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Insulin isophane trade name analogues. Insulin isophane human genetically engineered

The drug insulin Isofan is produced using genetic engineering, through the use of recombinant DNA technologies. This type differs in its average duration of action. Insulin injections are used for diabetes mellitus, when a person's blood glucose levels are abnormal.

Action of Isophane

Insulin Isofan improves the absorption of glucose by tissues and accelerates protein synthesis. Glycogenogenesis and lipogenesis are also enhanced. After administration, the rate of glucose production decreases.

Isofan is used for type 1 and type 2 diabetes mellitus with partial resistance and resistance to hypoglycemic drugs. The only contraindication is hypersensitivity to the components of the drug and hypoglycemia.

Insulin acts with cell membrane receptors and creates an insulin receptor complex. Upon penetration into cells, this complex begins to stimulate the synthesis of enzymes and other intracellular processes. Glucose transport increases and blood sugar levels decrease accordingly.

Isophane begins to act approximately 1.5 hours after administration, and the maximum effect is achieved after 4 hours. The duration of action of the drug depends on the individual dose and the composition of insulin, from 11-24 hours.

Disadvantages and side effects

Despite the positive therapeutic effect, insulin Isofan can cause various side reactions and complications in some people. This is due to the effect on carbohydrate metabolism.

The most common violations:

allergic reaction - includes hives, low blood pressure and fever;
hypoglycemia - characterized by agitation, anxiety, increased hunger and increased sweating;
hypoglycemic coma, diabetic acidosis;
comatose state (with impaired consciousness);
immunological reaction;
local skin reaction - skin redness, itching, swelling and lipodystrophy.

At the initial stage of insulin therapy, all symptoms may be short-term and disappear after a certain time after the injection.

In case of an overdose, the patient develops the following symptoms:

pale skin;
increased heart rate;
weakness, headache;
convulsions;
visual impairment;
hypoglycemic coma;
feeling of fear;
tremor.

First aid

If the person does not lose consciousness, dextrose is prescribed orally. A hypertonic dextrose solution or glucagon is injected subcutaneously or intravenously. In the event of a hypoglycemic coma, about 40 ml of dextrose solution is administered intravenously until the patient completely emerges from the coma.

How to use insulin?

Injections with insulin Isofan must be carried out 30 or 40 minutes before meals for the drug to begin its effect. Insulin is administered subcutaneously 1 time (2 times) per day, and the injection site must always be changed to a new one. The required dose of the drug is calculated by the attending physician separately for each patient. The course of the disease and the level of glucose in the urine are also taken into account.

For children and people with high sensitivity to the drug, the dose should be reduced. When switching to another insulin, it is best to hospitalize the patient and constantly monitor glucose levels.

Immediately before injection, insulin is checked for transparency and tightness of the solution. Contraindications for use are damage to the bottle, the presence of cloudy sediment or crystals in the solution. The temperature should be room temperature. The dose needs to be adjusted in case of thyroid diseases and infectious diseases.

Prescribed to control blood sugar and normalize work processes in the body. Can be used for full and partial treatment.

Composition and action

“Insulin-isophane” is a human genetically engineered hormone (lat. Insulinum isophanum humanum biosyntheticum) a hormone whose effect on the body is identical to natural and is medium-long-term.

The composition of the medicine contains 100 units of the active ingredient in 1 ml, as well as additional substances, including water for injections, protamine sulfate, sodium dihydrogen phosphate, crystalline phenol, metacresol and glycerol. Available in the form of a suspension. Has the following actions:

enhances lipogenesis and gluconeogenesis, thereby lowering blood sugar levels;
increases the absorption of glucose by tissues;
activates intracellular metabolic processes;
reduces glycogen breakdown;
after administration, it begins to act within 1-1.5 hours;
effectiveness lasts for 11-24 hours.

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When is it prescribed?

Indications for use:

The drug is prescribed for diabetes in pregnant women.

diabetes mellitus type 1 and 2;
the stage when the body resists antidiabetic drugs taken orally;
type 2 diabetes mellitus in pregnant women (in the absence of effect from diets);
partial resistance to sugar-lowering drugs as part of complex therapy;
complications of the disease;
surgical interventions (as part of complex or single treatment).

