Intermediate Acting Insulin
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does it Work
Insulin NPH/Isophane, Novolin NPH/Novolin N/Humulin N works on liver, muscle and adipose (fat) tissue to regulate the metabolism of carbohydrates, protein, and fats. In the liver and muscles, it increases glycogen synthesis which is the immediate storage form of glucose. It increases fat production by increasing fatty acid release from the liver in the form of lipoproteins which adipose tissue converts to fatty acids than to triglycerides for storage whilst also stopping the metabolism of triglycerides (fat). Insulin also increases the cellular uptake of amino acids and some electrolytes such as potassium into the cell. In muscle tissue, protein synthesis is increased.
Normally insulin is produced by the pancreas however insulin products for pharmaceutical use have been produced via recombinant DNA technology using certain bacteria (they splice the gene for insulin production into bacterial DNA so the cell produces insulin – a gene is a portion of DNA or RNA that produces one specific protein). NPH stands for neutral protamine Hagedorn named as it is regular human insulin in a neutral (N) solution mixed with protamine, which is a protein (P), and Hans Christian Hagedorn (H), and insulin researcher that helped discover it. The protamine and insulin form crystals that last far longer than normal human insulin and were the basal insulin.
Indications For Use
Insulin NPH/Isophane, Novolin NPH/Novolin N/Humulin N is indicated for diabetes mellitus types 1 and 2. It is also prescribed off-label for gestational diabetes.
Before starting Insulin NPH/Isophane, Novolin NPH/Novolin N/Humulin N make sure your physician is aware of any allergies or medications you currently take if you have had bariatric surgery, cardiovascular disease, have kidney disease, liver disease, are pregnant or breastfeeding.
Insulin NPH/Isophane, Novolin NPH/Novolin N/Humulin N is an intermediate-acting or basal insulin. It is given by subcutaneous injection in one, or more commonly, two daily injections. In type 2 diabetes someone usually starts around 10 units per day or 0.1-0.2mg/kg/day and the dosage is slowly increased until glucose control is achieved. In type 1 diabetes 40-50% of total daily insulin is given as intermediate or long-acting with the rest divided into fast-acting mealtime insulin. If converting from another insulin the number of units given may need to be lowered as a precaution
Pharmacist Tips On Using
How to Take Insulin NPH/Isophane, Novolin NPH/Novolin N/Humulin N: Follow instructions provided by physician/pharmacy label, use consistently at same times each day unless otherwise directed, refrigerate product not in use (36-46 Fahrenheit, 2-8 Celsius), the vial in use may be kept at room temperature (below 86 Fahrenheit, 30 Celsius) for up to 28 days (discard if not used by this point). Invert the vial multiple times and roll between fingers (the number of times varies with the brand) to mix prior to use. Inject generally into abdomen, thighs, buttocks, or arms with absorption rates varying from site to site. Be consistent with the part of the body you inject into but rotate the injection site to avoid redistribution of fat and excessive irritation to the area. For example, if you choose the abdomen which is the most common, inject in circular order at least 2 inches from the navel.
You Need to Avoid: Continue to mix if there is any sediment or clumps in the vial, it should appear uniformly cloudy or milky. Avoid injecting cold insulin as it may be painful.
Peripheral edema, injection site reaction, hypoglycemia, hypokalemia, weight gain, hypersensitivity reactions, immunogenicity, atrophy at injection site peripheral edema, visual disturbances, etc.
Note- this is not a complete list of side effects and as this medication had been in use since before the strict clinical trial requirements of today, the frequency of occurrence is not defined. This medication has been in use since the 1940s and is generally very well tolerated with hypoglycemia being the largest concern as with all insulin.
Frequently Asked Questions
What is hypoglycemia?
Hypoglycemia is a condition of low blood sugar (>3.9mmol/L-Canada; 70mg/dL-US) which is considered a medical emergency whereas hyperglycemia is a slow progressive condition. It generally occurs with irregularities in diet, exercise, and medications in diabetic patients. It is preferably treated with simple sugars such as dextrose; regular table sugar can work but is slower acting as it needs to be digested and if blood sugar is extremely low this delay can be a problem. Hypoglycemia has a large host of progressive symptoms from hunger, headache, nausea, sweating, palpitations, mood swings, irritability to seizure, coma and in severe cases, death.