Adult Dosing

Diabetes mellitus

• Dosing individualized to patient's needs
• Give SC; onset approx 30 mins, peak approx 2-12 hrs, duration 24 hrs

Pediatric Dosing

Diabetes mellitus

• Dosing individualized to patient's needs
• Give SC; onset approx 30 mins, peak approx 2-12 hrs, duration 24 hrs

[Outline]

• Adult Dosing
• Pediatric Dosing

• Type I & II Diabetes mellitus

• Hypersensitivity to any of the ingredients of the product
• Episodes of hypoglycemia

• N/A

Renal Dose Adjustment

• Renal impairment: Dose reduction recommended, dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose reduction recommended, dose adjustments not defined

• Hypoglycemia is the most common adverse effect of insulin. Change in insulin strength, timing of dosing, frequency may require a change in the dosage. Concomitant oral treatment may need to be changed
• Check blood sugar frequently and watch for signs of hypoglycemia. Any change should be made cautiously and only under medical supervision
• Unexplained hyperglycemia or ketosis characterized as drowsy feeling, flushed face, thirst, loss of appetite, fruity odor of the breath, heavy breathing and a rapid pulse can occur. Prompt identification and correction of the cause is necessary. Provide interim therapy with subcutaneous insulin injections
• Dose adjustment is required if there is any change in physical activity, usual meal plan, and also during illness, emotional disturbances, or other stress
• If lipoatrophy or lipohypertrophy occurs following subcutaneous insulin administration, change the injection technique
• Local or serious systemic allergic reactions can occur with insulin administration. Provide immediate treatment in case of allergic reaction
• Concomitant use of thiazolidinediones can cause dose-related fluid retention, which may lead to or exacerbate heart failure. Monitor for signs and symptoms of heart failure and treat accordingly or consider discontinuation or dose reduction

Cautions: Use cautiously in patients with

• Renal Impairment
• Hepatic Impairment
• Infection, stress, or illness
• Hypokalemia

Pregnancy Category:B

Breastfeeding: No specific data available on the use of insulin during breastfeeding. No adverse reactions have been reported due to insulin in breastmilk, infact insulin in breastmilk may decrease the risk of type 1 diabetes in breastfed infants. In general mothers with diabetes using insulin may nurse their infants. As per one study insulin requirements are reduced postpartum in women with type I diabetes. The lower basal insulin requirement was thought to be caused by glucose use for milk production. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 30 March 2011).

• METABOLIC: Hypoglycemia, hypokalemia
• MISC: Hypersensitivity and allergic reactions
• LOCAL: Lipodystrophy, injection site reaction

Insulin NPH

• Intermediate-acting insulin with a slower onset of action and a longer duration of activity; stimulates peripheral glucose uptake and inhibits hepatic glucose. Also inhibits lipolysis and proteolysis, and enhances protein synthesis
• Metabolism/ Excretion: Partly metabolized at the site of injection and partly by liver, kidney, fat, muscle
• Half-life: Unknown

Insulin regular

• Short acting insulin; regulates glucose metabolism, stimulates peripheral glucose uptake by skeletal muscle and fat, inhibits hepatic glucose production. inhibits lipolysis and proteolysis
• Metabolism/ Excretion: Cleared by metabolic degradation via a receptor-mediated process
• Half-life: 141 mins

US Trade Name(s)

• Humulin 70/30
• Novolin 70/30

US Availability

Humulin 70/30 (insulin nph/regular)

• OTC INJ: [70 units/30 units]/mL (10 mL vial)
• OTC Humulin 70/30 Pen: [70 units/30 units]/mL (3 mL prefilled disposable syringe)

Novolin 70/30 (insulin nph/regular)

• OTC INJ: [70 units/30 units]/mL (PenFill 3 mL cartridge)

Canadian Trade Name(s)

• Humulin 70/30

Canadian Availability

Humulin 70/30 (insulin nph/regular)

• INJ: [70 units/30 units]/mL (10 mL vial)
• INJ: [70 units/30 units]/mL (3 mL cartridge)

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Endocrine/Metabolic

Antidiabetic Agents

Insulins

Pricing data from www.DrugStore.com in U.S.A.

• HumuLIN 70/30 Pen 70-30 % SUSP [Pen] (LILLY)
  30 % = $451.98
  90 % = $1319.01
• HumuLIN 70/30 70-30 % SUSP [Vial] (LILLY)
  10 % = $73.99
  30 % = $205.97
• NovoLIN 70/30 70-30 % SUSP [Vial] (NOVO NORDISK)
  10 % = $75.99
  30 % = $205.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.