RP: Protofan NM 100MEML - 10 ML
D.T.D: №2 in amp.
S: PC, dose is prescribed by an endocrinologist.

pharmachologic effect

Medium duration insulin preparation. Reduces blood glucose concentration increases its absorption with tissues, enhances lipogenesis and glycogenogenesis, protein synthesis reduces glucose products with liver. Interacts with a specific receptor of the outer membrane of cells and forms an insulinceptor complex. Through the activation of the synthesis of CAMF (in fat cells and liver cells) or directly penetrating into the cell (muscle), the insulinceptor complex stimulates intracellular processes, incl. Synthesis of a number of key enzymes (hexokinase, pyruvatkinase, glycogenacentase, etc.). The reduction in the content of glucose in the blood is due to an increase in its intracellular transport, an increase in the absorption and assimilation by tissues, stimulation of lipogenesis, glycogenesis, protein synthesis, a decrease in the speed of glucose products to the liver (decrease in glycogen decay), etc. After p / k injecting the action occurs after 1-1.5 hours . The maximum effect - in the interval between 4-12 hours, the duration of action - 11-24 hours, depending on the composition of insulin and dose, reflects significant inter- and internal deviations.

Mode of application

For adults: P / k, 1-2 times a day, 30-45 minutes before breakfast (the injection site is changed each time). In special cases, the doctor may be prescribed to the drug injection. V / in the introduction of insulin of the average duration of action is prohibited! Doses are selected individually and depend on the content of glucose in the blood and the urine, the features of the course of the disease. Usually, the doses are 8-24 months 1 times a day. In adults and children with high sensitivity to insulin, a dose of less than 8 IU / day can be sufficient, in patients with reduced sensitivity - exceeding 24 IU / day. In a daily dose, exceeding 0.6 me / kg, - in the form of 2 injections in different places. Patients receiving 100 me and more, when replacing insulin, it is advisable to hospitalize. Translation from one drug on others should be carried out under blood glucose control.

Indications

Type 1. Diabetes mellitus type 2; stage of resistance to oral hypoglycemic drugs, partial resistance to oral hypoglycemic drugs (combined therapy); Intercurrent diseases, operational interventions (mono- or combination therapy), diabetes mellitus against the background of pregnancy (with ineffectiveness of diet and therapy).

Contraindications

Hypersensitivity, hypoglycemia, insulin.

Side effects

Allergic reactions (urticaria, angioedema edema - fever, shortness of breath, decreased blood pressure); hypoglycemia (pallor of skin, strengthening of sweating, hydrigation, heartbeat, tremor, feeling of hunger, excitement, anxiety, paresthesia in the field of mouth, headache, drowsiness, insomnia, fear, depressive mood, irritability, unusual behavior, uncertainty of movements, violations of speech and vision), hypoglycemic coma; hyperglycemia and diabetic acidosis (at low doses, passing injection, non-compliance with diet, on the background of fever and infections): drowsiness, thirst, decreased appetite, face hyperemia); violation of consciousness (up to the development of a precancetous and comatose state); transient visual impairment (usually at the beginning of therapy); immunological cross-reactions with man insulin; an increase in the titer of anti-zulin antibodies with the subsequent growth of glycemia; Hyperemia, itching and lipodystrophy (atrophy or hypertrophy of subcutaneous fatty fiber) at the injection site. At the beginning of treatment - swelling and disruption of refraction (they are temporary and pass with the continuation of treatment). Decode. Symptoms: Spirit, heartbeat, tremor, feeling of hunger, anxiety, paresthesia in the mouth, pallor, headache, drowsiness, insomnia, fear, depressive mood, irritability, unusual behavior, uncertainty of movements, violations of speech and vision, hypoglycemic coma, convulsions. Treatment: if the patient is conscious, prescribed dextrose inside; P / K, in / m or in / in glucagon or in / in a hypertensive solution of dextrose. With the development of the hypoglycemic coma B / in insertion, 20-40 ml (up to 100 ml) of 40% declaration solution is administered until the patient leaves the comatose state.

Form release

Suspension for injection in bottles of 10 ml (40, 80 and 100 meters or units per 1 ml).

ATTENTION!

Information on the page you will be viewed exclusively for informational purposes and does not promote self-treatment. The resource is intended to familiarize health officers with additional information about certain medicines, thereby increasing their level of professionalism. Using the drug " Insulin Isophan"It is mandatory providing advice with a specialist, as well as its recommendations for the method of application and dosage of the medicine you have chosen.

The drug refers to medium duration insuls. In essence, this is human insulin, which was obtained due to the technology of recombinant DNA.

pharmachologic effect

Insulin Isophane carries hypoglycemic effect. It involves interacting with special receptors of the outer cytoplasmic cell membrane and forms an insulin gelector system that stimulates intracellular processes, among which the synthesis of kernel of key enzymes (pyruvatenase, hexochinase, glycogenesis) is included.

Increased glucose intracellular transport causes a decrease in its blood level. This also helps to reduce the rate of production of glucose liver, enhancing the absorption and absorption of tissues. Stimulates glycogenogenesis, lipogenesis, protein synthesis.

The absorption rate, due to which the drugs have a long action, depends on several factors: places and method of administration, dose. In this regard, the effect of insulin can fluctuate to a large extent. Moreover, these oscillations can be observed not only in different people, but also in the same patient.

