#rdna origin

[siglerprescriptiondrugcards]

Liraglutide (rDNA Origin)

Common Brand Name: Victoza, Saxenda*

Common Dosage Forms:

Solution for Injection (Victoza): Pre-filled, multi-dose 3 mL pens deliver doses of 0.6 mg, 1.2 mg, 1.8 mg (6 mg/mL).

*Saxenda is not covered on this card. Is indicated with diet and exercise for weight management in adults.

FDA Indications/Dosages:

As an adjunct to diet and exercise to improve glycemic control in adults: One dose administered once daily by subcutaneous injection in the abdomen, thigh, or upper arm and independent of meals. Starting dose is 0.6 mg daily for one week and is intended to reduce gastrointestinal adverse effects during titration. After one week at 0.6 mg daily, increase the daily dose to 1.2 mg. If 1.2 mg does not produce sufficient glycemic control, the daily dose may be increased to 1.8 mg. Consider reducing the dose of concomitantly given sulfonylureas during initial titration.

Monitor: FBG, HbA1c, serum calcitonin

Pharmacology/Pharmacokinetics: Liraglutide is an acylated human glucagon-like peptide-1 (GLP-1) receptor agonist (97% similar to human GLP-1). In the presence of glucose, liraglutide increases intracellular cyclic AMP which results in the release of insulin from pancreatic beta cells. This insulin release decreases as glucose levels decrease. Liraglutide also decreases glucagon secretion in a glucose-dependent manner and delays gastric emptying. Unlike human GLP-1 which has a half-life of about 2 minutes, liraglutide has a half-life of 13 hours. Peak concentrations are reached 8-12 hours post dose. Plasma protein binding is extensive (98%). Liraglutide is endogenously metabolized similar to other proteins.

Drug Interactions: May decrease the plasma levels of digoxin and lisinopril. Additive effects may be seen when given with sulfonylureas.

Contraindications/Precautions: CONTRAINDICATED IN PATIENTS WITH A PERSONAL OR FAMILY HISTORY OF MEDULLARY THYROID CARCINOMA and in patients with Multiple Endocrine Neoplasia syndrome type 2. LIRAGLUTIDE INCREASES THE RISK OF MEDULLARY THYROID CARCINOMA, pancreatitis, hypoglycemia, and renal impairment. Pregnancy Category C.

Adverse Effects: Most common adverse effects are gastrointestinal in nature and include nausea (28%), diarrhea (17%), vomiting (11%), and constipation (10%). May also cause headache (9%). Rare but serious adverse effects include medullary thyroid carcinoma, pancreatitis, and renal impairment.

Patient Consultation:

Promptly report any signs of thyroid carcinoma (mass in the neck, dysphagia, dyspnea, or persistent hoarseness).

Promptly report any symptoms of pancreatitis (persistent severe abdominal pain with or without vomiting).

If a dose is missed, skip it and return to once daily dosing. Do not double doses. If more than 3 days have lapsed between doses, reinitiate with 0.5 mg daily.

Read and understand the medication guide which comes with the medication.

Store unused pens in the refrigerator. Opened pens may be stored below 86°F (30°C) for 30 days. If exposed to temperatures over 86°F, it should be discarded.

Do not store with a needle attached. Use a new needle for each dose.

[siglerprescriptiondrugcards]

Insulin Lispro, rDNA Origin

Brand Name: Humalog

Common Dosage Forms:

Humalog: 100 OR 200 units of insulin lispro per mL

Humalog Mix 75/25: 25% insulin lispro solution and 75% insulin lispro protamine suspension

Humalog Mix 50/50: 50% insulin lispro solution and 50% insulin lispro protamine suspension

FDA Indications/Dosages:

Treatment of Type I (insulin dependent) diabetes mellitus or Type II (non-dependent) diabetes mellitus that cannot be properly controlled by diet, exercise, and weight reduction: Dosage must be individualized. Insulin lispro has a more rapid onset and a shorter duration of action than regular insulin. Insulin lispro protamine suspension has a longer duration of action.

Monitor: HbA1c, FBG

Pharmacology/Pharmacokinetics: Insulin is the primary hormone responsible for carrying out proper glucose utilization in metabolic processes. In adipose and muscle tissue, insulin activates specific enzymes, promotes the transport of monosaccharides (including glucose) across cell membranes, and facilitates the transformation of intracellular amino acids into proteins. Insulin also decreases the formation of triglycerides. Insulin lispro is synthesized in a non-pathogenic strain of E. coli that has been genetically altered by the addition of the gene for insulin lispro. The difference between insulin lispro and human lispro is the reversal of the amino acids at the 28 and 29 positions on the B-chain. Peak serum levels are attained in 30-90 minutes. Terminal half-life is one hour.

