What is Novolin N: Uses, Warnings & Interactions

Follow the dosing schedule provided by the prescriber. You will typically give injections once or twice daily. 

• Injections should be given at the same time every day.

Please read the Patient Information sheet and the Instructions for Use that come with this medicine.

This medicine can only be injected into the skin. 

• Do not inject the medicine into a blood vessel. 

• Do not use Novolin N in an insulin pump.

A healthcare provider will demonstrate how to administer injections. Ask the healthcare provider to clarify if you’re unsure about any part of the process. 

A healthcare provider or the instructions that come with the medicine will provide guidance on which body areas to use for injections. 

• Use a different body area for each injection.

• Rotate the injection site for each new injection.

• Do not inject into skin that is damaged, bruised, thick, lumpy, scaly, hard, lumpy, or scarred.

How to prepare for an injection:

• Wash your hands.

• Always check the insulin type, concentration, expiration date, and appearance of the medicine. The medicine should appear cloudy or milky. 

• Use only syringes that are made for insulin injections. Use a new syringe for each injection.

How to administer injections using a needle and syringe:

• Do not use the medicine in the vial if the deposits at the bottom are lumpy or attached to the glass.

• To remix the medicine, hold the vial in a horizontal position and gently roll the vial 10 times. Do not shake the vial. Keep repeating this step until the liquid is uniformly milky and cloudy.

• Always use a new needle and syringe.

• Withdraw a dose following the procedure outlined in the instructions.

• The prescriber will instruct you about whether the skin needs to be pinched at the injection site. Follow these recommendations. If the doctor does not instruct you about pinching the skin, ask for this recommendation before you take the first shot.

• Wipe the skin with an alcohol swab and let dry.

• Insert the needle into the skin as instructed and push down the plunger.

• Remove the needle when finished.

• Do not recap the needle after giving an injection.

• Dispose of the needle and syringe in a sharps container.

• Dispose of the empty vial in a sharps container.

How to mix Novolin N with Novolin R:

• Do not mix Novolin N with any other insulin other than Novolin R.

• Draw enough air into the syringe to equal the dose of Novolin N.

• Inject this air into the Novolin N vial.

• Draw air into the syringe equal to the dose of Novolin R.

• Inject this air into the Novolin R vial.

• With the vial upside down, draw the Novolin R dose into the syringe. Do not draw in any of the air.

• With the vial upside down, draw the Novolin N dose into the syringe. Do not draw in any of the air.

• The total dose in the syringe should equal the prescribed sum of the Novolin N and Novolin R doses.

• Inject the mixture under the skin as soon as possible.

Storing Novolin N vials:

• Store unopened vials in the refrigerator. 

• Store used vials at room temperature for up to 42 days. Do not refrigerate.

• Do not freeze the medicine. Throw away any medicine that has been frozen.

• Protect the medicine from heat and direct light. 

• Dispose of any medicine that has passed its expiration date.

Using the Novolin N FlexPen:

• Take the injection pen out of the refrigerator. Allow the insulin to reach room temperature.

• Remove the pen cap.

• Holding the pen between your thumb and forefinger, extend your arm. Gently bend your arm until the pen is pointing upwards. Repeat this 20 times to mix the medicine. The medicine should appear uniformly cloudy and milky. Keep repeating this step until it does.

• Attach the needle following the step-by-step directions in the Instructions for Use.

• Always use a new needle for each injection. Only use a NovoFine, NovoFine Plus, or NovoTwist needle with the FlexPen.

• To ensure you receive the correct dose and avoid injecting any air, give an airshot with the pen following the directions in the Instructions for Use.

• Turn the dose selector to the prescribed number of units. 

• Wipe the skin with an alcohol swab and let dry.

• Insert the needle into the skin. Make sure the dose counter is visible.

• Press and hold the dose button until the dose counter reaches “0.” 

• Keep the needle in the skin and slowly count to “six” (6).

• Pull the needle out of the skin.

• Carefully remove the needle and dispose of it in a sharps container.

• Never keep the needle attached to a pen when not in use. 

• Replace the cap on the injection pen.

Storing the Novolin N FlexPen:

• Store unused FlexPens in the refrigerator. They can also be stored at room temperature for up to 28 days.

• Store a used FlexPen at room temperature for up to 28 days. Do not refrigerate the FlexPen after its first use.

• Do not freeze the medicine. Throw away any medicine that has been frozen.

• Protect the medicine from heat and direct light. 

• Dispose of any medicine that has passed its expiration date.

Ask the prescriber or your healthcare team how to manage missed doses. You should ask this question before you start taking Novolin N.

Follow their instructions if a dose is missed.

Do not take extra insulin to make up for a missed dose.

This medicine is not right for everyone. 

Do not use it if you:

• Have low blood sugar (hypoglycemia)

• Have had an allergic reaction to Novolin N

Insulin treatment requires regular doctor’s visits and blood tests to monitor the effectiveness of your dose. Keep all appointments.

Tell all doctors and other healthcare providers that you take insulin. 

Tell the prescriber if you are pregnant, planning to become pregnant, breastfeeding, or have kidney disease or liver disease.

Certain changes in lifestyle or health may require insulin doses to change. Tell the prescriber about the following:

• Increased or decreased stress

• Illness

• Injuries

• Weight gain or weight loss

• Changes in your diet

• Changes in your level of physical activity

Low blood sugar (hypoglycemia) is the most common side effect of insulin injections. Ask the doctor to explain the clinical signs of hypoglycemia and what you should do when your blood sugar is too low.

A common cause of low blood sugar is using the wrong insulin or getting the dose wrong. Always check the insulin labels before preparing an injection to make sure you’re using the correct insulin with the correct concentration.

Low potassium is another possible serious side effect. Familiarize yourself with the clinical signs of low potassium and contact a medical professional if you experience any symptoms.

Insulin treatment increases the risk of accidental injuries. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Exercise caution around hazards in the house and at work.

Because of the risk of infection, do not share insulin pens or needles with other people.

Do not inject Novolin N into thickened skin. Doing so will make the injection less effective at controlling blood sugar and may result in hyperglycemia.

Make sure the prescriber knows about all the prescription drugs, over-the-counter medications, and supplements you use, even if they’re only used occasionally.

Many drugs raise or lower blood sugar levels or cause other problems when taken with Novolin N. The list is very long and includes:

• Diabetes drugs, particularly thiazolidinediones

• Oral contraceptives

• Estrogens

• Progestogens

• Thyroid hormones

• Corticosteroids

• Drugs called sympathomimetics, like albuterol or epinephrine

• Blood pressure drugs called ACE inhibitors, angiotensin II receptor blockers, or beta blockers

• Cholesterol drugs called fibrates

• Drugs that make you urinate (diuretics)

• Sulfonamide antibiotics

• Antiviral drugs called protease inhibitors

• Atypical antipsychotics or phenothiazine antipsychotics

• Drugs called monoamine oxidase inhibitors (MAOIs)

• Drugs called salicylates, such as aspirin 

• Clonidine, danazol, disopyramide, fluoxetine, guanethidine, isoniazid, niacin, pentoxifylline, reserpine, somatropin

Always tell other healthcare providers about insulin therapy before they prescribe new medications.

If you start or use a new drug or supplement, immediately inform your diabetes doctor or healthcare team. Your insulin doses may need to change.

Do not drink alcohol or use any medications containing alcohol.