Insulin (Human-Isophane Recombinant)

Indications
 Subcutaneous
Diabetes mellitus
Adult: Usual insulin requirement: 0.3-1 IU/kg/day; may be given in 1-2 divided doses. Dose should be individualised, to be adjusted according to patient's needs. May be used alone or in combination with a fast-acting insulin.
Renal impairment: Dosage reduction may be needed.
Hepatic impairment: Dosage reduction may be needed.
Warnings / Precautions
 Monitor for signs of hypoglycaemia. Insulin requirements may change when there is illness, emotional disturbance or other stresses. Renal and hepatic impairment. Monitor blood glucose and haemoglobin A1c. Caution when changing insulin as changes in strength, brand, type, manufacturer and source may result in dosage changes. Inj area should be rotated to reduce the risk of lipodystrophy and inj-site reactions e.g. redness and inflammation. β-blockers may mask symptoms of hypoglycaemia. Pregnancy and lactation.
Adverse Reactions
 Inj site reactions e.g. swelling, redness, itch and pain.
Potentially Fatal: Anaphylactic reactions.
Overdose Reactions
 Overdose may lead to hypoglycaemic attack. Mild hypoglycaemia can be treated by oral admin of glucose or sugary products. Severe attack whereby the patient has become unconscious may require treatment using IM or SC glucagon (0.5-1 mg); IV glucose must be given concurrently if patient does not respond after 10-15 minutes. Oral carbohydrate should be administered after patient regains consciousness to prevent relapse.
Drug Interactions
 Concurrent use with oral antidiabetic agents, MAOIs, ACE inhibitors, salicylates, alcohol, anabolic steroids and non-selective β-blockers may reduce insulin requirements. Drugs that may increase insulin requirements include: Oral contraceptives, thiazides, thyroid hormones, growth hormone, danazol and β-sympathomimetics. Octreotide may affect insulin requirement.
See Below for More insulin isophane, human Drug Interactions
Mechanism of Actions
 Insulin isophane (human) is a crystalline suspension of human insulin with protamine and zinc. It is an intermediate-acting insulin. Insulin facilitates the uptake of glucose by binding to receptors on muscle and fat cells; it also inhibits glucose output from liver.
Onset: 1-2 hr.
Duration: 18-24 hr.
Absorption: Takes 6-12 hr to reach peak levels.
Excretion: Urine.
Storage Conditions
 Subcutaneous: Unopened vial or pen: Store at 2-8°C. Used vial and pen should be stored below 25°C; discard after 4 wk.
Storage
 Subcutaneous: Unopened vial or pen: Store at 2-8°C. Used vial and pen should be stored below 25°C; discard after 4 wk.
Available As
  • Insulin (Human-Isophane Recombinant) 40 iu
  • Insulin (Human-Isophane Recombinant) 50%/40 iu
  • Insulin (Human-Isophane Recombinant) 70%
  • Insulin (Human-Isophane Recombinant) 70%/40 iu

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