Jennifer Gold

Jennifer Gold

Creams, ointments, gels, sprays, lotions and patches are medicines that will enter your body by penetrating through the skin and entering the bloodstream. They can cause side effects if you use too much of the medicine.

Liquid medicines, especially those required for small children and pets, are often measured using oral syringes. Sometimes, there is a device that comes with the syringe called an adapter. This allows the oral syringe to directly attach to the bottle, eliminating the step of pouring the liquid into a cup for withdrawal by an oral syringe.Using a syringe adapter is a convenient way to accurately measure and administer liquids. However, depending on the actual product, parents should be aware they are not always childproof.

Acetaminophen is the most commonly used medication for pain and fever in infants and children. The drug is commonly known as Tylenol, but it is also widely sold under its generic name acetaminophen. Until just recently, there have been two forms of liquid acetaminophen available, children's, which is 160 mg per 5 mL and infants, which is actually more concentrated at 80 mg per 0.8 mL.

Extra care is needed because Levemir is a high-alert medicine.

High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed.

Top 10 List of Safety Tips for Levemir

When taking your medicine
1. Know your insulin. Levemir is a long-acting insulin that should be injected below the skin once or twice daily. (When taken in smaller doses, Levemir may be considered an intermediate-acting insulin.) When Levemir is taken once daily, inject the insulin with the evening meal or at bedtime. When taken twice daily, the evening dose should be taken with the evening meal, at bedtime, or 12 hours following the morning dose.
2. Prepare your insulin. A rapid- or short-acting insulin is often prescribed with Levemir. However, Levemir should never be mixed in the same syringe with other insulins before injection. Do not vigorously shake insulin before use.
3. Don't reuse or recycle. Discard used syringes/needles, pens, and lancets in a sealable hard plastic or metal container (e.g., empty detergent bottle, sharps container from your pharmacy). When the container is full, seal the lid before placing it in the trash. Don't reuse or recycle syringes, needles, or lancets.
4. Don't share. Even if you change the needle, sharing an insulin pen or syringe may spread diseases carried in the blood, including hepatitis and HIV.
To avoid serious side effects
5. t Avoid mix-ups. If you use more than one type of insulin, make sure each vial, pen, or cartridge looks different. If insulins look similar, put a rubber band around one type to help avoid mix-ups.
6. Check your medicine. There are dozens of different insulins on the market, many in similar looking vials, cartons, or pens. When you pick up your insulin at the pharmacy, be sure it's the right type of insulin.
7. Treat low blood sugar (hypoglycemia). Carry a quick source of sugar, such as glucose tablets, candy, or juice, to treat low blood sugar. Signs of low blood sugar are listed below.
8. Test your blood sugar level. Ask your doctor how often you should test your blood sugar level. Keep a log of your blood sugar levels and how much insulin you take each day. Bring the log with you each time you visit your doctor.
9. Get a periodic lab test. You should have a hemoglobin A1c test at least twice a year to determine how well your diabetes is being controlled. The test shows an average of your blood sugar control over a 6- to 12-week period. Your goal is a hemoglobin A1c of 7% or less.
When you should call your doctor
10. Call for illness or changes in habits. Your insulin needs may change because of illness, stress, changes in eating habits or physical activity, and other medicines you take. Call your doctor if you experience these conditions. Never change your insulin dose unless advised by your doctor.

Signs of hypoglycemia (low blood sugar)

  • hunger
  • feeling shaky
  • fast heartbeat
  • lightheadedness
  • dizziness
  • sweating
  • headache
  • confusion
  • irritability

Hypoglycemia is caused by too much insulin or increased work or exercise without eating. Symptoms of hypoglycemia may be different for each person and can change from time to time. Hypoglycemia can affect your ability to think and react quickly, so driving a car could be risky. Severe hypoglycemia can lead to loss of consciousness, seizures, brain damage, or even death. Know the symptoms of hypoglycemia and treat it quickly by drinking juice or a sugar-containing beverage, or eating sugar or candy. Talk to your doctor if hypoglycemia is a problem for you.

 

 Topics Fast Facts
Generic name
  • insulin detemir (pronounced IN soo lin DE te mir) (no generic available)
Common brand names
  • Levemir, Levemir FlexPen (prefilled pen)
Type of insulin, onset, duration
  • Intermediate- to long-acting; begins working in 3 to 4 hours and lasts 6 to 23 hours
  • Duration of effects depends on the dose; higher doses last longer than lower doses
Uses
  • Treatment of type 1 and type 2 diabetes mellitus to improve control of blood glucose
When to take the insulin
  • Inject Levemir under the skin once or twice daily as directed by your doctor
  • When taken once daily, inject the insulin with the evening meal or at bedtime; when taken twice daily, the evening dose should be taken with the evening meal, at bedtime, or 12 hours following the morning dose
  • Inject Levemir at the same time(s) each day
Usual dose
  • The dose and frequency of administering insulin are unique to each individual
  • Daily doses of insulin are based upon body weight, diet, activity level, age, individual sensitivity to insulin, type of diabetes (1 or 2)
Injecting the insulin
  • Do not mix Levemir with other insulins
  • Ask your doctor, nurse, or pharmacist to show you how to draw your dose of insulin into a syringe and inject it, or select the dose on a pen device and inject the insulin
  • Do not use Levemir with an external insulin pump
  • Before injecting a dose, take the chill off refrigerated insulin by gently rolling the vial or pen between the palm of both hands (do not shake the insulin vigorously)
  • Inject the insulin below the skin (not in the muscle) in the upper thighs, upper arms, buttocks, or abdomen; the injection site should be changed (rotated) with each dose
  • Don't use Levemir if the insulin appears cloudy instead of clear and colorless
Special instructions and precautions
  • Follow the diet prescribed by your doctor; keep your eating habits and exercise regular
  • Tell the doctor who prescribes insulin about any new medicines you are taking
  • Do not share insulin pens or syringes/needles with others
Safety during pregnancy/breastfeeding
  • Talk to your doctor about managing your diabetes during pregnancy and breastfeeding
Storage and disposal
  • Store unopened vials and pens in the refrigerator until first use (do not freeze) or at room temperature for 42 days
  • After first use, store vials in the refrigerator or at room temperature; discard after 42 days
  • After first use, store insulin pens at room temperature (do not refrigerate); discard after 42 days
  • Safely discard used syringes, needles, pens, and lancets (safety tip #3, other side)
Most common side effects
  • Hypoglycemia (low blood sugar); see signs and treatment of hypoglycemia above
  • Low potassium blood levels, fast heart rate, fatigue, headache, hunger, weight gain
Other conditions to report to your doctor
  • Chest pain or palpitations, persistent fatigue, confusion, numbness of mouth, lips, or tongue, muscle weakness, tremors, vision changes, swelling of feet, flu-like symptoms
  • Swelling, itching, redness, warmth, or pain at the injection site
Herbals that should not be taken with Levemir
  • These herbals can lower your blood glucose: chromium, garlic, gymnema
Prescription medicines that should not be taken with Levemir
  • Many prescription medicines can affect your blood sugar levels and insulin needs
  • Tell your doctor about all the medicines you take, particularly new medicines
Special tests your doctor may prescribe
  • Patients are often asked to test their own blood glucose using home testing equipment, test their urine for sugar and acetone, and take their blood pressure regularly
  • To monitor your diabetes, your doctor may periodically test your blood levels for hemoglobin A1c, potassium, cholesterol, and substances that measure kidney function