After subcutaneous injection On average, the drug begins to work after 1.5 hours, and the maximum effect occurs in the interval between 4 and 12 hours. The effect of the drug lasts within 24 hours.

The beginning of the effect and fullness of insulin suction varies:

• from the place of administration (belly, buttocks, thigh);
• from the concentration of hormone in the preparation;
• from the amount of insulin insertion (dose).

Other features:

1. Does not fall B. breast milk.
2. It is unevenly distributed over the tissues.
3. Does not break through the placental barrier.
4. By 30-80% excreted by the kidneys.
5. It is destroyed by insulsion mainly in the kidneys and liver.

In what cases to take insulin isofane

• Sugar diabetes I and II type.
• Phase resistance to hypoglycemic oral drugs.
• When carrying out a combined treatment, partial resistance to the preparations of this group.
• Sugar diabetes type II in pregnant women.
• Intercurrent diseases.

Contraindications

Side effects of the drug Insulin Isofane

Related to the effect on the exchange of carbohydrates:

Hypoglycemia:

1. reinforced sweat separation
2. hunger,
3. skin pallor
4. tremor, tachycardia,
5. excitation,
6. headache,
7. presthesia in the mouth;
8. severe hypoglycemia, which is fraught with the development of the hypoglycemic coma.

Allergic manifestations are extremely rare:

• swelling quinque,
• skin rash,
• anaphylactic shock.

• usually at the beginning of the treatment, transient disorders of refraction;
• edema.

Local reactions:

1. eveniness and itching in the injection area;
2. hyperemia;
3. lipodystrophy in the field of injection (with long use).

Interaction

Enhance the hypoglycemic effects of insulin:

• mao inhibitors;
• hypoglycemic oral preparations;
• bromocriptine;
• carboanhydrase inhibitors;
• sulfonamides;
• phenfluramin;
• preparations containing ethanol;
• aCE inhibitors;
• non-selective beta adrenoblays;
• negroesol;
• lithium preparations;
• tetracyclines;
• ketoconazole;
• anabolic steroid;
• cyclophosphamide;
• octreotide;
• pyridoxine;
• clofibrate;
• teophylline.

Weaken hypoglycemic effects of insulin:

1. tiazide diuretics;
2. oral contraceptives;
3. diazoxide;
4. thyroid hormones;
5. morphine;
6. glucocorticoids;
7. danazol;
8. heparin;
9. tricyclic antidepressants;
10. nicotine;
11. sympathomimetics;
12. clonidine;
13. phenitoin.

But salicylates and reserpine can also weaken and strengthen the effect of insulin.

Overdose

When overdose, hypoglycemia may occur.

Treatment of hypoglycemia

With mild hypoglycemia, the patient can cope with independently, eating a piece of sugar, candy or carbohyded-saturated products. Therefore, patients with diabetes should always have sugar, cookies, candy or fruit juice.

In cases of severe hypoglycemia, when the patient loses consciousness, it is administered intravenously 40% of the dextrose or glucagon.

The last genetic engineering insulin can be introduced intramuscularly, and subcutaneously. When consciousness comes back, he needs to take food rich in carbohydrates, it will prevent the re-development of hypoglycemia.

Method of application and dose

The dose of P / K is determined by a specialist individually in each case. It is based on the blood glucose level of the patient. Average daily dose The drug varies from 0.5 to 1 IU / kg, it depends on what and the individual characteristics of the patient, how it reacts to the human and genetic engineering insulin isofane.

Usually insulin isophane, as a human and genetic engineering drug introduced into the thigh subcutaneously, but you can make injections to the buttock, the front abdominal wall, to the area of \u200b\u200bthe deltoid muscle of the shoulder. The temperature of the injected drug should be room.

Precautions

In addition to the fact that the human and genetic engineering insulin can be exceeded, the causes of hypoglycemia can be:

1. passing meals;
2. diarrhea, vomiting;

Diseases that reduce the need for hormone insulin (pituitary hypofunction, adrenal cortex, thyroid gland, disorders of the kidney and liver);

1. replacement of the drug;
2. changing the injection zone;
3. increase physical Loads;
4. interaction with other drugs.

If the human and genetic engineering insulin is set with interruptions or incorrect dosage can lead to hyperglycemia, the symptoms of which are usually developing gradually (several hours or even days). Hyperglycemia is accompanied by:

• the appearance of thirst;
• dry mouth;
• rapid urination;
• nausea, vomiting;
• loss of appetite;
• dizziness;
• dry and redness of the skin;
• the smell of acetone from mouth.

If the hyperglycemia is treated in a timely manner during type I diabetes, a very dangerous diabetic disease is ketoacidosis.

In the illness of Addison, disorders of the thyroid, liver and kidneys, hypocituitarism and diabetes in the elderly, it is necessary to adjust the dose and is inserted to prescribe human and genetically engineering insulin.

Dose changes may be required in cases where the patient changes the familiar diet or increases the intensity of physical exertion.

Human and genetically engineered insulin reduces alcohol tolerance. In connection with the change of the type of insulin, its primary purpose, is the likelihood of a decrease in the ability to driving vehicles or control by various mechanisms.

