Description
Description
The Humulin N KwikPens (known as an isophane) are single-patient-use prefilled pen that contains 300 units of Humulin N intermediate-acting insulin.
Humulin N is slow-acting insulin that lasts longer than regular human insulin available for diabetes patients in two forms: Humulin N vials or in these Humulin N KwikPens. Humulin N is one of the components in the 70/30 mix.
Adults use this insulin pen with diabetes to manage blood sugar levels and avoid diabetes-related complications effectively.
Insulin should only be part of a treatment program and a proper diet, exercise, weight loss program, blood sugar testing, and special care. Follow instructions provided by your doctor closely to see the best results.
With the click of the dose knob dial, you can deliver 1 unit of insulin. Patients can administer between 1-60 units of insulin from a single injection. If your dose requires more than 60 units, you’ll have to inject yourself more than once.
Humulin N is injected under the skin (subcutaneously) and should not be injected into a vein or muscle.
This medication should only be taken under the direction of a medical expert. Before taking, be sure to read the instructions for use and have entirely understood your doctor’s recommendations.
Warnings and Precautions
Warnings and Precautions
Never share a Humulin N KwikPens or syringe between patients, even if the needle is changed.
Make changes to a patient’s insulin regimen (e.g., insulin strength, manufacturer, type, injection site, or method of administration) under close medical supervision with increased frequency of blood glucose monitoring.
Hypoglycemia may be life-threatening. Monitor blood glucose and increase monitoring frequency with changes to insulin dosage, use of glucose-lowering medications, meal pattern, physical activity; in patients with renal or hepatic impairment; and patients with hypoglycemia unawareness.
Hypersensitivity reactions may be life-threatening. Discontinue Humulin N, monitor, and treat if indicated.
Hypokalemia may be life-threatening. Monitor potassium levels in patients at risk of hypokalemia and treat if indicated.
Fluid Retention and Heart Failure with concomitant use of Thiazolidinediones (TZDs) may occur. Observe for signs and symptoms of heart failure; consider dosage reduction or discontinuation if heart failure occurs.
Usage
Usage
This medication should be taken exactly as prescribed and according to the guidance of your doctor or pharmacist. Do not use longer than needed or in smaller or larger amounts.
It’s recommended to follow directions on the prescription label and read medication guides and instruction sheets associated with the Humulin N KwikPens.
Do not share Humulin N KwikPens with others as this can spread infection and disease even if the needle has been changed.
Let your doctor know if you have any pre-existing conditions, especially heart, liver, or kidney disease.
Action typically starts to take effect a few hours after injection.
As mentioned, Humulin N KwikPens (insulin isophane) should be injected under the skin.
To properly administer insulin, gently roll the pen in the palm of your hands to mix the insulin with an alcohol swab. Clean the tip of the pen and attach the needle. Clean the site of injection with an alcohol swab. Pinch the skin into a fold (pinching may not be necessary for short needles). Inject the insulin and be sure to rotate injection sites every few days to avoid skin complications from happening to the same injection site.
Check your blood sugar regularly using a blood sugar monitoring system or appropriate device.
A healthcare provider, doctor, or nurse should teach you how to administer the medication by yourself properly.
It should not be given with an insulin pump or mixed with other insulin. Do not inject directly into a muscle or vein.
Do not inject into damaged skin that is bruised, pitted, thickened, tender, scaly, scarred, or lumpy.
Insulin should appear cloudy after mixing. Do not use if the medication looks clear or contains particles. If it does, contact your pharmacist or doctor for a new one.
Do not transfer the insulin from pen to syringe. Only use the injection pen that comes with the insulin isophane. Attach a new needle before each use.
Your doctor, in case of hypoglycemia, may prescribe a glucagon kit. Be sure your friends and family understand how to inject it in case of an emergency.
Watch for signs of hyperglycemia, such as frequent urination and increased thirst.
Illness, exercise, surgery, stress, alcohol use, or skipping meals can also affect blood sugar levels. Speak to your doctor before changing your dose or medication schedule.
Side Effects
Side Effects
Side effects related to insulin can happen. However, most side effects are rare; it’s essential to understand them and detect symptoms.