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Instructions for use of "Insulin-isophane"

The medicine is administered subcutaneously, sometimes it can be injected intramuscularly. The average dosage per day is 0.5-1 IU/kg. When performing manipulations, the drug should be at room temperature. The injection is given 1-2 times a day 30-45 minutes before breakfast, 8-24 units at a time. The location of the procedure is changed each time (thigh, buttock, anterior abdominal wall). The dosage is selected individually, based on glucose levels in the blood and urine, as well as the course of the disease.

The instructions recommend that children and adults with hypersensitivity use a daily dose of up to 8 IU, and with low sensitivity it may be higher than 24 IU. Patients who received 100 or more IU with hormone replacement should be hospitalized. If a patient is using a drug substitute, blood glucose levels should be monitored. According to the instructions for use, intravenous injections of medium-long-acting insulin are prohibited.

Contraindications

In addition to its beneficial qualities, the drug has the following contraindications:

hypersensitivity to the components of the medicinal product;
reduction in blood sugar during pregnancy;
the presence of a pancreatic tumor leading to excessive production of the hormone insulin (insulinoma);
Use cautiously in patients over 65 years of age and with liver and kidney problems.

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Side effects

Although Insulin is an important medication for diabetics, it has the following side effects:

allergic rashes in the form of urticaria;
decrease in pressure;
increase in temperature;
Quincke's edema and anaphylactic shock;
feeling cold and shortness of breath;
hyperglycemia;
swelling and itching at the injection site;
visual impairment;
feeling of fear and hunger, lack of sleep, depression and others.

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Compatibility

There are medications that enhance the properties of “Insulin-isophane” when taken together, these include:

hypoglycemic agents in tablets;
inhibitors of monoamine oxidase, angiotensin-converting enzyme, NSAIDs;
sulfonamides;
selected antibiotics;
assimilative steroids;
remedies for fungal diseases;
"Theophylline" and "Clofibrate";
medications with lithium.

Nicotine reduces the effect of the drug, alcohol enhances the hypoglycemic effect. There are also medications that increase and decrease the effectiveness of “Insulin-isophane” - these are β-blockers, “Reserpine”, “Pentamidine”. Drugs that reduce the effect include:

hormones of the thyroid gland and adrenal cortex;
"Heparin";
diuretics;
antidepressants;
"Danazol" and "Morphine";
oral contraceptives.

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Overdose symptoms

If an overdose of a medicinal product occurs, changes in the mental state may be observed, which are manifested by fear, depression, irritability, and unusual behavior. And also the occurrence of hypoglycemia - a decrease in blood sugar levels. Treated by administering dextrose or glucagon. In the case of a hypoglycemic coma, the patient is given dextrose until the condition stabilizes. Then foods high in carbohydrates are recommended.

Precautions

Before injection, you need to make sure that the solution is clear and free of cloudiness. If flakes, cloudy or sediment appears, the drug should not be used. If the patient has a cold or other infectious disease, it is recommended to consult a doctor about the dosage. The temperature of the medicine should be brought to room temperature before the injection. It is necessary to constantly change the injection area.

Analogues of the drug

The use of drug substitutes should be agreed with a doctor, because hormones are serious medications that can lead to unwanted reactions. Analogues of “Insulin-isophane” have been created, which have the trade names “Insumal”, “Humulin”, “Biogulin”, “Pensulin”, “Insulidd”, “Gensulin”, “Actrafan”, “Vozulim” and others. Drugs can only be prescribed to a patient by a doctor based on the composition, as well as the dosage, which is selected individually.

The information is provided for general information only and cannot be used for self-medication. You should not self-medicate, it can be dangerous. Always consult your doctor. When partially or completely copying materials from the site, an active link to it is required.

Insulin isophane: instructions for use and price of the drug

Treatment with insulin is of a replacement nature, because the main goal of therapy is to compensate for disruptions in carbohydrate metabolism by introducing a special drug under the skin. This medicine affects the body in the same way as natural insulin produced by the pancreas. In this case, treatment can be complete or partial.

Among the drugs used for diabetes, one of the best is Isofan insulin. The drug contains human genetically engineered insulin with an average duration of action.

The product is available in various forms. It is administered in three ways - subcutaneously, intramuscularly and intravenously. This allows the patient to choose the optimal option for controlling glycemic levels.

