What is Novolin®ge NPH?
Novolin®ge NPH Penfill Cartridges contains an insulin isophane that is a human biosynthetic substance that closely resembles the insulin produced by the pancreas in our body.
It is produced using recombinant DNA methods using S. cerevisiae (baker’s yeast) and followed by unique purification processes
Novolin®ge NPH is prescribed by doctors for patients with diabetes mellitus to manage blood glucose levels to control high blood sugar (hyperglycemia).
It is an antidiabetic agent used as a diabetes treatment to reduce levels
of sugar in the blood and urine.
Novolin NPH is an intermediate acting insulin that is commonly combined with short-acting insulin. Its begins taking effect within 30 minutes of injection and can last for approximately 24 hours.
It is a cloudy suspension with protamine and zinc.
None-medicinal ingredients include: glycerol, phenol, sodium hydroxide, disodium phosphate dihydrate, hydrocholoric acid, protamine sulphate, zinc chloride, metacresol and water for injections.
As with most medications, patients using Novolin GE may experience the following side effects:
- Injection site skin irritations such as itching, redness or rash
- Hypoglycemia (low blood glucose level)
- Blurred vision
- Loss of consciousness
To avoid side effects, speak to your doctor if any of the following apply:
- You have kidney or liver issues
- Have issues with your pituitary, adrenal or thyroid glands
- Drink alcohol (including beer or wine). You must monitor blood sugar levels for rises or falls
- You decide to alter your insulin dose
- Have an infection, experienced symptoms of fever or have had an operation
- Suffer from vomiting, diarrhea or decreased appetite then you may require less insulin than usual
- Exercise more than you regularly do or looking to make drastic dietary changes
- If you are ill, you may require a change in dosage
- Are travelling abroad to a different time zone which may affect your insulin schedule. Before travelling consult your doctor and ensure you bring enough Novolin ge with you on your trip.
- Are pregnant, breastfeeding or planning pregnancy speak to your doctor for advice
- Drive or operate heavy machinery: pay attention for signs of hypoglycemia as it may impact your ability to concentrate. You should discuss with your doctor whether you should drive.
- Are using Thiazolidinediones (oral antidiabetic drug). In combination with insulin can lead to increased risk of heart failure or oedema. Consult your doctor if you are experiencing localized swelling (oedema), signs of heart failure or shortness of breath.
- Experience hypokalemia (low potassium) which is a side effect associated with all insulins. You may be more at risk if you are losing potassium (ie diarrhea) or on potassium lowering drugs.
- Let your doctor know of any natural supplements, vitamins, minerals, alternative medications or over-the-counter medications you are currently taking
Seek medical attention immediately if you experience signs of allergic reaction or begin to feel unwell (start sweating, vomiting, have difficulty breathing, feel dizzy, rapid heart beat)
Repeated injections at the same site may cause fatty tissue under the skin to shrink (lipoatrophy) or thicken (lipohypertrophy). To avoid this, rotate injection sites. Notify your doctor if you begin to see skin thickening or pitting at the site of injection.
Diabetic retinopathy (eye background changes)
If you have diabetic retinopathy and your blood sugar levels improve very quickly, the retinopathy may worsen. Speak to your doctor about this.
Water retention may cause swelling around the ankles and joints. However this soon disappears.
Rare side effects include:
- Vision problems (this is usually temporary)
- Painful neuropathy (nerve related pain)
- Acute painful neuropathy (burning, tingling or electric pain) if blood glucose levels improve very fast. This usually disappears over time. If it doesn’t go away then notify your doctor.
Tell your friends or relative that if you become unconscious due to hypoglycemia they may be turn you on your side and seek medical attention immediately. If they have been trained, they may be required to use an emergency glucagon kit since you won’t be able to take sugar orally. Once you are conscious you should consume a glucose tablet or sugary snack or drink (non diet). If you are not responding to the glucagon treatment then you must be taken to hospital immediately. Severe hypoglycemia if not treated can lead to brain damage (temporary or permanent) or even death.
Some medication may affect the way glucose is processed in the body and can affect your insulin dose.
Certain drugs may interact with Novolin ge NPH. Let your doctor or pharmacist know if you are taking any of the following medications especially if they affect your blood sugar level as they may cause hypoglycemia.