Cost

Prices for Isophanes in Moscow pharmacies range from 500 to 1200 rubles depending on the dosage and manufacturer.

Insulin therapy - Introduction of insulin-based drugs therapeutic goal. There are a large number of medicines based on this hormone, which are divided into several groups, depending on the occurrence of the effect and duration of action. One of the representatives of medium duration of medium duration - insulin -isofane. It is described in more detail in the article.

pharmachologic effect

Insulin-Isofane (human genetically engineering) is synthesized by changing the DNA of the hormone using the attachment of the strain of single-cell fungi, which relate to the sugarmicette class. When entering the body, the substance forms specific complexes on the surfaces of cells, which activate a number of reactions within the cells themselves, including the synthesis of important substances.

The hypoglycemic effect of insulin-isophane is associated with the acceleration of the processes of sugar flow from the bloodstream into the cells of the human body, as well as slowing the synthesis of glucose hepatocytes of the liver. Also, the drug stimulates the processes of the formation of protein substances, participates in fat metabolism.

The duration of the effect after the administration of the drug depends on the rate of its suction, which, in turn, is determined by a number of factors:

• dose of substance;
• method of administration;
• introduction;
• the state of the patient himself;
• the presence of concomitant diseases (primarily infectious);
• physical activity;
• patient body weight.

Endocrinologist- specialist who will help you choose the scheme of insulin therapy

According to statistics, insulin-isophan activity is manifested after 1.5 hours from the moment of injection, the duration of action is up to 24 hours. The largest level of substance in the bloodstream is noted in the period from 2 to 18 hours after the administration of the medication under the skin.

Important! Insulin-isofane does not bind to proteins that circulate in the bloodstream, except those that are antigens to the insulin itself.

Medicine does not go into milk when breastfeeding. Up to 75% of the substance is derived from the body along with urine. According to research, the drug is not toxic for the reproductive system and DNA of human, does not have a carcinogenic effect.

When is the substance assign?

The application instruction indicates that testimony for the use of insulin-isophanes are:

• insulin-dependent form of diabetes;
• insulin-dependent form of diabetes;
• partial resistance to the action of tableted saccharincing preparations;
• the presence of intercurrent diseases (those that are joined by chance, but exacerbate the course of the main disease);
• gestational diabetes of pregnant women.

Mode of application

Form release drug - Suspension for injecting administration of 40 IU in 1 ml. There is 10 ml in the bottle.

Insulin isophane is used exclusively in the form of subcutaneous injection. The dosage picks up the attending specialist, given the floor, the age of the patient, its body weight, sugar indicators and physical activity. As a rule, 0.5-1 meters per day are prescribed on a kilogram of body weight.

Drug can be administered:

• in the thigh;
• buttock;
• front abdominal wall;
• delta muscle shoulder.

The medicinal substance is introduced exclusively subcutaneously, constantly changing the place of injection

The place is constantly changing. This is necessary to prevent the development of lipodystrophy (the condition in which the subcutaneous fat layer is atrophically).

Important! In Vienna, the drug is prohibited. When subcutaneous injection, the temperature of the introduced solution must remain within room numbers.

Insulin therapy using insulin-isophane, as well as any other drug based on the analogue of the pancreatic hormone, should be combined with checking the level of glycemia in the dynamics.

The dosage of the drug must be adjusted in the following situations:

• chronic adrenal cortex failure;
• thyroid hypofunction;
• heavy kidney or liver pathologies;
• infectious diseases that are accompanied by a high body temperature;
• elderly patient age.

Contraindications and side effects

Insulin Isofan is not prescribed for insulin therapy in the presence of an increased individual sensitivity to active components, in the presence of a hormone tumor of the pancreas and with a decrease in the level of glycemia.

The introduction of a greater dose of the drug than necessary can cause a hypoglycemic state. Its main manifestations are headache and dizziness, pathological sensation of hunger, high sweating. Patients complain of trembling of hands, fingers, the appearance of nausea and vomiting, fear and feeling of anxiety.

Important! During inspection, failures in memory can be determined, disoring coordination, disorientation in space, speech disorders.

Hypoglycemia - low level Sugar in the bloodstream, which can be caused by an overdose of the hormone of the pancreas

In addition to overdose, low-leveling factors can be a passing of regular food intake, the change of one insulin drug to another, excessive physical activity, the change of the area of \u200b\u200badministration, simultaneous treatment with several groups of drugs.

Another side effect that may arise against the background of non-compliance with the drug administration scheme or an incorrectly selected dose may be a hyperglycemic state. His symptoms are manifested as follows:

• the patient often drinks and urins;
• attacks of nausea and vomiting;
• dizziness;
• dry skin and mucous membranes;
• feeling acetone smell in exhaled air.

Both states (hypo- and hyperglycemia) require immediate medical care and further revision of insulin therapy scheme.

The drug can cause allergic reactions that are manifested by the following syndromes:

• hives;
• swelling quinque;
• anaphylactic shock.

At the injection site, edema may occur, inflammatory reaction, redness, itching, hemorrhage, lipodystrophy.

There are also situations against which the use of insulin-isophane violates the ability to manage transport and other mechanisms. This may be due to the primary use of the drug, the transition from one drug to another, the action of stress and with significant physical activity.

