Insuman Comb Cartridge
Insulin Aspart Biphasic
Sanofi India Ltd.
| Pack size | 3ml |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 336.40 NPR |
Indications
Insuman Comb Cartridge is used for:
Diabetes mellitus
Adult Dose
Subcutaneous
Diabetes Mellitus
Combination rapid-onset (faster than regular insulin) and intermediate-acting insulins in fixed dose
Typical daily insulin requirements range between 0.5-1 unit/kg
Dose regimen varies among patients depending on metabolic needs;
Administer SC q12hr (ie, before breakfast and evening meal); each dose intended to cover 2 meals or a meal and snack
Dosing Considerations:
Insulin naive patients: For patients with type 2 diabetes, the recommended starting dose of Insulin Aspart 30/70 is 6 Units at breakfast and 6 Units at dinner (evening meal). Insulin Aspart
30/70 can also be initiated once daily with 12 units at dinner (evening meal).
How to intensify: Insulin Aspart 30/70 can be intensified from once daily to twice daily. When using Insulin Aspart 30/70 once daily, it is generally recommended to move to twice daily when reaching 30 units by splitting the dose into equal breakfast and dinner doses.
From Insulin Aspart 30/70 twice daily to thrice daily: If twice daily dosing with Insulin Aspart 30/70 results in recurrent daytime hypoglycaemic episodes, the morning dose can be split into morning and lunchtime doses. The dinner doses remain unchanged.
How to adjust the dose:
- Adjust the dose of Insulin Aspart 30/70 on the basis of the lowest pre-meal blood glucose level from the three previous days
- Dose adjustment can be made once a week until target HbA1c is reached
- The dose should not be increased if hypoglycemia occurred within three days
- Adjustment of dose may be necessary if patients undertake increased physical activity, change their usual diet or during concomitant illness
The following titration guideline is recommended for dose adjustments:
Pre-meal blood glucose level Dose adjustment
< 4.4 mmol/l < 80 mg/dl - 2 units
4.4 – 6.1 mmol/l 80 – 110 mg/dl 0
6.2 – 7.8 mmol/l 111 – 140 mg/dl + 2 units
7.9 – 10 mmol/l 141 – 180 mg/dl + 4 units
> 10 mmol/l > 180 mg/dl + 6 units
Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment: Dose adjustments may be needed.
Administration
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
Rapid changes in serum glucose may induce symptoms of hypoglycemia
Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions (eg, long duration of diabetes, diabetic nerve disease, use of beta-blockers or intensified diabetes control)
Caution in conditions with decreased insulin requirements (eg, diarrhea, nausea, vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment)
Caution in conditions with increased insulin requirements (eg, fever, hyperthyroidism, trauma, infection, surgery)
May cause a shift in potassium from extracellular to intracellular space, possibly leading to hypokalemia; caution when coadministered with potassium-lowering drugs or conditions that may decrease potassium
Frequent glucose monitoring and insulin dose reduction may be required with renal or hepatic impairment; not recommended during periods of rapidly declining renal or hepatic function because of risk for prolonged hypoglycemia
Pregnancy-Lactation
Pregnancy (insulin requirements tend to fall during the 1st trimester, increase during the 2nd and 3rd) and lactation. Regular monitoring of HbA1c and blood glucose concentrations. Caution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery
Lactation: Unknown whether distributed in breast milk; compatible with breast feeding, but lactating women may require dosage adjustment; caution advised
Interactions
Reduce insulin requirements w/ oral hypoglycemics, octreotide, MAOIs, nonselective ?-adrenergic blockers, ACE inhibitors, salicylates, alcohol, anabolic steroids & sulfonamides; increase insulin requirements w/ OCs, thiazides, glucocorticoids, thyroid hormones, sympathomimetics & danazol. ?-blocking agents may mask the symptoms of hypoglycaemia. Alcohol may intensify & prolong the glucose lowering effect of insulin.
Adverse Effects
Side effects of Insulin Aspart Biphasic :
Adverse events commonly associated with human insulin therapy include the following: Allergic reactions. Injection site reaction, lipodystrophy, pruritus, rash, lipoatrophy, hypokalaemia, blurred vision. Hypoglycaemia, insulin resistance.
Mechanism of Action
Insulin aspart, a rapid-acting analog of human insulin, lowers blood glucose levels; it regulates carbohydrate, protein and fat metabolism by inhibiting hepatic glucose production and lipolysis, and enhancing peripheral glucose disposal.
Note
Insuman Comb Cartridge manufactured by Sanofi India Ltd.. Its generic name is Insulin Aspart Biphasic. Insuman Comb is availble in Nepal.
Farmaco Nepal drug index information on Insuman Comb Cartridge is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.