Humulin R Cartidge - Injection Insulin (Human) R - 100IU/ml 1 3ml Cartridge(s) / 3ml Cartridge Eli Lilly and Company Indication: Diabetic ketoacidosis, Diabetes mellitus Administration: Administer within 15 minutes 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. Adult Dose: Subcutaneous Type 1 Diabetes Mellitus Initial: 0.2-0.4 units/kg/day SC divided q8hr or more frequently Maintenance: 0.5-1 unit/kg/day SC divided q8hr or more frequently; in insulin-resistant patients (eg, due to obesity), substantially higher daily insulin may be required Approximately 50-75% of the total daily insulin requirements are given as intermediate- or long-acting insulin administered in 1-2 injections; rapid- or short-acting insulin should be used before or at mealtimes to satisfy the remainder balance of the total daily insulin requirements Type 2 Diabetes Mellitus Type 2 diabetes inadequately controlled by diet, exercise, or oral medication: Initial: 0.2-0.4 units/kg/day SC divided q8hr-q12hr Intramuscular... Child Dose: Subcutaneous Type 1 Diabetes Mellitus Initial: 0.2-0.4 unit/kg/day SC divided q8hr or more frequently Maintenance: 0.5-1 unit/kg/day SC divided q8hr or more frequently; in insulin-resistant patients (eg, due to obesity), substantially higher daily insulin may be required Adolescents: May require up to 1.5 mg/kg/day during puberty The average total daily insulin requirement for prepubertal children varies from 0.7-1 unit/kg/day but may be much lower Renal Dose: Renal impairment: Dose adjustments may be needed. Contraindication: Hypoglycaemia.Hypersensitivity to any of the components. Mode 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... Precaution: 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 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 Side Effect: Allergic reactions. Injection site reaction, lipodystrophy, pruritus, rash, lipoatrophy, hypokalaemia, blurred vision. Hypoglycaemia, insulin resistance. Headache,Influenza-like symptoms,Dyspepsia,Diarrhea,Back pain,Pharyngitis, Interaction: Possible absence of hypoglycaemic warning symptoms with beta-blockers. Decreased hypoglycaemic effect with corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetic agents, thyroid hormones, oestrogens, progestins (e.g. in oral contraceptives), protease inhibitors and atypical antipsychotic (e.g. olanzapine and clozapine). Increased hypoglycaemic effect with oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates and sulfonamide antibiotics. Decreased insulin resistance with octreotide and lanreotide. Increased risk of wt gain and peripheral oedema with pioglitazone, rosiglitazone. Decreased effect of sermorelin.