Rinsulin R, 100 me/ml 3 ml 5 pcs
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Pharmacotherapeutic group: Hypoglycemic drug, short-acting insulin.
ATC code: A10AB01
Pharmacological properties
Pharmacodynamics
Rinsulin R is a human insulin produced using recombinant DNA technology. It is a short-acting insulin. It interacts with specific receptor of outer cytoplasmic cell membrane and forms insulin-receptor complex, which stimulates intracellular processes, including synthesis of several key enzymes (hexokinase, pyruvate kinase, glycogen synthase and others). Decrease of glucose content in blood is caused by an increase of its intracellular transport, increased absorption and assimilation by tissues, stimulation of lipogenesis, glycogenogenesis, decrease of glucose production rate by liver, etc.
The duration of action of insulin drugs is mainly due to the speed of absorption, which depends on several factors (e.g., the dose, route and place of administration), so the action profile of insulin is subject to considerable variation, both in different people and in the same person. On average, after subcutaneous administration, Rinsulin P begins to act in 30 minutes, with maximum effect developing between 1 and 3 hours, with a duration of action of 8 hours.
Pharmacokinetics
The completeness of absorption and onset of effect of insulin depends on the route of administration (subcutaneous, intramuscular, intravenous), site of administration (stomach, thigh, buttocks), dose (amount of injected insulin), the concentration of insulin in the drug, etc. Distributed irregularly in tissues; does not penetrate through placental barrier and into breast milk. It is broken down by insulinase mainly in liver and kidneys. The elimination half-life is several minutes. It is excreted by the kidneys (30-80%).
Indications
- Diabetes mellitus type 1
- Diabetes mellitus type 2: stage of resistance to oral hypoglycemic agents, partial resistance to these drugs (when combined therapy), intercurrent disease
- Pregnant diabetes mellitus type 2
- Uncomplicated conditions in diabetic patients accompanied by decompensation of carbohydrate metabolism
.
Composition
1 ml of the drug contains:
active ingredient:
human insulin 100 ME;
excipients:
metacresol 3 mg,
glycerol (glycerin) 16 mg,
water for injection to 1 ml.
How to take, the dosage
The drug is intended for subcutaneous, intramuscular and intravenous administration.
The dose and route of administration is determined by a physician individually in each case based on the blood glucose concentration.
The average daily dose of the drug ranges from 0.5 to 1 IU/kg of body mass (depends upon the individual characteristics of the patient and the blood glucose concentration).
The drug is injected 30 minutes before a meal or snack containing carbohydrates.
The temperature of injected insulin should correspond to room temperature. In case of monotherapy the drug is injected 3 times a day (if necessary – up to 5 – 6 times a day). If the daily dose is more than 0.6 IU/kg, the drug should be given as 2 or more injections in different parts of the body. The drug is usually injected subcutaneously into the anterior abdominal wall. Injections can also be made in the thigh, buttock or shoulder in the projection of the deltoid muscle.
It is necessary to change the injection sites within the anatomical area to prevent the development of lipo-dystrophy. When injecting insulin subcutaneously, care must be taken to avoid entering a blood vessel during injection. After injection, the injection site should not be massaged. Patients should be trained in the correct use of the device for insulin injection.
Intramuscular and intravenous the drug may be administered only under the supervision of a doctor.
Vials may be used only if their contents is a clear colorless liquid without visible particles. The drug must not be used if there is sediment in the solution. Rinsulin® R is short-acting insulin and is usually used in combination with medium-acting insulin (Rinsulin® NPH).
The used drug may be stored at room temperature (from 15 to 25 ° C) for no more than 28 days.
Interaction
Rinsulin® P may be administered subcutaneously in the same syringe as a medium-acting insulin (Rinsulin® NPH). Rinsulin® R should not be administered in the same syringe with other drugs and insulins of other manufacturers.
There are a number of drugs that affect the need for insulin. Hypoglycemic effect of insulin is enhanced by oral hypoglycemic drugs, monoamine oxidase inhibitors, angiotensin-converting enzyme inhibitors, carboenhydrase inhibitors, non-selective beta-adrenoblockers, bromocriptine, octreotide, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, phenfluramine, lithium preparations, preparations containing ethanol.
