First introduced in the 1980s, injector pens are designed to make injectable medication easier and more convenient to use, thus increasing patient adherence. [23] Failure to use the pen as instructed may result in medication leakage and administration of a lower dose than was intended. It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. Over time, pen needles designed for insulin pens have become shorter, and a 4mm long needle is considered sufficient for most people to administer subcutaneously correctly. [9] Pen needles should be disposed of properly after each use, preferably in a purpose-made sharps container, to prevent injury from accidental contact after use. Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, or injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Each SoloStar contains in total 300 units of insulin. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Instead, the best way to dispose of your medication is through a medicine take-back program. Ask your doctor or pharmacist if you have questions about how to inject your dose. Store unopened vials of human insulin, unopened disposable dosing devices and unopened human insulin pens in the refrigerator. Ask your doctor about the safe use of alcoholic beverages while you are using human insulin. An International, Multicentre Cohort Analysis", "Efficacy and safety of adding alirocumab to rosuvastatin versus adding ezetimibe or doubling the rosuvastatin dose in high cardiovascular-risk patients: The ODYSSEY OPTIONS II randomized trial", "Effect of Fremanezumab Compared With Placebo for Prevention of Episodic Migraine: A Randomized Clinical Trial", "The role of basal insulin and GLP-1 receptor agonist combination products in the management of type 2 diabetes", "A portfolio of biologic self-injection devices in rheumatology: how patient involvement in device design can improve treatment experience", "Prefilled pen versus prefilled syringe: a pilot study evaluating two different methods of methotrexate subcutaneous injection in patients with JIA", "Subcutaneous sumatriptan delivery devices: comparative ease of use and preference among migraineurs", "What Can We Learn from Patient-Reported Outcomes of Insulin Pen Devices? [23], In 1989, an injector pen form of human growth hormone was licensed in New Zealand. Check the manufacturer's information to find out how long you may keep your pen or dosing device after the first use. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. [2] Insulin pens have also been shown to provide a higher quality of life than traditional injection methods. Ask your doctor or pharmacist if the type of insulin you are using should be mixed and how you should mix it if necessary. What is the most important information I should know about SOLIQUA 100/33? For this reason, it is recommended to rotate the injection site every administration. Do not inject human insulin into muscles, scars, or moles. Keep all appointments with your doctor and the laboratory. The desired injection site and the skin profile at the injection site will determine what needle length is appropriate for a person to use. All Rights Reserved. These changes can affect your blood sugar and the amount of human insulin you may need. When you first start using human insulin, ask your doctor what to do if you forget to inject a dose at the correct time. American Society of Health-System Pharmacists, Inc. Disclaimer, U.S. Department of Health and Human Services. Never mix more than one type of insulin in a syringe unless you are told to do so by your doctor. Human insulin is used to control blood sugar in people who have type 1 diabetes (condition in which the body does not make insulin and therefore cannot control the amount of sugar in the blood) or in people who have type 2 diabetes (condition in which the blood sugar is too high because the body does not produce or use insulin normally) that cannot be controlled with oral medications alone. To pay $99 per month, you must fill all your Sanofi Insulin prescriptions at the same time, together each month. An injector pen consists of a chamber or cartridge of medication, a tip to attach a needle, and a piston or plunger to inject the dose. Insulin regular (human) injectable solution is a prescription medication used to treat type 1 and type 2 diabetes. [5] Pen needles are designed for single use subcutaneous injection of medication and are not designed to be reused for more than one administration. (insulin glargine and lixisenatide injection) for subcutaneous use. Ask your doctor or pharmacist if you have questions about the type of syringe you should use. Pen needles generally do not require pinching of the skin for proper administration, unlike historically used syringes. Do not use more or less insulin or use it more often than prescribed by your doctor. Injector pens also decrease the fear or adversity towards self-injection of medications, which increases the likelihood that a person takes the medication. You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency. Always use the same brand and model of needle and syringe. The American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland. Changes in insulin regimen may result in hyperglycemia or hypoglycemia. Always look at your human insulin before you inject. [8] Furthermore, pen needles are designed for insertion at a 90-degree angle to the skin, as opposed to normal syringes which are designed to be injected at an angle. Instruction on how to properly attach and use needles is the responsibility of the doctor or pharmacist to ensure proper use. Ask your pharmacist any questions you have about refilling your prescription. The cartridges are designed to be placed in dosing pens. Ask your doctor or pharmacist for more information. 