Indications for use and trade names of the drug

The use of the drug is indicated for insulin-dependent diabetes. Moreover, therapy should be lifelong.

Insulin as Isophane, a human genetically engineered drug, is prescribed in the following cases:

diabetes type 2 (insulin dependent);
surgical procedures;
resistance to hypoglycemic drugs taken orally as part of complex treatment;
gestational diabetes (in the absence of effective diet therapy);
intercurrent pathologies.

Pharmaceutical companies produce human genetically engineered insulin under various names. The most popular are Vozulim-N, Biosulin-N, Protafan-NM, Insuran-NPH, Gensulin-N.

Other types of Isofan insulin are also used with the following trade names:

Insumal;
Humulin (NPH);
Pensulin;
Isophane insulin NM (Protafan);
Actrafan;
Insulydd N;
Biogulin N;
Protafan-NM Peniphyl.

It is worth noting that the use of any synonym for Isophane Insulin should be agreed with your doctor.

Pharmacological action

Human insulin has a hypoglycemic effect. The drug interacts with receptors of the cytoplasmic cell membrane, forming an insulin receptor complex. It activates the processes occurring inside cells and synthesizes the main enzymes (glycogen synthetase, pyruvate kinase, hexokinase, etc.).

The concentration of sugar is reduced by increasing its intracellular transport, reducing the rate of glucose production by the liver, stimulating the absorption and further absorption of glucose by tissues. Human insulin also activates protein synthesis, glycogenogenesis, and lipogenesis.

The duration of action of the drug depends on the speed of absorption, and it is determined by various factors (area of administration, method and dose of application). Therefore, the effectiveness of Isofan insulin can vary both in one patient and in other diabetics.

Often after injection, the effect of the drugs is observed after 1.5 hours. The highest peak of effectiveness occurs 4-12 hours after administration. Duration of action is one day.

Thus, the completeness of absorption and the onset of action of the drug depend on factors such as:

injection area (buttock, thigh, abdomen);
concentration of the active substance;
dosage.

Human insulin preparations are distributed unevenly in tissues. They do not penetrate the placenta and are not absorbed into breast milk.

They are destroyed by insulinase mainly in the kidneys and liver, excreted by the kidneys in an amount of 30-80%.

Directions for use and dosage

The instructions for use for insulin Isophane state that it is often administered subcutaneously up to 2 times a day before breakfast (zamin). In this case, you need to change the injection area every day and store the used syringe at room temperature, and the new one in the refrigerator.

Sometimes the drug is administered intramuscularly. And the intravenous method of using intermediate-acting insulin is practically not used.

The dosage is calculated individually for each patient, based on the level of sugar concentration in biological fluids and the specifics of the disease. As a rule, the average daily dosage ranges from 8-24 IU.

If patients have insulin hypersensitivity, then the optimal daily amount of the drug is 8 IU. If hormone sensitivity is poor, the dosage increases - from 24 IU per day.

When the daily volume of the drug is more than 0.6 IU per 1 kg of body weight, then 2 injections are given in different parts of the body. Patients whose daily dose is 100 IU or more should be hospitalized if insulin is replaced.

Moreover, when transferring from one type of product to another, it is necessary to monitor the sugar content.

Adverse reactions and overdose

The use of human insulin can cause allergic reactions. Most often it is angioedema (hypotension, shortness of breath, fever) and urticaria.

Also, exceeding the dosage can lead to hypoglycemia, manifested by the following symptoms:

insomnia;
pale skin;
depression;
hyperhidrosis;
fear;
excited state;
rapid heartbeat;
headache;
confusion;
vestibular disorders;
hunger;
tremor and so on.

Other side effects include diabetic acidosis and hyperglycemia, which are manifested by facial flushing, drowsiness, poor appetite and thirst. Most often, such conditions develop against the background of infectious diseases and fever, when an injection is missed, the dosage is incorrect, and in case of non-compliance with the diet.

Sometimes there is a disturbance of consciousness. In severe situations, a precomatous and comatose state develops.

At the beginning of treatment, transient disturbances in visual function may occur. There is also an increase in the titer of anti-insulin bodies with further progression of glycemia and immunological reactions of a cross nature with human insulin.

Often the injection site becomes swollen and itchy. In this case, the subcutaneous fatty tissue hypertrophies or atrophies. And at the initial stage of therapy, temporary refractive errors and swelling may occur.

