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Insulin Information for the Patient
Please read this leaflet carefully before using this product.
Please note the special directions under "PREPARING THE INJECTION".
Novolin® PenFill® cartridges are designed for use with NovoPen® and NovolinPen® Insulin Delivery Devices and NovoFine® disposable needles or other products specifically recommended by Novo Nordisk.
PenFill® cartridge is for single person use only.
See Important Notes section.
SPECIAL CARE SHOULD BE TAKEN WHEN THE TRANSFER IS FROM A STANDARD BEEF OR MIXED SPECIES INSULIN TO A PURIFIED PORK OR HUMAN INSULIN. IF A DOSAGE ADJUSTMENT IS NEEDED, IT WILL USUALLY BECOME APPARENT EITHER IN THE FIRST FEW DAYS OR OVER A PERIOD OF SEVERAL WEEKS. ANY CHANGE IN TREATMENT SHOULD BE CAREFULLY MONITORED.
PLEASE READ THE SECTIONS "INSULIN REACTION AND SHOCK" AND "DIABETIC KETOACIDOSIS AND COMA"FOR SYMPTOMS OF HYPOGLYCEMIA (LOW BLOOD GLUCOSE) AND HYPERGLYCEMIA (HIGH BLOOD GLUCOSE).
Your physician has explained that you have diabetes and that your treatment involves injections of insulin or insulin therapy combined with an oral antidiabetic medicine. Insulin is normally produced by the pancreas, a gland that lies behind the stomach. Without insulin, glucose (a simple sugar made from digested food) is trapped in the bloodstream and cannot enter the cells of the body. Some patients who don't make enough of their own insulin, or who cannot use properly the insulin they do make, must take insulin by injection in order to control their blood glucose levels. Each case of diabetes is different and requires direct and continued medical supervision. Your physician has told you the type, strength and amount of insulin you should use and the time(s) at which you should inject it, and has also discussed with you a diet and exercise schedule. You should contact your physician if you experience any difficulties or if you have questions.
Standard and purified animal insulins as well as human insulins are available. Standard and purified insulins differ in their degree of purification and content of noninsulin material. Standard and purified insulins also vary in species source: they may be of beef, pork, or mixed beef and pork origin. Human insulin is identical in structure to the insulin produced by the human pancreas, and thus differs from animal insulins. Insulins vary in time of action; see PRODUCT for additional information.
Your physician has prescribed the insulin that is right for you; be sure you have purchased the correct insulin and check it carefully before you use it.
A package contains five (5) cartridges.
Novolin® 70/30 PenFill contain Novolin® 70/30 which is a mixture of 70% NPH, Human Insulin Isophance Suspension (recombinant DNA origin) and 30% Regular, Human Insulin Injection (recombinant DNA origin) USP. The concentration of this product is 100 units of insulin per milliliter. It is a cloudy or milky suspension of human insulin with protamine and zinc. The insulin substance (the cloudy material) settles at the bottom of the cartridge, therefore, the cartridge must be rotated up and down as described under "PREPARING THE INJECTION" so that the contents are uniformly mixed before the dose is given.
Novolin® 70/30 has an intermediate duration of action. The effect of Novolin® 70/30 begins approximately 1 / 2 hour after injection. The effect is maximal between 2 and approximately 12 hours. The full duration of action may last up to 24 hours after injection.
The time course of action of any insulin may vary considerably in different individuals, or at different times in the same individual. Because of this variation, the time periods listed here should be considered as general guidelines only.
This human insulin (recombinant DNA origin) is structurally identical to the insulin produced by the human pancreas. This human insulin is produced by recombinant DNA technology utilizing Saccharomyces cerevisiae (bakers' yeast) as the production organism.
Novolin® N PenFill® cartridges contain Novolin® N, commonly known as NPH, Human Insulin Isophane Suspension (recombinant DNA origin). The concentration of this product is 100 units of insulin per milliliter. It is a cloudy or milky suspension of human insulin with protamine and zinc. The insulin substance (the cloudy material) settles at the bottom of the cartridge; therefore, the cartridge must be turned up and down at least 10 times or until the liquid appears uniformly white and cloudy (a glass ball inside the cartridge facilitates mixing).