99 ($0.09/Count) [9], Injector pens are an alternative to the manufacture of medication for injection in vials containing either liquid or a powder to which a diluent such as sterile water is added. [16] Other monoclonal antibodies designed for home use may also be manufactured as injector pens. [4] Some pens, including most insulin pens, include dials to adjust the dose of the injection before each administration. Your doctor will also tell you how to check your response to human insulin by measuring your blood or urine sugar levels at home. Offer valid for one fill per month. Dispose of needles and syringes in a puncture-resistant container. Never share a Humalog, Insulin Lispro Injection, Humalog Mix75/25, Insulin Lispro Protamine and Insulin Lispro Injectable Suspension Mix75/25, or Humalog Mix50/50 prefilled pen, cartridge, reusable pen compatible with Lilly 3 mL cartridges, or syringe between patients, even if the needle is changed. How to use SoloStar Pen for injecting Lantus (Glargine) and Apidra Insulin. Human insulin (Myxredlin, Humulin R U-100, Novolin R) solution may also be injected intravenously (into a vein) by a doctor or nurse in a healthcare setting. If you are using an NPH human insulin (Humulin N, Novolin N) or a premixed insulin that contains NPH (Humulin 70/30, Novolin 70/30), the insulin should appear cloudy or milky after you mix it. For patients using an insulin pen device (cartridge and disposable needles): Change the dose by rotating the head of the pen. Do not stop using insulin without talking to your doctor. [19] Contrary to most other injector pens, epinephrine injector pens are designed to administer the medication via intramuscular injection. A major barrier to adoption in the United States was the increased up-front cost of insulin pens compared to traditional injections. Different concentration insulin products may not have the same pharmacokinetic properties as other strengths. [19], Multiple studies have shown that many people prefer the use of injector pens over other forms of injectable medication, such as vial and syringe. Others use an insulin pen, jet injectors, inhaler, or pump. Your doctor may tell you to mix two types of insulin in the same syringe. Do not let anyone else use your medication. tell your doctor if you have or have ever had nerve damage caused by diabetes; heart failure; or heart, adrenal (a small gland near the kidneys), pituitary (a small gland in the brain), thyroid, liver, or kidney disease. [12], Another class of medication commonly available as an injector pen is monoclonal antibodies. Write down these directions so that you can refer to them later. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program. [2] They are available in multiple lengths and gauge of needle, including 3.5mm, 4mm, 5mm, and 8mm lengths, and 31 through 34 gauge. If administration by syringe or intravenous injection is necessary, a vial should be used. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. [1][2], Injector pens increase patient adherence by increasing the ease of self-administering injectable medication, as well as the portability of injection medication. Some types of insulin need to be gently agitated before injecting. [2] Injector pens which have dials to adjust dosages may also include a clicking sound or other method to confirm the dose adjustment. Examples of monoclonal antibodies available or studied as injector pens include adalimumab,[13] secukinumab,[14] and alirocumab. The primary difference between injector pens and traditional vial and syringe administration is the easier use of an injector pen by people with low dexterity, poor vision, or who need portability to administer medicine on time. Continue to use human insulin even if you feel well. After fully pressing the plunger button to activate the pen, the button must continue to be held for about 10 seconds to ensure the dose is administered before removing the pen needle from the skin and finally releasing the button. LotFancy Insulin Pen Needles, Pack of 210, Diabetic Pen Needles for Insulin Injections, 32G x 4mm (5/32â) 4.8 out of 5 stars 22 $17.99 $ 17 . Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. It is also important information to carry with you in case of emergencies. Never reuse needles or syringes and never share needles, syringes, cartridges, or pens. Insulin glargine is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Dials enable more accurate dose measuring than traditional vial and syringe administration, especially for low doses of insulin. Some types of human insulin must be shaken or rotated to mix before use. Studies have shown injector pens to be at least as effective as vial and syringe administration, and surveys have shown that a vast majority of people would prefer an injector pen over vial and syringe administration if one was available. The Humalog U-200 prefilled pen contains 2 times as much insulin per 1 milliliter as standard (U-100) insulin. [8] Over time, needles have also had bevels designed which decrease the force required to penetrate the skin, which decreases the pain associated with injection and may increase the acceptability of self-injection. [6] The needles are generally manufactured with an outer protective plastic shell, which is used by a person to attach the needle to the pen, and an inner plastic shell protecting the needle itself. Follow these directions carefully. It is not known if Humalog or Insulin Lispro Injection are safe and effective for children with type 2 diabetes or for children younger than 3 years of age with type 1 diabetes. You can set doses from 1 to 80 units in steps of 1 unit. Many other medications are also available as injector pens, including other injectable medicines for diabetes, high cholesterol, migraine prevention, and other monoclonal antibodies. [2] The same study found that the increase in adherence to therapy resulted in increased short-term pharmacy costs (i.e. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911. Injector pens are commonly used for medications that are injected repeatedly by a person over a relatively short period of time, especially insulin and insulin analogs used in the treatment of diabetes (called insulin pens). The primary goal of injector pens is to increase patient adherence by making it easier and more convenient for people to use injectable therapy. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. It is important to eat a healthy diet and to eat about the same amounts of the same kinds of foods at about the same times every day. But if you are using NPH insulin or a mixed insulin (a mixture of short-acting and intermediate-acting insulin), the pen or vial needs to be gently rolled back and forth in your hands and inverted up and down a few times to distribute the insulin evenly. Sharing poses a risk for transmission of blood-borne pathogens. If your human insulin comes in a disposable dosing device, read the instructions that come with the device carefully. Do not share your SOLIQUA 100/33 pen with other people, even if the needle has been changed. You can inject your human insulin in the stomach , upper arm, upper leg, or buttocks. You may give other people a serious infection, or get a serious infection from them. "Lack of Treatment Persistence and Treatment Nonadherence as Barriers to Glycaemic Control in Patients with Type 2 Diabetes", "A review of the new GLP-1 receptor agonist/basal insulin fixed-ratio combination products", "Penetration force and cannula sliding profiles of different pen needles: the PICASSO study", "EADSG Guidelines: Insulin Storage and Optimisation of Injection Technique in Diabetes Management", "Higher concentration insulins: an overview of clinical considerations", "Sanofi Receives FDA Approval of Soliqua 100/33, for the Treatment of Adults with Type 2 Diabetes", "Comparison of Adalimumab Serum Drug Levels When Delivered by Pen Versus Syringe in Patients With Inflammatory Bowel Disease. Talk to your doctor or pharmacist about the type of pen you should use. Make sure that the name and letter on your insulin are exactly what your doctor prescribed. [20] Other medications normally administered orally are also available or have been studied as injector pens, either due to different pharmacokinetic properties when administered via injection, or for those who cannot take oral medications. Be sure to mention any of the following: albuterol (Proair, Proventil, Ventolin, others); alpha blockers such as doxazosin (Cardura), prazosin (Minipress), terazosin (Hytrin), tamsulosin (Flomax), and alfuzosin (Uroxatral); angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Zestril), moexipril (Univasc), perindopril, (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); angiotensin receptor blockers (ARB) such as candesartan (Atacand), irbesartan (Avapro), losartan (Cozaar, in Hyzaar), valsartan (Diovan), others; antidepressants; asparaginase (Elspar); atypical antipsychotics such as aripiprazole (Abilify), clozapine (Clozaril, Fazaclo, Versacloz), olanzapine (Zyprexa, in Symbyax), risperidone (Risperdal), others; beta blockers such as atenolol (Tenormin), carvedilol (Coreg), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal), sotalol (Betapace, Sorine), and timolol (Blocadren); clonidine (Catapres, Kapvay); danazol; diazoxide (Proglycem); disopyramide (Norpace); diuretics ('water pills');fibrates such as fenofibrate (Fenoglide, Tricor, Trilipix), fenofibric