Insulatard Hm Penfill

Insulatard HM Penfill

Insulatard HM Penfill is an intermediate-acting insulin used for managing blood sugar levels in individuals with diabetes mellitus.

• Name:

  • Brand Name: Insulatard HM Penfill, Insulatard Penfill
  • Common Name: Human Insulin Isophane (NPH)

• Composition:

  • Active Ingredient: Human insulin (isophane NPH insulin) 100 IU/ml. Each 3 ml cartridge contains 300 IU of human insulin.
  • Other Ingredients: Zinc chloride, glycerol, metacresol, phenol, disodium phosphate dihydrate, sodium hydroxide/hydrochloric acid (for pH adjustment), protamine sulfate, and water for injections.

• Uses: Insulatard HM Penfill is prescribed for the treatment of diabetes mellitus in adults and children, including both Type 1 and Type 2 diabetes. It helps to lower high blood sugar levels and prevent long-term complications associated with diabetes. It achieves this by facilitating glucose uptake into muscle and fat cells and inhibiting glucose production by the liver.

• Dosage and Administration:

  • Dosage is individualized based on the patient's metabolic needs and blood glucose levels, and is determined by a healthcare professional.
  • It is administered by subcutaneous (under the skin) injection into the thigh, abdominal wall, gluteal region, or deltoid region.
  • Injection sites should be rotated within the chosen area to reduce the risk of lipodystrophy and cutaneous amyloidosis.
  • Before each use, the insulin suspension in the cartridge must be gently inverted at least 20 times (and then 10 times before each subsequent injection) until it appears uniformly white and cloudy.
  • Insulatard Penfill is designed for use with compatible Novo Nordisk insulin delivery systems and NovoFine or NovoTwist needles. It is not suitable for intravenous or intramuscular administration, nor for use in insulin infusion pumps.

• Side Effects:

  • Very Common: Hypoglycemia (low blood sugar), which can manifest as cold sweat, pale skin, headache, rapid heartbeat, nausea, hunger, temporary vision changes, drowsiness, weakness, nervousness, tremor, anxiety, confusion, and difficulty concentrating. Severe hypoglycemia can lead to unconsciousness.
  • Common: Injection site reactions such as pain, redness, hives, inflammation, bruising, swelling, and itching. These usually resolve over time.
  • Uncommon: Localized allergic reactions that spread, worsening of diabetic retinopathy with rapid blood sugar improvement.
  • Rare: Vision problems (usually temporary at the start of treatment), painful neuropathy (nerve-related pain with rapid blood sugar improvement).
  • Weight gain may also occur with insulin therapy.

• Precautions:

  • Do not use if allergic to human insulin or any other ingredients.
  • Close glucose monitoring is recommended, especially during transfer from other insulin products.
  • Inadequate dosing or discontinuation can lead to hyperglycemia and diabetic ketoacidosis, particularly in Type 1 diabetes.
  • Caution is advised in patients with reduced kidney or liver function, or in those over 65 years of age, as dose adjustments may be necessary.
  • Exercise, diet changes, illness, and alcohol consumption can affect blood sugar levels and may require insulin dose adjustment. Alcohol may intensify or reduce the hypoglycemic effect of insulin.
  • Patients should be advised to take precautions to avoid hypoglycemia, especially when driving or operating machinery.
  • Inform your doctor if taking pioglitazone, as cases of heart failure have been reported when combined with insulin.
  • Needles and cartridges should not be shared.

• Storage:

  • Before opening: Store in a refrigerator (2°C – 8°C). Do not freeze. Keep away from the cooling element and protect from light by storing in the outer carton.
  • During use or when carried as a spare: Can be stored for a maximum of 6 weeks (42 days) at room temperature (below 30°C). Do not refrigerate or freeze. Keep in the outer carton to protect from light.
  • Discard the needle after each injection.

What is Insulatard HM Penfill used for?

Insulatard HM Penfill is a medicine used to improve blood sugar control in adults and children with both type 1 and type 2 diabetes mellitus. It helps maintain blood sugar levels and can reduce the chances of developing serious complications associated with diabetes, such as kidney damage, eye problems, nerve issues, and diabetic foot ulcers.

How does Insulatard HM Penfill work?

Insulatard HM Penfill contains Isophane Insulin (NPH insulin human), which is an intermediate-acting insulin. It works by replacing the insulin naturally produced by the body. This insulin facilitates the uptake of sugar from the blood into muscle and fat cells, where it's used for energy. It also suppresses the production of sugar by the liver, thereby lowering blood glucose levels. Its effects typically begin about 1 to 2 hours after injection and can last for approximately 24 hours.

What is the usual dosage of Insulatard HM Penfill?

