Hypersensitivity reactions to insulin or any of the supporting components of the preparation, except in cases where insulinoterapiyaterapiya is vitally important.In such cases the use of hormonal Insuman Basal OptiPena possible only under careful medical supervision, and if necessary in combination with an anti-allergic therapy.Possible cross-immunological reaction to insulin human insulins of animal origin. If you are sensitive to the patient’s insulin anadrol 50 for sale of animal origin, as well as m-cresol, tolerability Insuman GT base for OptiPena should be evaluated in the clinic using the intradermal test. If the intradermal test revealed hypersensitivity to human insulin (immediate reaction, Arthus-type), then further treatment should be conducted under clinical supervision. Quite a large number of patients with hypersensitivity to insulin of animal origin difficult transition to human insulin in connection with the cross immunologic response human insulin and animal origin insulin.
Hypoglycemia can occur if the number of injected insulin exceeds the demand for it.
There are specific clinical symptoms and signs that shall indicate to the patient or others about a sharp drop in blood sugar levels. These include: sudden sweating, palpitations, tremor, hunger, sleepiness, sleep disturbances, anxiety, depression, irritability, unusual behavior, anxiety, paresthesia in the mouth and around the mouth, pallor, headache, incoordination of movements, as well as transient neurological disorders (disorders of speech and vision, paralytic symptoms) and abnormal sensations. With the rising incidence of sugar level the patient can lose self-control and even consciousness. In such cases, there may be cooling and moisture of the skin, and can appear convulsions.
In many patients, resulting adrenergic feedback mechanism, the following symptoms may develop, showing a decrease anadrol 50 for sale in blood sugar levels: sweating, damp skin, anxiety, tachycardia (heart rate) , high blood pressure, tremors, chest pain, heart rhythm disturbance.
Therefore, every patient who suffers from diabetes and take insulin should learn to recognize unusual symptoms are a sign of developing hypoglycemia. Patients regularly monitoring blood sugar and urine, less exposed to the risk of hypoglycemia. Tendency to severe hypoglycemia can impair the patient’s ability to drive the vehicle and management of any equipment. The patient himself can correct them noticed a decrease sugar levels by administering sugar or foods with high carbohydrate content. For this purpose, the patient must always carry 20 g of glucose. In more severe state of hypoglycemia shown n / a glucagon injection (which can make the average doctor or honey. Staff). After sufficient improvement, the patient should eat. If hypoglycemia persists at once, you should immediately call a doctor. You must immediately inform the doctor about the development of hypoglycemia, so that he made a decision on the need for dose adjustment of insulin.
In certain circumstances, symptoms of hypoglycemia may be mild or may not be available. Such situations occur in elderly patients, when there nervous system damage (neuropathy), with accompanying mental diseases, concomitant therapy with other drugs (see., “The interaction with other drugs”), low supports blood sugar levels when changing insulin.
possible reasons for the sharp decline in blood sugar: an overdose of insulin, abnormal insulin injection (in older patients), the transition to a different type of insulin, skipping meals, vomiting, diarrhea, exercise, elimination of stress, alcohol, disease, reducing the need insulin (severe liver or kidney disease, reduced adrenocortical function, pituitary or thyroid gland), change the injection site (for example, the abdominal skin, shoulder or hip), as well as interaction with other drugs (see. “interaction with other drugs means “)
The risk of hypoglycemia is high in the beginning of the insulin treatment, when switching to another insulin preparation, in patients with low supporting blood sugar levels.
a special risk group consists of patients with episodes of hypoglycemia and a significant narrowing of the coronary or cerebral vessels (impaired coronary or cerebral circulation ), as well as patients with proliferative retinopathy.
Failure diets permit injections of insulin, increased anadrol 50 for sale insulin requirements resulting from infectious or other diseases, reduction of physical activity may lead to increased levels of blood sugar (hyperglycemia), possibly with increased levels of ketone bodies in the blood (ketoacidosis). Ketoacidosis may develop within hours or days. When the first symptoms of metabolic ketoacidosis (thirst, frequent urination, loss of appetite, fatigue, dry skin, deep and rapid breathing, high concentrations of acetone and glucose in the urine) is urgently needed medical intervention.