Novolin® N has an intermediate duration of action. The effect of Novolin® N begins approximately 1 ½ hours after injection. The effect is maximal between 4 and 12 hours. The full duration of action may last up to 24 hours after injection. The time course of action of any insulin may vary considerably in different individuals, or at different times in the same individual. Because of this variation, the time periods listed here should be considered as general guidelines only. This human insulin (recombinant DNA origin) is structurally identical to the insulin produced by the human pancreas. This human insulin is produced by recombinant DNA technology utilizing Saccharomyces cerevisiae (bakers' yeast) as the production organism.
Novolin® R PenFill® cartridges contain Novolin® R, commonly known as Regular, Human Insulin (recombinant DNA origin). The concentration of this product is 100 units of insulin per milliliter. It is a clear, colorless solution which has a short duration of action. The effect of Novolin® R begins approximately ½ hour after injection. The effect is maximal between 2 ½ and 5 hours and ends approximately 8 hours after injection. The time course of action of any insulin may vary considerably in different individuals, or at different times in the same individual. Because of this variation, the time periods listed here should be considered as general guidelines only.
This human insulin (recombinant DNA origin) is structurally identical to the insulin produced by the human pancreas. This human insulin is produced by recombinant DNA technology utilizing Saccharomyces cerevisiae (bakers' yeast) as the production organism.
Insulin should be stored in a cold place, preferably in a refrigerator, but not in the freezing compartment. Do not let it freeze. Keep Novolin® 70/30 PenFill®, Novolin® N PenFill® and Novolin® R PenFill® cartridges in the carton so that they will stay clean and protected from light. Novolin® 70/30 PenFill®, and Novolin® N PenFill® 1.5ml cartridges can be kept unrefrigerated for 7 days. Novolin® N PenFill® 3.0ml cartridges can be kept unrefrigerated for 14 days, and Novolin® 70/30 PenFill® 3.0ml cartridges can be kept unrefrigerated for 10 days. Novolin® R PenFill® 1.5ml and 3.0ml cartridges can be kept unrefrigerated for one (1) month. Unrefrigerated cartridges must be used within this time period or discarded. Be sure to protect cartridges from sunlight and extreme heat or cold.
Never use any Novolin® 70/30 PenFill® or Novolin® N PenFill® cartridge if the precipitate (the white deposit), has become lumpy or granular in appearance or has formed a deposit of solid particles on the wall of the cartridge. This insulin should not be used if the liquid in the cartridge remains clear after it has been mixed.
Never use any Novolin® R PenFill® if it becomes viscous (thickened) or cloudy; use it only if it is clear and colorless.
Never use insulin after the expiration date which is printed on the label and carton.
Failure to comply with the following antiseptic measures may lead to infections at the injection site.
Novolin® R PenFill®
Place a single-use on the device. Be sure there is sufficient insulin in the cartridge to complete the injection. Refer to the instruction manual for your insulin delivery device for assistance in estimating the amount of insulin remaining in the cartridge.
Novolin® 70/30 PenFill® and Novolin® N PenFill®
Never place a single-use needle on your insulin delivery device until you are ready to give an injection, and remove it immediately after each injection. If the needle is not removed, some liquid may be expelled from the cartridge causing a change in the insulin concentration (strength).
The cloudy material in an insulin suspension will settle to the bottom of the cartridge, so the contents must be mixed before injection. These Novolin® PenFill® cartridges contain a glass ball to aid mixing.
When using a new cartridge, turn the cartridge up and down between positions A and B--See Figure 1. Do this at least 10 times until the liquid appears uniformly white and cloudy.
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Assemble your insulin delivery device following the directions in your instruction manual.
For subsequent injections when a cartridge is already in the device, turn the device up and down between positions A and B--See Figure 2. Do this at least 10 times until the liquid appears uniformly white and cloudy. Follow the directions in your insulin delivery device instruction manual.
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Always be sure there is sufficient insulin in the cartridge to complete the injection. In order to help you estimate the amount of insulin in the cartridge, the width of the black band corresponds to 12 units of insulin.
Note: Never initiate a new injection unless there is sufficient insulin in the cartridge to ensure proper mixing (the glass ball needs adequate room for movement to mix the suspension). When using a NovoPen® device, never initiate a new injection once the leading edge of the plunger has passed the top edge of the black band.
Insulin PenFill® cartridges may contain a small amount of air. To prevent an injection of air and make certain insulin is delivered, an air shot must be done before each injection. Directions for performing an air shot are provided in your insulin delivery device instruction manual.
