Insulin 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 30 minutes, reaches its maximum effect within the period from 1-3 hours after injection. Duration of action is 8 hours.
Profile of the drug action depends on dosage and reflects significant individual features.
Indications:
Diabetes mellitus type I: (insulin dependant) in children and adults.
Diabetes mellitus type II:( non insulin dependant) at the stage of resistance of per-oral hypoglycemic drugs, particular resistance to drugs (combined therapy), undercurrent diseases, surgical operations (mono or combined therapy), & 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, IM or IV.
In case of monotherapy the drug is administered 3 times per day or up to 5 -6 times if necessary.
If the daily dose exceeds 0.6 IU/Kg, insulin H bio R is injected two or more times /day 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 H bio R 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 H bio R 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.
