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Insulin NPH (isophane)

    Brands

    DEA Class; OTC

    Common Brand Names; Humulin N, Novolin N

    • Antidiabetics, Insulins; 
    • Antidiabetics, Intermediate-Acting Insulins

    Intermediate-acting insulin with a longer onset and duration of activity when compared to regular insulin
    Used in adult and pediatric patients with type 1 and type 2 diabetes mellitus
    Usually requires 2 or more injections/day when used as a basal insulin along with rapid-acting prandial insulins

    Indicated for the treatment of type 1 diabetes mellitus.

    For the treatment of type 2 diabetes mellitus.
    For the treatment of gestational diabetes or for the treatment of patients with pre-existing diabetes mellitus (type 1 or type 2) who are now pregnant.

    Hypoglycemia

    Documented hypersensitivity reactions to product or excipients

    Hypoglycemia

    Lipodystrophy

    Lipohypertrophy

    Local allergic reaction

    Hypokalemia

    Muscle weakness

    Paresthesia

    Tremor

    Edema

    Pain

    Itching

    Nausea

    Hunger

    Numbness of mouth

    Localized cutaneous amyloidosis

    Never share pen between patients even if needle is changed

    Intermediate-acting insulin; do not use for circumstances that require rapid-acting insulin

    Caution with decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment

    Hypokalemia may occur

    Not for IV or IM administration

    Use with caution in renal and hepatic impairment (dosage requirements may be reduced)

    Caution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery

    Thiazolidinediones are peroxisome proliferator-activated receptor (PPAR)-gamma agonists and can cause dose-related fluid retention, particularly when used in combination with insulin; fluid retention may lead to or exacerbate heart failure; monitor for signs and symptoms of heart failure, treat accordingly, and consider discontinuing thiazolidinediones

    When hyper-or hypoglycemia occurs, carry out changes in insulin regimen under close medical supervision; increase frequency of blood glucose monitoring

    Accidental mix-ups between insulin products reported; to avoid medication errors between this and other insulins, instruct patients to always check insulin label before each injection

    Available data from published studies over decades have not established association with human insulin use during pregnancy and major birth defects, miscarriage or adverse maternal or fetal Outcomes

    Available data from published literature suggests that exogenous human insulin products, are transferred into human milk

    Specific maximum dosage information is not available. Individualize dosage based on careful monitoring of blood glucose and other clinical parameters in all patient populations.

    NPH, human insulin isophane rDNA origin

    injectable suspension

    • 100units/mL (3mL)
    • 100units/mL (10mL)