The originating document has been archived. We cannot confirm the completeness, accuracy and currency of the content.
Insulin isophane pens
Generic Name: insulin isophane (IN-su-lin EYE-soe-fane)
Brand Name: Examples include Humulin N and Novolin N
Insulin isophane pens are used for:
Treating diabetes mellitus.
Insulin isophane pens are an intermediate-acting form of the hormone insulin. It works by helping your body to use sugar properly. This lowers the amount of glucose in the blood, which helps to treat diabetes.
Do NOT use insulin isophane pens if:
- you are allergic to any ingredient in insulin isophane pens
- you are having an episode of low blood sugar
Contact your doctor or health care provider right away if any of these apply to you.
Before using insulin isophane pens:
Some medical conditions may interact with insulin isophane pens. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you drink alcoholic beverages or smoke
- if you have heart problems (eg, heart failure); kidney or liver problems; nerve problems; adrenal, pituitary, or thyroid problems; or diabetic ketoacidosis
- if you use 3 or more insulin injections per day
- if you are fasting, have high blood sodium levels, or are on a low-salt (sodium) diet
Some MEDICINES MAY INTERACT with insulin isophane pens. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Beta-blockers (eg, propranolol), clonidine, guanethidine, lithium, or reserpine because they may increase the risk of high or low blood sugar, or may hide the signs and symptoms of low blood sugar, if it occurs
- Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), disopyramide, fenfluramine, fibrates (eg, clofibrate, gemfibrozil), fluoxetine, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), oral medicines for diabetes (eg, glipizide, metformin, nateglinide), pentamidine, propoxyphene, salicylates (eg, aspirin), somastatin analogs (eg, octreotide), or sulfonamide antibiotics (eg, sulfamethoxazole) because the risk of low blood sugar may be increased
- Thiazolidinediones (eg, pioglitazone, rosiglitazone) because the risk of heart failure may be increased
- Corticosteroids (eg, prednisone), danazol, diuretics (eg, furosemide, hydrochlorothiazide), estrogen, hormonal contraceptives (eg, birth control pills), isoniazid, niacin, phenothiazines (eg, chlorpromazine), progesterones (eg, medroxyprogesterone), somatropin, sympathomimetics (eg, albuterol, epinephrine, terbutaline), or thyroid hormones (eg, levothyroxine) because they may decrease insulin isophane pens's effectiveness, resulting in high blood sugar
This may not be a complete list of all interactions that may occur. Ask your health care provider if insulin isophane pens may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
How to use insulin isophane pens:
Use insulin isophane pens as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- An extra patient leaflet is available with insulin isophane pens. Talk to your pharmacist if you have questions about this information.
- Check with your doctor about how you should use insulin isophane pens with regard to meals.
- If you will be using insulin isophane pens at home, a health care provider will teach you how to use it. Be sure you understand how to use insulin isophane pens. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
- Carefully rotate the container as directed before each injection. This will ensure that the contents are evenly mixed. This insulin should look uniformly cloudy or milky.
- Do not use insulin isophane pens if it contains particles or clumps, is discolored, or if the vial or container is cracked or damaged.
- Do NOT use insulin isophane pens in an insulin pump.
- Use the proper technique taught to you by your doctor. Inject deep under the skin, NOT into muscle or a vein.
- Injection sites within an injection area (abdomen, thigh, upper arm) must be rotated from one injection to the next.
- Be sure you have purchased the correct insulin. Insulin comes in a variety of containers, including vials, cartridges, and pens. Make sure that you understand how to properly measure and prepare your dose. If you have any questions about measuring and preparing your dose, contact your doctor or pharmacist for information.
- Insulin isophane pens begins lowering blood sugar within 30 to 90 minutes after an injection. The peak effect occurs within 4 to 12 hours after a dose. The effect may last for up to 24 hours.
- Do not share pen or cartridge devices with another person even if the needle has been changed. Sharing these devices may pass infections from one person to another. This includes infections you may not know you have.
- Remove the needle after each injection. Store this device without a needle on it.
- Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse or share needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
- It is very important to follow your insulin regimen exactly. Do NOT miss any doses. Ask your doctor for specific instructions to follow in case you ever miss a dose of insulin.