This information does not replace the need to follow your doctor's instructions and read the drug information leaflet provided with your prescription.

This project was supported by grant number R18HS017910 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not represent the official views of the Agency for Healthcare Research and Quality.

Extra care is needed because Apidra is a high-alert medicine.

High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed.

Top 10 List of Safety Tips for Apidra

When taking your medicine
1. Know your insulin. Apidra is a rapid-acting insulin that should be injected below the skin within 15 minutes before or 20 minutes after starting a meal. Have food ready before injection. After injecting the insulin, do not delay eating or skip a meal.
2. Prepare your insulin. Apidra can be mixed with insulin NPH (intermediate-acting insulin), but always draw Apidra into the syringe first and use immediately after preparing the mixture. Do not mix Apidra with other insulins if using an insulin pen or external pump. Do not vigorously shake insulin before use.
3. Don’t reuse or recycle. Dispose of used syringes/needles, pens, and lancets in a sealable hard plastic or metal container (e.g., empty detergent bottle or sharps container from your pharmacy). When the container is full, seal the lid before placing it in the trash. Do not reuse or recycle syringes/needles or lancets.
4. Don’t share. Even if you change the needle, sharing an insulin pen or syringe may spread diseases carried in the blood, including hepatitis and HIV.
To avoid serious side effects
5. Avoid mix-ups. If you use more than one type of insulin, make sure each vial or pen looks different to avoid mix-ups. For example, Apidra and Lantus (a long-acting insulin) are both clear medicines in elongated vials or pens that can look similar. To make them look different, put a rubber band around one type of insulin.
6. Check your medicine. Handwritten prescriptions for insulin glulisine (Apidra) can be misread as insulin glargine (Lantus, another type of insulin). When you pick up your insulin at the pharmacy, be sure it's the right type of insulin.
7. Treat low blood sugar (hypoglycemia). Always carry a quick source of sugar, such as glucose tablets, candy, or juice, to treat low blood sugar. Signs of low blood sugar are listed below.
8. Test your blood sugar. Ask your doctor how often you should test your blood sugar. Keep a log of your blood sugar levels and how much insulin you take each day. Bring the log each time you visit your doctor.
9. Get a periodic lab test. You should have a hemoglobin A1c test at least twice a year to determine how well your diabetes is being controlled. The test shows an average of your blood sugar control over a 6- to 12-week period. Your goal is a hemoglobin A1c of 7% or less.
When you should call your doctor
10. Call for illness or changes in habits. Your insulin needs may change because of illness, stress, changes in eating habits or physical activity, and other medicines you take. Call your doctor if you experience these conditions. Never change your insulin dose unless advised by your doctor.

 

      apidrapen

 

Signs of hypoglycemia (low blood sugar)

  • hunger
  • feeling shaky
  • fast heartbeat
  • lightheadedness
  • dizziness
  • sweating
  • headache
  • confusion
  • irritability

Hypoglycemia is caused by too much insulin or increased work or exercise without eating. Symptoms of hypoglycemia may be different for each person and can change from time to time. Hypoglycemia can affect your ability to think and react quickly, so driving a car could be risky. Severe hypoglycemia can lead to loss of consciousness, seizures, brain damage, or even death. Know the symptoms of hypoglycemia and treat it quickly by drinking juice or a sugar-containing beverage, or eating sugar or candy. Talk to your doctor if hypoglycemia is a problem for you.

 

