Insulin human, isophane is used on its own or together with other medicines to treat diabetes by keeping your blood sugar under control.
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).
This medicine is meant to be used as part of a complete diabetes care programme that should include exercise, a healthy diet and regular monitoring of blood sugar levels.
Use Insulin human, isophane exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor as small changes in the amount of this medicine may affect your blood sugar levels.
This medicine is to be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm, buttocks or abdomen area). Try to administer it at the same time each day.
Insulin human, isophane is available as a vial, pre-filled pen, or as a suspension for injection in a cartridge. 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.
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.
- Gently roll the vial between your hands at least 10 times.
- Carefully invert the vial at least 10 times until the insulin suspension is evenly mixed. Do not shake the vial.
- If you are using a new vial, pull off the plastic protective cap of the medicine (on the top of the vial) then you will see a rubber stopper. Wipe the top of the rubber stopper with an alcohol swab.
- 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.
- Insert the needle through the 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 syringe with your fingers until the air bubbles rise to the top 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 be injecting the medicine.
- Wipe the selected injection site with alcohol swab.
- Insert the needle into your skin and push the plunger of the syringe as far as it will go to deliver your dose. The needle should stay in your skin for at least 5 seconds to make sure you have injected all of your insulin dose.
- 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 of your used needles and syringes according to your doctor or pharmacist's instructions. Use a 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:
- Wash your hands with soap and water.
- 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 5 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. Throw away the used needle; dispose of it as instructed by your doctor or pharmacist.
- Reset your pen as instructed by your doctor or nurse.
- Recap your pen and store it according to the instructions on the label or as instructed by your doctor or nurse.
- Use a new needle in every administration of this medicine.
How to use the insulin suspension for injection in a cartridge:
- Wash your hands with soap and water.
- Roll the cartridge between your hands 10 times and invert 10 times immediately before use to resuspend insulin until it appears uniformly cloudy or milky. Do not shake the cartridge.
- Disinfect the rubber membrane of the cartridge.
- Use the appropriate insulin pens as instructed to ensure you get the correct dose. Follow the instructions that come with the pen.
- Put the cartridge into the pen.
- Dial the correct dose.
- Hold the pen with the needle pointing up and tap the side of the pen so that any bubbles float to the top. With the pen still pointing up, press the injection mechanism. Do this until a drop of insulin comes out of the needle.
- Swab the injection site area with alcohol.
- Inject under the skin as instructed. Leave the needle in the skin for 5 seconds to get a full dose.
- Withdraw the injection pen from your body.
- Unscrew the needle from the pen using the outer needle cap. Replace the cap on your pen.
- Dispose of the used needle according to your doctor or pharmacist's instructions.
- Use a new needle in every administration of this medicine.
Remember to rotate the injection sites. Do not inject into the same area all the time. New injection sites should be at least 1.5 inches away from the previous injection site. Do not inject near the navel (belly button).
DO NOT inject Insulin human, isophane intravenously (into a vein) or intramuscularly (into a muscle).
Do not dilute or mix this medicine with any other insulin formulation or solution.
Do not share your insulin injection with anyone else.
Insulin human, isophane must be used regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor. If you suddenly stop using this medicine, it may lead to hyperglycaemia (high blood sugar level).
Discuss with your doctor on how you should manage your insulin injection if you miss a dose.
Check your blood sugar levels and ask your doctor on 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 some advice that can help you remember your dosing schedule.
DO NOT double a dose to make up for a missed dose.
Do not use Insulin human, isophane if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any of its ingredients.
Alert your doctor if you are experiencing episodes of hypoglycaemia (low blood sugar) as this medicine may not be suitable for you.
Inform your doctor if you have the following conditions:
- liver disease
- kidney disease
- diseases of the adrenal, pituitary or thyroid gland
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Insulin human, isophane to a child. Children may be more sensitive to the side effects.
Do not change the brand or type of insulin you are using without first consulting your doctor.
If you are sick (e.g. with fever or infections), 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 surgery and dental work, inform your doctor or dentist that you are using this medicine.
If you are travelling, discuss with your doctor about 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 sugar tests to check your body's response to the medicine. Routine tests (e.g. liver and kidney function, electrolyte levels) may also be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these 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 the 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 do not improve after the 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.
Other side effects include any of the following: weight gain, swelling of the ankles, feet or hand, and skin depression, enlargement or thickening, lumps, redness, swelling or itching around the area of injection.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes or mouth
- muscle cramps or weakness, irregular heartbeats, constipation
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- other medicines for diabetes e.g. pioglitazone
- medicines for high blood pressure e.g. propranolol, enalapril, losartan, guanethidine, reserpine
- medicines to treat pain, fever or inflammation known as salicylates e.g. aspirin
- certain cholesterol-lowering medicines e.g. clofibrate, gemfibrozil
- birth control pills
- certain antibiotics e.g. sulfamethoxazole
- medicines to treat depression e.g. isocarboxazid, fluoxetine
- water pills or medicines for water retention
- anti-inflammatory medicines e.g. prednisone
- medicines for mood disorders e.g. lithium, clozapine, chlorpromazine
- asthma medicines e.g. salbutamol, terbutaline
- certain medicines for HIV infection e.g. ritonavir
- medicines for thyroid problems
- danazol (medicine for endometriosis [abnormal growth of tissues outside the womb])
This list does not include all medicines that may interact with Insulin human, isophane.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol.
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 opened, Insulin human, isophane may be stored at room temperature not exceeding 30°C away from direct sunlight.
Do NOT freeze Insulin human, isophane otherwise it will become less effective and should not be used.
Available products of this medicine may vary with its storage requirements. Ask your doctor or pharmacist on how to properly store this medicine.
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 glass. This medicine should be milky or cloudy white in appearance. It should not have any lumps or solid material. Throw away any unused portion.
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 away from heat, light, and from the reach of children.
Medicines must not be used past the expiry date.
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