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The information below highlights important safety concerns and warnings associated with the use of this medication. Please read carefully and consult your healthcare professional if you have any questions or concerns.

• Infections or Diseases: To prevent the transmission of serious infections or diseases, do not share Novolin R pens, syringes, or needles with others.

• Low Blood Sugar (Hypoglycemia): Use of Novolin R, alone or in combination with other diabetes medications, may lead to low blood sugar levels, which can be life-threatening. Symptoms may include shakiness, anxiety, rapid heartbeat, sweating, confusion, drowsiness, weakness, and extreme hunger. These symptoms can vary among individuals and may occur suddenly. It is important to be prepared to manage low blood sugar by having fast-acting sugar available at all times, such as glucose tablets, hard candy, or fruit juice. Increased risk factors include changes in diet and exercise, alcohol consumption, use of other diabetes medications, age over 65, and liver or kidney issues, as well as improper insulin injection.

• Low Blood Potassium Levels: Use of Novolin R can result in decreased potassium levels, which may be hazardous. This risk is heightened if you are taking medications that also lower potassium. Regular monitoring of potassium levels by your healthcare provider is essential, and they may prescribe treatments to maintain normal levels. Symptoms of low potassium include weakness, muscle cramps, digestive issues, irregular heartbeats, and kidney problems. Risks are increased with the use of laxatives or medications that increase urination.

• Swelling and Heart Failure: Combining Novolin R with thiazolidinediones (PPAR-gamma agonists like pioglitazone or rosiglitazone) can lead to fluid retention, which can exacerbate heart failure. It is critical to inform your healthcare provider of your full medical history before starting this medication, especially if you have heart failure.

Contraindications: Novolin R should not be used if you experience episodes of low blood sugar (hypoglycemia). Consult your healthcare provider if this condition applies to you.

When using this medication, some individuals may experience common side effects such as low blood sugar (hypoglycemia), injection site reactions (including redness, warmth, or changes in skin color), weight gain, swelling (edema), and changes in fat tissue distribution (lipodystrophy). These effects are generally mild, but if they persist or worsen, consult a healthcare provider for guidance.

However, there are more serious side effects that require immediate medical attention. Severe hypoglycemia is a critical condition that, if untreated, can lead to unconsciousness, seizures, or even death. Symptoms of dangerously low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling in the hands or feet. To manage this, it is advisable to carry glucose tablets or gel and to consume a quick source of sugar like table sugar, honey, candy, or a sugary beverage if symptoms arise.

This medication can also cause dangerously low potassium levels, which may manifest as muscle cramps, weakness, or an irregular heartbeat. If not promptly addressed, it can lead to severe complications such as difficulty breathing or heart issues. Additionally, although rare, severe allergic reactions are possible, characterized by rash, hives, swelling of the face, tongue, or throat, and difficulty breathing. Should any of these symptoms occur, seek emergency medical help immediately.

Lastly, high blood sugar (hyperglycemia) can occur, leading to increased thirst and urination. If these symptoms are present, a doctor may need to adjust your diabetes management plan. This summary is not exhaustive of all potential side effects, so if you notice any other unexpected reactions, contact a healthcare professional for advice.

Beta-blocker medications, such as metoprolol, Propranolol, and Timolol (often found in glaucoma eye drops), can mask the fast or pounding heartbeat typically experienced when blood sugar levels drop too low, a condition known as hypoglycemia. However, they do not affect other low blood sugar symptoms like dizziness, hunger, or sweating. Many medications can influence your blood sugar levels, complicating diabetes management. It is crucial to consult your doctor or pharmacist before starting, stopping, or changing any medication, as it may impact your blood sugar. Regularly monitor your blood sugar as per your doctor's instructions, and report any symptoms of high or low blood sugar. Your doctor might need to adjust your diabetes medication, exercise routine, or diet accordingly.

Additionally, Novolin R, a type of insulin, can interact with various medications. It's important to inform your doctor and pharmacist about all medications and supplements you are taking, including prescriptions, over-the-counter drugs, vitamins, and herbal products. The interaction list for Novolin R includes several beta-blockers like Acebutolol, Atenolol, Bisoprolol, Carvedilol, Labetalol, metoprolol, propranolol, and timolol, among others. While using these medications together may increase the risk of side effects, your doctor may determine that the combination is necessary. In such cases, they might adjust the dosage or frequency of one or both medications to optimize treatment.