Topics

Fast Facts

Generic name
  • insulin glulisine (pronounced IN soo lin gloo LIS een) (no generic available)
Common brand names
  • Apidra, Apidra SoloSTAR (prefilled pen)
  • Apidra cartridges are used with OptiClik pens
Type of insulin, onset, duration
  • Rapid-acting; begins working in 12 to 30 minutes and lasts 3 to 4 hours
Uses
  • Treatment of type 1 and type 2 diabetes mellitus to improve control of blood glucose
When to take the insulin
  • Inject Apidra under the skin within 15 minutes before or 20 minutes after starting a meal
Usual dose
  • The frequency and dose of insulin are unique to each individual
  • Daily doses of insulin are based upon body weight, diet, activity level, age, individual sensitivity to insulin, type of diabetes (1 or 2)
  • Multiple daily doses according to blood glucose levels are typical
Injecting the insulin
  • See safety tip #2 to determine if Apidra can be mixed with another insulin before injection
  • If you have questions, ask your doctor, nurse, or pharmacist to show you how to draw your dose of insulin into a syringe and inject it, select the dose on a pen device and inject the insulin, or use an insulin pump
  • If using an OptiClik pen, be sure you are not holding the pen upside down when viewing the dose in the window (see pictures)
  • Before injecting a dose, take the chill off refrigerated insulin by gently rolling the vial, pen, or cartridge between the palm of both hands (do not shake the insulin vigorously
  • Inject the insulin below the skin (not in the muscle) in the upper thighs, upper arms, buttocks, or abdomen; the injection site should be changed (rotated) with each dose
  • Don't use Apidra if the insulin appears cloudy instead of clear and colorless
Special instructions and precautions
  • Inject Apidra within 15 minutes before or 20 minutes after starting a meal
  • Follow the diet prescribed by your doctor; keep your eating habits and exercise regular
  • Tell the doctor who prescribes insulin about any new medicines you are taking
  • Do not share insulin pens, cartridges, or syringes/needles with others
Safety during pregnancy/breastfeeding
  • Talk to your doctor about managing your diabetes during pregnancy and breastfeeding
Storage and disposal
  • Store unopened vials, cartridges, and pens in the refrigerator until first use (do not freeze)
  • After first use, store vials in the refrigerator or at room temperature; discard after 28 days
  • After first use, store cartridges and insulin pens at room temperature (do not refrigerate); discard after 28 days
  • Safely dispose of used syringes/needles, pens, and lancets (safety tip #3)
Most common side effects
  • Hypoglycemia (low blood sugar); see signs and treatment of hypoglycemia above
  • Low potassium blood levels, fast heart rate, fatigue, headache, hunger, weight gain
Other conditions to report to your doctor
  • Chest pain or palpitations, persistent fatigue, confusion, numbness of mouth, lips, or tongue, muscle weakness or tremors, vision changes, swelling of feet, flu-like symptoms
  • Swelling, itching, redness, warmth, or pain at the injection site
Herbals that should not be taken with Apidra
  • These herbals can lower your blood glucose: chromium, garlic, gymnema
Prescription medicines that should not be taken with Apidra
  • Many prescription medicines can affect your blood sugar levels and insulin needs
  • Tell your doctor about all the medicines you take, particularly new medicines
Special tests your doctor may prescribe
  • Patients are often asked to test their own blood glucose using home testing equipment, test their urine for sugar and acetone, and take their blood pressure regularly
  • To monitor your diabetes, your doctor may periodically test your blood levels for hemoglobin A1c, potassium, cholesterol, and substances that measure kidney function

This information does not replace the need to follow your doctor's instructions and read the drug information leaflet provided with your prescription.

This project was supported by grant number R18HS017910 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not represent the official views of the Agency for Healthcare Research and Quality.

Extra care is needed because Lantus is a high-alert medicine.

High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed.

Top 10 List of Safety Tips for Lantus

When taking your medicine
1. Know your insulin. Lantus is a long-acting insulin that should be injected below the skin once daily as directed by your doctor. On rare occasions, your physician may direct you to take Lantus two times daily. Take Lantus the same time every day.
2. Prepare your insulin. A rapid- or short-acting insulin is often prescribed with Lantus. However, Lantus should never be mixed in the same syringe with other insulins before injection. Do not vigorously shake insulin before use.
3. Don't reuse or recycle. Dispose of used syringes/needles, pens, and lancets in a sealable hard plastic or metal container (e.g., empty detergent bottle, sharps container from your pharmacy). When the container is full, seal the lid before placing it in the trash. Do not reuse or recycle syringes/needles or lancets.
4. Don't share. Even if you change the needle, sharing an insulin pen or syringe may spread diseases carried in the blood, including hepatitis and HIV.
To avoid serious side effects
5. Avoid mix-ups. List If you use more than one type of insulin, make sure each vial or pen looks different to avoid mix-ups. Lantus is a long-acting insulin that may look like a rapid- or short-acting insulin. For example, Lantus and Apidra (a rapid-acting insulin) are both clear medicines in elongated vials (or insulin pens) that look similar. To make them look different, put a rubber band around one type of insulin.
6. Check your medicine. There are many types of insulins that come in similar looking vials, cartons, or pens. When you pick up your insulin at the pharmacy, be sure it's the right type of insulin.
7. Treat low blood sugar (hypoglycemia). Always carry a quick source of sugar, such as glucose tablets, candy, or juice, to treat low blood sugar. Signs of low blood sugar are listed below.
8. Test your blood sugar. Ask your doctor how often you should test your blood sugar. Keep a log of your blood sugar levels and how much insulin you take each day. Bring the log each time you visit the doctor.
9. Get a periodic lab test. You should have a hemoglobin A1c test at least twice a year to determine how well your diabetes is being controlled. The test shows an average of your blood sugar control over a 6- to 12-week period. Your goal is a hemoglobin A1c of 7% or less.
When you should call your doctor
10. Call for illness or changes in habits. Your insulin needs may change because of illness, stress, changes in eating habits or physical activity, and other medicines you take. Call your doctor if you experience these conditions. Never change your insulin dose unless advised by your doctor.

 

      lantuspen

 

Signs of hypoglycemia (low blood sugar)

  • hunger
  • feeling shaky
  • fast heartbeat
  • lightheadedness
  • dizziness
  • sweating
  • headache
  • confusion
  • irritability

Hypoglycemia is caused by too much insulin or increased work or exercise without eating. Symptoms of hypoglycemia may be different for each person and can change from time to time. Hypoglycemia can affect your ability to think and react quickly, so driving a car could be risky. Severe hypoglycemia can lead to loss of consciousness, seizures, brain damage, or even death. Know the symptoms of hypoglycemia and treat it quickly by drinking juice or a sugar-containing beverage, or eating sugar or candy. Talk to your doctor if hypoglycemia is a problem for you.