In some cases, dizziness is possible, which is a barrier to control vehicles

Pregnancy and lactation period

The active substance of the drug does not penetrate into breast milk and through a placental barrier, so insulin-isofan can be prescribed to women during the period of tooling the child and breastfeeding. It is important to accurately calculate the dose of the injected means, since the critical increase or decrease in the blood sugar when using the incorrect dosage is fraught for the fetus.

Important! The first 12 weeks, as a rule, the amount of insulin intimidated is less than in the second and third trimester.

Medicinal interaction

There are preparations that can enhance the hypoglycemic effect of insulin-isophane, and there are those that, on the contrary, weaken it, leading to an increase in blood sugar in the patient.

The first group of medicines belongs:

• tableted Sugarins;
• aCE inhibitors;
• sulfonamides;
• some antibiotics;
• anabolic steroid;
• antifungal agents;
• Theophylline;
• lithium-based preparations;
• Cloofibrate.

Representatives of the tetracycline group are able to strengthen the hypoglycemic effect of insulin

The second group includes:

• hormones of adrenal cortex;
• Coki;
• hormones of the thyroid gland;
• heparin;
• diuretic;
• antidepressants;
• sympathomimetics.

Important! When a combination of any of the drugs with insulin-isofane should be consulted with the attending endocrinologist about the need for a dosage correction.

Trade names

Insulin Isofane is an active substance of many analogues of human insulin, so its trade name has several types (synonyms):

• Biosuline-n;
• PROTAFAN NM;
• Protafan NM Penfill;
• Rosinsulin C;
• Humodar b 100 rivers;
• Humulin NPH.

Insulin is considered a prescription drug. Self-treatment is unacceptable to a similar means.

Included in the preparations

JNVLP

Onls.

A.10.A.c. Insulins and their analogues of average duration of action

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

IV.E10-E14.e11 Insulin-dependent sugar diabetes

XV.O20-O29.O24 Sugar diabetes during pregnancy

Assigns to control blood sugar and lead workflows in the body. You can use for complete and partial treatment.

Composition and action

Insulin Isofan is human genetically engineering (lat. Insulinum IsoPhanum Humanum Biosyntheticum) Hormon, the action of which is identical to the body identically and refers to medium-long.

The composition of the medication contains in 1 ml of 100 units of the effective ingredient, as well as additional substances, including water for injections, protamine sulfate, sodium dihydrophosphate, phenol crystalline, metaceol and glycerol. Produced in the form of a suspension. Provides such actions:

• enhances lipogenesis and glukegenesis, which reduces blood sugar levels;
• increases the absorption of glucose tissues;
• activates intracellular metabolic processes;
• lowers glycogenize;
• after the introduction begins to act 1-1.5 hours;
• efficiency is maintained for 11-24 hours.

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When are you prescribed?

Indications for application:

The drug is appointed with diabetes in pregnant women.

• diabetes mellitus 1 and 2 types;
• stage when the body has resistance to opposing drugs taken orally;
• diabetes mellitus 2 in pregnant women (in the absence of effect from diets);
• partial resistance to sucroppy drugs in comprehensive therapy;
• complications of the disease;
• surgical interventions (as part of integrated or single treatment).

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Instructions for the use of "Insulin-Isophane"

The medicine is administered subcutaneously, sometimes you can prick intramuscularly. The average dosage per day is 0.5-1 IU / kg. When carrying out manipulations, the drug must be room temperature. The injection is made 1-2 times a day for 30-45 minutes before breakfast 8-24 pieces disposable. The place of procedure is changed each time (thigh, buttock, front abdominal wall). The dosage is selected individually, based on the blood glucose indicators and the urine, as well as the disease.

The instruction recommends that children and adults with increased sensitivity use the daily dose of up to 8 months, and low - it can be above 24 meters. Patients who introduced 100 and more, with the replacement of the hormone, should be hospitalized. If the patient is used by a substitute for a medical preparation, the blood glucose level should be controlled. According to the instructions for the use of intravenous injections, insulin, medium-continuous operation is prohibited.

Contraindications

In addition to useful qualities, the drug has such contraindications:

• increased sensitivity to the components of therapeutic agent;
• reduction of blood sugar and during pregnancy;
• the presence of a pancreatic tumor leading to excessive production of insulin hormone (insulinoma);
• carefully apply patients over 65 years and having problems with liver and kidneys.

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Sideflines

Although "insulin" is an important medical examination for diabetics, it has such side effects:

• allergic rash in the form of urticaria;
• lower pressure;
• temperature increase;
• sweep quinque and anaphylactic shock;
• feeling of cold and shortness of breath;
• hyperglycemia;
• in place of injection swelling and itching;
• violation of visual functions;
• feeling of fear and feelings of hunger, lack of sleep, depressive condition and others.

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Compatibility

There are medical preparations that enhance the properties of "Insulin-Isophane" with joint admission, they include:

• hypoglycemic drugs in tablets;
• monoaminoxidase inhibitors, angiotensin-shift enzyme, NVPS;
• sulfamide;
• separate antibiotics;
• assimilative steroids;
• funds from fungal diseases;
• "Theophyllin" and "clofibrate";
• drugs with lithium.

