Insunova Caution For Usage

Vial: Insunova-N (NPH)/Insunova-30/70 (Biphasic) is a cloudy, white, aqueous suspension of human insulin. Never use the vials if the liquid is not white and uniformly cloudy after gently rolling.
Before Injecting the Insulin: Disinfect the rubber stopper; roll the vial between the palms of the hands until the liquid is uniformly white and cloudy; draw into the syringe the same amount of air as the dose of insulin to be injected; inject the air into the vial; turn the vial and syringe upside down and draw the correct insulin dose into the syringe; withdraw the needle and expel the air from the syringe and check that the dose is correct; inject immediately. Injection sites should be rotated within an anatomic region in order to avoid lipodystrophy and an injection should be followed within 30 min by a meal or a snack containing carbohydrates.
How to Inject the Insulin: Pinch the skin between 2 fingers, push the needle into the skin fold and inject the insulin under the skin SC; SC injection into the abdominal wall results in a faster absorption than from the other injection sites; injection into a lifted skin fold minimizes the risk of IM injection; keep the needle under the skin for at least 6 sec to make sure all the insulin has been injected; if blood appears after the needle has been withdrawn, press the injection site lightly with a finger.
Cartridge: Instructions to be given to the patient on how to handle Insunova-R (Regular), Insunova-N (NPH) and Insunova-30/70 (Biphasic) Cartridge:
The Insunova-R (Regular), Insunova-N (NPH) and Insunova-30/70 (Biphasic) cartridges are designed to be used with the InsuPen. (Detailed instructions accompanying the InsuPen must be followed.)
If a patient is using another type of insulin cartridge besides what is used, 2 different InsuPen should be used for the respective insulins.
The Insunova-R (Regular), Insunova-N (NPH) and Insunova-30/70 (Biphasic) cartridge is for single person use only and should not be refilled.
Before using Insunova-R (Regular), Insunova-N (NPH) and Insunova-30/70 (Biphasic) Cartridge: Check the label to make sure it is the right type of insulin.
Remove the cartridge from the blister pack by pushing through the foil side of the packaging.
Do check the cartridge, including the plunger stopper. Do not use it if damage is seen or if there is a gap between the plunger and the label band.
Appearance of air bubble is a normal phenomenon, vigorous shaking immediately before the dose is administered may also result in the formation of air bubbles which could cause dosage errors; in that case, tap the container gently with a finger. A small air bubble may remain in the cartridge after tapping; this small air bubble will not affect the dose.
Cartridges containing Insunova-R (Regular) do not require resuspension and should only be used if it is clear, colourless, with no visible solid particles and if it is of water-like appearance.
If the InsuPen with the cartridge inside is in cold storage, take it out 1-2 hrs before injecting to allow it to warm up. Cold insulin is more painful to inject. Detailed instruction accompanying the InsuPen must be followed.
Use a medicinal swab to disinfect the rubber membrane.
To prevent contamination always use a new pen needle for each injection.
Do not use Insunova-R (Regular), Insunova-N (NPH) and Insunova-30/70 (Biphasic) Cartridge: In insulin infusion pumps.
If the cartridge or the InsuPen containing the cartridge is dropped, damaged or crushed as there may be a risk of leakage of insulin.
If it has not been stored properly or if it has been frozen.
If the liquid in Insunova-R (Regular) appears white and cloudy or has some suspended particles or if Insunova-N (NPH) and Insunova-30/70 (Biphasic) is not uniformly white and cloudy when resuspended.
Before Inserting a 3-mL Cartridge of Insunova-N or Insunova-30/70 into the InsuPen for the First Time: Roll the cartridge between the palms 10 times.
These steps should be done with the 3-mL cartridge in a flat (horizontal) position.
Then turn the cartridge up and down so the glass bead moves from one end of the cartridge to the other. Do this at least 10 times.
Repeat the rolling and turnings steps until the insulin looks uniformly white and cloudy. Resuspending is easier when the insulin is at room temperature.
Complete the other stages of injection without delay.
Do not force the dose knob.
Check for the desired units of insulin left in the cartridge before resuspending. If there are less than desired units left, use a new cartridge.
Insunova-G: Before injecting this insulin, disinfect the rubber stopper with an alcohol swab; visually inspect the vial to ensure that there are no suspended impurities; draw air into the syringe, the same amount as the volume of insulin to be injected; inject the air into the vial: Push the needle through the rubber stopper and press the plunger; turn the vial and syringe upside down; draw the correct dose of insulin into the syringe; before the patient take the needle out of the insulin vial, check the syringe for air bubbles. Make sure that there is no air left in the syringe: Point the needle upwards and push the air out. Appearance of air bubble is a normal phenomenon, vigorous shaking immediately before the dose is administered may also result in the formation of air bubbles which could cause dosage errors; in that case tap the side of the syringe gently with the patient's finger. A small air bubble may remain after tapping; this small air bubble will not affect your dose; check you have the right dose; inject straight away.
Drawing and Self-Injecting Insulin: Get supplies. Wash hands. Wipe top of bottle. Pull plunger down to appropriate number of units as advised by the physician. Push needle into bottle. Push plunger down. Pull plunger down to appropriate number of units as advised by the physician. Pick injection site wipe with alcohol swab. Pinch up skin, push needle into skin, push plunger in. Pull needle in. Dispose syringe safely, check the town rules. Eat after appropriate interval.
Special Precautions for Disposal and Handling: Any unused product or waste material should be disposed of in accordance with local requirements.
Insunova-G: lnsunova-G must not be mixed with any other insulin or diluted. Mixing or diluting can change its time or action profile and mixing can cause precipitation.
Inspect the vial before use. It must only be used if the solution is clear, colourless, with no visible solid particles. Since Insunova-G is a solution; it does not require re-suspension before use.