How to use Insulin NPH

• Read the Patient Information Leaflet provided by your pharmacist before you start using insulin isophane and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist. 
• Learn all preparation and usage instructions from your health care professional and the product package. 
• Before using, gently roll the vial or cartridge, turning it upside down and right side up 10 times to mix the medication. Do not shake the container. Check this product visually for particles or discoloration. If either is present, do not use the insulin. Insulin isophane should look evenly cloudy/milky after mixing. Do not use if you see clumps of white material, a “frosty” appearance, or particles stuck to the sides of the vial or cartridge. 
• Before injecting each dose, clean the injection site with rubbing alcohol. Change where you inject each time to lessen the risk of problems or damage under the skin (for example, pits/lumps or thickened skin). Inject this medication under the skin as directed by your doctor, usually once or twice a day. This insulin product may be injected in the stomach area, the thigh, the buttocks, or the back of the upper arm. Do not inject into a vein or muscle because very low blood sugar (hypoglycemia) may occur. Do not rub the area after the injection. Do not inject into skin that is red, swollen, itchy, or damaged. Do not inject cold insulin because this can be painful. The insulin container you are currently using can be kept at room temperature. 
• This product may be mixed only with certain other insulin products such as insulin regular. Always draw the insulin regular into the syringe first, then follow with the longer-acting insulin. Never inject a mixture of different insulins into a vein. Consult your health care professional about which products may be mixed, the proper method for mixing insulin, and the proper way to inject mixtures of insulin. Do not mix insulins if you are using an insulin pump. 
• Do not change brands or types of insulin without directions on how to do so from your doctor. 
• Do not share your pen device with another person, even if the needle is changed. You may give other people a serious infection, or get a serious infection from them. Learn how to store and discard medical supplies safely. 
• The dosage is based on your medical condition and response to treatment. Measure each dose very carefully because even small changes in the amount of insulin may have a large effect on your blood sugar. 
• Check your blood sugar regularly as directed by your doctor. Keep track of your results and share them with your doctor. This is very important in order to determine the correct insulin dose. 
• Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day.

  Tell your doctor if your condition does not improve or if it worsens (your blood sugar is too high or too low).