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Insulin Isofan: action, application. About pharmacological effects

Included in the preparations

Russia

Included in the list (Order of the Government of the Russian Federation No. 2782-r dated December 30, 2014):

VED

ONLS

ATX:

A.10.A.C Insulins and their analogs of intermediate duration of action

Pharmacodynamics:

The drug is a genetically engineered insulin with an average duration of action, identical to human insulin. The drug interacts with specific receptors (consisting of two alpha and two beta subunits). Beta subunits have tyrosine kinase activity, that is, they phosphorylate intracellular substrates. The formed insulin receptor complex activates intracellular processes (increasing intracellular glucose transport, reducing the rate of glucose production by the liver, stimulating lipogenesis, glycogenogenesis, stimulating protein synthesis), including increasing the synthesis of some key enzymes, such as pyruvate kinase, glycogen synthetase, hexokinase and others. Synthesis of the glucose transporter (GLUT-4) ensures the uptake of glucose into tissues; hexokinases - locking glucose in tissues; pyruvate kinase and phosphofructokinase - increased glucose utilization (stimulation of glycolysis); glycogen synthetase - increasing the formation of glycogen (glycogenesis).

Pharmacokinetics:

The onset of action is 30 minutes after administration, the maximum effect is between 2 and 8 hours, the duration of action is 24 hours. The rate of absorption of the drug depends on the route of administration, the distribution is uneven. Does not penetrate the placental barrier and into breast milk. Metabolized in the liver and kidneys under the action of the enzyme insulinase.Excreted by the kidneys (30-80%).

Indications:

Diabetes mellitus type 1.

WITH diabetes mellitus type 2 (non-insulin dependent), including with complete or partial resistance to oral hypoglycemic agents (combination therapy); for intercurrent diseases, surgical interventions; during pregnancy (if diet therapy is ineffective).

IV.E10-E14.E10 Insulin-dependent diabetes mellitus

IV.E10-E14.E11 Non-insulin dependent diabetes mellitus

XV.O20-O29.O24 Diabetes mellitus during pregnancy

Contraindications:

Hypoglycemia.

Hypersensitivity.

With caution:

Age over 65 years.

Liver and kidney diseases.

Pregnancy and lactation:

There are no restrictions on the treatment of diabetes mellitus with insulin during pregnancy, since insulin does not penetrate the placental barrier. When planning pregnancy and during it, it is necessary to intensify the treatment of diabetes mellitus. Insulin requirements usually decrease in the first trimester of pregnancy and gradually increase in the second and third trimesters. During and immediately after childbirth, the need for insulin may decrease dramatically. Shortly after birth, insulin requirements quickly return to pre-pregnancy levels. There are no restrictions on the treatment of diabetes mellitus with insulin during breastfeeding. However, a reduction in the insulin dose may be necessary, so careful monitoring is necessary for several months until insulin requirements stabilize.

Directions for use and dosage:

The dose is determined individually by the attending physician. The average daily dose is from 0.5 to 1 IU/kg. Intramuscular administration is also possible. The temperature of the drug during administration should be at room temperature.

Inject subcutaneously 1-2 times a day, 30-45 minutes before breakfast (change the injection site each time) from 8 units to 24 units 1 time per day.

Intravenous administration of intermediate-acting insulin is prohibited!

Side effects:

From the immune system: allergic reactions (skin rash, Quincke's edema, anaphylactic shock).

Caused by the effect on carbohydrate metabolism: hypoglycemic conditions (pallor, increased sweating, palpitations, sleep disturbances, tremors, chills, hunger, agitation, paresthesia in the mouth, headache, decreased visual acuity). Severe hypoglycemia can lead to hypoglycemic coma.

Local reactions: swelling and itching at the injection site, hyperemia; with prolonged use, lipodystrophy is possible.

Overdose:

Symptoms: hypoglycemia.

