Ultralente Insulin injection

What is Ultralente Insulin injection?

ULTRALENTE INSULIN (Humulin® U) is a human-made form of insulin. Insulin is a hormone produced naturally by the pancreas. Insulin lowers the amount of sugar in your blood. Keeping your blood sugar close to normal prevents or reduces long-term complications of diabetes including damage to the blood vessels, eyes, kidneys, or nerves. Ultralente insulin is a long-acting insulin that is usually administered once or twice a day. The time-course of action of insulin may vary in different people and at different times in the same person. The time-course of action of insulin may also vary depending on the place where the insulin is injected, your body temperature, and your physical activity. Ultralente insulin is available without a prescription. A prescription to obtain insulin syringes may or may not be required in the state where you live.

There are different types of insulin available. Each type has a different onset of action and a different duration of action in the body. You should learn which types you take and how you should administer them, and how each type acts in your body. Ultralente insulin is labeled with a large, black letter U. Insulin is obtained from beef, pork, or human sources. Beef insulin is no longer made in the US because of concerns of cow tissues spreading certain infections. Pork insulin is used by very few patients in the US. Because of this, pork insulin will no longer be made in the US, but will still be available until the end of the year 2005. If you use pork insulin, see your prescriber so that changes in your insulin therapy can be made.

Do not change the type of insulin you are taking without talking to your prescriber. If you must switch the type of insulin you use, you should realize that you may need to monitor your blood sugar more frequently and that dosage adjustments may be needed before you are stabilized on the new type. Take care to learn and recognize the symptoms of hypoglycemia (low blood sugar) and know how you should treat these reactions.

NOTE: This drug is discontinued in the United States

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

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

• adrenal or pituitary gland problems

• diarrhea

• fever or infection

• injury or trauma

• kidney disease

• liver disease

• nausea, vomiting

• recent surgery

• thyroid disease

• pregnant or trying to get pregnant

• breast-feeding

• an unusual or allergic reaction to insulin, beef or pork products, other medicines, foods, dyes, or preservatives

How should this medicine be used?

Insulin is for injection under the skin. Use exactly as directed. Do not use more insulin than prescribed. Do not use more or less often than prescribed. It is important to follow the directions given to you by your health care professional or prescriber. You will be taught how to inject your insulin. You will be taught how to administer doses for meals You will also be taught how to adjust doses for activities and illness.

Always check the appearance of your insulin before using it. Ultralente should be white and cloudy. Do not use ultralente insulin if it is not uniformly cloudy after mixing. To mix, roll the vial gently 10 times in your hands. Make sure to perform the mixing procedures before each injection.

What if I miss a dose?

It is important not to miss a dose. Your health care professional or prescriber should discuss a plan for missed doses with you. If you do miss a dose, follow their plan. Do not take double doses. Know the signs of low and high blood sugar and make sure a close family member or friend can also recognize these signs. Contact your health care professional or prescriber at once if you have any problems.

What drug(s) may interact with Ultralente Insulin?

• other medicines for diabetes

Many medications may cause changes (increase or decrease) in blood sugar, these include:

• alcohol containing beverages

• angiotensin converting enzyme inhibitors (ACE inhibitors), often used for high blood pressure or heart problems (examples include captopril, enalapril, lisinopril)

• antiretroviral protease inhibitors (examples include indinavir, ritonavir, saquinavir)

• aspirin and aspirin-like drugs

• beta-blockers, often used for high blood pressure or heart problems (examples include atenolol, metoprolol, propranolol)

• certain medicines used for mental depression, emotional, or psychotic disturbances

• chromium

• cisapride

• clonidine

• cyclosporine

• danazol

• diazoxide

• disopyramide

• epinephrine

• female hormones, such as estrogens, progestins, or contraceptive pills

• fenofibrate

• gemfibrozil

• glucagon

• growth hormone (somatropin)

• guanethidine

• isoniazid

• lithium

• metoclopramide

• male hormones or anabolic steroids

• medications to suppress appetite or for weight loss

• medicines for allergies, asthma, cold, or cough

• niacin

• nicotine (including nicotine found in patches and gum)

• pentamidine

• pentoxifylline

• phenytoin

• propoxyphene

• quinolone antibiotics, medicines used for infections (examples include ciprofloxacin, levofloxacin, norfloxacin)

• some herbal dietary supplements

• steroid medicines such as prednisone or cortisone

• sulfonamides, medicines for infection ( examples include Azulfidine®, Bactrim®, Gantrisin® Septra®)

• tacrolimus

• thyroid hormones

• water pills (diuretics)

Some medications can hide the warning symptoms of low blood sugar (hypoglycemia). You may need to monitor your blood sugar more closely if you are taking one of these medications. These include:

• beta-blockers, often used for high blood pressure or heart problems (examples include atenolol, metoprolol, propranolol)

• clonidine

• guanethidine

• reserpine

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking Ultralente Insulin?