In case of an overdose of hormonal drugs, blood sugar levels drop significantly. This causes hypoglycemia and sometimes the patient goes into a coma.

If the dose is slightly exceeded, you should take high-carbohydrate foods (chocolate, white bread, buns, candy) or drink a very sweet drink. In case of fainting, the patient is injected intravenously with a solution of Dextrose (40%) or Glucagon (s.c., i.m.).

When the patient regains consciousness, he must be fed food rich in carbohydrates.

This will prevent hypoglycemic relapse and glycemic coma.

The suspension for subcutaneous administration is not used with solutions of other drugs. And combined use with sulfonamides, ACE/MAO/carbonic anhydrase inhibitors, NSAIDs, ethanol, anabolic steroids, Chloroquinine, androgens, Quinine, Bromocriptine, Pyrodoxine, tetracyclines, lithium preparations, Clofibrate, Fenfluramine, Ketonozole, Cyclofosvamide, Mebendazole, om increases the hypoglycemic effect.

The weakening of the hypoglycemic effect is facilitated by:

H1-histamine receptor blockers;
Glucagon;
Somatropin;
Epinephrine;
Phenytoin;
oral contraceptives;
Epinephrine;
Estrogens;
calcium antagonists.

In addition, a decrease in sugar is caused by the combined use of Isofan insulin with loop and thiazide diuretics, Clondine, BMCC, Diazoxide, Danazol, thyroid hormones, tricyclic antidepressants, sympathomimetics, Heparin and sulfinpyrazone. Hypoglycemia is also enhanced by nicotine, marijuana and morphine.

Pentamidine, beta-blockers, Octreotide and Reserpine can increase or decrease glycemia.

Precautions for using Isofan insulin are that a person with diabetes must constantly change the places where the insulin injection will be given. After all, this is the only way to prevent the appearance of lipodystrophy.

During insulin therapy, glucose concentrations should be regularly monitored. Indeed, in addition to joint use with other drugs, hypoglycemia can be caused by other factors:

diabetic diarrhea and vomiting;
drug replacement;
diseases that reduce the need for the hormone (renal and liver failure, hypofunction of the thyroid gland, pituitary gland, etc.);
untimely eating;
changing the injection area.

Incorrect dosage or long pauses between insulin injections can contribute to the development of hyperglycemia, especially in type 1 diabetes. If therapy is not adjusted in time, the patient sometimes develops ketoacidotic coma.

In addition, a dose change is required if the patient is over 65 or has impaired functioning of the thyroid gland, kidneys or liver. This is also necessary for hypopituitarism and Addison's disease.

In addition, patients should be aware that human insulin preparations reduce tolerance to alcohol. At the initial stages of therapy, in case of changing the drug, stressful conditions, strong physical exertion, you should not drive a car or other complex mechanisms, or engage in potentially dangerous activities that require increased concentration and speed of reactions.

Pregnant patients should take into account that in the first trimester the need for insulin decreases, and in the 2nd and 3rd trimester it increases. Also, a smaller amount of the hormone may be needed during labor.

The video in this article will tell you about the pharmacological features of Isofan.

Insulin-isophane: instructions for use of the suspension

Active ingredient: insulin

human genetically engineered isophane

Manufacturer: Novo Nordisk, Denmark

Condition for dispensing from the pharmacy: By prescription

Storage conditions: t within 2-8 degrees

The human genetically engineered insulin isophane is used to treat conditions associated with insufficient production of the body's own hormone through the insular apparatus. There is no drug with this name on the market, since this is a form of the active substance, but there are analogues. A striking example of such a substance on sale is rinsulin.

Indications for use

The main indication is the treatment of type 1 diabetes, but in some cases it can be prescribed in the presence of a non-insulin-dependent form of the disease. Any trade name of isophane is suitable for the treatment of a person who is no longer taking hypoglycemic agents due to complete or partial resistance. The medication is used less frequently in pregnant women with type 2 diabetes.

Composition and release forms

1 ml of solution consists of 100 units of active ingredient. Auxiliary components - protamine sulfate, sterile water for injections, crystalline phenol, sodium phosphate dihydrate, glycerol, metacresol.

Suspension for injection, transparent. One bottle contains 3 ml of the substance. One package contains 5 cartridges or 10 ml of the drug is sold in one bottle.

