, concentration loss, drowsiness, headache, nausea, weakness, shakiness, vision changes.

Infrequent:

• Hives.
• Swelling, redness, itch at injection site.

Rare:

None expected.

Warnings & Precautions

Don't take if:

• Your diagnosis and dose schedule is not established.
• You don't know how to deal with overdose emergencies.

Before you start, consult your doctor:

• If you are allergic to insulin.
• If you take MAO inhibitors.
• If you have liver or kidney disease or low thyroid function.

Over age 60:
Guard against hypoglycemia. Repeated episodes can cause permanent confusion and abnormal behavior.

Pregnancy:
Possible drug benefits outweigh risk to unborn child. Adhere rigidly to diabetes treatment program.

Breast-feeding:
No problems expected. Consult doctor.

Infants & children:
Use only under medical supervision.

Prolonged use:
Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood sugar, serum potassium, urine.

Skin & sunlight:
No problems expected.

Driving, piloting or hazardous work:
No problems expected after dose is established.

Discontinuing:
Don't discontinue without doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:

• Diet and exercise affect how much insulin you need. Work with your doctor to determine accurate dose.
• Notify your doctor if you skip a dose, overeat, have fever or infection.
• Notify doctor if you develop symptoms of high blood sugar: drowsiness, dry skin, orange fruit-like odor to breath, increased urination, appetite loss, unusual thirst.
• Never freeze insulin.
• May interfere with the accuracy of some medical tests.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Anticonvulsants,	Decreased insulin
hydantoin*	effect.
Antidiabetics*,	Increased antibiabetic
oral	effect.
Beta-adrenergic	Possible increased difficulty
blockers*	in regulating blood sugar levels.
Bismuth	Increased insulin effect. May
subsalicylate	require dosage adjustment.
Carteolol	Hypoglycemic effects may be
	prolonged.
Contraceptives*,	Decreased insulin
oral	effect.
Cortisone drugs*	Decreased insulin effect.
Diuretics*	Decreased insulin effect.
Furosemide	Decreased insulin effect.
MAO inhibitors*	Increased insulin effect.
Nicotine gum	Increased insulin
and other smoking	effect.
Oxyphenbutazone	Increased insulin effect.
Phenylbutazone	Increased insulin effect.
Salicylates*	Increased insulin effect.
Smoking deterrents	May require insulin dosage adjustment.
Sotalol	Hypoglycemic effects may be
	prolonged.
Sulfa drugs*	Increased insulin effect.
Tetracyclines*	Increased insulin effect.
Thyroid hormones*	Decreased insulin effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	Increased insulin effect. May cause
	hypoglycemia and brain damage.
Beverages:	None expected.
Cocaine:	May cause brain damage.
Foods:	None expected.
Marijuana:	Possible increase in blood sugar.
Tobacco:	None expected.