The dosage of Insulatard HM Penfill is individualized and determined by a physician based on the patient's specific needs, metabolic requirements, blood glucose levels, and glycemic control goals. It is usually administered once or twice daily via subcutaneous injection (under the skin) in the thighs, abdomen, buttocks, or upper arm. It can be used alone or mixed with fast-acting insulin. It's crucial to follow the doctor's instructions regarding dosage and timing and to never adjust the dose independently.

What are the possible side effects of Insulatard HM Penfill?

The most frequently reported and common side effect of Insulatard HM Penfill is low blood sugar levels, known as hypoglycemia. Symptoms of hypoglycemia can include cold sweat, cool pale skin, nervousness or tremor, an anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, drowsiness, excessive hunger, temporary vision changes, headache, nausea, and palpitation.

Other possible side effects at the injection site may include pain, redness, itching, swelling, or thickening of the skin (lipodystrophy) or lump formation under the skin. Some people may also experience weight gain or edema (fluid retention causing swelling). If any side effects are persistent or concerning, consult your doctor.

Is Insulatard HM Penfill safe during pregnancy or breastfeeding?

Insulatard HM Penfill is generally considered safe for use during pregnancy if prescribed by a doctor. Your insulin dose may need to be adjusted during pregnancy and after delivery, and careful monitoring of blood sugar levels is important for the health of the baby.

There are no known restrictions on treatment with Insulatard HM Penfill during breastfeeding, as insulin treatment for the nursing mother is not expected to pose a risk to the baby. However, dose adjustments for the mother may still be required.

Can Insulatard HM Penfill be taken with other medications?

Yes, Insulatard HM Penfill can interact with other medications, potentially affecting blood sugar levels. Some medicines can increase the hypoglycemic effect (lower blood sugar), such as other antidiabetic agents, MAO inhibitors, beta-blockers, ACE inhibitors, salicylates, anabolic steroids, and sulfonamides.

Conversely, some medications can decrease the hypoglycemic effect (increase blood sugar), including oral contraceptives, thiazides, glucocorticoids (steroids), thyroid hormones, sympathomimetics, growth hormone, and danazol.

It's important to inform your doctor about all medications you are currently taking, including over-the-counter drugs and herbal supplements, as dose adjustments may be necessary. Beta-blockers, for example, can also mask the warning symptoms of low blood sugar. If you are taking pioglitazone with insulin, there have been reported cases of heart failure, especially in patients at high risk of cardiac heart failure.

What precautions should be taken when using Insulatard HM Penfill?

• Hypoglycemia: Be vigilant for symptoms of low blood sugar and always carry a source of sugar (e.g., glucose tablets, juice, or candy) to treat it immediately. Ensure you take the correct dose, have regular meals, and monitor blood sugar levels regularly.
• Injection Site: Rotate injection sites within the recommended areas (thighs, abdomen, buttocks, upper arm) to prevent skin damage like lipodystrophy (thickening or thinning of fat tissue). Do not inject into tender, red, bruised, hard, scarred, or stretch-marked skin.
• Alcohol Consumption: Avoid or limit alcohol consumption as it can significantly affect blood glucose levels, potentially causing them to rise or fall unpredictably.
• Driving and Operating Machinery: Your ability to concentrate and react may be impaired if you experience low blood sugar. Exercise caution while driving or operating machinery.
• Underlying Conditions: Inform your doctor if you have kidney, liver, or heart problems, as dose adjustments may be needed.
• Travel: If traveling across different time zones, consult your doctor, as your insulin schedule may need to be adjusted.
• Never Share: Do not share your Penfill cartridges or needles with others to prevent the risk of transmitting infections.

What happens if a dose is missed?

If you miss a dose of intermediate-acting insulin like Insulatard HM Penfill and remember within 2 hours of when it was due, it is generally acceptable to take your usual dose as soon as you remember. However, be aware that the insulin will work later than usual, which might increase the risk of hypoglycemia.

If more than 2 hours have passed, or you are unsure what to do, it's best to contact your diabetes care team for advice. Checking your blood glucose levels will provide valuable information to help them guide you. Never take a double dose to compensate for a missed one, as this can lead to a dangerous drop in blood glucose. Missing a dose can lead to high blood sugar levels (hyperglycemia).

How should Insulatard HM Penfill be stored?

Before opening, Insulatard HM Penfill cartridges should be stored in a refrigerator at a temperature between 2°C and 8°C. Do not freeze Insulatard HM Penfill, as freezing can damage the insulin.

Once an Insulatard HM Penfill cartridge is in use or carried as a spare, it can be stored at room temperature (below 30°C or 25°C depending on the specific instruction, generally below 30°C) for a maximum of 6 weeks. It should be protected from light. Discard any unused portion appropriately after the recommended period.