Novolin Insulin Nph U-100 Human

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 Attention Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:

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
Note: In rare cases, allergic reactions can be life-threatening.
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 immediately. If you have been instructed on what to do in case of low blood sugar, follow those instructions, which may include taking glucose tablets, liquid glucose, or consuming certain fruit juices.

Other Possible Side Effects

Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:

Irritation at the injection site
Weight gain

This is not an exhaustive list of possible side effects. 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 allergic reaction you experienced, including any symptoms that occurred.
If you have low blood sugar (hypoglycemia), as this may affect your treatment plan.

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 overall health, including any existing medical conditions

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 any potential interactions or adverse effects.

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 difficulties, 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, especially when used in combination with insulin. If you are taking one of these medications, consult your doctor to discuss the potential risks.

Ensure you are using the correct insulin product, as they come in various containers, including vials, cartridges, and pens. If you are unsure about measuring or preparing your dose, consult your doctor or pharmacist for guidance.

During periods of stress, such as illness, 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 inform others of your condition in case of an emergency. If you have experienced low blood sugar, do not drive, as this can increase your risk of being involved in an accident.

Monitor your blood sugar levels as directed by your doctor and undergo regular blood tests as scheduled. Consult your doctor before consuming alcohol or using products that contain alcohol.

Do not share your insulin product, including pens, cartridge devices, needles, or syringes, with anyone else, even if the needle has been changed. Sharing can transmit infections from one person to another, including those you may not be aware of having.

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 potential benefits and risks to you and your baby.

• Beta-blockers (may mask symptoms of hypoglycemia, prolong recovery from hypoglycemia)
• Thiazolidinediones (TZDs) (increased risk of fluid retention and heart failure when co-administered with insulin)
• Alcohol (can potentiate hypoglycemic effect)
• Certain atypical antipsychotics (e.g., clozapine, olanzapine) (may cause hyperglycemia, requiring increased insulin dose)
• Corticosteroids (may cause hyperglycemia, requiring increased insulin dose)
• Diuretics (e.g., thiazides, loop diuretics) (may cause hyperglycemia, requiring increased insulin dose)
• Sympathomimetics (e.g., epinephrine, albuterol) (may cause hyperglycemia, requiring increased insulin dose)

• ACE inhibitors (may enhance insulin sensitivity, increasing risk of hypoglycemia)
• Angiotensin Receptor Blockers (ARBs) (may enhance insulin sensitivity, increasing risk of hypoglycemia)
• Salicylates (e.g., aspirin in high doses) (may enhance insulin sensitivity, increasing risk of hypoglycemia)
• Sulfonamide antibiotics (may enhance insulin sensitivity, increasing risk of hypoglycemia)
• Octreotide/Lanreotide (may decrease insulin requirements in some patients, increase in others)
• Danazol (may cause hyperglycemia, requiring increased insulin dose)
• Oral contraceptives (may cause hyperglycemia, requiring increased insulin dose)
• Thyroid hormones (may cause hyperglycemia, requiring increased insulin dose)

• Not available

• Symptoms of hypoglycemia (e.g., sweating, tremor, dizziness, confusion, hunger, irritability, blurred vision, headache, rapid heartbeat, anxiety, weakness, slurred speech, seizures, unconsciousness)
• Symptoms of hyperglycemia (e.g., increased thirst, frequent urination, increased hunger, fatigue, blurred vision, weight loss)
• Signs of allergic reaction (e.g., rash, itching, swelling, difficulty breathing)
• Signs of injection site reactions (e.g., redness, swelling, itching, pain, lipodystrophy)

Insulin is the preferred treatment for diabetes in pregnancy. Insulin NPH has a long history of safe and effective use during pregnancy. Close monitoring of blood glucose is essential.

Insulin is considered 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 a breastfed infant.

Insulin NPH is used in pediatric patients with type 1 and sometimes type 2 diabetes. Dosing is highly individualized based on age, weight, pubertal status, and glycemic control. Close monitoring for hypoglycemia is crucial, especially in younger children who may not recognize symptoms.

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

• NPH insulin is a cloudy suspension and must be gently rolled or inverted several times before each injection to ensure uniform suspension.
• NPH insulin can be mixed with regular (short-acting) insulin in the same syringe, but it should be drawn up after the regular insulin (clear before cloudy). Administer immediately after mixing.
• Injection sites should be rotated within the same general area (e.g., abdomen) to minimize lipodystrophy and ensure consistent absorption.
• Patients should be educated on the signs and symptoms of hypoglycemia and how to treat it promptly.
• The timing of NPH administration relative to meals is important to optimize glycemic control and minimize hypoglycemia risk.
• NPH insulin is often used as a basal insulin, providing background glucose control, and may be combined with rapid-acting insulin for mealtime coverage.

• Long-acting insulins (e.g., insulin glargine, insulin detemir, insulin degludec) for basal coverage.
• Rapid-acting insulins (e.g., insulin lispro, insulin aspart, insulin glulisine) for mealtime coverage.
• Oral antidiabetic agents (e.g., metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists) for type 2 diabetes.
• Other injectable non-insulin antidiabetic agents (e.g., GLP-1 receptor agonists, amylin analogs).

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 is a good idea to consult with your pharmacist. If you have any questions or concerns about this medication, do not hesitate to discuss them with 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 seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.