Indications for HUMULIN R U-500:
Adults and Children:
Individualize. SC inj only. Rotate inj sites. Onset ~30mins, peak 4–8hrs, duration up to 24hrs. Should prescribe U-500 insulin syringes for use with Humulin R U-500 vials.
HUMULIN R U-500 Contraindications:
During episodes of hypoglycemia.
HUMULIN R U-500 Warnings/Precautions:
Instruct patients on proper administration of insulin, check insulin label before each injection, and management of hypoglycemia. Do not reuse or share pens, needles, or syringes between patients, even if the needle is changed. Do not inject into areas of lipodystrophy or localized cutaneous amyloidosis. Increased risk of hyperglycemia or hypoglycemia if changes in physical activity, meal patterns, concomitant medications, renal or hepatic function, insulin regimen, administration site, and if acute illness occurs: monitor glucose more frequently and may need to adjust dose. Monitor potassium levels in patients at risk for hypokalemia (eg, concomitant K+-lowering or K+-sensitive drugs). Discontinue if hypersensitivity reactions occur. Renal or hepatic impairment. Elderly. Pregnancy. Nursing mothers.
HUMULIN R U-500 Interactions:
Concomitant thiazolidinediones (TZDs) may cause fluid retention and heart failure; consider dose reduction or discontinue TZDs. Potentiated by oral antidiabetic agents, pramlintide, pentoxifylline, ACE inhibitors, ARBs, disopyramide, fibrates, fluoxetine, MAOIs, salicylates, somatostatin analog, sulfonamide antibiotics. Antagonized by atypical antipsychotics, corticosteroids, isoniazid, niacin, danazol, diuretics, glucagon, phenothiazines, sympathomimetics, somatropin, thyroid hormones, oral contraceptives, estrogens, protease inhibitors. Variable effects with β-blockers, clonidine, lithium salts, alcohol, pentamidine. Concomitant β-blockers, clonidine, guanethidine, reserpine may blunt hypoglycemia. Onset may be delayed if regular insulin is mixed with zinc insulin. Regular and NPH insulins may be mixed and used immediately or stored for future use.
Hypoglycemia, allergic reactions, inj site reactions, lipodystrophy, pruritus, rash, weight gain, edema, hypokalemia.
Vials 70/30, N, R (U-100)—3mL, 10mL; R (U-500)—20mL; KwikPen (70/30, N)—5x3mL; R (U-500)—2x3mL