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This document provides essential safety and warning information regarding the use of Novolin 70/30. Please read the following points carefully and discuss any concerns with your healthcare provider.

• Risk of Infections: Do not share Novolin 70/30 pens, syringes, or needles with others. Sharing injection supplies can significantly increase the risk of transmitting serious infections.

• Changes to Blood Sugar Levels: Altering your insulin regimen, such as changing the injection site or switching insulin brands, can impact your body's response to insulin, potentially leading to high or low blood sugar levels. Avoid injecting Novolin 70/30 into areas with lipodystrophy, as this may result in elevated blood sugar levels.

• Hypoglycemia Risk: Novolin 70/30 can cause dangerously low blood sugar levels. Regularly monitor your blood sugar to ensure it remains within a safe range. Factors that may affect blood sugar include dietary and exercise changes, alcohol consumption, use of other diabetes medications, and liver or kidney conditions.

• Low Potassium Levels: This medication may reduce potassium levels, posing risks especially if you are on other medications that lower potassium, such as diuretics. Your prescriber may monitor your potassium levels and provide treatment if necessary. Report symptoms like weakness, muscle cramps, nausea, vomiting, or irregular heartbeats to your prescriber.

• Fluid Retention and Heart Failure Risk: Combining Novolin 70/30 with glitazones, such as pioglitazone, can cause fluid retention, potentially leading to or worsening heart failure. Alert your prescriber if you experience sudden weight gain, swelling, breathing difficulties, or fatigue. Adjustments to your diabetes management may be needed.

• Contraindications: Do not use Novolin 70/30 during episodes of low blood sugar (hypoglycemia). Consult your healthcare provider if you have any concerns or questions regarding these conditions.

Common side effects:

• Low blood sugar
• Mild reactions at the injection site (redness, swelling, itching)

Less common but important to monitor:

• Weight gain
• Swelling in areas like the legs, ankles, or feet
• Changes at the injection site (fat deposits or pitting of the skin)

Serious side effects:

• Severely low blood sugar (dizziness, shakiness, confusion, irritability, faintness, sweating, extreme hunger)
• Dangerously low potassium levels (weakness, muscle cramps, constipation, abnormal heartbeat, tiredness, trouble breathing)
• Severe allergic reactions (rash, hives, swelling of the face, tongue, or throat, difficulty breathing)

When using Novolin 70/30, it's important to be aware of potential interactions with other medications and substances that can affect blood sugar levels. Some drugs may increase the risk of low blood sugar (hypoglycemia), while others might reduce the effectiveness of insulin, leading to high blood sugar (hyperglycemia). Additionally, certain substances can mask the symptoms of hypoglycemia, making it harder to recognize and treat.

Medications That May Increase the Risk of Hypoglycemia:

• Antidiabetic agents: Combining Novolin 70/30 with other diabetes medications can enhance blood sugar-lowering effects.
• ACE inhibitors and angiotensin II receptor blockers: These blood pressure medications may amplify insulin's effects.
• Certain heart medications: Drugs like disopyramide and fibrates can increase insulin sensitivity.
• Antidepressants: Fluoxetine and monoamine oxidase inhibitors may enhance insulin's action.
• Other agents: Medications such as Pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., Octreotide), and sulfonamide antibiotics can also heighten the risk of hypoglycemia.

Medications That May Decrease Insulin's Effectiveness:

• Atypical antipsychotics: Medications like Olanzapine and Clozapine can raise blood sugar levels.
• Corticosteroids: Often used for inflammation, these can counteract insulin's effects.
• Hormonal therapies: Estrogens, progestogens (found in some contraceptives), and thyroid hormones may interfere with blood sugar control.
• Other agents: Drugs such as Danazol, diuretics, glucagon, Isoniazid, Niacin, phenothiazines, protease inhibitors, somatropin, and sympathomimetic agents (e.g., Albuterol, Epinephrine, Terbutaline) can reduce insulin's efficacy.

Substances That May Increase or Decrease Insulin's Effectiveness:

• Alcohol: Consuming alcohol can unpredictably affect blood sugar levels, sometimes causing hypoglycemia or hyperglycemia.
• Beta-blockers, Clonidine, and lithium salts: These can either enhance or diminish insulin's blood sugar-lowering effects.
• Pentamidine: This medication may initially cause low blood sugar, followed by high blood sugar.

Substances That May Mask Hypoglycemia Symptoms:

• Beta-blockers, clonidine, guanethidine, and reserpine: These can obscure the typical signs of low blood sugar, such as rapid heartbeat and tremors, making it more challenging to detect and treat hypoglycemia promptly.

Lifestyle Considerations:

• Alcohol Consumption: Drinking alcohol while on Novolin 70/30 increases the risk of hypoglycemia. It's advisable to limit or avoid alcohol intake and monitor blood sugar levels closely if you choose to drink.
• Tobacco Use: Smoking can worsen insulin resistance, making blood sugar control more difficult. Quitting smoking is beneficial for overall health and diabetes management.

Always inform your healthcare provider about all medications, supplements, and lifestyle habits to ensure safe and effective use of Novolin 70/30. Regular monitoring of blood sugar levels and open communication with your healthcare team are essential for optimal diabetes management.