Insulin human, isophane is used on its own or together with other medicines to treat diabetes.
Diabetes is a condition where your body is unable to produce enough insulin to control your blood sugar levels or insulin becomes ineffective (insulin resistance).
Insulin human, isophane is meant to be used as part of a complete diabetes management programme that should include exercise, a healthy diet, weight control, foot care, eye care, dental care and regular monitoring of blood sugar.
Use Insulin human, isophane exactly as directed by your doctor. Do not inject more or less than instructed by your doctor as small changes in the amount of this medicine may affect your blood sugar levels.
Insulin human, isophane should be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm or abdomen area). Try to inject it quickly, completing the injection within 5 seconds. If injected too slowly, Insulin human, isophane may clog up the needle tip -- this may prevent the full dose from being delivered.
Insulin human, isophane is available as a vial and as a pre-filled pen. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist. This medicine may become ineffective if your insulin pen does not work properly.
How to use insulin vial:
- Gather all the supplies you will need for injection (e.g. vial, syringe, alcohol swab, cotton).
- Wash your hands with soap and water.
- Pull off the protective colour cap of the medicine (on the top of the vial) then you will see a gray rubber stopper. Wipe the top of the gray rubber stopper with alcohol swab.
- Roll the vial between your hands in a horizontal (flat) position until the insulin suspension is evenly mixed. Do not shake the vial.
- Remove the needle cover of the syringe recommended by your doctor. Draw air, equal to your required dose, into the syringe by pulling back the plunger.
- Put the vial on a flat surface then insert the needle down the gray rubber stopper.
- Push the plunger of the syringe down to inject the air and keep the needle inside the vial.
- Turn the vial upside down. Slowly pull back the plunger to fill the syringe with your dose.
- Keep the needle inside the vial. To remove air bubbles, gently tap the needle with your fingers until the air bubbles rise to the top of syringe then slowly push the plunger up. Pull the plunger back down to measure your required dose.
- Remove the prepared syringe and needle from the vial and hold it in your hand that will inject the medicine.
- Wipe the selected injection site with alcohol swab and pinch the skin using your other hand. Push the plunger of the syringe as far as it will go to deliver your dose.
- Slowly let go of the skin and gently pull the needle out of the skin. Do not recap the needle.
- Place a cotton ball over the injection site and press for several seconds.
- Dispose your used needles and syringes according to your doctor or pharmacist’s instructions. Use new needle and syringe for each injection.
Ensure that you are using the correct type of syringe. Check with your doctor or nurse if you are not sure.
How to use the insulin pre-filled pen:
- Prepare the injection pen as instructed by your doctor or nurse.
- Attach the needle to the injection pen. Ensure that the needle is screwed on securely.
- Dial the correct dose.
- Swab the injection site area with alcohol.
- Hold the injection pen with your thumb over the injection button.
- Press the injection pen against your body using the subcutaneous (under the skin) injection method.
- Use your thumb to push the injection button until it stops. Continue to hold the injection button in that position while slowly counting to 6 to get a full dose.
- Withdraw the injection pen from your body.
- Remove the needle from the pen. Never store the injection pen with the needle attached.
- Reset your pen as instructed by your doctor or nurse.
- Throw away the used needle. Recap your pen and store below 30°C or between 2 to 8°C.
- Use a new needle in every administration of this medicine.
Do not skip or delay meals after injecting insulin.
DO NOT inject Insulin human, isophane intravenously (into a vein) or intramuscularly (into a muscle).
Do not share your insulin injection with anyone else.
This medicine must be used regularly for it to work well. Do not stop using it unless instructed by your doctor. If you suddenly stop using this medicine, it may lead to hyperglycaemia (high blood sugar level).
Discuss with your doctor how you should manage your insulin injection if you miss a dose.
If it is almost time for your next dose, skip the missed dose and return to your normal injection schedule. Check your blood sugar levels and ask your doctor how to adjust your insulin doses if needed.
A missed dose may lead to hyperglycaemia (high blood sugar level). If you often forget to inject your medicine, let your doctor and pharmacist know. They can give you advise that can help you remember your dosing schedule.