Hypoglycemic effect of insulin is weakened by glucagon, somatropin, estrogens, oral contraceptives, glucocorticosteroids, iodine containing thyroid hormones, thiazide diuretics, loop diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazol, clonidine, epinephrine, H1-histamine receptor blockers, slow calcium channel blockers, diazoxide, morphine, phenytoin, nicotine. Under the influence of reserpine and salicylates both weakening and strengthening of the drug action are possible.
The drug reduces alcohol tolerance.
Special Instructions
During insulin therapy, continuous monitoring of blood glucose concentrations is necessary.
The causes of hypoglycemia in addition to insulin overdose may be: changing the drug, skipping meals, vomiting, diarrhea, increased physical activity, diseases that reduce the need for insulin (liver and kidney function disorders, adrenal gland, pituitary or thyroid hypofunction), change of injection site, and interaction with other medications.
Inadequate dosing or intermittent insulin administration, especially in patients with type 1 diabetes, can lead to hyperglycemia. Usually the first symptoms of hyperglycemia develop gradually over a few hours or days. They include the appearance of thirst, increased frequency of urination, nausea, vomiting, dizziness, red and dry skin, dry mouth, loss of appetite, and the smell of acetone in the exhaled air. If left untreated, hyperglycemia in type 1 diabetes can lead to life-threatening diabetic ketoacidosis.
The insulin dose should be adjusted for thyroid dysfunction, Addison’s disease, hypopituitarism, hepatic and renal dysfunction, and diabetes mellitus in individuals over 65 years of age.
The insulin dose may also need to be adjusted if the patient increases physical activity or changes their diet.
Concomitant illnesses, particularly infections and conditions with fever, increase the need for insulin.
The patient should be switched to a new type of insulin or to an insulin product from another manufacturer under the supervision of a physician.
Due to the potential for precipitation in some catheters, use of the product in insulin pumps is not recommended.
Impact on ability to drive and operate vehicles
In connection with the initial prescription of insulin, a change in its type, or in the presence of significant physical or mental stress, it is possible to impair the ability to drive vehicles or various moving mechanisms, as well as to engage in other potentially dangerous activities requiring increased attention and rapidity of reaction.
Contraindications
- Individual hypersensitivity to insulin or any of the drug components
- Hypoglycemia
Side effects
Conditioned by the effect on carbohydrate metabolism: hypoglycemic states (pale skin, increased sweating, palpitations, tremors, chills, hunger, agitation, paresthesias of the oral mucosa, weakness, headache, dizziness, decreased visual acuity). Severe hypoglycemia may lead to hypoglycemic coma.
Allergic reactions: skin rash, Quincke’s edema, anaphylactic shock.
Local reactions: hyperemia, swelling and itching in the injection site, with prolonged use – lipodystrophy in the injection site.
Other: edema, transient decrease in visual acuity (usually at the beginning of therapy).
If the patient noted the development of hypoglycemia or he had an episode of loss of consciousness, he should immediately inform the doctor.
If any other side effects not described above are identified, the patient should also consult a doctor.
Overdose
In overdose hypoglycemia may develop (symptoms – see side effects):
Treatment: mild hypoglycemia patient can eliminate himself by taking sugar or carbohydrate-rich foods. Therefore, diabetic patients ‘ is recommended to carry sugar, sweets, cookies or sweet fruit juice at all times.
In severe cases, if the patient loses consciousness, intravenous administration of a 40% solution of dextrose (glucose); intramuscularly, subcutaneously, intravenously – glucagon. After recovery of consciousness, the patient is advised to take a meal rich in carbohydrates to prevent recurrence of hypoglycemia.
Pregnancy use
There are no restrictions on the treatment of diabetes mellitus with insulin during pregnancy, as insulin does not penetrate the placental barrier. During pregnancy planning and during pregnancy it is necessary to intensify the treatment of diabetes mellitus. The need for insulin usually decreases in the first trimester of pregnancy and gradually increases in the second and third trimesters.
During childbirth and immediately after, the need for insulin may decrease dramatically. Shortly after delivery, the need for insulin quickly returns to pre-pregnancy levels. There are no restrictions on the treatment of diabetes with insulin during breastfeeding. However, it may be necessary to reduce the insulin dose, so close monitoring is necessary for several months until the need for insulin stabilizes.
Weight | 0.064 kg |
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Shelf life | 2 years. Do not use after the expiration date. |
Conditions of storage | In the dark place at the temperature from 2 to 8 ° C. Do not freeze. Keep out of reach of children. |
Manufacturer | Geropharm, Russia |
Medication form | solution for injection |
Brand | Geropharm |
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