Low blood sugar (hypoglycemia) is the most common symptom, including hunger, headache, irritability, shortness of breath, rapid breathing, palpitations: shakiness, and cold sweats.
If this happens, you will need to take the necessary action. This should include taking a glucose tablet, hard candy, or sugary drink to restore blood sugar levels. If this happens, let your doctor know as they may want to adjust your medication.
In addition to hypoglycemia, this prefilled insulin pen has very few side effects.
If you experience any allergy symptoms after injection, get medical help. Allergy symptoms may include skin rashes over the entire body, redness or swelling at the injection site, trouble breathing, tight chest, feeling like you may pass out, swelling of throat or tongue, hollowing or thickening of the skin at the injection site.
Contact your doctor immediately if you have the symptoms such as fluid retention, weight gain, swelling of hands and feet, shortness of breath, irregular heartbeat, low potassium, cramps, numbness or tingling, increased urination, limp feeling, or muscle weakness.
These are not all the side effects associated with the Humulin KwikPens. Speak to your doctor or pharmacist to get further information.
Drug Interactions
Drug Interactions
Drugs That May Increase the Risk of Hypoglycemia
The risk of hypoglycemia associated with Humulin N use may be increased when co-administered with antidiabetic agents, salicylates, sulfonamide antibiotics, monoamine oxidase inhibitors, fluoxetine, disopyramide, fibrates, pentoxifylline, ACE inhibitors, angiotensin II receptor blocking agents, and somatostatin analogs (e.g., octreotide). Dose adjustment and increased frequency of glucose monitoring may be required when Humulin N is co-administered with these drugs.
Drugs That May Decrease the Blood Glucose
The glucose-lowering effect of Humulin N may be decreased when co-administered with corticosteroids, isoniazid, niacin, estrogens, oral contraceptives, phenothiazines, danazol, diuretics, sympathomimetic agents (e.g., epinephrine, albuterol, terbutaline), somatropin, atypical antipsychotics, glucagon, protease inhibitors, and thyroid hormones. Dose adjustment and increased frequency of glucose monitoring may be required when Humulin N is co-administered with these drugs.
Drugs That May Increase Blood Glucose
The glucose-lowering effect of Humulin N may be increased or decreased when co-administered with beta-blockers, clonidine, lithium salts, and alcohol. Pentamidine may cause hypoglycemia, which may sometimes be followed by hyperglycemia. Dose adjustment and increased frequency of glucose monitoring may be required when Humulin N is co-administered with these drugs.
Drugs That May Blunt Signs and Symptoms of Hypoglycemia
The signs and symptoms of hypoglycemia may be blunted when beta-blockers, clonidine, guanethidine, and reserpine are co-administered with Humulin N.
Pregnancy
Pregnancy
Over decades, available data from published studies have not established an association with human insulin use during pregnancy and major birth defects, miscarriage, or adverse maternal or fetal outcomes. There are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy. Animal reproduction studies were not performed.
The estimated background risk of major birth defects is 6-10% in women with pre-gestational diabetes with an HbA1c >7% and has been reported to be as high as 20-25% in women with an HbA1c >10%. The estimated background risk of miscarriage for the indicated population is unknown. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively.
Overdose
Overdose
Excess insulin administration may cause hypoglycemia and hypokalemia. Mild episodes of hypoglycemia can be treated with oral glucose. Adjustments in drug dosage, meal patterns, or physical activity levels may be needed. More severe episodes with coma, seizure or neurologic impairment may be treated with intramuscular/subcutaneous glucagon or concentrated intravenous glucose. Sustained carbohydrate intake and observation may be necessary because hypoglycemia may recur after apparent clinical recovery. Hypokalemia must be corrected appropriately.
Storage
Storage
Not In-Use (Unopened) Humulin N KwikPens
Keep refrigerated and ensure it is stored in 36° to 46°F 2° to 8°C). Do not put medication in the freezer. Do not use it if it has been frozen.
If kept at room temperature, ensure it is stored at room temperature, below 86°F (30°C) the pen must be discarded after 14 days.
In-Use (Opened) Humulin N KwikPens
Do not store in a refrigerator. Keep in room temperature, below 86°F (30°C). The pen must be discarded after 14 days, even if the pen still contains Humulin N.
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