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thiazides; glucocorticoids; thyroid hormone
Inject the insulin 2. Before you use Mixtard®
plastic cap. If it isn’t in perfect condition
► Inject the insulin under the skin. Use the
hormone; danazol; octreotide or lanreotide.
when you get the vial, return the vial to
Do not use Mixtard
injection technique advised by your doctor
► If you are allergic (hypersensitive) to this PACKAGE LEAFLET: Pregnancy and breast-feeding
► If it hasn’t been stored correctly or been
► Keep the needle under your skin for at
insulin product, metacresol or any of the
INFORMATION FOR THE USER If you are pregnant, planning a pregnancy
frozen (see 6 How to store Mixtard)
least 6 seconds to make sure that the full
or breast-feeding: please contact your doctor
► If it’s not uniformly white and cloudy information). Look out for the signs of
Mixtard® 30
allergy in 5 Possible side effects
► If you feel a hypo coming on (a hypo is Driving and using machines How to use this insulin 100 IU/ml suspension for injection in a vial
short for a hypoglycaemic reaction and is a
4. What to do in an If you drive or use tools or machines: watch Colour: PMS 280C
(subcutaneously). Never inject your insulin
emergency
See 4 What to do in an emergency for more
Read all of this leaflet carefully before you
concentrate or to react will be less during a
directly into a vein or muscle. Always vary the
If you get a hypo start using your insulin.
hypo. Never drive or use machinery if you feel a
sites you inject, to avoid lumps (see 5 Possible
Keep this leaflet. You may need to read it
side effects). The best places to give yourself an
A hypo means your blood sugar level is too low. Take special care with Mixtard
whether you can drive or use machines at all, if
The warning signs of a hypo may come on
► If you have trouble with your kidneys or
If you have any further questions, ask your
you have a lot of hypos or if you find it hard to
(abdomen); your buttocks; the front of your
suddenly and can include: cold sweat; cool pale
liver, or with your adrenal, pituitary or
doctor, diabetes nurse or your pharmacist.
thighs or upper arms. Your insulin will work
skin; headache; rapid heart beat; feeling sick;
This medicine has been prescribed for you.
more quickly if you inject it around the waist.
feeling very hungry; temporary changes in vision;
► If you are drinking alcohol: watch for
Mixtard vials are for use with insulin syringes
drowsiness; unusual tiredness and weakness;
signs of a hypo and never drink alcohol on
them, even if their symptoms are the same
3. How to use Mixtard®
nervousness or tremor; feeling anxious; feeling
confused; difficulty in concentrating.
► If you are exercising more than usual or if
Talk about your insulin needs with your doctor
Just before injecting this insulin
If any of the side effects gets serious, or if
If you get any of these signs, eat glucose
1. Roll the vial between your hands until the
you notice any side effects not listed in this
tablets or a high sugar snack (sweets, biscuits,
► If you are ill: carry on taking your insulin
carefully. This leaflet is a general guide.
liquid is uniformly white and cloudy.
leaflet, please tell your doctor, diabetes
► If you are going abroad: travelling over
If your doctor has switched you from one type
Resuspending is easier if the insulin has
Don’t take any insulin if you feel a hypo
or brand of insulin to another, your dose may
2. Draw air into the syringe, in the same
Carry glucose tablets, sweets, biscuits or fruit
Eat a meal or snack containing carbohydrates
1. What Mixtard® is and Using other medicines
3. Inject the air into the vial: push the needle
Tell your relatives, friends and close what it is used for
Many medicines affect the way glucose works
It is recommended that you measure your blood
colleagues that if you pass out (become
unconscious), they must: turn you on your side
Mixtard® is human insulin to treat
and seek medical advice straight away. They
diabetes. Mixtard is a mixture of fast-acting Before using Mixtard
5. Draw the right dose of insulin into the
must not give you any food or drink as it
insulin and long-acting insulin. This means that
insulin treatment. Talk to your doctor or
► Check the label to make sure it is the
it will start to lower your blood sugar about half
pharmacist if you take or have recently taken
► If severe hypoglycaemia is not treated,
an hour after you take it, and the effect will last
any other medicines, even those not prescribed.
► Disinfect the rubber membrane with a
7. Make sure there is no air left in the syringe:
Your need for insulin may change if you also
point the needle upwards and push the air
take: oral antidiabetic products; monoamine
oxidase inhibitors (MAOI); beta-blockers;
Do not use Mixtard
ACE-inhibitors; acetylsalicylic acid; anabolic
► In insulin infusion pumps
steroids; sulphonamides; oral contraceptives;
► If the protective cap is loose or missing.
Length: Max. 29 mm (100%)Code: 100% Direction
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► If you have a hypo that makes you pass Causes of hyperglycaemia
sweating; start being sick (vomiting); have
The vials that are not being used are to be What Mixtard looks like and
out, or a lot of hypos, talk to your doctor.
difficulty in breathing; have a rapid heart
stored in a refrigerator (2°C - 8°C). contents of the pack
Repeatedly taking less insulin than you need
beat; feel dizzy; feel like fainting.
