How does Novolin NPH Insulin Work?
Insulin is a hormone that is naturally produced in our body by the pancreas. It helps our body store and process glucose (sugar) derived from food. For those with diabetes, their body may not produce enough insulin or none at all. This unfortunately can lead to a host of complications that results from accumulation of sugar in the bloodstream.
Insulin medication is commonly recommended by doctors to be injected under the skin (subcutaneously) to help manage blood glucose levels.
There are several types of insulin that are absorbed at different rates and their duration may vary. Novolin NPH in an intermediate-acting insulin that can take 1-3 hours to start working, reach its maximum effect within 5-8 hours and stops working between 18-24 hours.
A doctor may prescribe Novolin NPH for conditions other than those listed below. If you are unsure why you were given this medication then you should consult a doctor. Do not stop taking this medication unless under the direction of your doctor.
Do not share this medication with others even if they share similar symptoms. This medication can harm others if it has not been prescribed by a doctor.
What is Novolin NPH?
Novolin NPH is used to treat patients with diabetes mellitus who require insulin to managed high blood sugar (hyperglycemia). It is often prescribed in combination with fast-acting insulin medications.
The active ingredient is Insulin Isophane, Human Biosynthetic. Each mL contains 100 units of insulin NPH. Other non-medical ingredients include: glycerol, hydrocholoric acid and/or sodium hydroxide, disodium phosphate, metacresol, protamine sulphate, dihydrate, zinc chloride and water for injection.
Your insulin dosage should be measure din international units (IU). Each ml contains 100 IU.
Novolin NPH is produced by recombinant DNA method using a combination of unique purification and S. cerevisiae (baker’s yeast). Structurally, it is identical to human insulin which occurs naturally in the body.
Using Novolin NPH
Your doctor may prescribe your dosage based on your individual needs. This is determined based on factors such as blood sugar levels, body weight, existing medical conditions, other medications, lifestyle and how much insulin your pancreas produces.
This insulin should be injected (under the skin). Your doctor, nurse and/or pharmacist will provide instructions on how to properly inject insulin.
Novolin NPH is commonly injected once or twice daily. A fast-acting insulin is often accompanied in order to help manage the impact of blood glucose levels during the day.
Insulin is mixed by slowly rolling the vial between your hands until it becomes cloudy and uniformly white. If insulin appears grainy, unusually thick, appears discolored or sticks to the vial. Do not use if vial appears frosted, contains crystals or if suspension remains clear after rolling between hands.
Storing Novolin NPH
- Unopened bottles should be stored in the refrigerator until needed
- Use until expiry date on label
- Do not allow insulin to freeze
- Insulin currently in use can be kept at room temperature for up to 28 days
- Do not use and discard after 28 days
- Do not expose insulin to extremely heat or sunlight
- Keep out of reach from children or pets
When taking insulin, it’s crucial to follow your doctors instructions. This can include dosage and timing to ensure that blood glucose is managed in order to prevent any unwanted side effects.
Do not dispose of medication in wastewater (ie sink, toilet) or in household trash. Your pharmacist should provide instructions on how to properly dispose of medication that is expired or no longer needed.
Novolin NPH Side Effects
You should not take this medication if you have any of the following side effects:
- allergic to NPH insulin or any of its ingredients
- have low blood glucose levels (hypoglycemia)
- has diabetic coma
What side effects are possible with Novolin NPH?
As with any medication side effects may occur. These are unwanted responses that result from normal doses. Side effects are usually temporary and can range from mild to severe. They are not common with everyone taking this insulin. Speak to your doctor about the risks associated with taking this medication.
At least 1% of people taking insulin NPH have reported the following side effects. Typically side effects go away over time.
- itching, redness, swelling at injection site
- blurred vision
- difficulty concentrating
- difficulty speaking
- fast heartbeat
- numbness or tingling of the lips, fingers, or tongue
Consult your doctor if you experience any of the following side effects:
- signs of low blood glucose
- blurred vision
Stop taking this medication and seek medical attention immediately if you experience nay of the following:
- blisters or rash all over your body
- symptoms of serious allergic reaction (swelling of throat or face, wheezing, itchy skin rash, difficulty breathing)
Some patients may experience side effects other than those listed above, are severe or bothersome. Consult your doctor if you notice any symptoms that are concerning while taking this medication.
Your pharmacist should advise you about possible side effects and management. If unchecked, side effects can lead to serious complications if you do not consult your doctor or seek medical attention.
