Generic
Insulin (Human) N
19 brands available in the market
At a glance
Insulin (Human) N (NPH insulin) is an intermediate-acting insulin used for the treatment of diabetes mellitus.
Description
Insulin (Human) N is an NPH insulin (Neutral Protamine Hagedorn) which is an intermediate-acting insulin preparation. It lowers blood glucose levels and regulates carbohydrate, protein and fat metabolism. It inhibits hepatic glucose production and lipolysis, and enhances peripheral glucose disposal. NPH insulin contains equal amounts of protamine and insulin, ensuring slow release of insulin.
Indications
- Diabetes mellitus (Type 1 and Type 2)
Therapeutic class
Antidiabetic (Insulin)
Pharmacological class
Intermediate-acting Insulin (NPH)
Pharmacology
Insulin lowers blood glucose levels. It regulates carbohydrate, protein and fat metabolism by inhibiting hepatic glucose production and lipolysis, and enhancing peripheral glucose disposal. NPH insulin (isophane insulin) is an intermediate-acting preparation containing equal amounts of protamine and insulin, ensuring slow release of insulin.
Mechanism of action
Lowers blood glucose by binding to insulin receptors, facilitating glucose uptake in muscle and fat cells, and inhibiting glucose output from the liver.
Dosage
Adult Dose (Subcutaneous):
- Type 1 Diabetes: 0.5-1 unit/kg/day in divided doses; nonobese: 0.4-0.6 unit/kg/day; obese: 0.8-1.2 units/kg/day
- Type 2 Diabetes: 0.3-0.6 units/kg/day in 1-2 divided doses; starting: 0.2 unit/kg/day
- Change insulin doses in small increments: Type 1 (2 units); Type 2 (2-4 units)
- When combined with regular insulin: Morning: 2/3 of daily dose (Regular:NPH = 1:2); Evening: 1/3 (Regular:NPH = 1:1)
Child Dose (Type 1, >12 years): 0.5-1 unit/kg/day; adolescents <1.2 units/kg/day
Administration
Administer within 15 minutes before a meal or immediately after a meal as subcutaneous injection in the upper arm, thigh or abdominal wall; abdominal wall injection results in faster absorption; never administer intravenously.
Missed dose
If you miss a dose, please consult your doctor.
Side effects
Side Effects:
- Hypoglycemia
- Injection site reactions (redness, swelling, pain)
- Lipodystrophy
- Pruritus
- Rash
- Lipoatrophy
- Hypokalemia
- Blurred vision
- Insulin resistance
- Allergic reactions
Precautions & warnings
Precautions:
- Pregnancy (insulin requirements fall in 1st trimester, increase in 2nd and 3rd) and lactation
- Caution with decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment
- Hypokalemia may occur
- Caution in renal and hepatic impairment (dosage requirements may be reduced)
- Caution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery
- Not for IV or IM administration
Contraindications
Contraindications:
- Hypoglycemia
- Hypersensitivity to any of the components
Drug interactions
Drug Interactions:
- Possible absence of hypoglycemic warning symptoms with beta-blockers
- Decreased hypoglycemic effect with corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetic agents, thyroid hormones, estrogens, progestins
- Increased hypoglycemic effect with oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates, sulfonamide antibiotics
- Octreotide and lanreotide decrease insulin resistance
- Pioglitazone, rosiglitazone increase risk of weight gain and peripheral edema
Food interactions
No food interaction found/established.
Use in pregnancy
Use in Pregnancy: Insulin is safe during pregnancy; insulin does not cross placental barrier; insulin requirements fall in 1st trimester, increase in 2nd and 3rd; return to pre-pregnancy values after delivery.
Use in lactation
Use in Lactation: Safe during breastfeeding; safe to use while breastfeeding.
Pediatric use
Safety and efficacy not established in children <12 years; >12 years: 0.5-1 unit/kg/day; adolescents <1.2 units/kg/day.
Geriatric use
No specific data for elderly.
Renal / hepatic impairment
Renal Impairment: Dose adjustments may be needed (dosage may be reduced).
Hepatic Impairment: Dose adjustments may be needed (dosage may be reduced).
Overdose effects
Overdose: No specific overdose definition for insulin; hypoglycemia may develop; mild episodes treated with oral glucose or sugary products; severe episodes with glucagon (0.5-1 mg) IM/SC or IV glucose; oral carbohydrate recommended after regaining consciousness.
Storage conditions
Store between 2°C-8°C in refrigerator; do not freeze; protect from light; during use may be stored below 25°C for 6 weeks or below 30°C for 4 weeks.
Chemical structure
Insulin (Human) N