INSULIN H BIO NPH
Insulin NPH 100Insulin NPH 40Recombinant Human Insulin with Protamine sulphate
40 or 100 IU / ml suspension.10 ml
Composition:
Each 1 ml contains recombinant human insulin 40 or 100 IU, Protamine sulphate metacresol, glycerol, phenol crystalline, sodium phosphate dihydrate, and water for the injection

Description:
Suspension of white color. The suspension on standing deposits a white sediment. The sediment is readily resuspended by gentle shaking.

Pharmacological action:
Insulin Hbio NPH decreases glucose level in blood, enhances digestion of glucose by tissues, stimulates lipogenesis, glycogenesis , synthesis of protein, reduces the rate of glucose production in liver.

Pharmacokinetics:
In case of subcutaneous injection, the drug begins to act within 1.5 hours , reaches its maximum effect within the period from
4 to 12 hours after injection. Duration of action is up to 18 hours.
Profile of the drug action depends on dosage and scheme of individual therapy.

Indications:
‎Diabetes mellitus type I :( insulin dependent) found in children and adults.
‎Diabetes mellitus type II :( non insulin dependent) at the stage of resistance of per-oral hypoglycemic drugs, particular resistance to drugs (combined therapy), undercurrent diseases, surgical operations (mono or combined),& diabetes type II in pregnant women.

Contraindications:
Hypoglycemia, hypersensitivity to drugs on base of human insulin.

Methods of administration and dosage:
The dosage and route of administration is defined individually in each case.
‎The drug is administered subcutaneously 1-2 times per day.
‎Roll the vial carefully between the palms of the hands before use.
‎If the daily dose exceeds 0.6 IU / Kg, insulin H bio NPH is injected two times daily into different parts of the body.

Special indications:
It is advise to hospitalize the patients receiving more than 100 IU insulin/day.
In case of substitution of one insulin-containing preparation by another one, the substitution of insulin-containing drugs should be conducted under the control of glucose level in blood.
In case of the administration of the drug for the first time, special precaution should be taken for mental stress and ability to operate machinery.
The dose should be corrected upon changing the character and the mode of diet, strong physical stress, infectious diseases, surgical interventions, thyroid dysfunction, Addison disease, hypo-pituitarism, renal failure and patients over 62 years old.

Drug interactions:
Hypoglycemic effect of insulin Hbio NPH is enhanced by:

MAO inhibitors
Some selective beta-blockers
Sulfunamide preparations
Anabolic steroids
Antibiotics and tetracycline group
Clofibrates
Cyclophosphamide
Phenfluramine
Ethanol-containing drugs
Hypoglycemic effect of Hbio NPH insulin is reduced by:

Oral contraceptives
Gluccorticoids
Thyroid hormones
Thiazides diuretics
Heparin
Lithium-containing preparations
Tricyclic anti-depressants
Reserpin & salicylates can also increase or decrease the drug effect.

Side effects:
Influence of carbohydrate metabolism:
Hypoglycemic state (paleness of dermal integuments,intensifying of diaphoresis, palpitation, tremor)
Allergic responses: very rare dermal eruption.
Side reactions: lipo-dystrophy in places of drug administration (Upon long term use)
Others: temporal reflection disturbances ( usually at the beginning of the therapy)
Overdose:
In case of overdose, development of hypoglycemic state is possible. Initial symptoms of hypoglycemic state are as follow:
Intensifying of diaphoresis
Palpitation
Tremor
Sense of hunger
Paleness
Headache
- In severe case, the development of hypoglycemic coma is possible.20-40 ml of 40% glucose solutions intravenously, or 1mg of glucagon intramuscularly should be given.
- Mild hypoglycemia can be treated by administering sugar or sugar containing products.

Presentation:
Box containing vial of 10ml containing Recombinant Human insulin 40 or 100 IU/ ml

Storage conditions:
Store between 2°C - 8°C , avoid freezing
Keep medicine out of reach of children.

Shelf-life:
30 months do not use after the expiry date indicted on the label.
Dispensed by doctors prescription.