Drug Interactions: The following drugs may decrease the hypoglycemic effects of insulin detemir: corticosteroids, diltiazem, dobutamine, epinephrine and other sympathomimetic agents, oral contraceptives, thiazide diuretics, thyroid hormones, and tobacco smoke. The following drugs may increase the hypoglycemic effect of insulin detemir: Alcohol, anabolic steroids, nonselective beta-blockers, clofibrate, fenfluramine, guanethidine, MAO inhibitors, phenylbutazone, salicylates, sulfinpyrazone, and tetracyclines.

Contraindications/Precautions: Insulin dosage is very individualized and small changes in dose, syringe brand or size, or insulin brand may necessitate the need for an adjustment of dose. Hypoglycemic reactions are not uncommon in diabetics and may be caused by excessive insulin dose or when glucose absorption is decreased due to fasting, diarrhea, or vomiting. Hypoglycemia may be differentiated from ketoacidosis not only by lab tests but by its symptoms. Hypoglycemia has a sudden onset, causes headaches, shallow breathing, psychosis, convulsions or even nervousness, causes hunger instead of anorexia, and a normal pulse instead of a rapid pulse. Hypoglycemia may be treated with sugar or candy.

Adverse Effects: Hypoglycemia, hypersensitivity—characterized by redness, swelling, and itching at the injection site, and lipodystrophy at the injection site.

Patient Consultation:

Follow prescribed diet carefully.

Administer 15 minutes before eating.

Do not change syringe brands or dose without first notifying a physician.

Consult a physician during any illness.

Do not change the order of mixing insulins as prescribed by a physician.

Continually monitor blood or urine glucose as prescribed.

Wear or carry diabetic identification in case of emergency.

Store in a refrigerator, but not in a freezer.

Patient should be aware of the signs of hypoglycemia including sweating, tremor, blurred vision, weakness, hunger, and confusion. When two or more of these effects are seen, treat with oral glucose or contact a physician.

[siglerprescriptiondrugcards]

Insulin Glargine, rDNA Origin

Brand Names: Basaglar, Lantus, Toujeo

Common Dosage Forms:

Injection (Lantus): 100 units/mL in 10 mL vials, 3 mL SoloStar pens

Injection (Toujeo): 300 units/mL in 1.5 mL SoloStar pens

Injection (Basaglar): 100 units/mL in 3 mL Kwikpen delivery device

FDA Indications/Dosages:

Indicated for once-daily subcutaneous administration at bedtime in the treatment of adult and pediatric patients with type 1 diabetes mellitus or adult patients with type 2 diabetes mellitus who require basal (long-acting) insulin for the control of hyperglycemia: Dosage must be individualized. Patients with type 2 diabetes who have not used insulin before should be started on 10 units per day. If changing from a treatment regimen with an intermediate- or long-acting insulin, the amount and timing of any short- or fast-acting insulin analog or the dose of any oral antidiabetic drug may need to be adjusted. Blood glucose monitoring is recommended for all patients with diabetes mellitus.

Monitor: HbA1C, FBG

Pharmacology/Pharmacokinetics: Insulin is the primary hormone responsible for carrying out proper glucose utilization in metabolic processes. In adipose and muscle tissue, insulin activates specific enzymes, promotes the transport of monosaccharides (including glucose) across cell membranes, and facilitates the transformation of intracellular amino acids into proteins. Insulin glargine is a recombinant human insulin analog that is long-acting (up to 24 hours). Insulin glargine differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine and two arginine are added to the C-terminus of the B-chain. Insulin glargine has a low aqueous solubility at neutral pH. At the injection solution pH of 4.0, insulin glargine is completely in solution. Upon injection, the pH is neutralized and the insulin glargine precipitates from which small amounts of insulin are released over time.

Drug Interactions: The following drugs may decrease the hypoglycemic effects of insulin detemir: corticosteroids, diltiazem, dobutamine, epinephrine and other sympathomimetic agents, oral contraceptives, thiazide diuretics, thyroid hormones, and tobacco smoke. The following drugs may increase the hypoglycemic effect of insulin detemir: Alcohol, anabolic steroids, nonselective beta-blockers, clofibrate, fenfluramine, guanethidine, MAO inhibitors, phenylbutazone, salicylates, sulfinpyrazone, and tetracyclines.

Contraindications/Precautions: Insulin dosage is very individualized and small changes in dose, syringe brand or size, or insulin brand may necessitate the need for an adjustment of dose. Hypoglycemic reactions are not uncommon in diabetics and may be caused by excessive insulin dose or when glucose absorption is decreased due to fasting, diarrhea, or vomiting. Hypoglycemia may be differentiated from ketoacidosis not only by lab tests but by its symptoms. Symptoms of hypoglycemia include sudden onset, sweating, headache, dizziness, confusion, shakiness, slurred speech, hunger, and a rapid pulse. Symptoms of ketoacidosis include polydipsia, polyuria, drowsiness, anorexia, breathing difficulty, fruity-smelling breath, and nausea or vomiting. Hypoglycemia may be treated with glucose tablets, orange juice, or hard candy. Insulin glargine is not intended for intravenous administration. The prolonged duration of action of insulin glargine is dependent on subcutaneous administration. Pregnancy Category C.