Medicinal properties

Insulin isophane is a medium-lasting hypoglycemic agent that was manufactured using recombinant DNA technology. After subcutaneous administration, the endogenous hormone binds to the insulin receptor complex, resulting in the synthesis of many enzyme compounds - hexokinase, pyruvate kinase and others. Thanks to the substance introduced from the outside, the intracellular space of glucose increases, due to which it is intensively absorbed by tissues, and the rate of sugar synthesis by the liver is significantly reduced. With frequent use, the medication triggers the processes of lipogenesis, glycogenogenesis and proteinogenesis.

The duration of action and the speed of onset of the effect in different people depends on many factors, in particular on the speed of metabolic processes. What this means is that this process is individual in nature. On average, since this is a hormone of medium speed of action, the onset of the effect develops within an hour and a half from the moment of subcutaneous administration. The duration of the effect is a day, peak concentration occurs within 4 – 12 hours.

The drug is absorbed unevenly and is excreted primarily through the kidneys; the severity of the effect depends directly on the injection site (stomach, arm or thigh). The medication does not penetrate the placental barrier and into breast milk, therefore it is allowed for pregnant and new mothers.

Directions for use

The average cost of medicine in Russia is 1075 rubles per package.

Inject subcutaneously, once a day, in different places. The frequency of injections in one place should not exceed more than 1 time per month, so the injection sites for the medication are changed each time. Before direct use, ampoules are rolled in the palms of your hands. Instructions for carrying out injections are basic - sterile processing, needles are inserted subcutaneously at an angle of 45 degrees into the clamped fold, then the area is thoroughly disinfected. Dosages are selected by the doctor individually.

During pregnancy and breastfeeding

The drug is approved for use during these periods.

Contraindications and precautions

These include: intolerance to a specific active ingredient and low sugar levels at a particular moment.

Cross-drug interactions

Reduce the effect of the drug: systemic glucocorticoids, oral contraception, estradiol and progesterone, anabolic steroids, diuretics, antidepressants, thyroid hormones.

Increase effectiveness: alcohol, salicylates, sulfonamides and beta blockers, MAO inhibitors.

Side effects and overdose

Hypoglycemia or lipodystrophy is possible if the injection rules and prescribed dosage are not followed. Less commonly, systemic side effects occur in the form of allergic reactions, shortness of breath, decreased blood pressure, hyperhidrosis and tachycardia.

In case of an overdose, classic signs of low blood sugar appear: a strong feeling of hunger, weakness, loss of consciousness, dizziness, sweating, desire to eat sweets, and in severe cases, coma. Mild symptoms can be relieved by taking fast carbohydrates, while moderate symptoms can be treated with intravenous injections of dextrose or glucose. Difficult situations require urgent calls to doctors at home.

Analogues

Rinsulin PNH

Geropharm-bio LLC, Russia

The average cost in Russia is 1000 rubles per package.

Rinosulin is a complete analogue and consists of isophane insulin with an average duration of action. This dosage form is good because it does not require frequent subcutaneous administration.

Not the cheapest
Possible side effects.

Humulin NPH

Eli Lilly East, Switzerland

The average price in Russia is 17 rubles.

Humulin NPH is an analogue of medium speed of action.

Insulin Isophane is a human hormone made using genetic engineering

In maintenance therapy for both stage 1 and stage 2 diabetes, the hormone introduced into the body in a timely manner plays an important role. The new drug Insulin Isofan will help patients with diabetes live safely. Treatment of diabetes with insulin has a replacement property.

The purpose of such medical intervention is to compensate for the loss or excess of carbohydrates as part of metabolism through the subcutaneous administration of a special hormone. This hormone affects the body identically to natural insulin, which is produced by the pancreas. Treatment can be partial or complete.

Among the drugs successfully used to treat stage 2 and stage 1 diabetes mellitus, Isofan insulin has proven itself to be effective. It contains human genetically engineered insulin with an average duration of action.

This medicine, this hormone, is indispensable for a full life of a person who has problems with sugar in

blood is produced in different forms:

For guidance under the skin;
For injection into a vein;
For intramuscular administration.

This choice allows a person suffering from varying degrees of diabetes to keep their blood sugar levels under control by any method of introducing it into the blood, adjusting it when necessary.

