Insulatard Penfill 100IU/ml

Indications

All people with type 1 diabetes should be treated. Diet and/or oral hypoglycemic medications are ineffective in treating patients with type 2 diabetes. Patients with diabetic ketoacidosis, hyperosmolar non-ketotic syndrome, and diabetic patients who are under stress from serious infections or extensive surgery. Diabetic pregnancy treatment

Pharmacology

After interacting to insulin receptors on muscle and fat cells, insulin increases glucose absorption, while simultaneously inhibiting glucose production from the liver. Insulatard is an insulin with a long-acting time. The activity begins within 112 hours, reaches its greatest effect within 4-12 hours, and lasts for around 24 hours in total.

Insulin's half-life in the blood stream is only a few minutes. As a result, the absorption parameters of an insulin formulation affect its time-action profile.

Dosage & Administration

Dosage is individual and determined in accordance with the needs of the patient. The individual insulin requirement is usually between 0.3 and 1.0 IU/kg day. The daily insulin requirement may be higher in patients with insulin resistance (e.g. during puberty or due to obesity) and lower in patients with residual, endogenous insulin production.

The physician determines one or several daily injections are necessary. Insulatard may be used alone or mixed with fast-acting insulin. In intensive insulin therapy the suspension may be used as basal insulin (evening and/or morning injection) with fast-acting insulin given at meals. In patients with diabetes mellitus optimised glycaemic control delays the onset of late diabetic complications. Close blood glucose monitoring is recommended.

For subcutaneous use. Insulatard is usually administered subcutaneously in the thigh. If convenient, the abdominal wall, the gluteal region or the deltoid region may also be used. Subcutaneous injection into the thigh results in a slower and less variable absorption compared to the other injection sites. Injection into a lifted skin fold minimises the risk of unintended intramuscular injection.

Keep the needle under the skin for at least 6 seconds to make sure the entire dose is injected. Injection sites should be rotated within an anatomic region in order to avoid lipodystrophy. Insulin suspensions are never to be administered intravenously. Insulatard is accompanied by a package leaflet with detailed instruction for use to be followed. The vials are for use with insulin syringes with corresponding unit scale. When two types of insulin are mixed, draw the amount of fast-acting insulin first, followed by the amount of long-acting insulin

Interactions

Many pharmaceuticals are known to interact with glucose metabolism. Therefore, physicians should consider possible interactions and should always ask patients about the medications they take. 
 

The following substances may reduce insulin requirements: oral hypoglycemic agents (OHA), monoamine oxidase inhibitors (MAOIs), non-selective beta-blockers, angiotensin converting enzyme (ACE) inhibitors, salicylate and alcohol. 
 

The following substances may increase the demand for insulin: thiazides, glucocorticoids, thyroid hormones and beta sympathomimetic drugs, growth hormones, and danazol. Beta-blockers can mask the symptoms of hypoglycemia and delay recovery from hypoglycemia. Octreotide/lanreotide can reduce and increase the need for insulin. Alcohol can strengthen and prolong the blood sugar lowering effect of insulin.

Contraindications

Hypoglycemia, allergy to human insulin or any excipient.

Side Effects

Hypoglycemia is the most common adverse reaction during insulin treatment, and symptoms of hypoglycemia can appear suddenly. There are few reports of allergic reactions such as redness and itching. It usually disappears after a few days. In some cases, allergies can be due to reasons other than insulin, such as disinfectants and poor injection techniques.

Pregnancy & Lactation

There are no restrictions on the use of insulin to treat diabetes during pregnancy because insulin cannot cross the placental barrier.

Precautions & Warnings

Insufficient dose or stopping treatment, especially in type 1 diabetes, can lead to high blood sugar. Usually the first symptoms of hyperglycemia will appear gradually over a period of hours or days. They include thirst, increased frequency of urination, nausea, vomiting, drowsiness, redness and dryness of the skin, dry mouth, loss of appetite, and acetone breath. In type 1 diabetes, untreated hyperglycemic episodes can eventually lead to diabetic ketoacidosis. This can be fatal. If the insulin dose is too high in relation to the insulin requirement, hypoglycemia can occur. 
 

Skipping meals or unplanned vigorous physical exercise can cause hypoglycemia. Patients with significantly improved blood sugar control, for example through intensive insulin therapy, their usual warning symptoms of hypoglycemia may change, so appropriate advice should be given. The usual warning symptoms of long-term diabetic patients may disappear.

Storage Conditions

Store in a refrigerator (2°C-8°C). Do not freeze. Keep the container cartridge or vial in the outer carton in order to protect from light.

During use: do not refrigerate. Do not store vials above 25°C and cartridges above 30°C. Protect from excessive heat and sunlight.