Insulin soluble [human semisynthetic] (Insulin soluble [human semisynthetic])

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Insulins

Included in the formulation
  • Humodar® R 100
    solution for injections 
    Indar, Inc. for the production of insulin     Ukraine
    • АТХ:

    A.10.A.B.01   Insulin (human)

    Pharmacodynamics:It is a short-acting insulin preparation. Forms an insulin-receptor complex due to interaction with a specific receptor of the outer membrane of cells. It stimulates the synthesis of a number of key enzymes (hexokinase, pyruvate kinase, glycogen synthetase and others) and reduces the glucose content in the blood due to the increase in its intracellular transport.
    Pharmacokinetics:The effect of the drug after subcutaneous injection develops within 20-30 minutes, reaching a maximum after 1-3 hours. The duration of action is 5-8 hours, depending on the dose. The duration of the drug is affected not only by the dose, but also by the method, site of administration and individual characteristics. It does not penetrate the placental barrier and into breast milk. It is destroyed by insulinase, mainly in the liver and kidneys. The half-life is from a few to 10 minutes. It is excreted by the kidneys (30-80%).
    Indications:Diabetes mellitus type 1.

    Diabetes mellitus type 2: the stage of resistance to oral hypoglycemic drugs or partial resistance.

    Diabetic ketoacidosis.

    Ketoacidotic and hyperosmolar coma.

    Diabetes mellitus, which occurred during pregnancy (in the absence of the effect of diet therapy).

    For intermittent use in patients with diabetes mellitus against a background of infections accompanied by high fever.

    At forthcoming surgical operations, traumas, sorts, at infringements of a metabolism.

    Before switching to treatment with prolonged insulin preparations.

    ICD-10

    IV.E10-E14.E10   Insulin-dependent diabetes mellitus

    IV.E10-E14.E10.0   Insulin-dependent diabetes mellitus with coma

    IV.E10-E14.E11   Non-insulin-dependent diabetes mellitus

    Contraindications:Hypersensitivity, hypoglycemia.
    Carefully:With caution, select the dose of the drug in patients with previously existing disorders of cerebral circulation according to the ischemic type and with severe forms of coronary heart disease. The need for insulin can change when: switching to another type of insulin; changes in diet, diarrhea, vomiting; changing the usual amount of physical exertion; diseases of the kidneys, liver, pituitary, thyroid gland; change the injection site. Correction of the dose of insulin is required for infectious diseases,thyroid dysfunction, Addison's disease, hypopituitarism, chronic renal failure and diabetes in patients over 65 years of age. Transfer of a patient to human insulin must always be strictly justified and carried out only under the supervision of a doctor.
    Pregnancy and lactation:In pregnancy, it is necessary to take into account a decrease in the requirement for insulin in the first trimester or an increase in the II and III trimesters, during and immediately after delivery, the need for insulin can drop dramatically. When lactating, the patient needs daily observation for several months (until the insulin needs stabilize).
    Dosing and Administration:The drug is administered subcutaneously, intramuscularly, intravenously, 15-30 minutes before meals. With monotherapy, the frequency of administration is usually 3 times a day, but can be increased to 5-6 times a day.

    For the prevention of lipodystrophy, it is recommended that the injection site be changed every time. The average daily dose is 30-40 units, in children - 8 units, then in an average daily dose - 0.5-1 ED / kg or 30-40 units 1-3 times a day, if necessary - 5-6 times a day . At a daily dose of more than 0.6 U / kg, insulin should be administered as two or more injections in various areas of the body.

    It is allowed to combine with long-acting insulin.

    Side effects:Allergic reactions: urticaria, angioedema

    Hypoglycemia: anxiety, pallor, increased sweating, palpitation, tremor, hunger, paresthesia in the mouth, headache, drowsiness, insomnia, fear, depressed mood, irritability, unusual behavior, movement uncertainty, speech and vision impairment, including hypoglycemic coma .

    Hyperglycemia and diabetic acidosis (at low doses, skipping injections, non-compliance with diets, against fever and infections): drowsiness, thirst, decreased appetite, hyperemia of the face.

    Violation of consciousness.

    Transient visual impairment, most often at the beginning of treatment.

    Immunological cross-reactions with human insulin.

    An increase in the titer of anti-insulin antibodies with a subsequent increase in glycemia.

    Local reactions: hyperemia, itching and lipodystrophy.

    At the beginning of therapy, edema and refractive error may occur.

    Overdose:When an overdose develops hypoglycemia (trembling, weakness, nervousness, hunger, "cold" sweat, pale skin, palpitation, paresthesia in the hands, feet, lips, tongue, headache), hypoglycemic coma, seizures.

    Easy patient hypoglycemia can be eliminated independently, taking sugar inside or rich in digestible carbohydrates food. In severe cases, dextrose intravenously.

    Interaction:Simultaneous use with sulfonamides (including oral hypoglycemic drugs), MAO inhibitors (including furazolidone, procarbazine, selegiline), carbonic anhydrase inhibitors, ACE inhibitors, non-steroidal anti-inflammatory drugs (including salicylates), anabolic steroids (including stanozolol, oxandrolone, methandrostenolone), androgens, bromocriptine, tetracycline, clofibrate, ketoconazole, mebendazole, theophylline, cyclophosphamide, fenfluramine, drugs Li +, pyridoxine, quinidine, quinine, chloroquine, ethanol leads to an increase in hypoglycemic action.

    Hypoglycemic effect weakens glucocorticosteroids, glucagon, somatropin, oral contraceptives, estrogens, thyroid hormones, thiazide and loop diuretics, slow calcium channel blockers, heparin, sulfinpyrazone, sympathomimetics, calcium antagonists, danazol, tricyclic antidepressants, clonidine, diazoxide, morphine, marijuana, nicotine, epinephrine, phenytoin, H1-histamine receptor blockers.

    Beta-blockers, octreotide, reserpine, pentamidine can both enhance and weaken the hypoglycemic action of insulin.

    Special instructions:Before taking insulin from the vial, you need to check the transparency of the solution. When foreign bodies appear, turbidity or precipitation of the substance on the glass of the vial, the drug should not be used.
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