Reduces the effect of nicotine preparation, alcohol enhances the sugar effect. And also exist drugs that affect the strengthening and decrease in the effectiveness of "insulin-isophane" - these are β-adrenoblays, "reserpine", "pentamidine". The preparations that reduce the action include:

• hormones of the thyroid gland and adrenal cortex;
• "Heparin";
• diuretic drugs;
• antidepressants;
• "Danazole" and "Morphine";
• oral contraceptive means.

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Symptoms overdose

If overdose happened therapeutic agent, there may be changes in mental statewhich are manifested by fear, depression, irritability, unusual behavior. And also the occurrence of hypoglycemia is a decrease in blood sugar levels. It is treated by administering dextrose or glucagon. In the case of the hypoglycemic coma, the patient is administered to dextrose until the condition stabilizes. Then welcome food with increased content Carbohydrates.

Precautions

Before injection, you need to make sure that the solution is transparent, without clouds. When flakes, muddy, sediment drug is prohibited. If a patient has a cold or other infectious disease, it is recommended to consult a dosage doctor. The temperature of the medication before the enroll should be adjusted to room floor. It is necessary to constantly change the injection injection zone.

Analogs of the drug

The use of substitutes of the drug must be coordinated with the doctor, because hormones are serious drugs that can lead to undesirable reactions. Analogues of Insulin-Isophane have been created, which have the trade name "Insumal", "Humulin", "Biogulin", "Pensulin", "Insulidd", "Sensulin", "Aktrafan", "arise" and others. Preparations to the patient can only be prescribed by the doctor based on the composition, as well as the dosage that is selected individually.

Information is given only for general familiarization and cannot be used for self-medication. Do not deal with self-medication, it can be dangerous. Always consult your doctor. With partial or complete copying of materials from the site, an active reference to it is required.

Insulin Isofane: Instructions for use and price of the drug

Insulin treatment has a substitution, because the main task of therapy is compensation of failures in carbohydrate exchange By introducing a special preparation under the skin. Such a medicine affects the body as well as natural insulin produced by the pancreas. At the same time, treatment is full or partial.

Among the means used in diabetes, one of the best is insulin isofane. The drug contains human genetically engineering insulin of the average duration of action.

The tool is produced by B. various forms. It is introduced in three ways - subcutaneously, intramuscularly and intravenously. This allows the patient to choose the optimal version of the level of glycemia.

Indications for the use and trade names of the drug

The use of the means is shown in the insulin-dependent form of diabetes. Moreover, therapy should be lifelong.

Insulin as Isophane The human genetically engineering drug is appointed in such cases:

1. diabetes 2 Type (insulin-dependent);
2. surgical manipulations;
3. resistance to sugar-imaging agents assigned orally as part of comprehensive treatment;
4. gestational diabetes (in the absence of effectiveness of diet and therapy);
5. interpurrente pathologies.

Pharmaceutical companies produce human genetically engineering insulin under various names. The most popular - engaged-n, biosuline-H, Protafan-nm, Insuran-NPH, general-n.

Other types of isophanes insulin are used with the following trade names:

• Insumal;
• Humulin (NPH);
• Pensulin;
• Isophane Insulin NM (Protafan);
• Akratran;
• Insulidd n;
• Biogulin H;
• PROTAFAN-NM PENIFILL.

It is worth noting that the use of any synonym of Isophane insulin should be coordinated with the doctor.

pharmachologic effect

Human insulin has a hypoglycemic effect. The drug interacts with the receptors of the cytoplasmic cell membrane, forming an insulinseptor complex. It activates the processes occurring inside the cells and synthesizes the main enzymes (glycogenxintytase, piruvatkinase, hexochinase, etc.).

A decrease in sugar concentration is carried out by increasing its intracellular transport, lowering the glycosis rate of the liver, stimulation of suction and further absorption of glucose tissues. Also, human insulin activates protein synthesis, glycogenogenesis, lipogenesis.

The duration of the means depends on the speed of absorption, and it is due to various factors (area of \u200b\u200badministration, method and dose of application). Therefore, the effectiveness of isophane insulin can be flawed both in one patient and in other diabetics.

Often after injection, the effect of drugs is observed after 1.5 hours. The highest performance of efficiency is 4-12 hours after administration. Duration of action - one day.

So, the fullness of the absorption and the beginning of the action means depend on such factors as:

1. region of administration (buttock, thigh, belly);
2. concentration active substance;
3. dosage.

Preparations of human insulin are distributed in the tissues unevenly. They do not penetrate the placenta and are not absorbed into breast milk.

Insulinsee is destroyed mainly in the kidneys and liver, withdrawing with the kidneys in the amount of 30-80%.

Methods of application and dosage

Instructions for use to insulin isophane says that it is often administered subcutaneously to 2 times a day before breakfast (Zamin). At the same time, it is necessary to change the area of \u200b\u200bthe injection daily and store the used syringe with room temperatureand new - in the refrigerator.

Sometimes the means is injected intramuscularly. And an intravenous way to use insulin of an average action is practically not applicable.

The dosage is calculated individually for each patient, based on the level of sugar concentration in biological fluids and the specifics of the disease. As a rule, the average daily dosage fluctuates in the range of 8-24 IU.

If patients have hypersensitivity to insulin, then the optimal daily amount of the drug is 8 meters. With poor susceptibility of hormone, the dosage increases - from 24 meters per day.

