Formulary
Insulin: Indications, Dosing, Side Effects and Interactions
Soluble insulin is a natural or recombinant insulin with a short duration of action.
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Insulin: Indications, Dosing, Side Effects and Interactions
Soluble insulin is a natural or recombinant insulin with a short duration of action.
Drug action
Soluble insulin is a natural or recombinant insulin with a short duration of action.
Indications and dose
**Diabetes mellitus**
- **Adult** (By Subcutaneous Injection, Or By Intramuscular Injection, Or By Intravenous Injection, Or By Intravenous Infusion): According to requirements.
**Diabetic ketoacidosis,Diabetes during surgery**
- **Adult** (By Intravenous Infusion): (consult local protocol).
**Diabetes mellitus for insulin**
- **Child** (By subcutaneous injection): According to requirements.
**Hyperglycaemia during illness for insulin**
- **Neonate** (By intravenous infusion): 0.02-0.125 unit/kg/hour, dose to be adjusted according to blood-glucose concentration.
- **Child** (By intravenous infusion): 0.025-0.1 unit/kg/hour, dose to be adjusted according to blood-glucose concentration.
**Neonatal hyperglycaemia, Neonatal diabetes for insulin**
- **Neonate** (By intravenous infusion): 0.02-0.125 unit/kg/hour, dose to be adjusted according to blood-glucose concentration.
**Diabetic ketoacidosis, Diabetes during surgery for insulin**
- **Child** (By intravenous infusion): (consult local protocol).
Side effects
Common or very common Oedema Uncommon Lipodystrophy Frequency not known Cutaneous amyloidosis Overdose Overdose causes hypoglycaemia. Side-effects For insulin Uncommon Skin reactions Rare or very rare Refraction disorder
Interactions
**Severe interactions:**
- If a beta-blocker is used in combination with clonidine, the gradual withdrawal of beta-blocker should first be considered before the withdrawal of clonidine.
**Other interactions (74):**
- Insulin and oral antidiabetic drugs Beta-blockers may intensify the blood sugar lowering effects of insulin and oral antidiabetic drugs, and the dosage of antidiabetics may therefore require...
- Pharmacodynamic interactions Insulin and sulphonylureas Insulin and sulphonylureas may increase the risk of hypoglycaemia.
- Therefore, a lower dose of insulin or sulphonylureas may be required to reduce the risk of hypoglycaemia when used in combination with Glyxambi (see sections 4.2, 4.4 and 4.8).
- Concomitant use of landiolol and insulin or oral antidiabetic medicinal products may affect the blood sugar lowering effect.
- When starting therapy with Myalepta there is a risk of hypoglycaemia in patients who are on anti-diabetic medicinal products, in particular insulin or insulin secretagogues (see section 4.4).
- Combinations requiring precautions for use Potentiation of the blood glucose lowering effect and thus, in some instances, hypoglycaemia may occur when one of the following drugs is taken: Other...
Pregnancy
During pregnancy, insulin requirements may alter and doses should be assessed frequently by an experienced diabetes physician. The dose of insulin generally needs to be increased in the second and third trimesters of pregnancy.
Breast feeding
During breast-feeding, insulin requirements may alter and doses should be assessed frequently by an experienced diabetes physician.
Hepatic impairment
Insulin requirements may be decreased.
Renal impairment
The compensatory response to hypoglycaemia is impaired in renal impairment. Dose adjustments Insulin requirements may decrease in patients with renal impairment and therefore dose reduction may be necessary. M
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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