insulin NPH

Action and Spectrum

Actions and Spectrum: 

The spectrum of insulin NPH can vary depending on the individual and the dosage used. Still, generally, it starts to lower blood glucose levels within 1-2 hours after injection, peaks between 4-12 hours, and continues to work for up to 24 hours. 

The actions of insulin NPH include: 

• Inhibiting glucose production: insulin NPH reduces the liver’s glucose production. 
• Promoting glycogen synthesis: insulin NPH helps to store excess glucose in the liver. 
• Stimulating protein synthesis: insulin NPH promotes cell uptake and synthesis of amino acids. 

Drug Interaction

Adverse Reaction

Frequency defined 

Lipodystrophy 

Hypoglycemia 

Hypokalemia 

Local allergic reaction 

Muscle weakness 

Tremor 

Parasthesia 

Pain 

Edema 

Nausea 

Itching  

Mouth numbness 

Hunger 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

insulin NPH is generally considered safe and well-tolerated, but specific contraindications and precautions should be considered.  

The contraindications include: 

• Hypersensitivity to the drug 
• Hypoglycemia 
• Diabetic ketoacidosis 

The drug should be used cautiously in the conditions- 

• Pregnancy 
• Breastfeeding 
• Changes in insulin requirements 

Pregnancy / Lactation

Pregnancy consideration:  

No data is available regarding insulin NPH during pregnancy, but diabetes can cause congenital disabilities in neonates if not treated in women. 

Breastfeeding warnings:  

The drug is excreted in breast milk. No adverse effects are reported in lactating females and infants. 

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies do not show fetal risks in the first or later trimester.        
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women        
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.       
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.        
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.        
• Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

insulin NPH is a type of insulin produced by genetically modified Escherichia coli bacteria. It is an intermediate-acting insulin typically administered subcutaneously (under the skin) and absorbed into the bloodstream. 

insulin NPH works by binding to insulin receptors on the surface of cells throughout the body, including muscle, fat, and liver cells. This binding activates a signaling pathway that triggers glucose uptake from the bloodstream into the cells, where it can be used for energy or stored for later use. 

Pharmacodynamics: 

insulin NPH is a type of insulin with several pharmacodynamic effects on the body. These effects are related to how insulin NPH interacts with insulin receptors on the surface of cells throughout the body, including muscle, fat, and liver cells. 

The primary pharmacodynamic effect of insulin NPH is to lower blood glucose levels. insulin NPH binds to insulin receptors on cells, activating a signaling pathway that triggers glucose uptake from the bloodstream into cells. This glucose can then be used for energy or stored as glycogen for later use. 

Pharmacokinetics: 

Absorption 

The drug is well absorbed 

The time for onset of action is 1-1.5 hours 

The time taken for peak effect is 4-12 hours 

The duration of action is 14-24 hours 

The peak plasma concentration is achieved in 6-10 hr 

Distribution 

The protein-bound is 5% 

The volume of distribution for insulin NPH is 0.15 L/kg 

Metabolism 

The drug is metabolized in the liver 

Elimination and Excretion 

The drug is excreted in urine 

Adminstartion

Administration: 

insulin NPH is typically administered subcutaneously (under the skin) using a syringe, insulin pen, or insulin pump.

Patient Information Leaflet

Patient information leaflet 

Generic Name: insulin NPH  

Pronounced: in-su-lin N PH  

Why do we use insulin NPH? 

insulin NPH is used to control basal insulin levels.