 

 Topics Fast Facts
Generic name
  • insulin glargine (pronounced IN soo lin GLAR jeen) (no generic available)
Common brand names
  • Lantus, Lantus SoloSTAR (prefilled pen)
  • OptiClik pens are used with Lantus cartridges
Type of insulin, onset, duration
  • Long-acting; begins working in 3 to 4 hours and lasts up to 24 hours or more
Uses
  • Treatment of type 1 and type 2 diabetes mellitus to improve control of blood glucose
When to take the insulin
  • Lantus should be injected under the skin once daily at the same time each day
  • In rare circumstances, Lantus may be taken twice daily if prescribed by your doctor
Usual dose
  • The frequency and dose of insulin are unique to each individual
  • Daily doses of insulin are based upon body weight, diet, activity level, age, individual sensitivity to insulin, type of diabetes (1 or 2)
  • Monitor glucose levels more closely during the first few weeks of taking Lantus
Injecting the insulin
  • Do not dilute or mix Lantus with other insulins
  • Ask your doctor, nurse, or pharmacist to show you how to draw your dose of insulin into a syringe and inject it, or how to select the dose on a pen device and inject the insulin
  • Lantus should not be used with an insulin pump or injected into a vein
  • If using an OptiClik pen, be sure you are not holding the pen upside down when viewing the dose in the window (see pictures on bottom of other side of page)
  • Before injecting a dose, take the chill off refrigerated insulin by gently rolling the vial, pen, or cartridge between the palm of both hands (do not shake the insulin vigorously)
  • Inject the insulin below the skin (not in the muscle) in the upper thighs, upper arms, buttocks, or abdomen; the injection site should be changed (rotated) with each dose
  • Don't use Lantus if the insulin appears cloudy instead of clear and colorless
Special instructions and precautions
  • Inject Lantus at the same time each day
  • Follow the diet prescribed by your doctor; keep your eating habits and exercise regular
  • Tell the doctor who prescribes insulin about any new medicines you are taking
  • Do not share insulin pens, cartridges, or syringes/needles with others
Safety during pregnancy/breastfeeding
  • Talk to your doctor about managing your diabetes during pregnancy and breastfeeding
Storage and disposal
  • Store unopened vials, cartridges, and pens in the refrigerator until first use (do not freeze)
  • After first use, store vials in the refrigerator or at room temperature; discard after 28 days
  • After first use, store cartridges and insulin pens at room temperature (do not refrigerate); discard after 28 days
  • Safely dispose of used syringes/needles, pens, and lancets (safety tip #3)
Most common side effects
  • Hypoglycemia (low blood sugar); see signs and treatment of hypoglycemia above
  • Low potassium blood levels, fast heart rate, fatigue, headache, hunger, weight gain
Other conditions to report to your doctor
  • Chest pain or palpitations, persistent fatigue, confusion, numbness of mouth, lips, or tongue, muscle weakness or tremors, vision changes, swelling of feet, flu-like symptoms
  • Swelling, itching, redness, warmth, or pain at the injection site
Herbals that should not be taken with Lantus
  • These herbals can lower your blood glucose: chromium, garlic, gymnema
Prescription medicines that should not be taken with Lantus
  • Many prescription medicines can affect your blood sugar levels and insulin needs
  • Tell your doctor about all the medicines you take, particularly new medicines
Special tests your doctor may prescribe
  • Patients are often asked to test their own blood glucose using home testing equipment, test their urine for sugar and acetone, and take their blood pressure regularly
  • To monitor your diabetes, your doctor may periodically test your blood levels for hemoglobin A1c, potassium, cholesterol, and substances that measure kidney function

This information does not replace the need to follow your doctor's instructions and read the drug information leaflet provided with your prescription.

This project was supported by grant number R18HS017910 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not represent the official views of the Agency for Healthcare Research and Quality.

Extra care is needed because NovoLog is a high-alert medicine.

High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed.

Top 10 List of Safety Tips for NovoLog

When taking your medicine
1. Know your insulin. NovoLog is a rapid-acting form of insulin that should be injected below the skin 5 to 10 minutes before meals. Have food ready before injection. After injecting the insulin, do not skip a meal or delay eating.
2. Prepare your insulin. An intermediate- or long-acting insulin is often prescribed with NovoLog. NovoLog can be mixed with insulin NPH (intermediate-acting insulin), but always draw NovoLog into the syringe first. Never mix NovoLog with Lantus. Do not mix NovoLog with other insulins if using an insulin pen or external pump. Do not vigorously shake insulin before use.
3. Don't reuse or recycle. Dispose of used syringes/needles, pens, and lancets in a sealable hard plastic or metal container (e.g., empty detergent bottle, special sharps container from your pharmacy). When the container is full, seal the lid before placing it in the trash. Do not reuse or recycle syringes/needles or lancets.
4. Don't share. Even if you change the needle, sharing an insulin pen or syringe may spread diseases carried in the blood, including hepatitis and HIV.
To avoid serious side effects
5. Avoid mix-ups. If you use more than one type of insulin, make each vial or pen look different by putting a rubber band around one type of insulin.
6. Check your medicine. NovoLog can be confused with Humalog (another rapid-acting insulin). When you pick up your insulin at the pharmacy, be sure it's the right type of insulin.
7. Treat low blood sugar (hypoglycemia). Carry a quick source of sugar, such as glucose tablets, candy, or juice, to treat low blood sugar. Signs of low blood sugar are listed below.
8. Test your blood sugar level. Ask your doctor how often you should test your blood sugar level. Keep a log of your blood sugar levels and how much insulin you take each day. Bring the log with you each time you visit your doctor.
9. Get a periodic lab test. You should have a hemoglobin A1c test at least twice a year to determine how well your diabetes is being controlled. The test shows an average of your blood sugar control over a 6- to 12-week period. Your goal is a hemoglobin A1c of 7% or less.
When you should call your doctor
10. Call for illness or changes in habits. Your insulin needs may change because of illness, stress, changes in eating habits or physical activity, and other medicines you take. Call your doctor if you experience these conditions. Never change your insulin dose unless advised by your doctor.

Signs of hypoglycemia (low blood sugar)

  • hunger
  • feeling shaky
  • fast heartbeat
  • lightheadedness
  • dizziness
  • sweating
  • headache
  • confusion
  • irritability

Hypoglycemia is caused by too much insulin or increased work or exercise without eating. Symptoms of hypoglycemia may be different for each person and can change from time to time. Hypoglycemia can affect your ability to think and react quickly, so driving a car could be risky. Severe hypoglycemia can lead to loss of consciousness, seizures, brain damage, or even death. Know the symptoms of hypoglycemia and treat it quickly by drinking juice or a sugar-containing beverage, or eating sugar or candy. Talk to your doctor if hypoglycemia is a problem for you.