Insulin Isofan - indications for use:

Resistance to sugar-lowering drugs, which must be taken in tablet form as part of complex treatment;
Diabetes 2 and 1 degree, insulin dependent;
Gestational diabetes, if there is no effect from diets;
Pathologies of intercurrent type.

Isofan: analogues and other names

Trade names for Isofan insulin may be as follows:

How it works

Human genetically engineered insulin Isophane affects the body, providing a hypoglycemic effect. This drug comes into contact with receptors in the cytoplasm of the cell membrane. This creates the insulin receptor complex. Its task is to make active the metabolism that takes place inside the cells themselves, as well as to help in the synthesis of the most important of all existing enzymes.

Reducing the amount of sugar in the blood occurs by increasing its transport within the cell, as well as reducing the rate of sugar production, helping in the absorption process. Another advantage of human insulin is protein synthesis, activation of lithogenesis, glycogenogenesis.

How long a given drug lasts is directly proportional to the rate of absorption of the drug into the blood, and the absorption process depends on the method of administration and dose of the drug. Therefore, the effect of this drug varies from patient to patient.

Traditionally, after the injection, the effect of the medicine begins after 1.5 hours. Peak effectiveness occurs 4 hours after administration of the drug. Duration of action – 24 hours.

The intensity of absorption of Isophane depends on the following:

Injection site (buttock, abdomen, thigh);
Concentration of the active substance;
Dose.

This medicine is excreted by the kidneys.

How to use: indications for use

According to the instructions for use of Isofan, it must be administered subcutaneously twice a day: in the morning and in the evening before meals (one minute before meals). The injection site must be changed every day, the used syringe should be stored at normal, ordinary temperature, and the new one - in its packaging in the refrigerator. This drug is rarely injected into the muscle, and almost never intravenously, since it is an intermediate-acting insulin.

The dose of this drug is calculated individually for each person suffering from diabetes, in consultation with the attending physician. Based on the volume of sugar in plasma and the specifics of diabetes. The average daily dose traditionally varies between 8-24 IU.

In case of hypersensitivity to insulin, no more than 8 IU should be taken per day; if the hormone is poorly perceived, the dose can be increased to 24 or more IU per day. If the daily dose of the drug should exceed 0.6 IU per kilogram of the patient’s body weight, then 2 injections are given at a time in different places.

Hives;
Hypotension;
Increase in temperature;
Chills;
Dyspnea;
Hypoglycemia (fear, insomnia, pale face, depression, overexcitement, sucking hunger, shaking limbs);
Diabetic acidosis;
Hyperglycemia;
Deterioration of vision;
Swelling and itching at the injection site.

An overdose of this drug can lead to hypoglycemia and coma. Excess of the dose can be neutralized by taking food high in carbohydrates (chocolate, candy, cookies, sweet tea).

In case of loss of consciousness, a solution of Dextrose or Glucagon should be administered intravenously to the patient. When consciousness returns, the patient should be given food high in carbohydrates. This will make it possible to avoid both glycemic coma and hypoglycemic relapse.

Insulin Isofan: can it be used with other medications?

Increases the hypoglycemic effect (bringing the volume of sugar in the blood to normal) the symbiosis of Isofan with:

Sulfonamides;
Chloroquinine;
ACE/MAO/carbonic anhydrase inhibitors;
Ethanol;
Mebendazole;
Drugs included in the group of anabolic steroids;
Fenfluramine;
Tetracycline group drugs;
Clofibrate;
Medicines of the theophylline group.

The hypoglycemic effect (bringing the amount of sugar in the blood to normal) is reduced due to the symbiosis of Isofan with the following drugs:

The amount of sugar in the blood decreases due to the symbiosis of Isofan insulin with thiazide and loop diuretics, with BMCC, as well as with thyroid hormones, sympathomimetics, Clondine, Danazol, sulfinpyrazone. Morphine, marijuana, alcohol and nicotine also reduce blood sugar. Patients with diabetes should not drink or smoke.

In addition to taking inappropriate medications together with Isofan, hypoglycemia can also be triggered by factors such as:

Switching to another medicine that maintains normal sugar levels;
Vomiting caused by diabetes;
Diarrhea caused by diabetes;
Increased physical loads;
Diseases that reduce the need for insulin (pituitary gland, hypothyroidism, liver failure, renal failure);
When the patient does not eat on time;
Changing the injection site.