Do not store them in or too near the freezer
The suspension for injection comes as a cloudy,
You may have a very rare serious allergic reaction to Mixtard or one of its ingredients
Do not freeze. Keep the vials in the original
Using glucagon
It is supplied in packs of 1 or 5 vials of 10 ml or
(called a systemic allergic reaction). See also
in a multipack of 5 × (1 × 10 ml) vials.
warning in 2 Before you use Mixtard.The vials that are being used or about to be
used are not to be kept in a refrigerator. After
Diabetic retinopathy (eye background 5. Possible side effects
removing the vial from the refrigerator it is
Marketing Authorisation Holder and
changes). If you have diabetic retinopathy and
how to use it. If you are given glucagon you
recommended to let it reach room temperature
Manufacturer
your blood glucose levels improve very fast, the
will need glucose or a sugary snack as soon as
Like all medicines, Mixtard can cause side
before resuspending the insulin as instructed
retinopathy may get worse. Ask your doctor
you are conscious. If you do not respond to
effects, although not everybody gets them.
for the first time use. See 3 How to use
glucagon treatment, you will have to be treated
Mixtard may cause hypoglycaemia (low blood
Mixtard. You can carry them with you and keep
in a hospital. Seek medical advice after an
sugar). See the advice in 4 What to do in anThis leaflet was last approved in Swollen joints. When you start taking insulin,
them at room temperature (not above 25°C) for
injection of glucagon; you need to find the
water retention may cause swelling around
reason for your hypo to avoid getting more.
Always keep the vial in the outer carton when
Side effects reported
you’re not using it in order to protect it from
Causes of a hypo uncommonly Painful neuropathy (nerve related pain). If
You get a hypo if your blood sugar gets too
Mixtard must be protected from excessive heat
your blood glucose levels improve very fast it
may cause a burning, tingling or electric pain. Changes at the injection site
This is called acute painful neuropathy and it
(Lipodystrophy). If you inject yourself too
usually disappears. If it does not disappear, see
often at the same site, fatty tissue under the
pharmacist how to dispose of medicines no
skin at this site may shrink (lipoatrophy) or
longer required. These measures will help to
If your blood sugar gets too
thicken (lipohypertrophy). Changing the site
Side effects reported very rarely
with each injection may help to prevent such
skin changes. If you notice your skin pitting or
Your blood sugar may get too high (this is
thickening at the injection site, tell your doctor
Vision problems. When you first start your 7. Further information
or diabetes nurse because these reactions can
treatment, it may disturb your vision, but the
The warning signs appear gradually. They
become more severe, or they may change the
What Mixtard 30 contains
include: increased urination; feeling thirsty;
absorption of your insulin if you inject in such a
If any of the side effects gets serious, or if you
The active substance is insulin human
losing your appetite; feeling sick (nausea or
notice any side effects not listed in this leaflet,
made by recombinant biotechnology (30% as
vomiting); feeling drowsy or tired; flushed, dry
please tell your doctor, diabetes nurse or
soluble insulin and 70% as isophane insulin).
skin; dry mouth and a fruity (acetone) smell of
Signs of allergy. Reactions (redness, swelling,
1 ml contains 100 IU of insulin human. 1 vial
itching) at the injection site may occur (local
If you get any of these signs, test your blood
allergic reactions). These usually disappear after
The other ingredients are zinc chloride,
sugar level and test your urine for ketones if
a few weeks of taking your insulin. If they do
6. How to store Mixtard®
you can. Then seek medical advice straight
Seek medical advice immediately:
Keep out of the reach and sight of children.
These may be signs of a very serious condition
if signs of allergy spread to other parts of
Do not use Mixtard after the expiry date which
called diabetic ketoacidosis. If you don’t treat it,
is stated on the label and the carton. The expiry
this could lead to diabetic coma and death.
if you suddenly feel unwell and you start
date refers to the last day of that month.
Length: Max. 29 mm (100%)Code: 100% Direction
APPLIED PHARMACOLOGY COURSE TITLE: MW 6420 APPLIED PHARMACOLOGY Course hours: 25 hours (5 classes) each class is 5 hours Course Description: This course will cover the use, preparation and effects of drugs relative to pregnancy, labor, birth, postpartum and the neonate Course Objectives: Given pertinent information, supported by instructional resources, the student will be capabl
Ministério dos Petróleos As operações petrolíferas pelo alto risco que encerram e pelo grande volumede investimentos que requerem, justificam que gozem de um regime aduaneirodiferenciado daquele que vigora para as restantes actividades económicas. A necessidade de se proceder à uniformização do regime aduaneiro aplicávelàs diferentes concessões petrolíferas e constantes dos