Novolin N

Insulin is a hormone that lowers blood glucose (sugar) levels. Novolin N is an intermediate-acting insulin that begins to work within 2 to 4 hours after injection, reaches its highest effect in 4 to 12 hours, and continues to work for 12 to 18 hours.

Novolin N is used to help control blood sugar levels in adults and children with diabetes mellitus.

Novolin N may also be used for reasons not mentioned in this medication guide.

You should not use Novolin N if you are having low blood sugar.

Never share an injection pen or syringe with another person, even if you have changed the needle.

You should not use Novolin N if you are allergic to it, or if you are experiencing hypoglycemia (low blood sugar).

Do not give Novolin N to a child without a doctor's advice.

Tell your doctor if you have ever had:

• liver or kidney disease; or
• low levels of potassium in your blood (hypokalemia).

Inform your doctor if you are also taking pioglitazone or rosiglitazone (which may be in combinations with glimepiride or metformin). Taking some oral diabetes medications while using insulin may increase your risk of serious heart problems.

Tell your doctor if you are pregnant or breastfeeding.

Follow your doctor's instructions about using insulin if you are pregnant or become pregnant. Managing diabetes is very important during pregnancy, as high blood sugar may lead to complications for both the mother and the baby.

Get emergency medical help if you have signs of an insulin allergy: redness or swelling where you got an injection, an itchy skin rash all over your body, trouble breathing, tightness in your chest, feeling like you might faint, or swelling in your tongue or throat.

Novolin N may cause serious side effects. Call your doctor immediately if you experience:

• fluid retention—weight gain, swelling in your hands or feet, feeling short of breath; or
• low potassium—leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or feeling weak.

Common side effects of Novolin N may include:

• low blood sugar;
• weight gain, swelling in your hands or feet;
• itching, mild skin rash; or
• thickening or hollowing of the skin where you injected the medicine.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Novolin N is injected under the skin. A healthcare provider can teach you how to properly use the medication by yourself.

Novolin N must not be given with an insulin pump, or mixed with other insulins. Do not inject into a vein or a muscle.

Do not inject Novolin N into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions.

Novolin N should look cloudy after mixing. Do not use the mixture if it looks clear or has particles in it. Call your pharmacist for new medicine.

Your care provider will show you where on your body to inject Novolin N. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

If you use an injection pen, use only the injection pen that comes with Novolin N. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe.

Never share an injection pen or syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Novolin N is only part of a complete treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Keep this medicine in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) Novolin N:

• Refrigerate and use until expiration date; or
• Store at room temperature and use within the number of days specified in the Instructions for Use provided with your medicine.

Storing opened (in use) Novolin N:

• Store in a refrigerator or at room temperature as directed in the Instructions for Use provided with your medicine. Do not refrigerate an in-use injection pen.
• In-use Novolin N is stable for only a certain number of days. Throw away any medicine not used within that time. Follow all storage directions provided with your medicine.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

In case of emergency, wear or carry medical identification to let others know you have diabetes.

Use the medicine as soon as you can, but skip the missed dose if it is close to the time for your next dose. Do not use two doses at the same time.

Get your prescription refilled before you completely run out of medicine.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222. An insulin overdose can lead to dangerous hypoglycemia. Symptoms may include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizures (convulsions), or loss of consciousness.

Insulin can lead to low blood sugar. Do not drive or operate machinery until you know how Novolin N will affect you.

To prevent medication errors, always check the medicine label before injecting your insulin. Some brands of insulin isophane and syringes can be swapped, while others cannot. Your doctor and/or pharmacist can inform you about which brands can be substituted for one another.

Do not drink alcohol. It can cause low blood sugar and may disrupt your diabetes treatment.

Novolin N may not work as effectively if you are using other medicines at the same time. This includes both prescription and over-the-counter medicines, vitamins, and herbal products. Some drugs can also reduce your symptoms of hypoglycemia, making it difficult to recognize when your blood sugar is low. Not all possible interactions are mentioned here. Inform your doctor about any medicines you begin or stop using.