Insulatard

When and how do I take it?

Insulatard is for injection under the skin (subcutaneously). Never inject your insulin directly into a vein or muscle (intramuscular). Always vary the sites you inject within the same region to avoid lumps. The best places to give yourself an injection are: the front of your waist (abdomen), the upper arm or the front of your thighs.
You should always measure your blood glucose regularly.

To inject Insulatard on its own:

• 1. Just before injecting this insulin, roll the vial between your hands until the liquid is uniformly white and cloudy. Resuspending is easier if the insulin has reached room temperature
• 2. Draw air into the syringe, in the same amount as the dose of insulin you need
• 3. Inject the air into the vial: push the needle through the rubber stopper and press the plunger
• 4. Turn the vial and syringe upside down
• 5. Draw the right dose of insulin into the syringe
• 6. Pull the needle out of the vial
• 7. Make sure there is no air left in the syringe: point the needle upwards and push the air out
• 8. Check you have the right dose
• 9. Inject straight away.

To mix Insulatard with fast-acting insulin:

• 1. Roll the vial of Insulatard between your hands. Do this until the liquid is uniformly white and cloudy. Resuspending is easier if the insulin has reached room temperature
• 2. Draw as much air into the syringe as the dose of Insulatard you need. Inject the air into the Insulatard vial, then pull out the needle
• 3. Draw as much air into the syringe as the dose of fast-acting insulin you need. Inject the air into the fast-acting insulin vial. Then turn the vial and syringe upside down
• 4. Draw the right dose of fast-acting insulin into the syringe. Pull the needle out of the vial.

Make sure there is no air left in the syringe:  point the needle upwards and push the air out. Check the dose

• 5. Now push the needle into the vial of Insulatard. Then turn the vial and syringe upside down
• 6. Draw the right dose of Insulatard into the syringe. Pull the needle out of the vial. Make sure there is no air left in the syringe, and check the dose
• 7. Inject the mixture straight away.

Always mix fast-acting and long-acting insulin in this order.

• Inject the insulin
• Inject the insulin under the skin. Use the injection technique advised by your doctor or
• diabetes nurse.
• Keep the needle under your skin for at least 6 seconds to make sure that the full dose has been delivered.

What’s the dose?

Insulatard dosing is individual and determined in accordance with the needs of the patient. It should normally be given at least once a day. Blood glucose monitoring and insulin dose adjustments are recommended to achieve optimal glycaemic control.

Could it interact with other tablets?

A number of medicinal products are known to interact with the glucose metabolism. The following substances may reduce the patient's insulin requirements:

• Oral antidiabetic medicinal products
• monoamine oxidase inhibitors (MAOI)
• beta-blockers
• angiotensin converting enzyme (ACE) inhibitors
• salicylates
• anabolic steroids
• sulphonamides

The following substances may increase the patient's insulin requirements:

• Oral contraceptives
• thiazides
• glucocorticoids
• thyroid hormones
• sympathomimetics
• growth hormone
• danazol
• Beta-blocking agents may mask the symptoms of hypoglycaemia.
• Octreotide/lanreotide may both increase or decrease insulin requirement.
• Alcohol may intensify or reduce the hypoglycaemic effect of insulin.

Herbal supplements should be used with caution and only after informing your doctor first.

What are the possible risks or side-effects?

The most common side effect is hypoglycaemia (low blood sugar levels). Omission of a meal or unplanned strenuous physical exercise may lead to hypoglycaemia.

Possible symptoms of hypoglycaemia include:

• headache
• ravenous hunger
• nausea
• vomiting
• lassitude
• sleepiness
• disordered sleep
• restlessness
• aggressiveness
• impaired concentration, alertness and reaction time
• depression
• confusion
• speech and visual disorders
• aphasia
• tremour
• paresis
• sensory disturbances
• dizziness
• helplessness
• loss of self-control
• delirium
• cerebral convulsions
• somnolence and loss of consciousness up to and including coma
• shallow respiration and bradycardia 

In addition, signs of adrenergic counter-regulation may be present such as sweating, clammy skin, anxiety, tachycardia, hypertension, palpitations, angina pectoris and cardiac arrhythmias.

Symptoms can almost always be promptly controlled by immediate intake carbohydrates (sugar). Artificial sweeteners have no effect.

Can I drink alcohol while taking it?

• If you are drinking alcohol your need for insulin may change as your blood sugar level may either rise or fall. Careful monitoring is recommended.
• Always ask your doctor/pharmacist however as this may depend on what other tablets you are taking.

What if I’m pregnant/breastfeeding?

Insulatard may be used during pregnancy and while breast feeding. Doses may need to be adjusted.

How do I store it?

• Insulatard that is not being used is to be kept in the fridge, between 2 and 8° C.
• Insulatard that is being used or carried with you is not to kept in the fridge. It can be kept at room temperature for six weeks. Any remainder should then be discarded.

If you have any more questions please ask your Pharmacist.

Remember to keep all medicines out of reach of children
Please Note: We have made every effort to ensure that the content of this information sheet is correct at time of publish, but remember that information about drugs may change. This sheet does not list all the uses and side-effects associated with this drug. For full details please see the drug information leaflet which comes with your medicine. Your doctor will assess your medical circumstances and draw your attention to any information or side-effects which may be relevant in your particular case.

References:

http://www.diabetes.co.uk/insulin/insulin-types.html

http://www.novonordisk.com/patients/diabetes-care/insulin-pens-and-needles.html

http://www.drugs.com/international/insulatard.html