Treatment: The patient can eliminate mild hypoglycemia himself by ingesting sugar or carbohydrate-rich foods (in this regard, patients with diabetes are recommended to constantly carry sugar, sweets, cookies or sweet fruit juice with them). In severe cases, when the patient loses consciousness, a 40% dextrose solution is administered intravenously; intramuscularly, subcutaneously, intravenously -. After regaining consciousness, the patient is advised to eat a meal rich in carbohydrates to prevent the recurrence of hypoglycemia.

Interaction:

Oral hypoglycemic drugs, angiotensin-converting enzyme inhibitors, non-selective beta-blockers, anabolic steroids, clofibrate, fenfluramine, monoamine oxidase inhibitors,carbonic anhydrase inhibitors, sulfonamides, tetracyclines, lithium preparations, drugs containing, enhance the hypoglycemic effect of insulin.

Oral contraceptives, thyroid hormones, heparin, sympathomimetics, calcium channel blockers, glucocorticoids, thiazide diuretics, tricyclic antidepressants, H1-histamine receptor blockers, diazoxide, weaken the hypoglycemic effect of insulin.

Reserpine and salicylates can both enhance and reduce the hypoglycemic effect of insulin.

Special instructions:

It is necessary to change the site of drug administration to avoid lipodystrophy. While taking the drug, it is necessary to monitor blood glucose levels.The causes of hypoglycemia, in addition to insulin overdose, can be: drug change, skipping meals, vomiting, diarrhea, increased physical activity, diseases that reduce the need for insulin (impaired liver and kidney function, hypofunction of the adrenal cortex, pituitary gland or thyroid gland), change of place injections, as well as interaction with others medicines.

Incorrect dosing or interruptions in insulin administration, especially in patients with type 1 diabetes, can lead to hyperglycemia. Typically, the first symptoms of hyperglycemia develop gradually, over several hours or days. They include the appearance of thirst, increased urination, nausea, vomiting, dizziness, redness and dryness of the skin, dry mouth, loss of appetite, and the smell of acetone in the exhaled air. If left untreated, hyperglycemia in type 1 diabetes can lead to life-threatening diabetic ketoacidosis.

The dose of insulin must be adjusted in cases of thyroid dysfunction, Addison's disease, hypopituitarism, impaired liver and kidney function, and diabetes mellitus in patients over 65 years of age. A change in insulin dose may also be necessary if the patient increases the intensity of physical activity or changes the usual diet.

Concomitant diseases, especially infections and conditions accompanied by fever, increase the need for insulin.

The drug reduces tolerance to alcohol.

Impact on the ability to drive vehicles and other technical devices

When transferring a patient to this insulin, a temporary decrease in the speed of psychomotor reactions is possible.

When using insulin for the first time, changing its type, or in the presence of significant physical or mental stress, the speed of psychomotor reactions and the ability to concentrate may decrease.

Exercise caution.

Instructions

Russian name

Insulin isophane [human genetically engineered]

Latin name of the substance Insulin-isophane [human genetically engineered]

Insulinum isophanum ( genus. Insulini isophani)

Pharmacological group of the substance Insulin-isophane [human genetically engineered]

Nosological classification (ICD-10)

Characteristics of the substance Insulin-isophane [human genetically engineered]

Medium-acting insulin preparation. Human insulin produced using recombinant DNA technology.

Pharmacology

Pharmacological action- hypoglycemic.

Interacts with specific receptors of the outer cytoplasmic membrane of the cell and forms an insulin receptor complex that stimulates intracellular processes, incl. synthesis of a number of key enzymes (hexokinase, pyruvate kinase, glycogen synthetase, etc.). The decrease in blood glucose levels is due to an increase in its intracellular transport, increased absorption and assimilation by tissues, and a decrease in the rate of glucose production by the liver. Stimulates lipogenesis, glycogenogenesis, protein synthesis.

The duration of action of insulin preparations is mainly determined by the rate of absorption, which depends on several factors (including the dose, route and site of administration), and therefore the insulin action profile is subject to significant fluctuations both from person to person and from person to person. the same person. On average, after subcutaneous administration, the onset of action is after 1.5 hours, the maximum effect develops between 4 and 12 hours, and the duration of action is up to 24 hours.

