Hypersensitivity reactions to insulin or any of the supporting components of the preparation, except in cases where insulin is life-saving. In such cases the use of hormonal Insuman what is anadrol Comb 25 is possible only under careful medical supervision, and if necessary in combination with an anti-allergic therapy.
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 what is anadrol 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.
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.
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 what is anadrol 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 support levels of blood sugar.
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 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 what is anadrol 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 Comb 25 GT 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 what is anadrol 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 Comb 25 GT is usually administered by deep subcutaneous 30-45 minutes before a meal, intramuscular allowed in exceptional cases. 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 Comb 25 GT is not being used in different kinds of insulin pumps (including implanted).
Intravenous drug completely ruled out!
You can not mix Insuman Comb 25 Gt C insulins different concentrations (e.g., 40ME / ml 100ME / ml), insulin of animal origin or other drugs.
it should be remembered that the concentration of insulin in the vial was 100 IU / ml, so it is necessary 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). Immediately before the set of slurry should be well mixed, and the foam should not be formed. This is best done by turning the bottle, holding it at an acute angle between the palms. 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 vial. In such cases, you should use a different bottle that meets the above conditions, and should inform the doctor. Before dialing 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 must be removed from air bubbles. 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 what is anadrol 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 heat spot.
VII. Interaction with other drugs
Simultaneous administration of several drugs can weaken or strengthen the glucose-lowering effect of Insuman Comb 25 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 hormone.
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 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 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 blood sugar, due svozmozhnym development of severe hyperglycemia.
Under certain conditions, it is what is anadrol recommended hospitalization of patients in the intensive care unit for more thorough observation and monitoring of the therapy.
X. Release Form
Suspension for injection 100 IU / ml in 5 ml vials.
The pack contains 5 vials with instructions for use.
XI. Storage conditions
Store at temperature from + 2 ° 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