Adverse Effects: Pain at the injection site is slightly more prevalent with insulin glargine versus NPH human insulin although it is usually mild and does not result in discontinuation of therapy. Allergic reactions are rare and may include rash, edema, pruritus, bronchospasm, hypotension, or shock. As with any insulin, hypoglycemic reactions may be associated with administration of insulin glargine.

Patient Consultation:

Follow prescribed diet closely.

Do not change insulin brands, syringe brands, or dose without first notifying a physician.

Consult a physician during any illness.

Do not dilute or mix insulin glargine with any other insulin or solution.

Insulin glargine should be clear and colorless with no particles visible.

Unopened vials should be stored in the refrigerator (36°F-46°F). Do not freeze. Insulin glargine can be kept at room temperature (<86°F) for 28 days. Opened vials should be discarded after 28 days.

Wear or carry diabetes identification in case of emergencies.

Continually monitor blood or urine glucose as prescribed.

If a dose is missed, take it as soon as possible.

Patients should be aware of the signs of hypoglycemia including sweating, tremor, blurred vision, weakness, hunger, and confusion. When two or more of these effects are seen, treat with oral glucose or contact a physician.

[siglerprescriptiondrugcards]

Insulin Aspart, rDNA Origin

Brand Name: Novolog

Common Dosage Forms:

Novolog: 100 units of insulin aspart per mL

Novolog Mix 70/30: 30% insulin aspart solution and 70% insulin aspart protamine suspension

FDA Indications/Dosages:

Treatment if Type I (insulin-dependent) diabetes mellitus or Type II (non-insulin dependent) diabetes mellitus that cannot be properly controlled by diet, exercise, and weight reduction: Dosage must be individualized. Insulin aspart has a more rapid onset and a shorter duration of action than human regular insulin and should be given close (within 5-10 minutes) to a meal. Insulin aspart protamine suspension has a longer duration of action than insulin aspart.

Monitor: HbA1C, FBG

Pharmacology/Pharmacokinetics: Insulin is the primary hormone responsible for carrying out proper glucose utilization in metabolic processes. In adipose and muscle tissue, insulin activates specific enzymes, promotes the transport of monosaccharides (including glucose) across cell membranes and facilitates the transformation of intracellular amino acids into proteins. Insulin also decreases the formation of triglycerides. Insulin aspart is synthesized by recumbent DNA using Saccharomyces cerevisiae (baker’s yeast). The difference between insulin aspart and human insulin is the substitution of proline with aspartic acid at the B28 position. Peak serum levels are attained in 40-50 minutes. Terminal half-life averages 81 minutes.

Drug Interactions: The following drugs may decrease the hypoglycemic effects of insulin: corticosteroids, diltiazem, dobutamine, epinephrine, oral contraceptives, thiazide diuretics, thyroid, and tobacco smoke. The following drugs may increase the hypoglycemic effects of insulin: alcohol, anabolic steroids, nonselective beta-blockers, clofibrate, fenfluramine, guanethidine, MAO inhibitors, phenylbutazone, salicylates, sulfinpyrazone, and tetracyclines.

Contraindications/Precautions: Insulin dosage is very individualized and small changes in dose, syringe brand or size, or insulin brand may necessitate the need for an adjustment of dose. Hypoglycemic reactions are not uncommon in diabetics and may be caused by excessive insulin dose or when glucose absorption is decreased due to fasting, diarrhea, or vomiting. Hypoglycemia may be differentiated from ketoacidosis not only by lab tests but by its symptoms. Hypoglycemia has a sudden onset, causes headaches, shallow breathing, psychosis, convulsions, or even nervousness, causes hunger instead of anorexia, and a normal pulse instead of a rapid pulse. Hypoglycemia may be treated with sugar and candy. Pump-infused Novolog should not be mixed with any other insulin. Do not mix Novolog with Lantus (insulin glargine [rDNA origin]).

Adverse Effects: Hypoglycemia, hypersensitivity—characterized by redness, swelling, and itching at the injection site. May also cause lipodystrophy at the injection site.

Patient Consultation:

Follow prescribed diet carefully.

Administer 5-10 minutes before eating.

Do not change syringe brand or dose without first notifying a physician.

Consult a physician during any illness.

Do not change the order of mixing insulins as prescribed by a physician.

Continually monitor blood or urine glucose as prescribed.

Wear or care diabetic identification in case of emergencies.

Store in a refrigerator, but not in a freezer.

Patients should be aware of the signs of hypoglycemia including sweating, tremor, blurred vision, weakness, hunger, and confusion. When two or more of these effects are seen, treat with oral glucose or contact a physician.

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Riptropin 100IU

Riptropin (100 IU kit) Pack: 10iu/vial,100iu/kit

Riptropin is a way to supply natural growth human growth hormone for people who may deficient or may require higher levels of this hormone. Riptropin is identical to natural growth hormone that your pituitary gland produces because it is made by secretion technology that makes a 191 amino acid sequence.

Riptropin is an injectable human growth…

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