The completeness of absorption and the onset of the effect of insulin depends on the injection site (abdomen, thigh, buttocks), dose (volume of insulin administered), insulin concentration in the drug, etc. It is unevenly distributed throughout the tissues; does not penetrate the placental barrier and into breast milk. It is destroyed by insulinase mainly in the liver and kidneys. Excreted by the kidneys (30-80%).

Application of the substance Insulin-isophane [human genetically engineered]

Diabetes mellitus type 1. Diabetes mellitus type 2: stage of resistance to oral hypoglycemic agents, partial resistance to these drugs (during combination therapy), intercurrent diseases; diabetes mellitus type 2 in pregnant women.

Contraindications

Hypersensitivity, hypoglycemia.

Side effects of the substance Insulin-isophane [human genetically engineered]

Caused by the effect on carbohydrate metabolism: hypoglycemic conditions (pallor of the skin, increased sweating, palpitations, tremor, hunger, agitation, paresthesia in the mouth, headache). Severe hypoglycemia can lead to the development of hypoglycemic coma.

Allergic reactions: rarely - skin rash, Quincke's edema; extremely rarely - anaphylactic shock.

Other: swelling, transient refractive errors (usually at the beginning of therapy).

Local reactions: hyperemia, swelling and itching at the injection site; with long-term use - lipodystrophy at the injection site.

Interaction

The hypoglycemic effect of insulin is enhanced by: oral hypoglycemic drugs, MAO inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, non-selective beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, uramine, lithium preparations , preparations containing ethanol. The hypoglycemic effect of insulin is weakened by: oral contraceptives, glucocorticoids, thyroid hormones, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazol, clonidine, CCB, diazoxide, morphine, phenytoin, nicotine. Under the influence of reserpine and salicylates, it is possible to both weaken and enhance the action of insulin.

Overdose

Symptoms: hypoglycemia.

Treatment: The patient can eliminate mild hypoglycemia himself by ingesting sugar or carbohydrate-rich foods (in this regard, patients with diabetes are recommended to constantly carry sugar, sweets, cookies or sweet fruit juice with them). In severe cases, when the patient loses consciousness, a 40% dextrose solution is administered intravenously; IM, SC, IV - glucagon. After regaining consciousness, the patient is advised to eat a meal rich in carbohydrates to prevent the recurrence of hypoglycemia.

Routes of administration

Precautionary measures for the substance Insulin-isophane [human genetically engineered]

It is necessary to change injection sites within the anatomical region to prevent the development of lipodystrophies.

During insulin therapy, constant monitoring of blood glucose levels is necessary. The causes of hypoglycemia, in addition to insulin overdose, can be: drug change, skipping meals, vomiting, diarrhea, increased physical activity, diseases that reduce the need for insulin (impaired liver and kidney function, hypofunction of the adrenal cortex, pituitary gland or thyroid gland), change of place injections, as well as interaction with other drugs.

Concomitant diseases, especially infections and conditions accompanied by fever, increase the need for insulin.

The transition from one type of insulin to another should be carried out under the control of blood glucose levels.

The drug reduces tolerance to alcohol.

In connection with the primary prescription of insulin, a change in its type, or in the presence of significant physical or mental stress, there may be a decrease in the ability to drive a car or operate various mechanisms, as well as engage in other potentially hazardous activities that require increased attention and speed of mental and motor reactions.

Interactions with other active ingredients

Trade names

Name	The value of the Vyshkowski Index ®

Modern pharmaceuticals offer many medications aimed at treating diabetes.

Medicines based on new substances are being developed to ensure a normal life for as many patients as possible. Among these drugs, you should consider a drug such as insulin Isofan.

General information, indications for use

The drug belongs to the group of insulins. Its main function is to combat the manifestations of insulin-dependent diabetes mellitus.

Made in the form of an injection suspension, the active component of which is human genetically engineered insulin. Its development is based on recombinant DNA technology. The drug has an average duration of effect.

Like most drugs in this group, Isofan should be used only on the recommendation of a doctor. An accurate dose calculation is necessary so as not to provoke an attack of hypoglycemia. Therefore, patients must strictly follow the instructions.

