Posology : מינונים

4.2     Posology and method of administration

Posology
The potency of human insulin is expressed in international units.

Mixtard dosing is individual and determined in accordance with the needs of the patient.
Premixed insulin medicinal products are usually given once or twice daily when a rapid initial effect together with a more prolonged effect is desired. Blood glucose monitoring is recommended to achieve optimal glycaemic control.

The individual insulin requirement is usually between 0.3 and 1.0 international unit/kg/day.

Adjustment of dose may be necessary if patients undertake increased physical activity, change their usual diet or during concomitant illness.

Special populations
Elderly (≥ 65 years old)
Mixtard can be used in elderly patients.
In elderly patients, glucose monitoring should be intensified and the insulin dose adjusted on an individual basis.

Renal and hepatic impairment
Renal or hepatic impairment may reduce the patient’s insulin requirements.
In patients with renal or hepatic impairment, glucose monitoring should be intensified and the human insulin dose adjusted on an individual basis.

Paediatric population
Mixtard can be used in children and adolescents.

Transfer from other insulin medicinal products
When transferring from other intermediate or long-acting insulin medicinal products, adjustment of the Mixtard dose and timing of administration may be necessary.

Close glucose monitoring is recommended during the transfer and in the initial weeks thereafter (see section 4.4).

Method of administration

Mixtard is a dual-acting human insulin. It is a biphasic formulation containing both fast-acting and long-acting insulin.

Mixtard is administered subcutaneously by injection in the thigh, the abdominal wall, the gluteal region or the deltoid region. Injection sites should always be rotated within the same region in order to reduce the risk of lipodystrophy and cutaneous amyloidosis (see sections 4.4 and 4.8). Insulin suspensions are never to be administered intravenously. Injection into a lifted skin fold minimises the risk of unintended intramuscular injection.

The needle should be kept under the skin for at least 6 seconds to make sure the entire dose is injected.
Subcutaneous injection into the abdominal wall ensures a faster absorption compared to the other injection sites. The duration of action will vary according to the dose, injection site, blood flow, temperature and level of physical activity.

An injection should be followed within 30 minutes by a meal or snack containing carbohydrates.

Insulin suspensions are not to be used in insulin infusion pumps.
For detailed user instructions, please refer to the package leaflet.

Mixtard 30 vial (100 international units/ml)
Administration with a syringe
Mixtard vials are for use with insulin syringes with a corresponding unit scale.

Mixtard 30 Penfill
Administration with an insulin delivery system
Mixtard Penfill is designed to be used with Novo Nordisk insulin delivery systems and NovoFine or NovoTwist needles. Mixtard Penfill is only suitable for subcutaneous injections from a reusable pen. If administration by syringe is necessary, a vial should be used.