When the daily volume of the means is greater than 0.6 meters per 1 kg of mass, then 2 injections are made in different parts of the body. Patients whose daily dose from 100 me and more, in the event of insulin replacement should be hospitalized.

Moreover, when translating from one type of means to another, it is necessary to monitor the sugar content.

Side reactions and overdose

The use of human insulin can cause allergic manifestations. Most often is angioedema edema (hypotension, shortness of breath, fever) and urticaria.

Also, the dosage can also lead to hypoglycemia, manifested by the following symptoms:

• insomnia;
• leather pale;
• depression;
• hyperhydrosis;
• fear;
• excited state;
• frequent heartbeat;
• headache;
• confusion of consciousness;
• vestibular disorders;
• hunger;
• tremor and so on.

Even the side effects include diabetic acidosis and hyperglycemia, which manifests the hyperemia of the face, drowsiness, poor appetite and thirst. Most often, such states are developing against the background of infectious diseases and fever, when the injection pass, incorrect dosage and in the event of non-compliance with the power mode.

Sometimes there is a violation of consciousness. In difficult situations, a precomath and comatose state develops.

At the beginning of treatment, transitional failures may occur in the visual function. There is also an increase in the titer of anti-zulin bodies with further progression of glycemia and immunological reactions of cross-character with human insulin.

Often, the place of introduction swells and zudit. At the same time, the subcutaneous fatty tissue is hypertrophy or atrophy. And at the initial stage of therapy, temporary disorders of refraction and swelling may occur.

In case of overdose hormonal drugs The blood sugar level is greatly reduced. This causes hypoglycemia, and sometimes the patient falls into someone.

With a slight output of the dose, highly carbonate food should be accepted (chocolate, white bread, bun, candy) or drink a very sweet drink. In the case of fainting the patient in / in a solution of dextrose (40%) or glucagon (p / k, V / m).

When the patient comes into consciousness, it must be fed by food, abundant carbohydrates.

This is allowed to prevent hypoglycemic recurrence and glycemic to whom.

The suspension for p / to administration is not applied with solutions of other LS. And joint taking with sulfonamides, aPF inhibitors/ Mao / carboangendresses, NSAIDs, ethanol, anabolic steroids, chlorochinine, androgens, quinin, bromocriptine, podoxin, tetracycline, drugs, cloth, phenfloramine, ketonozol, cyclophosvamide, theophylline, furnacesol effect.

The weakening of hypoglycemic action contributes:

1. blockers H1-histamine receptors;
2. Glucagon;
3. Somatopin;
4. Epinephrine;
5. Phenytoin;
6. oral contraceptives;
7. Epinephrine;
8. Estrogens;
9. calcium antagonists.

In addition, the reduction of sugar causes joint use of isophane insulin with loop and thiazide diuretics, clone, BMKK, diazoxide, danasol, thyroid hormones, tricyclic antidepressants, sympathomimetics, heparin and sulfinpyrazone. Also, hypoglycemia enhances Nicotine, marijuana and morphine.

Pentamidin, beta-adrenoblays, octreotide and reserpine can enhance or relax glycemia.

Precautions for the use of Isophane insulin in the fact that a person, with diabetes, must constantly change the places where the insulin injection will be made. After all, it is possible to prevent the appearance of lipodystrophy.

Against the background of insulin therapy, it is necessary to regularly monitor glucose concentration. After all, in addition to joint admission with other drugs, other factors can cause hypoglycemia:

• diabetic diarrhea and vomiting;
• replacement of the drug;
• diseases that reduce the need for hormone (renal and liver failure, pitpofunction of thyroid, pituitary gland and other);
• non-time meal;
• change in the injection area.

Incorrect dosage or large pauses between insulin injections may contribute to the development of hyperglycemia, especially when type 1 diabetes. If the therapy is not adjusted on time, then the patient sometimes develops a ketoacidotic coma.

In addition, the change in the dose is required if the patient is greater than 65, it has the functioning of the thyroid, kidney or liver. It is also necessary for hyponituitarism and Addison's disease.

In addition, patients should know that human insulin preparations reduce alcohol tolerance. At the initial stages of therapy, in the event of replacing funds, stressful states, strong physical exertion should not be controlled by car and other complex mechanisms Either to engage in potentially hazardous activities requiring increased concentration and speed of reactions.

Pregnant patients should be borne in mind that in the first trimester the need for insulin decreases, and in 2 and 3 - increases. Also fewer hormone may be needed at generic activity.

ABOUT pharmacological features Isophan will tell the video in this article.

Insulin-Isofan: Instructions for the use of suspension

Active Substance: Insulin

human genetically engineering isofan

Manufacturer: Novo Nordisk, Denmark

Pharmacy vacation condition: prescription

Storage conditions: T in the range of 2-8 degrees

Human genetically engineered insulin isophane is used for state therapy associated with the insufficiency of the organism of its own hormone using an insular apparatus. There is no drug with such names on sale, as it is a form of a valid substance, but there are analogues. A vivid example of such a substance on sale - Rinsulin.