You should start using this product only when necessary. The attending physician usually conducts an examination to ensure that such treatment is appropriate and that there are no contraindications.

It is prescribed in situations such as:

type 1 diabetes mellitus;
type 2 diabetes mellitus (if there are no results from the use of other drugs with a hypoglycemic effect or if these results are too small);
development of diabetes in connection with pregnancy (when glucose levels cannot be corrected with diet).

But even the presence of an appropriate diagnosis does not mean that this drug should necessarily be used. It has certain contraindications, although they are few.

A strict ban applies only to patients with individual intolerance to this medicine. It is also necessary to exercise caution when selecting the dosage for patients with an increased tendency to hypoglycemia.

There are several medications based on the substance Isophane. Essentially these are the same drug. These drugs have the same properties, they have the same side effects and contraindications; differences can only be observed in the amount of the main ingredient and in the trade name. That is, these are synonymous drugs.

Among them are:

Protafan;
Humulin;
Vozulim;
Gensulin;
Insuran.

These products are analogues of Isophan in composition. Despite their similarities, the same patient may experience difficulties using either of them, but when choosing a different drug, these difficulties disappear. Sometimes you have to try several different medications before you can choose the one that is most effective in a particular case.

Pharmacological action

The result of exposure to the substance is a decrease in the amount of glucose in the body. This is achieved through its connection with cell membrane receptors, during which the insulin receptor complex is formed.

Such complexes contribute to the active occurrence of intracellular processes and the synthesis of enzymes. The amount of sugar is reduced due to the faster rate of its movement between cells.

This ensures its absorption by muscle tissue and organs. In this case, insulin slows down the production of glucose in the liver. Also, under its influence, the production of proteins is enhanced, the processes of glycogenogenesis and lipogenesis are activated.

The duration of the drug's effect depends on how quickly the active substance is absorbed. This is influenced by the dosage of the drug, the method of administration and the injection site. Because of this, the drug's effect profile is unstable. Effectiveness rates may vary not only between individuals, but also within the same patient. In most cases, the drug begins to act 1.5 hours after the injection. Its peak effectiveness is observed within 4-12 hours. The medicine continues to have an effect on the patient for about a day.

The onset of its effect and absorption activity are also determined by the dose, concentration of the active substance and the injection site. The distribution is uneven. The substance does not have the ability to penetrate the placenta barrier, as well as into breast milk. Isophane is destroyed in the kidneys and liver; most of it is excreted by the kidneys.

Instructions for use

One of the main aspects of success in treatment is compliance with instructions for using medications. Their violation leads to adverse consequences in the form of complications. That is why it is not allowed to independently make changes to the medication schedule prescribed by the doctor.

Insulin isophane is intended exclusively for subcutaneous injection (in rare cases, intramuscular administration is used). It is advisable to do them before breakfast. The frequency of injections is 1-2 times a day, and the time for their execution should be the same.

Doses of the drug are selected according to the glucose level. In addition, it is necessary to take into account the patient’s age, degree of insulin sensitivity and other characteristics. This means that it is unacceptable to adjust the injection schedule without the instructions of the attending physician.

An important nuance in using the drug is the choice of injection site. They should not be done on the same area of the body, as this may cause disturbances in the absorption of active substances. Injections into the shoulder, thigh and buttock areas are allowed. You can also inject the medicine into the anterior abdominal wall.

Video lesson on the technique of administering insulin using a syringe pen:

Adverse reactions and overdose

Side effects from Isophane insulin are rare if you follow the rules. But even if they are observed, the possibility of negative reactions cannot be ruled out.

Most often there are:

In case of an overdose, the patient’s blood sugar level may sharply decrease, causing hypoglycemia. Methods for relieving this condition depend on its severity. Sometimes hospitalization and treatment with medication may be required.

Insulin Isofan must be properly combined with other medications. Since diabetes mellitus is often complicated by other diseases, it is necessary to use different means.

But not all of them are compatible with each other. Some drugs can enhance the effects of each other, which leads to overdose and side effects.

