Possible cross-immunological reaction to insulin human insulins of animal origin. With increased patient’s sensitivity to insulin of animal origin, as well as m-cresol, portability anadrol dosage Insuman Rapid ADT should be evaluated in the clinic using intradermal tests. 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, seizures may occur coldness and moisture of the skin, and may anadrol dosage also appear
sweating, skin moisture, anxiety, tachycardia (heart rate): In many patients, resulting adrenergic feedback mechanism, the following symptoms may develop, showing a decrease in blood sugar levels 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 anadrol dosage 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 anadrol dosage cerebral vessels (impaired coronary or cerebral circulation ), as well as patients with proliferative retinopathy.
Failure diets permit injections of insulin, increased 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 acidosis (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 Insuman Rapid ADT 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 anadrol dosage 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 anadrol dosage 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 Rapid GT is usually administered by deep subcutaneous 15-20 minutes before meals. Allowed intramuscular administration of the drug. 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 Rapid GT can be administered intravenously for the treatment of hyperglycemic coma and ketoacidosis, as well as to reach metabolic compensation in the pre-, intra- and postoperative periods in patients with diabetes .
Insuman Rapid GT is not being used in different kinds of insulin pumps (including implanted), which uses a silicone coating.
You can not mix Insuman Rapid GT with insulins other concentration (eg 40ME / ml and 100ME / ml), with insulins of animal origin or other drugs. Only clear, colorless solutions Insuman Rapid HT should be used without visible mechanical impurities.
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 must not contain any other drug or its residual amount.
Before the first set of insulin from the vial, remove the plastic cap (the presence of the cap – evidence of unopened vials). Injection solution must be completely clear and colorless.
Prior dial insulin from the vial into the syringe suck air volume equal to the prescribed dose of insulin and inject it into the vial (not liquid). Then the vial with a syringe inverted syringe down and gain the right amount of insulin. Prior to injection, the syringe should be removed from air bubbles.
In the injection site take a fold of skin, insert the needle under the skin and slowly injected insulin. After injection, the needle is slowly withdrawn, and pressing the injection site with a cotton swab for a few seconds. The date of the first set of insulin from the vial should be written on the label.
Once opened, the bottles may be stored at a temperature not exceeding 25 ° C for 4 weeks in the dark and warm places.
VII. Interaction with other drugs
Simultaneous administration of several drugs can weaken or strengthen the glucose-lowering effect of Insuman Rapid GT. 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 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 can occur if the dose of insulin exceeds the demand for it (see. “Precautions and special instructions”).
Substantially significant fluctuations in blood anadrol dosage 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, m-cresol), you must immediately inform your doctor, since in some cases, such reactions may threaten the patient’s life. Severe hypersensitivity reactions are rare. They may also be accompanied by the development of angioedema, bronchospasm, drop 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 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 anadrol dosage hospitalization of patients in the intensive care unit for more thorough observation and monitoring of the therapy.
X. Release Form
The solution for injection 100 IU / ml in 5 ml vials ..
The package 5 bottles, together with instructions for use.
XI. Storage conditions
Store at temperatures between + 2 ° C to + 8 ° C (vegetable department domestic refrigerator). Avoid freezing, avoiding direct contact with the walls of the vial the freezer or cold storage.
Keep out of reach of children!
XII. Shelf life
Shelf life is 2 years.
The product should not be used beyond the expiration date printed on the package.
Vacation pharmacy : a doctor’s prescription