Dosage of NovoMix 30 is individual and determined in accordance with the needs of the patient.
In patients with type 2 diabetes, NovoMix 30 can be given in monotherapy or in combination with metformin when the blood glucose is inadequately controlled with oral antidiabetic drugs alone. For patients with type 2 diabetes, the recommended starting dose of NovoMix 30 is 6 units at breakfast and 6 units at dinner (evening meal). NovoMix 30 can also be initiated once daily 12 units at dinner (evening meal). When using NovoMix 30 once daily, it is generally recommended to move to twice daily when reaching 30 units splitting the dose to equal breakfast and dinner doses. If twice-daily dosing with NovoMix 30 results in recurrent daytime hypoglycaemic episodes, the morning dose can be split into morning and lunchtime doses (thrice-daily dosing).
The following titration guideline is recommended for dose adjustment: (See table.)
Click on icon to see table/diagram/image
The lowest of the 3 previous days' pre-meal levels should be used. The dose should not be increased if hypoglycaemia occurred within these days. Dose adjustments can be made once a week until target HbA1C is reached. Pre-meal blood glucose levels should be used to evaluate the adequacy of the preceding dose.
In patients with type 1 diabetes, the individual insulin requirement is usually between 0.5 unit/kg/day and 1 unit/kg/day. NovoMix 30 may fully or partially meet its requirement. The daily insulin requirement may be higher in patients with insulin resistance (eg, due to obesity) and lower in patients with residual endogenous insulin production. NovoMix 30 can be used in elderly patients; however, there is limited experience with the use of NovoMix 30 in combination with metformin in patients >75 years.
Administration: NovoMix 30 has a faster onset of action than biphasic human insulin and should generally be given immediately before a meal. When necessary, NovoMix 30 can be given soon after a meal.
NovoMix 30 is administered SC in the thigh or in the abdominal wall. If convenient, the gluteal or deltoid region may be used. Injection sites should be rotated within the same region. As with all insulins, the duration of action will vary according to the dose, injection site, blood flow, temperature and level of physical activity. The influence of different injection sites on the absorption of NovoMix 30 has not been investigated. NovoMix 30 should never be administered IV.
Renal or hepatic impairment may reduce the patient's insulin requirements.
NovoMix 30 can be used in children and adolescents ≥10 years with type 1 diabetes when premixed insulin is preferred. For children 6-9 years, limited clinical data exists.