 

 Topics Fast Facts
Generic name
  • insulin aspart (pronounced IN soo lin AS part) (no generic available)
Common brand names
  • NovoLog, NovoLog FlexPen
  • NovoPen Junior (for kids) and NovoPen 3 are used with NovoLog PenFill cartridges
Type of insulin, onset, duration
  • Rapid-acting insulin; begins working in 12 to 18 minutes and lasts for 3 to 5 hours.
Uses
  • Treatment of type 1 and type 2 diabetes mellitus to improve control of blood glucose
When to take the insulin
  • NovoLog should be injected under the skin 5 to 10 minutes before a meal; meal should be eaten no longer than 10 minutes after injection
Usual dose
  • The frequency and dose of insulin are unique to each individual
  • Daily doses of insulin are based upon body weight, diet, activity level, age, individual sensitivity to insulin, type of diabetes (1 or 2)
  • Multiple daily doses according to blood glucose levels are typical
Injecting the insulin
  • See safety tip #2 (other side of page) to determine if NovoLog can be mixed with another insulin before injection
  • Ask your doctor, nurse, or pharmacist to show you how to draw your dose of insulin into a syringe and inject it, select the dose on a pen device and inject the insulin, or use an insulin pump
  • Before injecting a dose, take the chill off refrigerated insulin by gently rolling the vial, pen, or cartridge between the palm of both hands (do not shake the insulin vigorously)
  • Using a syringe or insulin pen, inject the insulin below the skin (not in the muscle) in the upper thighs, upper arms, buttocks, or abdomen; the site of the injection should be changed (rotated) with each dose
  • Don't use NovoLog if the insulin appears cloudy instead of clear and colorless
Special instructions and precautions
  • Take within 10 minutes of eating a meal
  • Follow the diet prescribed by your doctor
  • Keep your eating habits and exercise regular
  • Do not share insulin pens, cartridges, or syringes/needles with others
Safety during pregnancy/breastfeeding
  • Talk to your doctor about managing your diabetes during pregnancy and breastfeeding
Storage and disposal
  • Store unopened vials, cartridges, and pens in the refrigerator until first use (do not freeze)
  • After first use, store vials in the refrigerator or at room temperature; discard after 28 days
  • After first use, store cartridges and insulin pens at room temperature (do not refrigerate); discard after 28 days
  • Safely dispose of used syringes/needles, pens, and lancets (safety tip #3, other side)
Most common side effects
  • Hypoglycemia (low blood sugar); see signs and treatment of hypoglycemia above
  • Low potassium blood levels, fast heart rate, fatigue, headache, hunger
Other conditions to report to your doctor
  • Chest pain or palpitations, persistent fatigue, confusion, numbness of mouth, lips, or tongue, muscle weakness or tremors, vision changes, flu-like symptoms
  • Swelling, itching, redness, warmth, or pain at the injection site
Herbals that should not be taken with NovoLog
  • These herbals can lower your blood glucose: chromium, garlic, gymnema
Prescription medicines that should not be taken with NovoLog
  • Many prescription medicines can affect your blood sugar levels and insulin needs
  • Tell your doctor about all the medicines you take, particularly new medicines
Special tests your doctor may prescribe
  • Patients are often asked to test their own blood glucose using home testing equipment, test their urine for sugar and acetone, and take their blood pressure regularly
  • To monitor your diabetes, your doctor may periodically test your blood levels for hemoglobin A1c, potassium, cholesterol, and substances that measure kidney function

This information does not replace the need to follow your doctor's instructions and read the drug information leaflet provided with your prescription.

This project was supported by grant number R18HS017910 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not represent the official views of the Agency for Healthcare Research and Quality.

Extra care is needed because oxycodone with acetaminophen is a high-alert medicine.

High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed.

Top 10 List of Safety Tips for Oxycodone with Acetaminophen

When filling your prescription
1. Check your medicine. If your doctor prescribes this medicine using one of its brand names, it could be confused with other medicines that have similar names. For example, a handwritten prescription for Endocet might be mistaken as Indocin. Percocet might be mistaken as Percodan. Roxicet may be mistaken as Roxanol. Tylox might be mistaken as Trimox. When you pick up your prescription at the pharmacy, be sure you have the right medicine.
When taking your medicine
2. Do not take with other acetaminophen medicines. This pain reliever has two active ingredients: oxycodone and acetaminophen (also known as Tylenol, and often abbreviated as APAP). Too much acetaminophen can damage the liver and cause death. While taking oxycodone with acetaminophen, do not take nonprescription acetaminophen or other medicines that contain acetaminophen, including many cold medicines. Adults should not take more than 3,000 to 4,000 mg of acetaminophen each day. Depending on what your doctor prescribed, each tablet or liquid dose of this medicine contains between 300 mg and 650 mg of acetaminophen.
3. Report all medicines. Let your doctor and pharmacist know about all the prescription and nonprescription medicines you are taking, so other medicines that contain acetaminophen can be identified.
4. Read medicine labels. Always read the active ingredients on medicine labels (under Drug Facts on nonprescription medicine labels) to avoid taking other medicines that contain acetaminophen.
5. Take precautions. You may feel sleepy while taking this medicine. Avoid tasks that require mental alertness, such as driving or operating machinery. Avoid drinking alcohol while taking this medicine.
6. Prevent and treat constipation. Constipation is a common side effect when taking this medicine for more than a few days. Exercising, eating fiber, and drinking water can help, but you may need to ask your doctor or pharmacist to recommend a laxative. If your constipation seems severe or does not respond to laxatives, call your doctor. This can be a sign of a blockage in your bowels, a rare but serious side effect.
When discarding unused medicine
7. Dispose of medicine safely. Oxycodone is a drug with a high potential for abuse. As a precaution, this medicine is one of just a few medicines that the US Food and Drug Administration says must be flushed down the toilet for disposal rather than discarded in the trash.
When you should call your doctor
8. Unrelieved pain. Call your doctor if the pain gets worse while taking the medicine, or if the medicine does not help control your pain. Do not take extra doses. Taking too much medicine can be fatal because it can slow or stop your breathing.
9. Signs of overdose. Call your doctor if you experience extreme fatigue, difficulty waking up, and/or shallow or very slow breathing.
10. Signs of withdrawal. Long-term use of oxycodone can lead to dependence. Abruptly stopping the medicine after long-term use can lead to withdrawal symptoms (e.g., dilated pupils, runny nose, sweating, flushed face, flu-like symptoms, irritability, rapid breathing). Seek medical help if these symptoms occur.

