insulin (cont.)

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STORAGE: Unopened insulin should be stored between 2 C and 8 C (36 F and 46 F); it should not be placed in a freezer. Insulin vials that are being used can be kept at room temperature for up to a month. All vials should be protected from sunlight and excessive heat. Unused insulin should be thrown away after the expiration date. The vials should never be shaken.

DOSING: The abdomen is the preferred site for insulin injection, but the sites of injection must be rotated in order to prevent erosion of the fat beneath the skin, a condition called lipodystrophy. Dosing is adjusted for each patient. A combination of short acting/rapid acting and intermediate insulin or long acting insulin are typically used.

DRUG INTERACTIONS: Beta blockers (for example, propranolol [Inderal, Indearl LA, Innopran XL], atenolol [Tenormin]) may mask symptoms of low blood glucose and affect how the body uses glucose. Repaglinide (Prandin) increases the risk of low blood glucose while rosiglitazone (Avandia) increases the occurrence of low blood glucose, fluid retention, and heart failure. Thiazide diuretics, steroids, and estrogens reduce the effect of insulin by increasing blood glucose. Levofloxacin (Levaquin) and other fluoroquinolones increase the risk of high or low blood glucose. Monoamine oxidase inhinbitors (for example selegiline), sulfonylureas (for example, glyburide [Diabeta, Glynase]), and yohimbe increase the risk of low blood glucose. Thyroid hormones increase insulin requirements. Insulin alters the chemical properties of pramlintide (Symlin). Therefore, pramlintide and insulin should not be mixed in the same syringe.

PREGNANCY: Insulin is the drug of choice for controlling diabetes mellitus during pregnancy, that is, it is preferred over oral drugs to reduce blood sugar. NPH, insulin aspart, insulin detemir, and insulin lispro also are used during pregnancy.

NURSING MOTHERS: Insulins are considered safe to use by nursing mothers.

Medically reviewed by Omudhome Ogbru, PharmD

Reference: FDA Prescribing Information

Medically Reviewed by a Doctor on 4/14/2015

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