Indications for use

The main indication is the therapy of the diabetes of the first type, but in some cases it may be written in the presence of an insulin-dependent form of the disease. Any trading name isophane is suitable for human therapy, which is no longer taken by hypoglycemic substances due to complete or partial resistance. Less often, medicine is used in pregnant women with the second type of diabetes.

Composition and form of release

1 ml of solution consists of 100 units of the active active ingredient. Auxiliary components - Protamina sulfate, sterile water for injections, crystalline phenol, sodium dihydrate phosphate, glycerol, metacrezol.

Suspension for injection, transparent. One bottle contains 3 ml of substance. In one package there are 5 cartridges or for sale in one bottle of 10 ml of the drug at once.

Medical properties

Isophane insulin is a secondary duration of the hypoglycemic agent, which was manufactured using recombinant DNA technology. After subcutaneous administration Endogenous hormone binds to an insulin-geceptor complex, as a result of which the synthesis of many enzyme compounds - hexokinase, pyruvatkinase and others occur. Due to the substance administered from the outside, the intracellular glucose space increases, so that it is absorbed by the tissues, and the rate of synthesis of sugar liver is significantly reduced. For frequent use The medication launches lipogenesis, glycogenesis and proteinogenesis.

The duration of action and the rate of occurrence of the effect of different people depends on many factors, in particular from speed exchange processes. What means - this process is individual. On average, since this is a hormone of average speed, the beginning of the effect is developing after an hour and a half from the date of subcutaneous administration. The duration of the effect is a day, peak concentration occurs within 4 - 12 hours.

The tool is absorbed unevenly, excreted mainly through the kidneys, the severity of the effect depends directly from the place of administration (abdomen, arm or thigh). The medication does not penetrate the placental barrier and in breast milk, therefore allowed pregnant and recently born mothers.

Mode of application

The average cost of medication in Russia is 1075 rubles per pack.

Pricking subcutaneously, once a day, in different places. The frequency of injections in one place should not exceed more than 1 time per month, so the location of the medication is changed each time. Before direct use, the ampoule is rolled in the palms. Injection instructions for injections Basic - sterile treatment, the needles are entered subcutaneously at an angle of 45 degrees into a clamping fold, then the place is carefully disinfected. Dosages are selected by the doctor individually.

During pregnancy and breastfeeding

The drug is allowed to use in these periods.

Contraindications and precautions

These include: the intolerance of a specific active substance and low sugar levels at a specific point.

Cross drug interactions

Reduce the effect of the drug: systemic glucocorticoids, oral contraception, estradiol and progesterone, anabolic steroids, diuretics, antidepressants, thyroid hormones.

Enhance efficiency: alcohol, salicylates, sulfonamides and beta blockers, Mao inhibitors.

Side Effects and Overdose

Hypoglycemia or lipodystrophy is possible when not complying with the injection and appointed dosage rules. Systemic arises less often side effects as allergic reactions, shortness of breath, reduction of blood pressure, hyperhydroposis and tachycardia.

In case of overdose, classical signs of low blood sugar are manifested: a strong feeling of hunger, weakness, loss of consciousness, dizziness, sweating, the desire to eat sweet, in severe cases - a comatose state. Easy signs are stopped by the reception of fast carbohydrates, medium-in-decrement injections or glucose intravenously. Heavy situations require an urgent call to doctors.

Analogs

Rincelin PNH

Herofarm Bio Ltd., Russia

The average cost in Russia is 1000 rubles per pack.

Riosuline is a complete analogue and consists of an insulin of isophane an average duration of action. This medication form is good because it does not require frequent subcutaneous administration.

• Not from the cheapest
• Side effects are possible.

Humulin NPH

Eli Lilly East, Switzerland

The average price in Russia is 17 rubles.

Humulin NPH is an analogue of the average impact speed.

Insulin Isophane - Human hormone made using genetic engineering

In supporting therapy in diabetes, both 1 and 2 degrees, an important role is played by a hormone introduced into the body. New drug Insulin Isophane will help to safely live patients with diabetes. Treatment of diabetes with insulin has substitution.

The purpose of such medication is to fill the loss or oversupply of carbohydrates as part of metabolism using the subcutaneous introduction of a special hormone. This hormone affects the body identically natural insulin, which produces pancreas. Treatment can be partial or complete.

Among the preparations successfully used for the treatment of diabetes mellitus 2 and 1 degree, insulin Isofane has proven well. It includes the human genetic engineering insulin, which has an average duration of action.

This medicine, this hormone, indispensable for the full-fledged life of a person who has problems with sugar in

blood is produced in different forms:

• For leading under the skin;
• For introduction to Vienna;
• For intramuscular administration.

Such a choice gives the opportunity to keep a diabetes of varying degrees to keep the blood sugar level under control by any method of its introduction to the blood, adjusting it when necessary.

Insulin Isofane - Indications for use:

1. Resistance to sucroppural drugs that need to be drunk in the form of tablets within the framework of complex treatment;
2. Diabetes 2 and 1 degree, insulin-dependent;
3. Diabetes gestational, if there is no effect from diets;
4. Intercurrent type pathology.

Isophan: Analogs and other names

Trade names of Isophane insulin may be as follows:

How valid

Insulin Isophane The human genetic engineering influences the body, having hypoglycemic effect. This drug is in contact with the membrane cell cytoplasm receptors. This is how an insulin gelector complex is created. His task is to make an active metabolism, which is carried out inside the cells themselves, as well as assistance in the synthesis of the main of all existing enzymes.