 

 Topics Fast Facts
Generic name
  • oxycodone and acetaminophen (pronounced oks i KOE done and a seet a MIN oh fen) (generic available)
Common brand names
  • Percocet, Endocet, Roxicet, Roxicet 5/500, Tylox, Magnacet, Primalev
Uses
  • Treats moderate to severe pain
Usual dose limits
  • Moderate pain: 2½ (2.5) to 5 mg of oxycodone every 4 to 6 hours as needed for pain
  • Severe pain: 10 mg of oxycodone every 4 to 6 hours as needed for pain
  • Do not take more than 3,000 to 4,000 mg of acetaminophen each day (depending on what your doctor prescribed, each tablet or liquid dose contains between 300 mg and 650 mg of acetaminophen)
Special instructions and precautions
  • Take the medicine exactly as prescribed
  • Call your doctor if your pain is not relieved; do not take an extra dose
  • Do not take regular acetaminophen (Tylenol) while taking this medicine
  • While taking this medicine, do not take nonprescription cough and cold medicines or other medicines that contain acetaminophen
  • Do not drive or operate machinery while taking this medicine because it may make you sleepy and impair your coordination; use caution when climbing stairs
  • Avoid drinking alcohol while taking this medicine
  • Do not start or stop any medicine, including nonprescription medicines, herbals, and vitamins, without letting your doctor or pharmacist know
Possible drug dependence with long-term use
  • Oxycodone is an opioid that causes an exaggerated sense of well-being, which can lead to physical and psychological dependence with long-term use
  • Abruptly stopping the medicine after long-term use can lead to withdrawal symptoms (see safety tip #10)
  • Serious dependence rarely occurs when the medicine is taken as prescribed for short-term relief of pain
Safety during pregnancy/breastfeeding
  • Tell your doctor if you are pregnant or become pregnant
  • Use of this medicine during pregnancy may produce physical dependence in a newborn
  • Avoid taking this medicine for long periods or in high doses near your due date
  • Oxycodone enters breast milk, so it is best to limit intake and use caution
  • If taken while breastfeeding, let your baby's doctor know, take doses immediately after breastfeeding or 3 to 4 hours before the next feeding, and immediately report changes in your baby, such as increased sleepiness (beyond the usual), breathing difficulties, changes in the baby's feeding pattern, or limpness
Tell your doctor if you have:
  • Diseases: liver disease, lung disease, breathing problems, heart disease, a head injury, history of seizures, thyroid disorder, Addison's disease
  • Allergies to: acetaminophen, codeine, other powerful pain relievers
  • Been taking illicit drugs or drink 3 or more alcoholic beverages daily
Storage and disposal
  • Store at room temperature, protect from moisture
  • Flush any unused medicine down the toilet
Side effects to report to your doctor immediately
  • Difficulty breathing, very slow breathing, persistent dizziness or headache, excessive sleepiness, confusion, weakness, trembling, blurred vision, vomiting, allergic reaction
Other conditions to report to your doctor
  • Constipation, nausea
Nonprescription medicines/herbals that should not be taken with oxycodone and acetaminophen
  • Acetaminophen (including Tylenol)
  • Cough and cold medicines that contain acetaminophen
  • St. John's wort
Prescription medicines that should not be taken with oxycodone and acetaminophen
  • Other prescription medicine that contains acetaminophen
  • Sedatives, tranquilizers, antihistamines, other strong pain medicines
  • Alvimopan (Entereg), imatinib (Gleevec)

This information does not replace the need to follow your doctor's instructions and read the drug information leaflet provided with your prescription.

This project was supported by grant number R18HS017910 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not represent the official views of the Agency for Healthcare Research and Quality.

Extra care is needed because hydrocodone with acetaminophen is a high-alert medicine.

High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed.

Top 10 List of Safety Tips for Hydrocodone with Acetaminophen

When filling your prescription
1. Check your medicine. If your doctor prescribes this medicine using one of its brand names, it could be confused with other medicines that have similar names. For example, a handwritten prescription for Lorcet may be mistaken as Fioricet. Lortab might be mistaken as Luride. Vicodin might be mistaken as Hycodan. When you pick up your prescription at the pharmacy, be sure you have the right medicine.
When taking your medicine
2. Do not take with other acetaminophen medicines. This pain reliever has two active ingredients: hydrocodone and acetaminophen (also known as Tylenol, and often abbreviated as APAP). Too much acetaminophen can damage the liver and cause death. While taking hydrocodone with acetaminophen, do not take nonprescription acetaminophen or medicines that contain acetaminophen, including cold medicines. Adults should not take more than 3,000 to 4,000 mg of acetaminophen each day. Depending on what your doctor prescribed, each tablet or liquid dose of this medicine contains between 300 mg and 750 mg of acetaminophen.
3. Report all medicines. Let your doctor and pharmacist know about all the prescription and nonprescription medicines you are taking, so other medicines that contain acetaminophen can be identified.
4. Read medicine labels. Always read the active ingredients on medicine labels (under Drug Facts on nonprescription medicine labels) to avoid taking other medicines that contain acetaminophen.
5. Take precautions. You may feel sleepy while taking this medicine. Avoid tasks that require mental alertness, such as driving or operating machinery. Avoid drinking alcohol while taking this medicine.
6. Prevent and treat constipation. Constipation is a common side effect when taking this medicine for more than a few days. Exercising, eating fiber, and drinking water can help, but you may need to ask your doctor or pharmacist to recommend a laxative. If your constipation seems severe or does not respond to laxatives, call your doctor. This can be a sign of a blockage in your bowels, a rare but serious side effect.
When discarding unused medicine
7. Dispose of medicine safely. Discard unused or expired medicine in a sealed container (coffee can with lid, sharps container from pharmacy) after mixing it with an undesirable substance such as cat litter or coffee grounds. This helps stop children and pets from getting into the medicine in the trash.
When you should call your doctor
8. Unrelieved pain. Call your doctor if the pain gets worse while taking the medicine, or if the medicine does not help control your pain. Do not take extra doses. Taking too much medicine can be fatal because it can slow or stop your breathing.
9. Signs of overdose. Call your doctor if you experience extreme fatigue, difficulty waking up, and/or shallow or very slow breathing.
10. Signs of withdrawal. Long-term use of hydrocodone can lead to dependence. Abruptly stopping the medicine after long-term use can lead to withdrawal symptoms (e.g., dilated pupils, runny nose, sweating, flushed face, flu-like symptoms, rapid breathing). Seek medical help if these symptoms occur.
 