- Other diabetes medications
- Anabolic steroids
- Angiotensin converting enzyme (ACE) inhibitors
- Monoamine oxidase inhibitors (MAOI)
The following medications may lead to hyperglycemia:
- Oral contraceptives
- Glucocorticoids (such as cortisone)
- Thyroid hormones
- Sympathomimetics (such as epinephrine, salbutamol, terbutaline used to treat asthma)
- Growth hormone
- Octreotide and lanreotide
Novolin®ge NPH is taken by injection under the skin. Never inject into a muscle or vein.
Rotate injection sites to avoid lumps.
Best places to inject Novolin ge NPH are the abdomen (front of waist), front of thighs, upper arms or bottocks.
Insulin works quicker when injected into the waist area.
Usually this type of insulin is taken after a meal. It is injected under the skin (subcutaneously) in the arm, abdomen or buttocks.
It’s important to rotate injection sites to avoid the formation of bumps or lumps.
Do not massage the area after injection.
Do not inject into vein or muscle.
Before using Novolin ge NPH:
- Check the label to ensure that it’s the correct type of insulin.
- Remove the protective cap (vial).
- Always check the Penfill® cartridge, including the rubber stopper (plunger). Do not use if damaged or if there is a gap between the white barcode label and the rubber stopper. If damaged, return to supplier.
- Always use a new needle to prevent contamination.
The first time you use Novolin®ge NPH Penfill® roll the cartridge between your palms ten times. It is also important that the cartridge is kept horizontal
Move the cartridge up and down 10 times so that the glass ball moves from one end of the cartridge to the other. Repeat the rolling and moving procedure until the liquid appears uniformly cloudy and white.
Mixing is easier when the insulin has reached room temperature. Complete the other stages of injection without delay.
For all subsequent injections move the insulin delivery device, with the cartridge inside it, up and down between a and b (see picture B) at least 10 times until the liquid appears uniformly white and cloudy.
Check there are at least 12 units of insulin left in the cartridge to allow even resuspending. If there are less than 12 units left, use a new Penfill®.
How to store Novolin®ge NPH?
- Keep out of reach from children and pets
- Store Novolin®ge NPH Penfill® not currently used in a refrigerator between 2°C-10°C
- Do not freeze or store near the freezer section or cooling element
- Novolin®ge NPH Penfill® that is being used or about to be used is not to be kept in a refrigerator.
- After removing Novolin®ge NPH Penfill® from the refrigerator let the Penfill® cartridge reach room temperature before resuspending the insulin as instructed for first time use.
- You can carry the Novolin®ge NPH Penfill® with you and keep it at room temperature (not above 30°C) for up to 4 weeks.
- Always keep Penfill® cartridge in the outer carton when you are not using it, in order to protect it from light.
- Novolin®ge NPH Penfill® cartridge must be protected from excessive heat and light.
- Do not use Novolin®ge NPH Penfill® cartridge after the expiry date which is printed on the label and the carton.
- Novolin®ge NPH Penfill® cartridge should not be disposed of in waste water or household waste.
- Ask your pharmacist how to dispose of medicines no longer needed. These measures will help protect the environment.
Warnings & Precations
Do not take this medication if you have an allergy to any of its ingredients.
In case of emergency, always carry and extra penfill cartridge.
Patients should carry a glucose tablet, sugary snack or beverage in case of hypoglycemia (low blood sugar).
Hypoglycemia and hyperglycemia are the most common side effects that can result in loss of consciousness, coma or lead to death.
It is recommended that patients with diabetes closely monitor glucose levels.
Any change in insulin dosage should be made under the direction of a doctor.
Novolin®ge NPH insulin suspensions should not to be used with infusion pumps or administered intravenously.
Do not use if it is not uniformly white and cloudy after resuspension.
Do not use Novolin ge NPH if:
- You are allergic to any of its ingredients such as insulin isophane, metacresol or other ingredients contained in Novolin NPH.
- You are experiencing hypoglycemia (low blood sugar).
- The penfill cartrige is dropped, damaged, is leaking or crushed.
- Do not share Novolin®ge Penfill® with others as it may spread infection.
- Do not refill a Novolin®ge NPH Penfill® insulin cartridge.
- Novolin®ge NPH Penfill® cartridges are developed to be used only with Novo Nordisk Delivery Devices
Do not change your insulin dosage unless instructed by your doctor.