ISOPHANE INSULIN (NPH) (EYE soe fane IN su lin) is a human-made form of insulin. This medicine lowers the amount of sugar in the blood. It is an intermediate-acting insulin that starts working about 1.5 hours after it is injected.
Insulin is for injection under the skin. Use exactly as directed. It is important to follow the directions given to you by your health care professional or doctor. You will be taught how to use this medicine and how to adjust doses for activities and illness. Do not use more insulin than prescribed. Do not use more or less often than prescribed.
Always check the appearance of your insulin before using it. This medicine should be white and cloudy. Do not use it if it is not uniformly cloudy after mixing. If you use a pen, be sure to take off the outer needle cover before using the dose. It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or healthcare provider to get one.
Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children for selected conditions, precautions do apply.
Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
signs and symptoms of high blood sugar such as dizziness, dry mouth, dry skin, fruity breath, nausea, stomach pain, increased hunger or thirst, increased urination
signs and symptoms of low blood sugar such as feeling anxious, confusion, dizziness, increased hunger, unusually weak or tired, sweating, shakiness, cold, irritable, headache, blurred vision, fast heartbeat, loss of consciousness
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
increase or decrease in fatty tissue under the skin due to overuse of a particular injection site
itching, burning, swelling, or rash at site where injected
other medicines for diabetes
Many medications may cause an increase or decrease in blood sugar, these include:
alcohol containing beverages
aspirin and aspirin-like drugs
female hormones, like estrogens or progestins and birth control pills
male hormones or anabolic steroids
medicines for weight loss
medicines for allergies, asthma, cold, or cough
medicines for mental problems
medicines called MAO Inhibitors like Nardil, Parnate, Marplan, Eldepryl
NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
quinolone antibiotics like ciprofloxacin, levofloxacin, ofloxacin
some herbal dietary supplements
steroid medicines like prednisone or cortisone
Some medications can hide the warning symptoms of low blood sugar. You may need to monitor your blood sugar more closely if you are taking one of these medications. These include:
beta-blockers such as atenolol, metoprolol, propranolol
It is important not to miss a dose. Your health care professional or doctor should discuss a plan for missed doses with you. If you do miss a dose, follow their plan. Do not take double doses.
Keep out of the reach of children.
Store unopened insulin vials or pens in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Do not freeze or use if the insulin has been frozen. Protect from light and excessive heat. Throw away any unopened and unused medicine that has been stored in the refrigerator after the expiration date.
Vials that you are using:
Humulin N vials: Store in the refrigerator or at room temperature below 30 degrees C (86 degrees F). Do not freeze. Keep away from heat and light. Throw the opened vial away after 31 days.
Novolin N vials: Store at room temperature below 25 degrees C (77 degrees F). Do not refrigerate. Do not freeze. Keep away from heat and light. Throw the opened vial away after 42 days.
Pens that you are using:
Humulin N pens: Store at room temperature below 30 degrees C (86 degrees F). Do not refrigerate or freeze. Keep away from heat and light. Throw the pen away after 14 days, even if it still has insulin left in it.
Novolin N pens: Store at room temperature below 30 degrees C (86 degrees F). Do not refrigerate or freeze. Keep away from heat and light. Throw the pen away after 28 days, even if it still has insulin left in it.
They need to know if you have any of these conditions:
episodes of hypoglycemia
eye disease, vision problems
an unusual or allergic reaction to insulin, metacresol, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
Visit your health care professional or doctor for regular checks on your progress.
A test called the HbA1C (A1C) will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.
Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.
Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.
Tell your doctor or health care professional if you have high blood sugar. You might need to change the dose of your medicine. If you are sick or exercising more than usual, you might need to change the dose of your medicine.
Do not skip meals. Ask your doctor or health care professional if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.
Make sure that you have the right kind of syringe for the type of insulin you use. Try not to change the brand and type of insulin or syringe unless your health care professional or doctor tells you to. Switching insulin brand or type can cause dangerously high or low blood sugar. Always keep an extra supply of insulin, syringes, and needles on hand. Use a syringe one time only. Throw away syringe and needle in a closed container to prevent accidental needle sticks.
Insulin pens and cartridges should never be shared. Even if the needle is changed, sharing may result in passing of viruses like hepatitis or HIV.
Each time you get a new box of pen needles, check to see if they are the same type as the ones you were trained to use. If not, ask your health care professional to show you how to use this new type properly.
Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medicine and dosage times.