Reducing the amount of blood sugar passes by increasing the transportation of it inside the cell, as well as a reduction in sugar production rate, using the suction process. Another advantage of human insulin is protein synthesis, activation of lithogenesis, glycogenogenesis.

Time, as a long time, this drug is directly proportional to the absorption rate of the drug into blood, and the suction process depends on the method of maintaining and dose of the drug. Therefore, the effect of this drug in different patients is different.

Traditionally, after an injection, the medication begins after 1.5 hours. The peak of efficiency falls at the time 4 hours after the administration of the drug. Duration of action - 24 hours.

Isophane suction intensity depend on the following:

1. Injection place (buttock, belly, thigh);
2. Concentration of active substance;
3. Dose.

This medicine is derived to the kidneys.

How to use: reading to use

According to the instructions for the use of isophane, it is necessary to enter it subcutaneously twice a day: in the morning and in the evening before meal (they will be removed before meals). The injection site must be changed every day, the used syringe should be stored at normal, normal temperature, and the new one is in the package, in the refrigerator. Rarely this drug is introduced into the muscle, and intravenously - almost never, since it is an insulin of an average action.

The dose of this drug is calculated individually for each suffering from diabetes, as part of consultation with the attending physician. Based on the volume of sugar in the plasma and the specifics of diabetes. The average daily dose is traditionally varied within 8-24 IU.

In the case of hypersensitivity to insulin, it is necessary to take no more than 8 months per day if the hormone is perceived poorly, the dose can be increased to 24 and more of me during the day. If the daily dose of the drug should exceed 0. 6 IU per kilogram of the patient's body mass, then at once there are 2 injections in different places.

• Hives;
• Hypotension;
• Temperature increase;
• Chills;
• Dyspnea;
• Hypoglycemia (fear, insomnia, face pallor, depression, over-excitation, sucking feeling of hunger, shaking limbs);
• Diabetic acidosis;
• Hyperglycemia;
• Impairment;
• Edema and itching at the injection site.

Overdose by this preparation is fraught with hypoglycemia and a coma. Dose excess can be neutralized if you take a high carbohydrate food (chocolate, candy, cookies, sweet tea).

In the case of loss of consciousness, enter the patient intravenously a solution of dextrose or glucagon. When consciousness returns, you should give a patient to food, with a high content of carbohydrates. It will give the opportunity to avoid both the glycemic coma and hypoglycemic recurrence.

Insulin Isofane: Is it possible to eat with other medicines

Increases the hypoglycemic effect (bringing the volume of blood sugar to normal) isophane symbiosis with:

1. Sulfonamides;
2. Chlorochinin;
3. ACF / MAO / carboanhydrase inhibitors;
4. Ethanol;
5. Negroesol;
6. Funds belonging to the group by anabolic steroids;
7. Phenfloramine;
8. Tetracycline drug preparations;
9. Clofibrate;
10. Medicines of theophylline group.

The hypoglycemic effect decreases (bringing the amount of blood sugar to normal) due to the symbiosis of isophane with such drugs:

The amount of sugar in the blood is reduced due to symbiosis of isophane insulin with thiazide and loop diuretics, with BMKK, as well as with thyroid hormones, sympathomimetics, clone, danasol, sulfintizon. Morphy, marijuana, alcohol and nicotine also reduce the amount of blood sugar. Drinking and smoking patients with diabetes can not.

In addition to the joint admission of unsuitable drugs with isofan, hypoglycemia can provoke such factors as:

• Transition to another medicine supporting sugar levels normally;
• Vomiting caused by diabetes;
• Diabetes diarrhea;
• Increase physical. load;
• Diseases that reduce the need for insulin (pituitary gland, thyroid pit hypofunction, liver failure, renal failure);
• When the patient did not sing on time;
• Change point of injection.

Incorrect dose or a large temporary interval between injections can cause hyperglycemia (especially in diabetes 1 degree). If you do not adjust therapy in time, the patient can go to the ketoacidotic to whom.

Consisting of this medicine patient older than sixty years old and the more the one who has broken the work of the thyroid gland, kidneys, liver, it is necessary to consult with the attending physician about the dosage of insulin isofan. The same measures should be taken if the patient suffers from hypocituitarism or Addison's disease.

Insulin Isofane: Cost

The price of Isophane insulin varies from 500 to 1200 rubles per package in which 10 ampoules are included, based on the producer and dosage country.

How to prick: special instructions

Before tying a medicine into a syringe, check that the solution is not dying. It must be transparent. If there are flakes, foreign bodiesThe solution became muddy, a precipitate was formed, it was impossible to use the medicine.

The temperature of the injected drug must be room. If at the moment you are cut or more than others infectious diseaseIt is necessary to consult with a doctor about a dose. When replacing the drug, it should be done under the supervision of a doctor, we are prudent to go to the hospital.

Pregnancy, lactation and insulin isofane

Pregnant, suffering sugar diabetes, you can take insulin isofan, it will not get to the fetus through the placenta. You can use them and nursing mothers forced to live with this disease. It is important to know that during pregnancy in 1 trimester, the need for insulin decreases, and in the second and third - rises.