An incorrect dose or a long time interval between injections can cause hyperglycemia (especially in type 1 diabetes). If therapy is not adjusted in time, the patient may fall into a ketoacidotic coma.

A patient using this medicine over sixty years of age, and especially one who has impaired functioning of the thyroid gland, kidneys, or liver, must consult with the attending physician about the dosage of insulin Isofan. The same measures should be taken if the patient suffers from hypopituitarism or Addison's disease.

Insulin Isofan: cost

The price of Isofan insulin varies from 500 to 1200 rubles per package, which includes 10 ampoules, depending on the country of origin and dosage.

How to inject: special instructions

Before drawing the medicine into the syringe, check to see if the solution is cloudy. It should be transparent. If flakes or foreign bodies appear, the solution becomes cloudy, or a precipitate forms, the medicine cannot be used.

The temperature of the administered drug should be room temperature. If you currently have a cold or any other infectious disease, you should consult your doctor about the dose. When changing the drug, you should do this under the supervision of a doctor; it is prudent to go to the hospital.

Pregnancy, lactation and insulin Isofan

Pregnant women with diabetes can take Isofan insulin; it will not reach the fetus through the placenta. It can also be used by nursing mothers who are forced to live with this disease. It is important to know that during pregnancy in the 1st trimester the need for insulin decreases, and in the second and third it increases.

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.

Others: 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.

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 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 ®

Latin name: insulinum isophanum
ATX code: A10A
Active ingredient: insulin
human genetically engineered isophane
Manufacturer: Novo Nordisk, Denmark
Conditions for dispensing from a pharmacy: By prescription
Storage conditions: t within 2-8 degrees
Best before date: 2 years.

Indications for use

Composition and release forms

Suspension for injection, transparent. One bottle contains 3 ml of the substance. One package contains 5 cartridges or 10 ml of the drug is sold in one bottle.

Medicinal properties

Directions for use

The average cost of medicine in Russia is 1075 rubles per package.

During pregnancy and breastfeeding

The drug is approved for use during these periods.

Contraindications and precautions

These include: intolerance to a specific active ingredient and low sugar levels at a particular moment.

Cross-drug interactions

Reduce the effect of the drug: systemic glucocorticoids, oral contraception, estradiol and progesterone, anabolic steroids, diuretics, antidepressants, thyroid hormones.

Increase effectiveness: alcohol, salicylates, sulfonamides and beta blockers, MAO inhibitors.

Side effects and overdose

Analogues

Geropharm-bio LLC, Russia

The drug is a medium-duration insulin. In fact, it is human insulin, which was obtained thanks to recombinant DNA technology.

Pharmacological action

Isophane insulin has a hypoglycemic effect. It interacts with special receptors on the outer cytoplasmic cell membrane and forms an insulin receptor system that stimulates intracellular processes, which include the synthesis of the core of key enzymes (pyruvate kinase, hexokinase, glycogen synthetase).

An increase in intracellular glucose transport causes a decrease in its level in the blood. This is also facilitated by a decrease in the rate of glucose production by the liver, increased absorption and absorption by tissues. Stimulates glycogenogenesis, lipogenesis, protein synthesis.

The rate of absorption, due to which drugs have a long-lasting effect, depends on several factors: place and method of administration, dose. In this regard, the effect of insulin can fluctuate significantly. Moreover, these fluctuations can be observed not only in different people, but also in the same patient.

After a subcutaneous injection, on average, the drug begins to work after 1.5 hours, and the maximum effect occurs between 4 and 12 hours. The effect of the drug lasts for 24 hours.

The onset of effect and completeness of insulin absorption varies:

from the injection site (abdomen, buttocks, thigh);
on the concentration of the hormone in the drug;
on the amount of insulin administered (dose).

Other features:

Does not pass into breast milk.
Unevenly distributed throughout tissues.
Does not penetrate the placental barrier.
30-80% is excreted by the kidneys.
It is destroyed by insulinase mainly in the kidneys and liver.

When to take insulin isophane

Diabetes mellitus type I and II.
Phase of resistance to hypoglycemic oral drugs.
When carrying out combination treatment, partial resistance to drugs of this group.
Diabetes mellitus type II in pregnant women.
Intercurrent diseases.