If you change the doctor (for example, hospitalization for accident , illness while on holiday), the patient should inform the doctor that he had diabetes.
Pregnancy and lactation
Treatment HT Insuman Basal for OptiPena should be continued during pregnancy. During pregnancy, especially after the first trimester, should expect an increase in insulin requirements. However, immediately after delivery, insulin requirements normally decreases, which entails a significant risk of hypoglycemia. In the event of pregnancy or when planning a pregnancy, it is imperative to inform the doctor.
In the period of breastfeeding is no limit to the insulin is not available. However, it may require adjustment of the dose and diet.
VI. Dosage and administration .
Selection of the insulin dose in a patient by a medical doctor individually, depending on diet, physical activity and lifestyle. The insulin dose is determined based on the blood sugar level, and based on the intended physical activity and state of carbohydrate metabolism. Insulin treatment requires appropriate patient self. The physician should give the necessary instructions to determine how often the blood sugar level and possibly in the urine, and also to give appropriate recommendations in the event of any changes in diet or insulin mode.
The average daily dose of insulin is from 0.5 to 1.0 ME per kg of patient body weight, and 40-60% of the dose is necessary for long-acting human insulin.
When switching from animal insulin to human insulin may be required to decrease insulin doses. Switching from other types of insulin at the preparation can be done only under medical supervision.Particularly frequent monitoring of the state of carbohydrate metabolism needs in the first weeks after the transition.
Insuman Basal for OptiPena GT is designed for use in a pen OptiPen. The patient must know the rules of this type of pen.
Insuman Basal GT for OptiPena usually injected deep subcutaneously for 45-60 minutes before meals, in exceptional cases, intramuscular administration. The injection site should be changed each time.Changing the injection site (eg the abdomen to the thigh) should be done only after consultation with your doctor.
Insuman Basal for OptiPena GT is not being used in different kinds of insulin pumps (including implanted).
Intravenous drug completely excluded!
Before installing the cartridge in shprits- handle, hold it for 1-2 hours at room temperature. Then, gently turning the cartridge (10 times) until a homogeneous suspension. Each cartridge further comprises three metal balls for more rapid mixing of its contents. After the establishment of the cartridge in the pen before each injection of insulin several times flip the pen to produce a homogeneous slurry. After stirring the suspension must have a uniform consistency, and a milky white color. The suspension should not be used if it is any other type, ie, if it is transparent or flakes or lumps formed in the fluid itself, on the bottom or walls of the cartridge. In such cases, you should use a different tape satisfying the above conditions, and should inform the doctor. Remove any air bubbles from the cartridge before injection (see. Instructions for using the pen OptiPen).
The cartridge is not designed to mix Insuman Basal GT for OptiPena with other insulins. Empty cartridges can not be refilled.
In case that any failure pen can enter the desired dose from the cartridge using a conventional syringe. It must be remembered that the concentration of insulin in the vial is 100 IU / ml, so you need to use only plastic syringes designed for this insulin concentration. The syringe should not contain any other drug or its residual quantity.
In the period of use or transportation of cartridges can if necessary be stored at temperatures not exceeding 25 ° C and must be protected from direct exposure to heat and light. In use, the cartridge, the pen should not be stored in the refrigerator.
After you install a new print cartridge, check the correct operation of the pen to the first dose of injection (see. Instructions for using the pen OptiPen).
VII. Interaction with other drugs
Simultaneous administration of several drugs can weaken or strengthen the glucose-lowering effect of Insuman Basal GT for OptiPena. Therefore, the application of insulin should not take any other medications without the express permission of a doctor.