Visit your health care professional or prescriber for regular checks on your progress. To control your diabetes properly you must use insulin regularly and follow a regular diet and exercise schedule. Diabetes cannot be cured. Careful, daily control of blood sugar can postpone or prevent many of the long-term complications of diabetes.

Dangerously high or low blood sugar can occur when meals and insulin are not spaced properly. Checking and recording your blood glucose and urine ketone levels regularly is important. Sometimes it is hard to tell the difference between low and high blood sugar (see side effects). Use a glucometer (blood glucose or sugar measuring device), whenever possible, before you treat high or low blood sugar.

Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar (hypoglycemia). Examples include hard sugar candy or glucose tablets.

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 syringe unless your health care professional or prescriber tells you to. Use a syringe one time only. Throw away syringe and needle in a closed container to prevent accidental needle sticks.

Do not switch brands or types of insulin without consulting your health care professional or prescriber. 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.

Wear a Medic Alert bracelet or necklace and/or carry an identification card with your name and address, condition, medication, and prescriber's name and address.

If you develop a cold, diarrhea, vomiting, or other infection or illness, you should contact your health care professional or prescriber. 'Sick-days' may require changes to your insulin dosage. Or your illness may need to be evaluated. Ask your health care professional or prescriber what you should do if you become ill. Do not stop taking your insulin; check with your health care professional or prescriber for advice.

If you are a long time smoker and suddenly stop, you may need a change in insulin dose. Talk to your health care professional or prescriber first.

Many nonprescription cough and cold products contain sugar or alcohol. These can affect diabetes control or can alter the results of tests used to monitor blood sugar. Avoid alcohol. Avoid products that contain alcohol or sugar.

If you are going to have surgery, make sure you tell the health care professionals that you take insulin.

What side effects may I notice from receiving Ultralente Insulin?

Learn how and when you should monitor your blood sugar, and what you should do if high or low blood sugar occurs. Side effects that you should report to your health care professional or prescriber as soon as possible:

Symptoms of hypoglycemia (low blood glucose):

• anxiety or nervousness, confusion, difficulty concentrating, hunger, pale skin, nausea, fatigue, sweating, headache, palpitations, numbness of the mouth, tingling in the fingers, tremors, muscle weakness, blurred vision, cold sensations, uncontrolled yawning, irritability, rapid heartbeat, shallow breathing, and loss of consciousness. You should learn to recognize your own symptoms of hypoglycemia. Your symptoms may be different than others. If you are uncertain about your symptoms of hypoglycemia, check your blood sugar often to help you learn to recognize the symptoms. Hypoglycemia may cause you to not be aware of your actions or surroundings if it is severe, so you should let others know what to do if you cannot help yourself in a severe reaction. Your health care professional or prescriber will teach you how to treat hypoglycemia. Always carry a quick source of sugar such as candies or glucose tablets with you.

Symptoms of high blood sugar (hyperglycemia):

• dizziness, dry mouth, flushed dry-skin, fruit-like breath odor, loss of appetite, nausea, stomach ache, unusual thirst, frequent passing of urine

Insulin also can cause rare but serious allergic reactions in some patients, including:

• severe skin rash and itching (hives)

• difficulty breathing

Side effects that usually do not require medical attention (report to your health care professional or prescriber if they continue or are bothersome):

• increase or decrease in fatty tissue under the skin, through overuse of a particular injection site

• itching, burning, swelling, or rash at the injection site

Where can I keep my medicine?

Keep out of the reach of children.

Store unopened insulin vials in a refrigerator between 2—8 degrees C (36—46 degrees F). Do not freeze or use if the insulin has been frozen. Opened vials (vials currently in use) may be stored in the refrigerator or at room temperature, at approximately 25 degrees C (77 degrees F) or cooler. Keeping your insulin at room temperature decreases the amount of pain during injection. Your insulin can be used until the expiration date printed on the vial. There may be a decrease in the effect of insulin after it has been kept at room temperature for longer than one month. If you notice a change in your blood sugar concentrations, a new insulin vial may be needed.

Protect from light and excessive heat. Throw away any unused medicine after the expiration date or after the specified time for room temperature storage has passed.