Ask your health care provider any questions you may have about how to use insulin isophane pens.
Important safety information:
- Drowsiness, dizziness, light-headedness, or blurred vision may occur while you use insulin isophane pens. These effects may be worse if you take it with alcohol or certain medicines. Use insulin isophane pens with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
- Do not drink alcohol without discussing it with your doctor. Drinking alcohol may increase the risk of developing high or low blood sugar.
- Do NOT take more than the recommended dose, use insulin isophane pens more often than prescribed, or change the type or dose of insulin you are using without checking with your doctor.
- Any change of insulin should be made cautiously and only under medical supervision. Changes in purity, strength, brand (manufacturer), type (regular, NPH, lente), species (beef, pork, beef-pork, human), and/or method of manufacture may require a change in dose.
- Illness, especially with nausea and vomiting, may cause your insulin requirements to change. Even if you are not eating, you still require insulin. You and your doctor should establish a sick day plan to use in case of illness. When you are sick, test your blood/urine frequently and call your doctor as instructed.
- Tell your doctor or dentist that you take insulin isophane pens before you receive any medical or dental care, emergency care, or surgery.
- If you will be traveling across time zones, consult your doctor concerning adjustments in your insulin schedule.
- Carry an ID card at all times that says you have diabetes.
- An insulin reaction resulting from low blood sugar levels (hypoglycemia) may occur if you take too much insulin, skip a meal, or exercise too much. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or nondiet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
- Developing a fever or infection, eating significantly more than prescribed, or missing your dose of insulin may cause high blood sugar (hyperglycemia). High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
- Check with your doctor if you notice a depression in the skin or skin thickening at the injection site. You may need to change your injection technique.
- Proper diet, regular exercise, and regular testing of blood sugar are important for best results when using insulin isophane pens.
- Lab tests, including fasting blood glucose levels and hemoglobin A1c, may be performed while you use insulin isophane pens. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
- Use insulin isophane pens with caution in the ELDERLY; if low blood sugar occurs, it may be more difficult to recognize in these patients.
- PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using insulin isophane pens while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use insulin isophane pens, check with your doctor. Discuss any possible risks to your baby.
Possible side effects of insulin isophane pens:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:
Seek medical attention right away if any of these SEVERE side effects occur:
Redness, swelling, itching, or mild pain at the injection site.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; wheezing; muscle pain); change in skin to thick or thin where the injection was given; changes in vision; chills; confusion; dizziness; drowsiness; fainting; fast or irregular heartbeat; headache; loss of consciousness; mood changes; seizures; shortness of breath; slurred speech; swelling of the hands, ankles, or feet; tremor; trouble breathing; trouble concentrating; unusual hunger; unusual sweating; weakness.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.
If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.Proper storage of insulin isophane pens:
Store new (unopened) InnoLets, Pens, or PenFill cartridges in the refrigerator, between 36 and 46 degrees F (2 and 8 degrees C). Do not freeze. Store used (open) InnoLets , Pens, or PenFill cartridges at room temperature, below 86 degrees F (30 degrees C). Do NOT store used (open) InnoLets, Pens, or PenFill cartridges in the refrigerator. Store away from heat and light. If insulin isophane pens has been frozen or overheated, throw it away. Throw away unrefrigerated or used InnoLets, Pens, or PenFill cartridges after 14 days, even if they still contain medicine.
Do not leave insulin isophane pens in a car on a warm or sunny day. Do not use insulin isophane pens after the expiration date stamped on the label. Keep insulin isophane pens, as well as syringes and needles, out of the reach of children and away from pets. Ask your doctor, pharmacist, or other health care provider how to store insulin isophane pens.
- If you have any questions about insulin isophane pens, please talk with your doctor, pharmacist, or other health care provider.
- Insulin isophane pens are to be used only by the patient for whom it is prescribed. Do not share it with other people.
- If your symptoms do not improve or if they become worse, check with your doctor.
- Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take insulin isophane pens or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about insulin isophane pens. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to insulin isophane pens. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using insulin isophane pens.