 

 Topics Fast Facts
Generic name
  • hydrocodone and acetaminophen (pronounced hye droe KOE done and a seet a MIN oh fen) (generic available)
Common brand names
  • Vicodin, Vicodin ES, Vicodin HP, Lorcet 10/650, Lorcet Plus, Lortab, Maxidone, Norco, Zydone, Co-Gesic, Hycet, Margesic H, Stagesic, Xodol 10/300, Xodol 5/300, Xodol 7.5/300, Zamicet
Uses
  • Treats moderate to severe pain
Usual dose limits
  • Moderate pain: 2½ (2.5) to 5 mg of hydrocodone every 4 to 6 hours
  • Severe pain: 10 mg of hydrocodone every 4 to 6 hours
  • Do not exceed 3,000 to 4,000 mg each day of acetaminophen (depending on what your doctor prescribed, each tablet or liquid dose contains between 300 mg and 750 mg of acetaminophen)
Special instructions and precautions
  • Take exactly as prescribed
  • Call your doctor if your pain is not relieved; do not take an extra dose
  • Do not take regular acetaminophen (Tylenol) while taking this medicine
  • Do not take nonprescription cough and cold medicines or other medicines that contain acetaminophen while taking this medicine
  • Do not drive or operate machinery while taking this medicine because it may make you sleepy and impair your coordination; use caution when climbing stairs
  • Avoid drinking alcohol while taking this medicine
  • Do not start or stop any medicine, including nonprescription medicines, herbals, and vitamins, without letting your doctor or pharmacist know
Possible drug dependence with long-term use
  • Hydrocodone is an opioid that causes an exaggerated sense of well-being, which can lead to physical and psychological dependence with long-term use
  • Abruptly stopping the medicine after long-term use can lead to withdrawal symptoms (see safety tip #10)
  • Serious dependence rarely occurs when the medicine is taken as prescribed for short-term relief of pain
Safety during pregnancy/breastfeeding
  • Tell your doctor if you are pregnant or become pregnant
  • Use of this medicine during pregnancy may produce physical dependence in a newborn
  • Avoid taking this medicine for long periods or in high doses near your due date
  • Hydrocodone enters breast milk, so breastfeeding is not recommended
  • If taken while breastfeeding, let your baby's doctor know, take doses immediately after breastfeeding or 3 to 4 hours before the next feeding, and immediately report changes in your baby, such as increased sleepiness (beyond the usual), breathing difficulties, changes in the baby's feeding pattern, or limpness
Tell your doctor if you have:
  • Diseases: liver disease, lung disease, breathing problems, heart disease, a head injury, history of seizures, thyroid disorder, Addison's disease
  • Allergies to: acetaminophen, codeine, other powerful pain relievers
  • Been taking illicit drugs or drink 3 or more alcoholic beverages daily
Storage and disposal
  • Store at room temperature, protect from light and moisture
  • Dispose of tablets securely in the trash; do not flush down the toilet
Side effects to report to your doctor immediately
  • Difficulty breathing, very slow breathing, slow heart rate, persistent dizziness or headache, excessive sleepiness, confusion, weakness, trembling, blurred vision, vomiting, muscle spasms, difficulty urinating, hearing loss, allergic reaction
Other conditions to report to your doctor
  • Constipation, nausea, itchiness, skin rash
Nonprescription medicines/herbals that should not be taken with hydrocodone and acetaminophen
  • Acetaminophen (including Tylenol)
  • Cough and cold medicines that contain acetaminophen
  • Herbals such as valerian, St. John's wort, SAMe, kava kava
Prescription medicines that should not be taken with hydrocodone and acetaminophen
  • Other prescription medicine that contains acetaminophen
  • Sedatives, tranquilizers, antihistamines, other strong pain medicines
  • Alvimopan (Entereg), imatinib (Gleevec)

This information does not replace the need to follow your doctor's instructions and read the drug information leaflet provided with your prescription.

This project was supported by grant number R18HS017910 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not represent the official views of the Agency for Healthcare Research and Quality.

Extra care is needed because enoxaparin is a high-alert medicine.

High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed.