In relation to Isophane, such means are:

MAO and ACE inhibitors;
beta blockers;
tetracyclines;
anabolic steroid;
agents with hypoglycemic effect;
alcohol-containing medications;
sulfonamides, etc.

Typically, doctors try to avoid the combined use of insulin medications and the listed medications. But if this is not possible, it is necessary to adjust the doses of both.

There are medications that, on the contrary, reduce the effect of the drug in question, making the treatment ineffective.

These include:

diuretics;
glucocorticoids;
hormonal contraception;
some types of antidepressants.

If it is necessary to take them simultaneously with insulin, you need to select the appropriate dosage.

Caution must also be exercised with respect to salicylates and reserpine, which can have both enhancing and weakening effects.

While taking this medicine, you should avoid frequent drinking of alcohol. At the beginning of insulin therapy, you should avoid controlling the mechanisms, since the patient’s attention and reaction speed may be impaired.

You should not replace this medicine with another without your doctor's knowledge. If unpleasant sensations occur, you should report them to a specialist and together determine which drug is best to use.

In diabetes mellitus, sooner or later a lack of insulin produced by the pancreas begins to be felt; its deficiency is replenished with a solution of an artificial hormone, which is administered by injection.

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Insulin Isofan is one of the components of replacement therapy. In the body, this insulin acts like natural insulin: it transports excess glucose to the tissues, where it is broken down, providing the body with energy. In type 1 diabetes, Isofan is always combined with a shorter-acting hormone, which is designed to control postprandial (after eating) glycemia. For type 2 diabetics, only Isofan insulin may be sufficient.

Composition of the drug

Insulin used for diabetes mellitus is divided into several large groups according to the duration of action. To completely simulate your own insulin secretion, you need two types of hormone: long (or medium) and short (or ultrashort) -. Isophane is classified as a medium insulin. When used 2 times a day, it is able to provide a relatively even basal level of the hormone in the blood, thereby reducing the glucose that enters the bloodstream from the liver around the clock.

Insulin Isofan contains 2 active components:

Insulin. Previously, porcine and bovine hormones were used; now only human genetically engineered hormones are used, which are identical to the hormone produced by the human pancreas. It is produced using modified bacteria, the drug has a high degree of purification, is more easily accepted by the body and is much less likely to cause allergies than its predecessors.
Protamine- a protein that is used as an extender of insulin action. Thanks to it, the time for the hormone to enter the blood vessels from subcutaneous tissue increases from 6 to 12 hours. In insulin, Isophane hormone and protamine are mixed in isophane quantities, that is, there is no excess of either substance in the solution. By the name of its creator, the Danish scientist Hagedorn, insulin Isophane in the medical literature is often called neutral protamine Hagedorn, or NPH insulin.

So that protamine and insulin can form crystals, zinc is added to the solution. The preparation contains phenol and m-cresol as preservatives; to obtain a solution with neutral acidity, a weak acid or base is used. Analogues of different brands have different compositions of auxiliary components; a complete list is given in the instructions for use.

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Indications for use

The reasons for prescribing basal artificial insulin may be:

Type 1 diabetes. An intensified insulin therapy regimen is used, that is, both Isofan and.
Some types.
Type 2, if glucose-lowering pills are contraindicated or do not provide adequate control of diabetes. As a rule, insulin therapy begins with Isofan. The need for a short-term hormone appears later.
Type 2 during pregnancy.
As a replacement for pills if type 2 diabetes is in. After reducing sugar, the patient can be transferred back to oral medications.
Gestational diabetes, if it does not reduce sugar to normal.

Trademarks

Insulin Isophane is the most popular basal insulin in the world. More modern drugs are much more expensive and have only just begun to conquer the market. The following trade names of Isofan are registered in the Russian Federation:

Name	Price, rub.	Packaging, method of administration		Manufacturer
Name	Price, rub.	Vials, insulin syringe	Cartridges, syringe pens	Manufacturer
Biosulin N	from 506	+	+	Pharmstandard
	from 400	+	+	Geropharm
Rosinsulin S	from 1080	+	+	Medsintez plant
Protamine-insulin ChS	from 492	+	—	VIAL
Gensulin N	—	+	+	MFPDK BIOTEK
Insuran NPH	—	+	—	IBCh RAS
	from 600	+	+	Eli Lilly
	from 1100	+	+	Sanofi
	from 370	+	+	Novo Nordisk
Vozulim-N	—	+	+	Wockhard Limited

All the above drugs are analogues. They have the same concentration and are similar in strength, so in case of diabetes mellitus it is possible to switch from one drug to another without dosage adjustment.

