What is nph for diabetes?

An intermediate-acting insulin used in the treatment of diabetes mellitus. Administered once or twice daily, NPH (neutral protamine hagedorn) insulin lowers blood glucose within 1 to 2 hours after administration and exerts a peak effect at 6 to 10 hours.

ISOPHANE INSULIN (NPH) (EYE soe fane IN su lin) treats diabetes. It works by increasing insulin levels in your body, which decreases your blood sugar (glucose). It belongs to a group of medications called intermediate-acting insulins. Changes to diet and exercise are often combined with this medication.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Humulin N, Novolin N, ReliOn

They need to know if you have any of these conditions:

Insulin is for injection under the skin. Use exactly as directed. It is important to follow the directions given to you by your care team. You will be taught how to use this medication and how to adjust doses for activities and illness. Do not use more insulin than prescribed. Do not use more or less often than prescribed.

Always check the appearance of your insulin before using it. This medication should be white and cloudy. Do not use it if it is not uniformly cloudy after mixing.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one.

If you use a pen, be sure to take off the outer needle cover before using the dose.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team regarding the use of this medication in children. While this medication may be prescribed for children for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

It is important not to miss a dose. Your care team should discuss a plan for missed doses with you. If you do miss a dose, follow their plan. Do not take double doses.

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your care team for regular checks on your progress.

A test called the HbA1C (A1C) will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.

Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.

Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.

Tell your care team if you have high blood sugar. You might need to change the dose of your medication. If you are sick or exercising more than usual, you might need to change the dose of your medication.

Do not skip meals. Ask your care team if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.

Make sure that you have the right kind of syringe for the type of insulin you use. Try not to change the brand and type of insulin or syringe unless your care team tells you to. Switching insulin brand or type can cause dangerously high or low blood sugar. Always keep an extra supply of insulin, syringes, and needles on hand. Use a syringe one time only. Throw away syringe and needle in a closed container to prevent accidental needle sticks.

Insulin pens and cartridges should never be shared. Even if the needle is changed, sharing may result in passing of viruses like hepatitis or HIV.

Each time you get a new box of pen needles, check to see if they are the same type as the ones you were trained to use. If not, ask your care team to show you how to use this new type properly.

Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medication and dosage times.

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children and pets.

Unopened Vials:

Humulin N Vials: Store in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F) or at room temperature up to 30 degrees C (86 degrees F). Do not freeze or use if the insulin has been frozen. Protect from light and excessive heat. If stored at room temperature, the vial must be discarded after 31 days. Throw away any unopened and unused medication that has been stored in the refrigerator after the expiration date.

Novolin N Vials: Store in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F) or at room temperature up to 25 degrees C (77 degrees F). Do not freeze or use if the insulin has been frozen. Protect from light and excessive heat. If stored at room temperature, the vial must be discarded after 42 days. Throw away any unopened and unused medication that has been stored in the refrigerator after the expiration date.

Unopened Pens:

Humulin N KwikPens: Store in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F) or at room temperature up to 30 degrees C (86 degrees F). Do not freeze or use if the insulin has been frozen. Protect from light and excessive heat. If stored at room temperature, the pen must be discarded after 14 days. Throw away any unopened and unused medication that has been stored in the refrigerator after the expiration date.

Novolin N FlexPens: Store in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F) or at room temperature up to 30 degrees C (86 degrees F). Do not freeze or use if the insulin has been frozen. Protect from light and excessive heat. If stored at room temperature, the pen must be discarded after 28 days. Throw away any unopened and unused medication that has been stored in the refrigerator after the expiration date.

Vials that you are using:

Humulin N vials: Store in the refrigerator or at room temperature up to 30 degrees C (86 degrees F). Do not freeze. Keep away from heat and light. Throw the opened vial away after 31 days.

Novolin N vials: Store at room temperature up to 25 degrees C (77 degrees F). Do not refrigerate. Do not freeze. Keep away from heat and light. Throw the opened vial away after 42 days.

Pens that you are using:

Humulin N KwikPens: Store at room temperature up to 30 degrees C (86 degrees F). Do not refrigerate or freeze. Keep away from heat and light. Throw the pen away after 14 days, even if it still has insulin left in it.

Novolin N FlexPens: Store at room temperature up to 30 degrees C (86 degrees F). Do not refrigerate or freeze. Keep away from heat and light. Throw the pen away after 28 days, even if it still has insulin left in it.

Neutral Protamine Hagedorn (NPH) insulin, also known as isophane insulin, is an intermediate-acting insulin given to help control blood sugar levels in people with diabetes. It is used by injection under the skin once to twice a day. Onset of effects is typically in 90 minutes and they last for 24 hours. Versions are available that come premixed with a short-acting insulin, such as regular insulin.

The common side effect is low blood sugar. Other side effects may include pain or skin changes at the sites of injection, low blood potassium, and allergic reactions. Use during pregnancy is relatively safe for the baby. NPH insulin is made by mixing regular insulin and protamine in exact proportions with zinc and phenol such that a neutral-pH is maintained and crystals form. There are human and pig insulin based versions.

Protamine insulin was first created in 1936 and NPH insulin in 1946. It is on the World Health Organization's List of Essential Medicines. NPH is an abbreviation for "neutral protamine Hagedorn". In 2020, insulin isophane was the 221st most commonly prescribed medication in the United States, with more than 2 million prescriptions. In 2020, the combination of human insulin with insulin isophane was the 246th most commonly prescribed medication in the United States, with more than 1 million prescriptions.

NPH insulin is cloudy and has an onset of 1–3 hours. Its peak is 6–8 hours and its duration is up to 24 hours.

It has an intermediate duration of action, meaning longer than that of regular and rapid-acting insulin, and shorter than long acting insulins (ultralente, glargine or detemir). A recent Cochrane systematic review compared the effects of NPH insulin to other insulin analogues (insulin detemir, insulin glargine, insulin degludec) in both children and adults with Type 1 diabetes. Insulin detemir appeared provide a lower risk of severe hyperglycemia compared to NPH insulin, however this finding was inconsistent across included studies. In the same review no other clinically significant differences were found between different insulin analogues in either adults nor children.

Hans Christian Hagedorn (1888–1971) and August Krogh (1874–1949) obtained the rights for insulin from Banting and Best in Toronto, Canada. In 1923 they formed Nordisk Insulin laboratorium, and in 1926 with August Kongsted he obtained a Danish royal charter as a non-profit foundation.

In 1936, Hagedorn and B. Norman Jensen discovered that the effects of injected insulin could be prolonged by the addition of protamine obtained from the "milt" or semen of river trout. The insulin would be added to the protamine, but the solution would have to be brought to pH 7 for injection. University of Toronto, Canada later licensed protamine zinc insulin (PZI), to several manufacturers. This mixture only needs to be shaken before injection. The effects of PZI lasted for 24–36 h.

In 1946, Nordisk was able to form crystals of protamine and insulin and marketed it in 1950, as neutral protamine Hagedorn (NPH) insulin. NPH insulin has the advantage that it can be mixed with an insulin that has a faster onset to complement its longer lasting action.

Eventually all animal insulins made by Novo Nordisk were replaced by synthetic, recombinant 'human' insulin. Synthetic 'human' insulin is also complexed with protamine to form NPH.

The timeline is as follows:

NPH stands for neutral protamine Hagedorn, and the words refer to neutral pH (pH = 7), protamine (a protein), and Hans Christian Hagedorn (an insulin researcher).Brand names include Humulin N, Novolin N, Novolin NPH, Gensulin N, SciLin N, Insulatard, and NPH Iletin II.