Top 10 List of Safety Tips for Enoxaparin

When taking enoxaparin (blood thinner)
1. Take exactly as directed. Take enoxaparin the same time each day. Do not take extra doses or skip any doses.
2. Prepare exact dose. Ask your doctor, nurse, or pharmacist to teach you how to measure your dose.You may need to inject the full contents of a prefilled syringe, or discard a portion of the medicine in the syringe before injection. Do not expel the air bubble from the 30 mg and 40 mg syringes before injecting the medicine. It helps push the medicine into the body so it will not leak back out the injection site.
3. Inject the medicine. Follow the instructions below to inject the medicine into fatty areas of the abdomen, about 2 inches from the belly button. Do not inject the medicine into muscle, as this can cause a painful bruise.
4. Rotate injection sites. Write down the date, time, and location of the injection site for every dose. Use the opposite side of the abdomen each time you inject your medicine to prevent the skin from hardening.
To prevent the spread of diseases
5. Don't reuse or recycle. Dispose of used syringes in a sealable hard plastic or metal container (e.g.,empty detergent bottle or a special sharps container from your pharmacy). Keep this container away from children. When the container is full, seal the lid before placing it in the trash. Do not recycle or reuse syringes.
To avoid serious side effects (bleeding)
6. Tell your doctor about new medicines. Avoid starting or stopping other medicines without informingthe doctor who prescribed enoxaparin. This includes prescription medicines and nonprescription medicines such as aspirin, ibuprofen (Motrin, Advil), and naproxen (Aleve), which can increase your risk of bleeding.
7. Take precautions. Use an electric razor. Avoid sharp objects and fall risks (climbing a ladder, for example).
8. Tell your dentist and doctor. Let your physicians and dentists know you are taking enoxaparin before any surgery or procedure is scheduled and before any new medicine is prescribed or taken.
When you should call your doctor
9. Signs of bleeding or clot. Call your doctor immediately if you experience any signs of bleeding or clot formation, which are listed below.
10. Injection site redness. Call your doctor if you develop redness, swelling, burning, or pain in the abdomen where you injected the medicine.

To watch a video with step-by-step instructions for injecting enoxaparin (Lovenox), visit:
www.lovenox.com/consumer/prescribed-lovenox/self-inject/inject-lovenox.aspx.

 

Signs of bleeding

  • Unusual pain, swelling, discomfort (may also be a sign of a clot)
  • Unusual or easy bruising
  • Pink or brown urine
  • Prolonged bleeding of gums or cuts
  • Persistent, frequent nosebleeds that don't stop within 7 minutes
  • Unusually heavy/long menstrual flow
  • Coughing up blood
  • Vomit that is bloody or looks like coffee grounds
  • Rash of dark red or purple spots under the skin
  • Severe dizziness, weakness, confusion, headache, fainting, unusual tiredness
  • Tingling, numbness, muscle weakness in legs
  • Bloody or black stools
  • Pain in joints, back, or chest
  • Bleeding at the injection site

Signs of a clot

  • In the lung: chest pain, fast heart rate, coughing, shortness of breath, fever
  • In the arm or leg: sudden leg, arm, or back pain, swelling, redness and warmth, tenderness
  • In the brain: headache, vision changes, seizure, slurred speech, weakness on one side of body, dizziness
  • In the heart: chest pain, shortness of breath, sweating, nausea and vomiting
  • In the abdomen: abdominal pain, vomiting, diarrhea

 

Public Health Advisory

Caution with spinal anesthesia

Patients on enoxaparin who undergo spinal or epidural anesthesia or spinal puncture are at risk for bleeding into their spine. This may cause long-term or permanent paralysis. The risk of bleeding is greater in those who take nonsteroidal anti-inflammatory drugs such as Celebrex (celecoxib), Motrin (ibuprofen), and Aleve (naproxen). These patients should tell their doctor they are taking enoxaparin and immediately report any signs of spinal bleeding, especially tingling, numbness, and muscle weakness in the legs.

 

 Topics Fast Facts
Generic name
  • enoxaparin (pronounced ee noks a PA rin)
Brand name
  • Lovenox
Uses
  • Prevent blood clots after major surgeries (i.e., hip or knee replacement, abdominal surgery) or in very ill patients with limited mobility
  • Treat heart conditions such as angina or after certain heart attacks
Usual dose limits
  • 30 mg to 40 mg every 12 or 24 hours daily for 7 to 10 days for adult patients
  • Doses may vary by condition being treated and by body weight
What to do if you miss a dose
  • If it is still the same day, take the dose as soon as you remember it
  • If it is the next day, skip the missed dose and take your normal dose
  • Do not double the dose to catch up
  • Contact your doctor if you miss two or more doses in a row
Special instructions and precautions
  • Take exactly as prescribed, the same time each day
  • Do not make major changes to your diet unless instructed by your doctor
  • You will have a tendency to bleed easily, so use a soft toothbrush, waxed dental floss, electric razor; avoid sharp objects and fall risks (such as climbing a ladder)
  • Do not start or stop any medicine, including nonprescription medicines, herbals, and vitamins, without letting your doctor or pharmacist know
Safety during pregnancy/breastfeeding
  • Tell your doctor if you are pregnant or become pregnant
  • While breastfeeding, let the infant's doctor know for proper monitoring
Tell your doctor if you have:
  • Diseases: prosthetic heart valve or kidney impairment
  • Procedures: recently had or are going to have spinal or epidural anesthesia, or spinal injections, for surgery or to manage pain
Storage and disposal
  • Store at room temperature; do not freeze or refrigerate
  • Dispose of syringes securely in a hard container as noted in safety tip #5 (front page)
Side effects to report to your doctor immediately
  • Signs of bleeding or clot (see top of page), accidental falls or trauma (even if you feel fine), headache, confusion
Other conditions to report to your doctor
  • New or stopped medicines (including nonprescription drugs, herbals, and vitamins), changes in smoking or eating habits, infection, fever
Nonprescription medicines/herbals/vitamins that should not be taken with enoxaparin
  • Aspirin, nonsteroidal anti-inflammatory drugs (ibuprofen [Advil, Motrin], naproxen [Aleve]), most herbals (particularly cat’s claw, dong quai, evening primrose, feverfew, garlic, ginkgo, American ginseng, ginger, green tea, horse chestnut, red clover, alfalfa, anise, bilberry)
Prescription medicines that should not be taken with enoxaparin
  • Many prescription medicines interact with enoxaparin
  • Tell your doctor about all the medicines you take
Special tests your doctor may prescribe
  • Your doctor will determine when you will need a blood test done, usually to check your platelets (cells that help blood clot); also, stool and urine may be checked for blood

This information does not replace the need to follow your doctor's instructions and read the drug information leaflet provided with your prescription.

This project was supported by grant number R18HS017910 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not represent the official views of the Agency for Healthcare Research and Quality.