Side effects of insulin Isofan

The action of insulin is significantly influenced by environmental factors. If more insulin is administered than the body requires, the diabetic experiences hypoglycemia. It can lead to:

Fasting, skipping meals - see the article about.
Digestive disorders that interfere with the absorption of glucose: vomiting, diarrhea.
Prolonged physical activity.
Additional intake of antidiabetic tablets.
Endocrine diseases.
Severe diseases of organs involved in insulin metabolism: liver and kidneys.
Changing the injection site, physical (rubbing, massage) or temperature (sauna, heating pad) effect on it.
Incorrect injection technique.
Tablets that enhance the effect of insulin. Hormonal and diuretic drugs have the greatest impact.
Alcohol and nicotine.

Less commonly, patients with diabetes mellitus experience lipodystrophy (dystrophic changes in subcutaneous fat in areas of frequent injections) and hypersensitivity reactions in the form of swelling, rash, and redness.

Introduction rules

The dose of Isofan is selected first of all, before short-term insulin. It is individual for each diabetic. Approximately, the total need for the hormone in the absence of its own is 0.3-1 units per 1 kg of weight, Isophan accounts for 1/3 to 1/2 of the need. Less insulin is needed for type 2 diabetes, more for patients with obesity and insulin resistance. Dietary features have little effect on the dose of Isofan, since short-acting insulin is used to compensate for prandial glycemia.

How to inject Isofan:

The instructions recommend administering the drug only subcutaneously. To prevent the solution from getting into the muscle, you need to choose the right needle length. Intravenous administration is prohibited.
Insulin syringes and more modern syringe pens can be used for administration. Medium insulin cannot be used in pumps.
Insulin Isofan is a suspension, so sediment will form at the bottom of the bottle over time. Before injecting, the drug must be mixed well. If it is not possible to achieve a uniform color of the suspension, the insulin is spoiled and cannot be used.
The best injection site is the thigh. It is also allowed to give injections in the stomach, buttocks, shoulder -.
A new injection is given at a distance of at least 2 cm from the previous one. You can inject in the same place only after 3 days.

Use during pregnancy

Isophane can be used during pregnancy and breastfeeding, since it does not enter the baby’s blood through the placenta and milk. In women with diabetes who are pregnant, insulin therapy is the only method of reducing glycemia approved in Russia.

The need for the drug changes several times over 9 months along with changes in the woman’s hormonal levels, so the insulin dose has to be regularly adjusted. Strict control of sugar during pregnancy is a prerequisite for preventing malformations and intrauterine fetal death.

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Isophane is a highly purified engineered insulin that is used for the treatment of patients diagnosed with diabetes. Human insulin, produced by genetic engineering using recombinant DNA technologies, is considered a medium-lengthening agent. In pharmacy kiosks it is sold in the form of a suspension used for injections injected under the skin. The price depends on the dosage, manufacturer and varies from 500 to 1000 rubles.

Pharmacology

Isophane is an insulin that has a hypoglycemic effect. It contacts special ends of the outer cytoplasmic cell membrane, as a result of which the insulin receptor system is formed. It helps stimulate intracellular processes.

Due to the fact that the movement of glucose within cells increases, its amount in the blood decreases. A similar effect is achieved by reducing the rate of glucose formation by the liver and increasing the level of its absorption by tissues.

The drug acts for a long time due to the speed of absorption, which is influenced by several factors: how insulin is administered (it can be injected into the stomach, thigh or buttocks), method of administration, dosage.

