Human Mixtard Solution
Insulin (Human) Regular + Insulin (Human) Isophane (pre mixed)
40IU
Torrent Pharmaceuticals Ltd.
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Indications
Human Mixtard Solution is used for:
Diabetes mellitus
Adult Dose
Subcutaneous
Type 1 Diabetes Mellitus
Suggested guidelines for beginning dose
Ketones moderate or less: 0.5 U/kg/day SC
Ketones large: 0.7 U/kg/day SC
Typically, 50-75% of total daily dose is given as intermediate- or long-acting insulin
Type 2 Diabetes Mellitus
Suggested guidelines for beginning dose; adjust according to blood glucose levels
Initial dose: 0.5-1 units/kg/day in divided doses
Initial dosages for type 2 diabetic patients are often lower, e.g. 0.3 to 0.6 IU/kg/day.
Typically, 50-75% of total daily dose is given as intermediate- or long-acting insulin
Morning
Give two thirds of daily insulin SC
Ratio of regular insulin to NPH insulin 1:2
Evening
Give one third of daily insulin SC
Ratio of regular insulin to NPH insulin 1:1
Dosing Considerations
Dosage of human insulin, must be based on the results of blood and urine glucose tests and must be carefully individualized to optimal effect
Dose adjustments should be based on regular blood glucose testing
Change insulin doses in small increments: Type 1 diabetes (2 unit change); type 2 diabetes (2-4 unit change). Look for consistent pattern in blood sugars for >3 days
Adjust to achieve appropriate glucose control
Hepatic impairment: Dosage reduction may be needed.
Child Dose
Subcutaneous
Type 1 Diabetes Mellitus
Suggested guidelines for beginning dose
Ketones moderate or less: 0.5 U/kg/day SC
Ketones large: 0.7 U/kg/day SC
Renal Dose
Renal impairment: Dose adjustments may be needed.
Administration
Administer within 15 min before a meal or immediately after a meal. Administer subcutaneously in the upper arm, thigh or abdominal wall. A subcutaneous injection into the abdominal wall results in a faster absorption than from other injection sites.
Contra Indications
Hypoglycaemia.Hypersensitivity to any of the components.
Precautions
Pregnancy (insulin requirements tend to fall during the 1st trimester, increase during the 2nd and 3rd) and lactation. Caution with decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment
Hypokalemia may occur
Not for IV or IM administration
Use with caution in renal and hepatic impairment (dosage requirements may be reduced)
Caution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery
Lactation: Safe to use while breastfeeding
Pregnancy-Lactation
Interactions
Oral hypoglycemic agents, MAOIs, nonselective beta-blocker, ACE inhibitors, salicylates, alcohol, anabolic steroids & sulphonamides may reduce insulin requirement. OCs, thiazides, glucocorticoids, thyroid hormones, sympathomimetics & danazol may increase insulin requirements.
Octreotide/lanreotide may both decrease & increase insulin requirement. beta-blockers may mask symptoms of hypoglycemia. Alcohol may intensify or reduce hypoglycemic effect of insulin.
Adverse Effects
Side effects of Insulin (Human) Regular + Insulin (Human) Isophane (pre mixed) :
Allergic reactions. Injection site reaction, lipodystrophy, pruritus, rash, lipoatrophy, hypokalaemia, blurred vision. Hypoglycaemia, insulin resistance.
Headache,Influenza-like symptoms,Dyspepsia,Diarrhea,Back pain,Pharyngitis,
Mechanism of Action
Insulin lowers blood glucose levels. It regulates carbohydrate, protein and fat metabolism by inhibiting hepatic glucose production and lipolysis, and enhancing peripheral glucose disposal. The various insulin formulations are classified according to their durations of action after SC Inj. They are divided into short-, intermediate-, or long-acting insulin. Soluble insulin (also known as 'neutral insulin' or 'regular insulin') is a short-acting preparation.
To extend the duration of action of insulin, preparations are formulated as suspensions in 2 methods. The 1st method involves complexing insulin with a protein so that it is slowly released, e.g. protamine zinc insulin (contains an excess of protamine) and isophane insulin (or NPH insulin which contains equal amounts of protamine and insulin). An alternative method is particle size modification e.g. insulin zinc suspensions. While all the formulations can be admin by SC inj, most by IM inj, only soluble insulin can be admin by IV. Compared to SC inj, IM admin usually has a faster onset of action, with a shorter duration of action.
Note
Human Mixtard 40IU Solution manufactured by Torrent Pharmaceuticals Ltd.. Its generic name is Insulin (Human) Regular + Insulin (Human) Isophane (pre mixed). Human Mixtard is availble in Nepal.
Farmaco Nepal drug index information on Human Mixtard Solution is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.