Warnings & Precautions
Before starting Novolin NPH, inform your doctor:
- of any allergies
- existing medical conditions
- medications you are taking
- whether you are pregnant or breastfeeding
- any significant facts about your health
The above list will impact how your doctor may adjust your insulin dosage.
Do not modify your dosage unless under the direction of your doctor. Rationing insulin can have serious side effects. Consult your doctor first if you plan on adjusting your dosage.
Do not inject insulin into a muscle or vein.
If you notice any symptoms of allergic reactions such as body rash, wheezing, difficulty breathing, swelling of face and throat – stop taking this medication and seek medical attention.
Appearance of Insulin
Novolin NPH should appear cloudy and white. Do not use if it appears grainy, lumpy, unusuall thick, discoloured or sticks to the bottom of the vial, looks frosted or contains crystals or if suspension remains clear after you roll it between your hands.
Blood Glucose Monitoring
For those with diabetes, it’s important to monitor your blood glucose levels regularly. Your doctor or diabetes educator should provide instructions on measuring blood glucose. Your levels may be affected by schedule changes, travelling over to another time zone, stress or if you are ill. If you find your blood sugar levels are consistently too high or too low, consult you doctor.
Changes at Injection Site
Adverse effects may happen at the site of insulin injection. Fatty tissue under the skin may thicken or shrink if you inject too often at the same location. To avoid this from happen, rotate injection sites. Speak to you doctor or diabetes educator on rotating injection sites. Notify you doctor if you experience any skin pitting or thickening at the site of injection.
Modification to Insulin Requirements
Changes to insulin requirements may be affected by the following:
- certain medical conditions (thyroid conditions, kidney or liever disease, infections etc)
- medications that may affect blood glucose levels
- travelling over time zones
It is important that your doctor understands your current health situation and any changes in order to adjust insulin dosage. As for any diabetics, blood glucose measurement should be performed regularly or as suggested by your doctor.
It is a good idea to carry identification that implies you have diabetes and are taking insulin. This can include a bracelet, necklace or card.
Educate Family & Friends
Educate family and friends about signs and symptoms related to your condition, especially hypoglycemia (low blood glucose). Keep a glucagon kit available and educate family and friends on how to administer it in the event of loss of consciousness caused by severely low blood glucose levels.
Low blood glucose (hypoglycemia)
Hypoglycemia may occur if meals are missed, exercising more than usual or using too much insulin. Symptoms of mild to moderate hypoglycemia include:
- cold sweats
- nervousness or shakiness
- fast heartbeat
- tingling (tongue, fingers, lips)
Mild to moderate hypoglycemia can be treated by eating sugary foods or drinks. For a quick source of sugar, those with diabetes often carry hard candies, glucose tablets, juice or soft drinks (non-diet).
Signs of severe hypoglycemia include:
- loss of consciousness
A glucagon injection or glucose through intravenous treatment (into the vein) may be used to treat patients who have exprienced unconsciousness. This is done since the person cannot take sugar by mouth.
Pregnancy or Breast Feeding
It is important to manage glucose levels during pregnancy. Typically, insulin medication may be decreased during the first trimester and increase during the second and third. Contact your doctor if you are either pregnant or considering pregnancy.
Breastfeeding mothers may require an adjustment to their insulin medication or diet.
Your doctor may recommend lower doses of insulin in order to avoid low blood glucose levels for seniors.
Drug interactions with Novolin NPH
There may be an interaction between Novolin NPH and the following medications:
- ACE inhibitors (ie lisinopril, ramipril, enalapril)
- anabolic steroids (ie testosterone)
- beta-blockers (ie atenolol, metoprolol, propranolol, pindolol, sotalol)
- birth control pills
- certain diuretics (ie hydrochlorothiazide)
- corticosteroids (ie prednisolone, prednisone)
- decongestants (ie pseudoephedrine)
- growth hormone
- MAO inhibitors (ie tranylcypromine, phenelzine)
- oral medications for diabetes (ie gliclazide,rosiglitazone, pioglitazone, glyburide)
- salicylates (ie ASA)
- sulfa antibiotics (ie sulfadiazine, sulfamethoxazole)
- thyroid replacement therapy (if beginning or changing dose)
Consult your doctor if you are taking any of the medications listed above. This includes if you are taking any herbal supplements, over-the-counter medications, vitamins or other prescription medications your doctor should know about.
Let your doctor know if you are taking any caffeine, nicotine/smoking cigarettes or street drugs as they can affect the action of your medication.
Your doctor may make modifications to the drugs you are taking or dosages.