Hypoglycemia may occur when patients both with insulin anadrol 50 for sale receive ACE inhibitors, aspirin and other salicylates, amphetamines, anabolic steroids and male sex hormones, tsibenzolin, fibrates, disopyramide, cyclophosphamide, fenfluramine, fluoxetine, guanethidine, ifosfamide, MAO inhibitors, oral hypoglycemic agents, pentoxifylline, phenoxybenzamine, phentolamine, propoxyphene, somatostatin and its analogs, sulfonamides, tetracyclines, tritokvalin or trofosfamide.
The weakening of insulin action may occur with concomitant administration of insulin and of corticotropin, corticosteroids, diazoxide, heparin, isoniazid, barbiturates, nicotinic acid, phenolphthalein, phenothiazine derivatives, phenytoin, diuretics, danazol, doxazosin, glucagon, estrogens and progestogens, somatotropin, sympathomimetic drugs and thyroid Gomonov.
In patients concomitantly receiving insulin and clonidine, reserpine or salts lithium, attenuation can be observed as well as potentiation of insulin action. Pentamidine may cause hypoglycemia followed by hyperglycemia.
Drinking alcohol can cause hypoglycemia or reduce the already low level of sugar in the blood to dangerous levels. Alcohol tolerability in patients receiving insulin decreased. The permissible volume of alcohol consumed must be determined by your doctor. Alcoholism is a chronic and excessive use of laxatives, can influence blood glucose levels.
Beta-blockers increase the risk of hypoglycemia and, along with other sympatholytic drugs (clonidine, guanethidine, reserpine) may weaken or even mask the manifestation of hypoglycemia.
VIII. Adverse reactions
Hypoglycaemia, the most frequent side effects may occur, if the dose of insulin exceeds the demand for it (see. “Precautions and special instructions”).
Substantially significant fluctuations in blood sugar levels can cause acute disorders of the visual organs. Also, especially in the intensive insulin therapy, perhaps short-term worsening of diabetic retinopathy. In patients with proliferative retinopathy, without the use of laser therapy, severe hypoglycemic condition can lead to blindness.
Sometimes the injection site may occur atrophy or hypertrophy of adipose tissue, which can be avoided by constantly changing the injection site. In rare cases there may be a slight redness at the injection site, disappearing with continued therapy. In the formation of a significant erythema, accompanied by itching and swelling, and its rapid spread beyond the injection site, as well as in case of other serious adverse reactions to components of the drug (insulin, protamine, m-cresol, phenol), you must immediately inform your doctor so in some cases, these reactions may threaten the patient’s life. Severe hypersensitivity reactions are rare. They may also be accompanied by the development of angioedema, bronchospasm, a fall in blood pressure and rarely anaphylactic shock. Hypersensitivity reactions require immediate correction in insulin therapy and appropriate urgent measures to help.
Perhaps the formation of antibodies to insulin, which may require dose adjustment of insulin. It is also possible to sodium retention with subsequent swelling of tissues, especially after intensive treatment with insulin.
With a sharp decrease in blood sugar levels may develop hypokalemia (complications of the cardiovascular system) or the development of cerebral edema.
Since some side effects may be, under certain conditions, life-threatening, it is necessary when they appear sure to inform your doctor.
If you notice any side effects, please consult anadrol 50 for sale your physician!
An overdose of insulin can lead to severe and sometimes life-threatening hypoglycemia. If the patient is conscious, he should take immediate glucose followed by a reception, containing carbohydrates products (see. “Precautions and special instructions”). If the patient is unconscious, enter glucagon 1 mg / m. As an alternative method or the injection of glucagon was not effective is inputted 20-30 ml of 30% glucose solution 50% w / w. If necessary, possible re-introduction of the above doses of glucose. In children the amount of glucose injected proportionally set the child’s body weight.
In cases of severe or prolonged hypoglycemia after glucagon injection or administration of glucose infusion is recommended less concentrated glucose solution to prevent the re-development of hypoglycemia. Young children need to carefully monitor the level of sugar in the blood, due to the possibility of severe hyperglycemia.
Under certain conditions, it is recommended hospitalization of patients in the intensive care unit for more thorough observation and monitoring of the therapy. probol