Note: Use the injection Technique recommended by your physician.
For additional information see GIVING THE INJECTION on the reverse side of this insert.
It is particularly important to maintain good control of your diabetes during pregnancy and special attention must be paid to your diet, exercise and insulin regimens. If you are pregnant or nursing a baby, consult your physician or nurse educator.
Insulin reaction (hypoglycemia) occurs when the blood glucose falls very low. This can happen if you take too much insulin, miss or delay a meal, exercise more than usual or work too hard without eating, or become ill (especially with vomiting or fever). Hypoglycemia can also happen if you combine insulin therapy and other medications that lower blood glucose, such as oral antidiabetic agents or other prescription and over-the-counter drugs. The first symptoms of an insulin reaction usually come on suddenly. They may include a cold sweat, fatigue, nervousness or shakiness, rapid heartbeat, or nausea. Personality change or confusion may also occur. If you drink or eat something right away (a glass of milk or orange juice, or several sugar candies), you can often stop the progression of symptoms. If symptoms persist, call your physician--an insulin reaction can lead to unconsciousness. If a reaction results in loss of consciousness, emergency medical care should be obtained immediately. If you have had repeated reactions or if an insulin reaction has led to a loss of consciousness, contact your physician. Severe hypoglycemia can result in temporary or permanent impairment of brain function and death.
In certain cases, the nature and intensity of the warning symptoms of hypoglycemia may change. A few patients have reported that after being transferred to human insulin, the early warning symptoms of hypoglycemia were less pronounced than they had been with animal-source insulin.
Diabetic ketoacidosis may develop if your body has too little insulin. The most common causes are acute illness or infection or failure to take enough insulin by injection. If you are ill you should check your urine for ketones. The symptoms of diabetic ketoacidosis usually come on gradually, over a period of hours or days, and include a drowsy feeling, flushed face, thirst and loss of appetite. Notify your physician right away if the urine test is positive for ketones (acetone) or if you have any of these symptoms. Fast, heavy breathing and rapid pulse are more severe symptoms and you should have medical attention right away. Severe, sustained hyperglycemia may result in diabetic coma and death.
A few people with diabetes develop red, swollen and itchy skin where the insulin has been injected. This is called a "local reaction" and it may occur if the injection is not properly made, if the skin is sensitive to the cleansing solution, or if you are allergic to the insulin being used. If you have a local reaction, tell your physican.
Generalized insulin allergy occurs rarely, but when it does it may cause a serious reaction, including skin rash over the body, shortness of breath, fast pulse, sweating, and a drop in blood pressure. If any of these symptoms develop, you should seek emergency medical care.
If severe allergic reactions to insulin have occured (i.e., generalized rash, swelling or breathing difficulties) you should be skin-tested with each new insulin preparation before it is used.
Helpful information for people with diabetes is published by American Diabetes Association, 1660 Duke Street, Alexandria, VA 22314
For information contact:
Novo Nordisk Pharmaceuticals, Inc.
100 College Road West
Princeton, NJ 08540
1-800-727-6500
Manufactured by
Novo Nordisk A/S
DK-2880 Bagsvaerd, Denmark
Novo Nordisk TM , Novolin® PenFill®, NovoPen®,
NovolinPen®, NovoFine® and Lente®
are trademarks owned by Novo Nordisk A/S
Date of issue: Feb. 2000
License under U.S. Patent No. 5,462,535 and Des. 347,894 restricted to use with Novo Nordisk insulin delivery devices and Novo Nordisk pen needles.
Novolin® 70/30 PenFill® cartridges, U-100, 100 units/mL, 1.5 mL, (List No. 183717) (5's)
Novolin® 70/30 PenFill® cartridges, U100, 100 units/mL, 3mL, (List no. 347718) (5's)
Novolin® N PenFill® cartridges. U-100, 100 units/mL, 1.5 mL, (List No. 183417) (5's)
Novolin® N PenFill® cartridges, U100, 100 units/mL, 3 mL, (List no. 347418) (5's)
Novolin® R PenFill® cartridges, U-100, 100 units/mL, 1.5 mL, (List No. 183317) (5's)
Novolin® R PenFill® cartridges, U100, 100 units/mL, 3 mL, (List no. 347318) (5's)
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