DO NOT double a dose under any circumstances.
Insulin human, isophane may not be suitable for you if you suffer from hypoglycaemia (low blood sugar).
Alert your doctor if you have kidney, liver, thyroid, adrenal or pituitary gland disease.
Alert your doctor if you are pregnant or breastfeeding.
Alert your doctor if you regularly drink alcohol, especially if you drink a lot.
Do not change the brand or type of insulin you are using without first consulting your doctor.
If you are under stress or have changes in meal patterns (e.g. amount of food or timing of meals), inform your doctor as these conditions may affect your blood sugar level.
Exercise will also change your insulin requirement. Consult your doctor if you change your exercise routine or start on a new exercise program.
If you are going for an operation, including minor operations and dental work, inform your doctor or dentist that you are using Insulin human, isophane.
If you are travelling, discuss with your doctor how to adjust your injection schedule. Carry your insulin in your hand-carry luggage. Do not put insulin in your check-in luggage as it may freeze.
For as long as you are using Insulin human, isophane, you will need to have regular blood tests to make sure that your sugar level is under control. Your doctor will advise you about how often you need to have these blood tests.
If you are using this medicine, you may have been warned about hypoglycaemia (low blood sugar).
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is the medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, sweating. These signs are your body’s way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 grams of glucose tablet at first sign of hypoglycaemia, wait for 15 minutes and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 grams of glucose tablet.
If you don’t have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms did not improve after second serving.
Insulin human, isophane may cause hypoglycaemia (low blood sugar) which may affect your ability to concentrate and react. If affected, do not drive or take part in any activity in which you need to be alert.
At the start of treatment you may also experience changes in your vision, swelling around your ankles and joints as well as redness, swelling and itching at the injection site. These side effects usually resolve with time. Alert your doctor if the symptoms become severe or refuse to go away.
Sometimes you may experience thickening and sinking of the skin around the injection area. This can usually be minimised by rotating the injection site. Ask your nurse about how you should rotate the injection sites.
Always inform your family and close friends that you have diabetes so that they know how to help you in an emergency.
If you develop rashes, breathlessness, swollen mouth or eyes, stop using this medicine and inform your doctor immediately. These could be signs of an allergic reaction.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Alert your doctor if you are taking any other medicines, especially those listed here:
- oral anti-diabetic medicines
- heart or high blood pressure medicines such as propranolol, enalapril, captopril
- cholesterol medicines such as clofibrate, gemfibrozil
- birth control pills
- antibiotics such as sulfamethoxazole, ciprofloxacin, ofloxacin
- water retention pills (also known as diuretics or "water pills") such as frusemide, hydrochlorothiazide
- thyroid medicines
- oral or inhaled steroids
- asthma medicines such as salbutamol (albuterol), terbutaline
- antidepressants known as MAO inhibitors such as isocarboxazid, phenelzine, moclobemide, selegiline and tranylcypromine
- other medicines such as somatropin, octreotide, lanreotide
Always inform your doctor or pharmacist if you are taking any other medicines, including herbal tonics, supplements and medicines that you buy without a prescription.
It is important for you to maintain a healthy diet and weight in order to help keep your diabetes under control.
It may be helpful to discuss your diet plan with your doctor or dietitian to manage your weight and blood sugar levels.
If you have not yet opened it, store Insulin human, isophane in a refrigerator between 2-8°C.
Once you have opened it, store Insulin human, isophane at room temperature (below 30°C) away from direct sunlight. It will expire 28 days after opening. Throw away any remaining injection solution, even if the vial is not empty.
Do NOT freeze Insulin human, isophane. Once frozen, it should not be used. It must be thrown away.
Do not use Insulin human, isophane if it has changed colour, has a frosted appearance or if you see lumps floating in the liquid or stuck to the side of the vial. Insulin human, isophane should be milky or cloudy white in appearance. It should not have any lumps or solid material.
Make sure you know how to store your medicine. This medicine may become ineffective if not stored properly. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
Keep all medicines away from the reach of children.
Medicines must not be used past the expiry date.