Contraindications

Side effects of the drug Insulin isophane

Related to the effect on carbohydrate metabolism:

Hypoglycemia:

increased sweating,
feeling hungry
pale skin,
tremor, tachycardia,
excitation,
headache,
paresthesia in the mouth;
severe hypoglycemia, which is fraught with the development of hypoglycemic coma.

Allergic manifestations are extremely rare:

Quincke's edema,
skin rash,
anaphylactic shock.

usually at the beginning of treatment there are transient refractive errors;
swelling.

Local reactions:

swelling and itching in the injection area;
hyperemia;
lipodystrophy in the injection area (with long-term use).

Interaction

Strengthen the hypoglycemic effect of insulin:

MAO inhibitors;
hypoglycemic oral drugs;
bromocriptine;
carbonic anhydrase inhibitors;
sulfonamides;
fenfluramine;
preparations containing ethanol;
ACE inhibitors;
non-selective beta-blockers;
mebendazole;
lithium preparations;
tetracyclines;
ketoconazole;
anabolic steroid;
cyclophosphamide;
octreotide;
pyridoxine;
clofibrate;
theophylline.

Reduces the hypoglycemic effect of insulin:

thiazide diuretics;
oral contraceptives;
diazoxide;
thyroid hormones;
morphine;
glucocorticoids;
danazol;
heparin;
tricyclic antidepressants;
nicotine;
sympathomimetics;
clonidine;
phenytoin.

But salicylates and reserpine can both weaken and enhance the effect of insulin.

Overdose

In case of overdose, hypoglycemia may occur.

Treatment of hypoglycemia

The patient can cope with mild hypoglycemia on his own by eating a piece of sugar, candy, or carbohydrate-rich foods. Therefore, diabetic patients should always have sugar, cookies, candy or fruit juice with them.

In cases of severe hypoglycemia, when the patient loses consciousness, 40% dextrose solution or glucagon is administered intravenously.

The latest genetically engineered insulin can be administered both intramuscularly and subcutaneously. When consciousness returns to a person, he needs to take food rich in carbohydrates, this will prevent the re-development of hypoglycemia.

Directions for use and doses

The dose of subcutaneous injection is determined by a specialist individually in each specific case. It is based on the level of glucose in the patient's blood. The average daily dose of the drug varies from 0.5 to 1 IU/kg, it depends on the type and individual characteristics of the patient, how he reacts to human and genetically engineered insulin isophane.

Usually insulin isophane, as a human and genetically engineered drug, is injected into the thigh subcutaneously, but injections can be made into the buttock, the anterior abdominal wall, and in the area of the deltoid muscle of the shoulder. The temperature of the administered drug should be room temperature.

Precautions

In addition to the fact that human and genetically engineered insulin can be exceeded, the causes of hypoglycemia can be:

skipping meals;
diarrhea, vomiting;

Diseases that reduce the need for the hormone insulin (hypofunction of the pituitary gland, adrenal cortex, thyroid gland, impaired renal and liver function);

drug replacement;
changing the injection zone;
increased physical activity;
interaction with other drugs.

If human and genetically engineered insulin is given intermittently or the wrong dosage can lead to hyperglycemia, the symptoms of which usually develop gradually (several hours or even days). Hyperglycemia is accompanied by:

the appearance of thirst;
dry mouth;
frequent urination;
nausea, vomiting;
loss of appetite;
dizziness;
dryness and redness of the skin;
smell of acetone from the mouth.

If hyperglycemia in type I diabetes is not treated promptly, a very life-threatening diabetic disease, ketoacidosis, can develop.

In case of Addison's disease, dysfunction of the thyroid gland, liver and kidneys, hypopituitarism and diabetes mellitus in the elderly, it is necessary to adjust the dose and carefully prescribe human and genetically engineered insulin.

A dose change may also be required in cases where the patient changes his usual diet or increases the intensity of physical activity.

Human and genetically engineered insulin reduces alcohol tolerance. Due to a change in the type of insulin, its primary purpose, there is a high probability of a decrease in the ability to drive vehicles or control various mechanisms.

Price

Prices for Isofan in Moscow pharmacies range from 500 to 1200 rubles, depending on the dosage and manufacturer.