acid (Fibricor), gemfibrozil (Lopid); isoniazid (in Rifater, Rifamate); lithium; medications for asthma and colds; medications for mental illness or nausea; monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); hormonal contraceptives (birth control pills, patches, rings, injections, or implants); niacin (Niacor, Niaspan, Slo-Niacin); octreotide (Sandostatin);oral medications for diabetes such as pioglitazone (Actos, in Actoplus Met and others) and rosiglitazone (Avandia, in Avandamet and others); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); pentamidine (Nebupent); pentoxifylline (Pentoxil); pramlintide (Symlin); HIV protease inhibitors (PI) such as atazanavir (Reyataz, in Evotaz), darunavir (Prezista), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir; in Kaletra, Viekira Pak, others); quinine; quinidine; salicylate pain relievers such as aspirin; somatropin (Genotropin, Humatrope, Zomacton, others); sulfa antibiotics; terbutaline (Brethine); and thyroid medications. The end user must then perform a series of actions to insert the needle of the syringe under the skin, and depress the plunger on the syringe to inject the dose. Use all available sites in the same general area before switching to a different area (for example, the upper arm). Your doctor will tell you exactly how to draw both types of insulin into the syringe. Well, after injection, after reapplying the outer pen cap and carefully trying to unscrew both parts off, more othen than not, the outer cap and inner needle NEVER SEEM to reattach into one piece again and unscrew off easily. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. What should I know about storage and disposal of this medication? If you are using a regular human insulin (Humulin R, Novolin R), the insulin should be as clear, colorless, and fluid as water. Generic alternatives may be available. This medication may be prescribed for other uses. Your blood sugar and glycosylated hemoglobin (HbA1c) should be checked regularly to determine your response to human insulin. Due to the molecular size of monoclonal antibodies, they must be administered via injection. If you are using an insulin pen, always remove the needle right after you inject your dose. tell your doctor and pharmacist if you are allergic to any type of insulin or any other medications. ask your doctor how often you should check your blood sugar. When a vial is used as a means of storage, the end-user must use a syringe to "draw up" or remove the medication from the vial to prepare it for administration. Human insulin is usually injected subcutaneously several times a day, and more than one type of insulin may be needed. [22], Most injector pens are designed for subcutaneous injection just under the skin, but some are designed for injection into muscle. It works by helping move sugar from the blood into other body tissues where it is used for energy. If your human insulin comes in cartridges, you may need to buy an insulin pen separately. Opened vials of human insulin should be stored in the refrigerator but may also be stored at room temperature, in a cool place that is away from heat and direct sunlight. [28] In the US, a pen form of octreotide was approved by the FDA in 2020, under the trade name Byfenzia. After a slow uptake in the United States, injector pens have surpassed vial and syringe administration of insulin in type 2 diabetes. [3] The reduction in number of injections required may decrease the risk of non-adherence due to forgetfulness or unwillingness to self-inject medication. [2] One study of the use of injector pens for insulin administration found that the chance a person initiated on insulin continued therapy for at least 12 months was higher with insulin pens than with vial and syringe administration. [2] Dials enable more accurate dose measuring than traditional vial and syringe administration, especially for low doses of insulin. Do not use any type of insulin after the expiration date printed on the bottle has passed. [2], Some pens may include a cartridge filled with medication which can be replaced when empty to enable reuse of the pen itself, whereas other pens are designed to be disposed of after their prefilled chamber is depleted. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. Ask your doctor or pharmacist to show you how to use the device. The same insulin pen disassembled, showing replaceable cartridge and reusable housing pieces. [29], Example of a reusable injector pen used for insulin. [2] Injector pens designed for single use may also be autoinjectors, which do not require the user to press a plunger to inject the dose. [27] Historically, pen needles were manufactured in lengths up to 12.7mm. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. If your human insulin comes in vials, you will need to use syringes to inject your dose. Human insulin is used to take the place of insulin that is normally produced by the body. Insulins that are clear in appearance do not require this step. What special precautions should I follow? Your doctor will tell you which type(s) of insulin to use, how much insulin to use, and how often to inject insulin. What side effects can this medication cause? Talk to your doctor or pharmacist about where on your body you should inject human insulin. If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088). [2] As with insulin vials, some insulin pens are made with higher concentrations including U-200, U-300, and U-500. [3], An injector pen consists of a chamber or cartridge of medication, a tip to attach a needle, and a piston or plunger to inject the dose. [26] Pen adoption in the United States accelerated after studies showed that the higher up-front cost of insulin pens was offset by the increase in compliance, which decreased overall healthcare costs. These pen needles come in various lengths to accommodate varying depths of subcutaneous tissue under the top of the skin. for the pens/needles) but resulted in an overall decrease in healthcare costs related to diabetes. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Be sure you know what type of container your insulin comes in and what other supplies, such as needles, syringes, or pens, you will need to inject your medication. [2] A 2011 systematic review which examined preference of insulin pens over vial and syringe administration found that in almost all studies and surveys a majority of people preferred insulin pens. to be injected subcutaneously (under the skin). Human insulin comes as a solution (liquid) and a suspension (liquid with particles that will settle on standing). [24], The effectiveness of an injector pen can also depend on the technique used to inject. redness, swelling, and itching at the injection site, changes in the feel of your skin, skin thickening (fat build-up), or a little depression in the skin (fat breakdown), large weight gain in a short period of time, swelling of the arms, hands, feet, ankles, or lower legs. Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. Some pen devices can only inject certain doses of insulin with each injection. Read the information in this section about the different kinds of insulin devices. [4], All injector pens other than those designed for single use require the use of single-use replaceable pen needles for each injection. Never share a Fiasp ® FlexTouch ® Pen, PenFill ® cartridge or PenFill ® cartridge device between patients, even if the needle is changed. The dose window on the pen shows your insulin dose. Information is also available online at https://www.poisonhelp.org/help. An injector pen (also called a medication pen) is a device used for injecting medication under the skin. http://www.upandaway.org. [2][7], Today, pen needles are manufactured at shorter needle lengths than required for typical vial and syringe administration, which decreases the pain associated with injection. [2], Many insulin analogs and GLP-1 agonists for diabetes treatment are available as injector pens. [2] Injector pens may also remove stigma or fear around the use of injection medication in public environments, such as insulin before a meal at a restaurant. [23] For products with included needles, such as epinephrine pens, different brands may have different included needle lengths, which must be taken into account. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar. Some pens, including most insulin pens, include dials to adjust the dose of the injection before each administration. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. Not valid for SOLIQUA 100/33 (insulin glargine and lixisenatide injection) 100 Units/mL and 33 mcg/mL or Toujeo Max SoloStar pen. Follow these directions carefully. [10] The higher concentrations are used to lessen the volume of the injection, and allow the same dose of insulin to be injected with less force. This includes methotrexate for juvenile idiopathic arthritis[21] and sumatriptan for treatment of migraines. Human insulin is in a class of medications called hormones. Do not switch to another brand or type of insulin or change the dose of any type of insulin you use without talking to your doctor. AHFS® Patient Medication Information™. Carefully read the manufacturer's instructions to learn how to draw insulin into a syringe and inject your dose. Alcohol may cause a decrease in blood sugar. What special dietary instructions should I follow? [2] Injector pens in general have also been shown to be at least as effective therapeutically as other injection methods. ask your doctor what to do if you get sick, experience unusual stress, plan to travel across time zones, or change your exercise and activity level. [23] Another administration problem which may impact effectiveness of an injector pen is lipohypertrophy of the subcutaneous tissue near the injection site. Store opened human insulin pens and opened dosing devices at room temperature. The cartridge (Penfill) is designed to be used with Novo Nordisk reusable insulin pens and NovoFine Plus, NovoFine or NovoTwist injection needles for subcutaneous injection only.
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