Humulin N Insulin (hi-310)

Insulin NPH (Isophane Insulin Suspension) is an intermediate-acting insulin. It lowers blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin also inhibits lipolysis and proteolysis, and enhances protein synthesis.

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Some allergic reactions can be life-threatening, so prompt medical attention is crucial.
Signs of low potassium levels, including:
+ Muscle pain or weakness
+ Muscle cramps
+ An irregular heartbeat
Swelling in the arms or legs
Thick skin, pits, or lumps at the injection site
Low blood sugar, which may cause:
+ Dizziness or fainting
+ Blurred vision
+ Mood changes
+ Slurred speech
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
+ Seizures

If you experience any of these symptoms, call your doctor right away. If you have low blood sugar, follow the instructions you have been given, which may include taking glucose tablets, liquid glucose, or some fruit juices.

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience:

Irritation at the injection site
Weight gain

These are not all the possible side effects that may occur. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
If you have low blood sugar (hypoglycemia).

This is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to discuss all of the following with your doctor and pharmacist:

All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your existing health problems

Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to confirm that it is safe to do so. This will help prevent potential interactions and ensure the safe use of this medication.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

This drug may cause low blood sugar, which can lead to seizures, loss of consciousness, permanent brain damage, and even death if not properly managed. It is crucial to discuss this risk with your doctor. Additionally, this medication may cause low blood potassium levels, which can result in abnormal heart rhythms, severe breathing problems, and potentially death if left untreated. If you experience any symptoms, consult your doctor promptly.

Until you understand how this medication affects you, avoid driving and other activities that require your full attention. Certain diabetes medications, such as pioglitazone or rosiglitazone, may increase the risk of heart failure or worsen existing heart failure, especially when combined with insulin. If you are taking one of these medications, consult your doctor to discuss the potential risks.

Ensure you have the correct insulin product and are familiar with its administration. Insulin products are available in various containers, including vials, cartridges, and pens. If you have any questions or concerns about measuring or preparing your dose, contact your doctor or pharmacist.

During periods of stress, such as fever, infection, injury, or surgery, it may be more challenging to control your blood sugar levels. Changes in physical activity, exercise, or diet can also impact your blood sugar levels.

Wear a medical alert identification to ensure prompt care in case of an emergency. Avoid driving if you have experienced low blood sugar, as it increases the risk of accidents. Monitor your blood sugar levels as directed by your doctor and undergo regular blood tests as recommended.

Before consuming alcohol or using products containing alcohol, consult your doctor to discuss potential risks. Never share your insulin product, including pens, cartridge devices, needles, or syringes, with another person, even if the needle has been changed, as this can transmit infections.

If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects. Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding, as you will need to discuss the benefits and risks of this medication for both you and your baby.

• Beta-blockers (may mask hypoglycemia symptoms)
• Thiazolidinediones (TZDs) (increased risk of fluid retention and heart failure when used with insulin)
• Alcohol (can potentiate hypoglycemic effect)

• Oral antidiabetic agents (additive hypoglycemic effect)
• Corticosteroids (may increase blood glucose, requiring higher insulin doses)
• Diuretics (thiazide and loop diuretics may increase blood glucose)
• Sympathomimetics (e.g., decongestants, asthma medications; may increase blood glucose)
• Atypical antipsychotics (may cause hyperglycemia)
• Protease inhibitors (may cause hyperglycemia)
• Somatostatin analogs (e.g., octreotide, lanreotide; may decrease insulin requirements)
• Salicylates (e.g., aspirin; high doses may enhance insulin effect)
• Sulfonamide antibiotics (may enhance insulin effect)

• Symptoms of hypoglycemia (e.g., sweating, tremor, confusion, hunger, dizziness, blurred vision, irritability)
• Symptoms of hyperglycemia (e.g., polyuria, polydipsia, polyphagia, fatigue, blurred vision)
• Signs of allergic reaction (e.g., rash, itching, swelling, difficulty breathing)
• Injection site reactions (e.g., redness, swelling, itching, pain)

Insulin is the preferred treatment for diabetes in pregnancy. Insulin NPH has been widely used and is considered safe and effective for controlling blood glucose during pregnancy. Close monitoring of blood glucose is essential.

Insulin is compatible with breastfeeding. Insulin is a large protein molecule and is not excreted into breast milk in clinically significant amounts. It is not expected to cause adverse effects in breastfed infants.

Insulin NPH is commonly used in pediatric patients with type 1 diabetes. Dosing is highly individualized based on age, weight, pubertal status, and glycemic control. Close monitoring of blood glucose is crucial to prevent hypoglycemia.

Older adults may be more susceptible to hypoglycemia due to impaired renal function, reduced counter-regulatory responses, and polypharmacy. Start with lower doses and titrate slowly. Monitor blood glucose frequently and educate patients/caregivers on hypoglycemia symptoms and management.

• NPH insulin has a pronounced peak effect, which can increase the risk of nocturnal hypoglycemia if the evening dose is too high or not properly timed with a bedtime snack.
• It is often used in combination with rapid-acting or short-acting insulin to provide both basal and prandial coverage.
• Patients should be educated on proper injection technique, site rotation, and storage to ensure efficacy and prevent complications like lipodystrophy.
• Humulin N and Novolin N are interchangeable in terms of active ingredient (NPH insulin) but always confirm with the prescribing physician or pharmacist before switching brands.
• The suspension must be gently rolled or inverted several times before each injection to ensure uniform mixing, but not shaken vigorously to avoid foaming.

• Long-acting insulins (e.g., insulin glargine, insulin detemir, insulin degludec) for basal insulin needs.
• Rapid-acting insulins (e.g., insulin lispro, insulin aspart, insulin glulisine) for mealtime coverage.
• Short-acting insulins (e.g., regular insulin) for mealtime coverage or correction doses.
• Oral antidiabetic agents (for Type 2 Diabetes, often in combination with insulin or as monotherapy for milder cases).

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.