After introducing soluble human genetically engineered insulin under the skin using an injection, its activation occurs after an hour and a half. The drug is most effective from the 4th to the 12th hour and is active throughout the day.

The important features of Isofan include the following factors: it is not concentrated in mother's milk. Distribution in tissues is uneven. Does not cross the placenta. From 30 to 80% is excreted from the body by the kidneys.

Directions for use

The instructions for use highlight the main type of disease for which genetically engineered insulin is used - insulin-dependent diabetes mellitus. Treatment in such a situation is carried out throughout life. It is important to follow the injection schedule. In addition, Isofan is used for diabetes mellitus types 1 and 2.

The doctor may prescribe the drug if there is no effect from medications that have a sugar-lowering effect. Then insulin is prescribed as a combination treatment.

An increase in blood sugar can also be a consequence of complications, for example, after surgery. In this case, insulin can also be prescribed as a complex treatment. It is also prescribed to pregnant women with the onset of diabetes.

Isophane is used only for diabetes mellitus types 1 and 2!

The drug is contraindicated in patients prone to allergic reactions and with hypoglycemia.

Malicious influence

The main side effects from taking Isofan are:

Detrimental effect on carbohydrate metabolism. This is expressed in the form of pale skin, profuse sweating, rapid heartbeat, the appearance of tremors, a person constantly wants to eat, experiences nervous overexcitation, and frequent headaches.
Allergy expressed by skin rash, Quincke's edema. In rare cases, the drug causes anaphylactic shock.
Swelling may appear.
After an injection, itching, swelling, and bruising may occur. If therapy lasts for a long time, lipodystrophy forms.

In this regard, at the beginning of treatment, insulin therapy can be carried out only after a doctor’s prescription and under his supervision.

Exceeding the permissible dose

If an increased dose of the drug is administered, the patient may experience signs of hypoglycemia. In this case, you need to eat a piece of sugar or foods rich in carbohydrates. These could be cookies, sweet fruit juice, candy.

Taking too large a dose of Isophane may cause loss of consciousness. Here it is recommended to give an intravenous injection of dextrose solution 40%. Glucagon can be administered intramuscularly, intravenously, or subcutaneously.

Precautions

When using Isofan, it should be taken into account that if the drug is injected into the same place, lipodystrophy may form. To prevent it, it is recommended to change the injection site. When carrying out insulin therapy, you should carefully monitor your blood sugar levels.

The drug must be injected strictly according to the regimen prescribed by the doctor. Otherwise, hypoglycemia may develop. It can also appear due to untimely eating. In this case, a person develops a feeling of thirst, dry mouth, frequent urination, poor health, expressed by nausea, including vomiting, decreased appetite, and an unpleasant odor of acetone from the mouth.

The injected drug must be free of foreign bodies, transparent, and without sediment at the bottom. Its presence indicates insulin toxicity, so the use of the product can be dangerous for the patient.

Isophane should be at room temperature when administered. In case of infectious pathologies resulting from disorders of the thyroid gland, hypopituitarism, the dosage of the administered drug needs to be adjusted.

Isofan is prescribed by a doctor when there is no effect from treatment with sugar-lowering drugs.

Cross interaction

The instructions for use of the drug describe in detail the characteristics of the product and the nuances of its use.

Human genetically engineered isophane acts more actively if the following drugs are taken in parallel:

Hypoglycemic oral agents.
MAO and ACE inhibitors, carbonic anhydrase.
Sulfonamides.
Anabolics.
Tetracyclines.
Medicines containing ethanol.

The effectiveness of Isofan decreases when using: oral contraception, glucocorticoid drugs, thyroid hormones, antidepressants, morphine. If it is not possible to discontinue medications that affect the action of insulin, you must notify your doctor about this.

Similar drugs

Diabetes patients are interested in the question of what product can replace insulin. It is recommended to use the following analogues of Isofan for treatment: Humulin (NPH), Protafan-NM, Protafan-NM Penfill, Insumal, Actrafan.

Before changing Isofan to an analogue, you should consult with your doctor. Insulin therapy is a serious treatment. It requires discipline on the part of the patient and supervision on the part of the doctor.