DRUGS AND SUPPLEMENTS

Isophane Insulin (NPH)

March 21, 2017

Insulin Suspension Isophane (NPH) Suspension for injection

What is this medicine?

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.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • episodes of hypoglycemia

  • kidney disease

  • liver disease

  • an unusual or allergic reaction to insulin, metacresol, other medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

How should I use this medicine?

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.

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.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

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.

What may interact with this medicine?

  • 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

  • chloramphenicol

  • chromium

  • diuretics

  • female hormones, like estrogens or progestins and birth control pills

  • heart medicines

  • isoniazid

  • 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

  • niacin

  • NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen

  • pentamidine

  • phenytoin

  • probenecid

  • quinolone antibiotics like ciprofloxacin, levofloxacin, ofloxacin

  • some herbal dietary supplements

  • steroid medicines like prednisone or cortisone

  • thyroid medicine

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

  • clonidine

  • guanethidine

  • reserpine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

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.

Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medicine and dosage times.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your health care professional or doctor as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

  • breathing problems

  • 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 health care professional or doctor 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

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store unopened insulin vials 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. Store opened insulin vials in the refrigerator or at room temperature below 30 degrees C (86 degrees F). Keeping your insulin at room temperature decreases the amount of pain during injection. If you are using Humulin N brand vials, your open insulin vial should be thrown away after 31 days. If you are using Novolin N brand vials, your open insulin vial should be thrown away after 42 days. Protect from heat and light.

Store unopened prefilled insulin 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. After opening, keep this medicine at room temperature below 30 degrees C (86 degrees F). Do not store in the refrigerator. Protect from heat and light. Throw away the insulin pen 14 days after opening.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.

Updated:  

March 21, 2017

Sources:  

U.S. FDA-approved Package Insert