Insulin (Parenteral Route)

Tell your doctor if you have ever had any unusual or allergic reaction to medicines in this group or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Use in older adults is similar to use in other age groups. However, sometimes the first signs of low or high blood sugar are missing or not easily seen in older patients. This may increase the chance of low blood sugar during treatment. Also, some older people may have vision problems or other medical problems that make it harder for them to measure and inject the medicine. Special training and equipment may be needed.

The amount of insulin you need changes during and after pregnancy. It is especially important for your health and your baby's health that your blood sugar be closely controlled. Close control of your blood sugar can reduce the chance of your baby gaining too much weight, having birth defects, or having high or low blood sugar. Be sure to tell your doctor if you plan to become pregnant or if you think you are pregnant.

The presence of other medical problems may affect the use of medicines in this class. Make sure you tell your doctor if you have any other medical problems, especially:

• Changes in female hormones for some women (e.g., during puberty, pregnancy, or menstruation) or
• High fever or
• Infection, severe or
• Mental stress or
• Overactive adrenal gland, not properly controlled or
• Other conditions that cause high blood sugar—These conditions increase blood sugar and may increase the amount of insulin you need to take, make it necessary to change the time when you inject the insulin dose, and increase the need to take blood sugar tests.

• Diarrhea or
• Gastroparesis (slow stomach emptying) or
• Intestinal blockage or
• Vomiting or
• Other conditions that delay food absorption or stomach emptying—These conditions may slow the time it takes to break down and absorb your meal from your stomach or intestines, which may change the amount of insulin you need, make it necessary to change the time when you inject the insulin dose, and increase the need to take blood sugar tests.

• Injury or
• Surgery—Effects of insulin may be increased or decreased; the amount and type of insulin you need may change rapidly.

• Kidney disease or
• Liver disease—Effects of insulin may be increased or decreased, partly because of slower removal of insulin from the body; this may change the amount of insulin you need.

• Overactive thyroid, not properly controlled—Effects of insulin may be increased or decreased, partly because of faster removal of insulin from the body. Until your thyroid condition is controlled, the amount of insulin you need may change, make it necessary to change the time when you inject the insulin dose, and increase the need to take blood sugar tests.

• Underactive adrenal gland, not properly controlled or
• Underactive pituitary gland, not properly controlled or
• Other conditions that cause low blood sugar—These conditions lower blood sugar and may lower the amount of insulin you need, make it necessary for you to change the time when you inject the insulin dose, and increase the need to take blood sugar tests.

Store in the refrigerator. Do not freeze.

Unopened bottles of insulin should be refrigerated until needed and may be used until the printed expiration date on the label. Insulin should never be frozen. Remove the insulin from the refrigerator and allow it to reach room temperature before injecting it.

An insulin bottle in use may be kept at room temperature for up to 1 month. Insulin that has been kept at room temperature for longer than a month should be thrown away.

Storing prefilled syringes in the refrigerator with the needle pointed up reduces problems that can occur, such as crystals forming in the needle and blocking it up.

Do not expose insulin to extremely hot temperatures or to sunlight. Extreme heat will cause insulin to become less effective much more quickly.