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INSULIN HUMAN, ISOPHANE (NPH) 100 UI/ml, 10ml, vial N

https://medicalguidelines.msf.org/en/node/824
https://unicat.msf.org/cat/product/11716
STD DINJINSHI1VN

Valid Article

Former Code(s): DINJINSH1VI DINJINSHI1V
The product is supplied (and stored) sterile, it must remain sterile until its use. Sterile = state of being free from all living microorganisms.
18.5.1 - Insulins
Classification of the medicines in groups and subgroups according to their therapeutic use. The classification used by MSF is based on the WHO Model List of Essential Medicines.
A018006 - Hypodermic needles pen injectors
European Medical Device Nomenclature (EMDN) is the nomenclature of use by manufacturers when registering their medical devices in the EUDAMED database. EMDN is characterised by its alphanumeric structure that is established in a seven-level hierarchical tree.
A10AC01
Anatomical Therapeutic Chemical Classification according to WHOCC
0208
Thermosensitive codes are defined for storage and transportation temperature requirements of the products.
The product is part of at least one Kit. A kit is a collection of products (medical and/or logistic) that are needed for a certain intervention in emergency. The choice and quantity of the articles reflects the MSF protocols for this specific situation. The use of Kits allows to start an intervention without a detailed evaluation.
OC subscriptions: included in supply or field order tools (e.g. UniField)
SC subscriptions: included in supply or field tools
OC validations: approved for procurement and use by an OC for international or local orders specifying context and activity in Medical Standard Lists (MSL)

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INSULIN ISOPHANE (NPH) human
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Full Name

Insulatard®(DINJINSHI1VN)

Therapeutic Action

Pancreatic hormone, antidiabetic

Intermediate-acting isophane human insulin.

Isophane insulin is a mixture of regular human insulin and NPH (Neutral Protamine Hagedornis), which is used to delay absorption and prolong the duration of action.

Action profile:

  • onset of action: 1 - 2 hours
  • peak action: 4 - 12 hours
  • duration of action: 14 - 18 hours

These action profiles are based on subcutaneous injections and are approximate. They depend on the dose injected, the type and brand of insulin and can vary significantly from one patient to another.

See Preliminary remarks on Insulins.

Indications

Diabetes

Insulin to cover basal insulin needs.

Instructions for use

Must be given as deep SC injection only.

Before using insulin for the first time, allow it to reach room temperature for 1 or 2 hours (cold insulin is more painful).

Preparation for administration

  • Wash hands.
  • Check the insulin vial (type and strength of insulin, expiry date) and inspect the solution (it should be opaque, white and aqueous).
  • Use an insulin syringe with a fixed needle: 1 ml syringe graduated in 2 IU or 0.5 ml syringe graduated in 1 IU (for children).
  • Stir the insulin by gently rolling the vial between the palms of the hands.
  • Draw air into the syringe and inject it into the vial.
  • Draw the required dose of insulin into the syringe.

How to administer SC insulin

  • Insulin can be injected into the abdomen (two fingers away from the belly button), upper arm, buttocks, hips, buttocks, or the front or side of the thigh.
  • Repeatedly injecting insulin in the same area can cause lumps, swelling and thickened skin, which may interfere with proper absorption of the insulin. See the picture below on “rotating” injection sites.
  • Do not inject insulin into areas with wounds or bruising.
  • Clean the chosen injection site with soap and water. Allow to dry.
  • Pinch the skin.
  • Hold the syringe like a pencil at a 90-degree angle to the skin and insert the needle with one quick motion.
  • Inject the dose of insulin. Wait for 5 seconds before removing the needle from the skin.
  • Apply gentle pressure on the injection site with a finger for 5-10 seconds to prevent insulin from leaking out.
  • Do not recap the syringe. Dispose of the needle safely in a sharps container.
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Precautions for Use

Mixing two types of insulin (rapid-acting and isophane) in the same syringe should only be done under strict medical prescription.

Switching the patient to a different insulin type or brand (manufacturer) is not recommended.

The manufacturer is identified by a letter at the end of the code and the label: N = Novo Nordisk, S = Sanofi, L = Lilly.

Caution! In order to simplify ordering and the medical list, the standard is the isophane insulin from Novo Nordisk (DINJINSHI1VN).

Storage

  • Unopened vials: store in the refrigerator between 2°C and 8°C - Protect from sunlight
  • Opened vials (in-use) Insulatard®: may be kept for up to 4 weeks at temperature not exceeding 25ºC.
  • Do not freeze. Discard any vial that has been frozen.
  • Keep the vial in its outer packaging.

(Cf Introduction: Thermosensitive products)