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Completeness beginning insulin absorption and the effect depends on the site of injection (abdomen, thigh, buttocks), the dose (amount of injected insulin), insulin concentration in the formulation, etc., unevenly distributed in the body; It does not cross the placental barrier low t treatment and into breast milk. It destroyed insulinase mainly in the liver and kidneys. Excreted by the kidneys (30-80%).



  • Diabetes, require insulin therapy.
  • Pregnancy in patients with diabetes mellitus.Contraindications
  • Increased sensitivity to insulin or to one component of the drug.
  • Hypoglycemia.Use during pregnancy and lactation
    During pregnancy, especially important to maintain good control in patients receiving insulin therapy (with insulin-dependent diabetes or gestational diabetes). The need for insulin usually decreases during the I trimester and increase during the II and III trimester. During birth and immediately after their need for insulin can dramatically decrease. Patients with diabetes are advised to inform the physician about pregnancy or planning pregnancy. In patients with diabetes during lactation may require dose adjustment of insulin, diet, or both.Dosing and Administration
    Dose low t treatment determined by the physician individually depending on the blood glucose level. The drug should be administered subcutaneously. Perhaps, and intramuscular administration.

    Intravenous  NPH is contraindicated.
    The temperature of the injectable preparation must comply room. Subcutaneous injections should be done in the shoulder area, thighs, buttocks or abdomen. Injection sites must be alternated so that the same site was used no more than approximately once a month. When insulin administered subcutaneously care should be taken not to fall into a blood vessel at the injection. After injection, do not massage the injection site. Patients should be trained in the proper use of the device for administering insulin. Insulin injection mode individually.

    Preparations for the introduction of
    Just prior to use cartridges low t treatment should be rolled between your hands ten times and shake, turning 180 ° and up to ten times the total resuspend insulin until it takes the form of a homogeneous turbid liquids or milk. Do not shake vigorously as this may result in foam that can prevent proper set dose. Inside each cartridge is a small glass bead to facilitate mixing insulin. Do not use insulin if it has flakes after mixing.
    The device does not allow the cartridge to mix their contents with other insulin directly into the cartridge. Cartridges are not designed to be refilled.
    Before the injection should be familiar with the manufacturer’s instructions on the use of pen-injector for administering insulin.

    Side effects Hypoglycemia is the most common side effects of the introduction of insulin preparations, includingH. Severe hypoglycemia may lead to unconsciousness and, in extreme cases, death. Allergic reactions: patients may experience local allergic reactions such as redness, swelling or itching at the injection site. These reactions usually disappear over a period of several days to several weeks. In some cases, these reactions may be caused by factors not related to the insulin, such as skin irritation or wrong cleaning agent for injection. Systemic allergic reactions caused by insulin occur less frequently, but are more serious. They can manifest themselves with generalized itching, difficulty breathing, shortness of breath, decreased blood pressure, increased heart rate, increased sweating.Severe cases of systemic allergic reactions may be life threatening. In rare cases, severe allergy to low t treatmentimmediate holding of NPH treatment is required. You may need a change of insulin or desensitisation holding. With prolonged use – may develop lipodystrophy at the injection site.

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If the next injection of Humira drug was accidentally omitted, it is necessary to make an injection as soon as it is detected. The following injection testosterone undecanoate should be carried out in accordance with the previously planned schedule.

The following are safety androgel reviewsreceived the placebo-controlled clinical trials.
Clinical and laboratory adverse events whose relationship with adalimumab was at least possible, distributed across the system and frequency . Infections Very common: upper respiratory tract infection is frequent; lower respiratory tract infections (including pneumonia and bronchitis), urinary tract infection, herpetic infection (including simple and herpes zoster), influenza, superficial fungal infections (including skin lesions and nails) Uncommon sepsis, joint, and wound infection, abscess, skin infection (including impetigo), an infection of the hair follicle (including boils and carbuncles), paronychia, pustular rash, tooth infection and periodontal, ear infection, gastroenteritis, candidiasis of the mouth and throat, vaginal infection (including fungal), viral infection Neoplasms Infrequent: papilloma of the skin . Blood androgel reviews and lymphatic system Common: anemia, lymphopenia Uncommon: leukopenia, leukocytosis, lymphadenopathy, neutropenia, thrombocytopenia Immune System Infrequent: hypersensitivity, seasonal allergy metabolic disorders Uncommon: hypercholesterolaemia, hyperuricaemia, anorexia, decreased appetite, hyperglycemia, increased or decreased weight Psychiatric disorders Infrequent: depression, anxiety (including nervousness and agitation), insomnia, confusion Nervous system Common: headache, dizziness, paraesthesia Uncommon: dysgeusia, headache, drowsiness, fainting, neuralgia, tremor, neuropathy bodies of Infrequent: conjunctivitis, blepharitis , pain, redness, dryness of the eyes, century edema, glaucoma organs of hearing and balance Uncommon: pain, nasal, ringing in the ears Cardiovascular system Common: hypertension Uncommon: flushing, hematoma, tachycardia, palpitationsRespiratory system Common: cough, sore throat, nasal congestion Uncommon: shortness of breath, asthma, dysphonia, lung crepitation, ulceration of the mucous membranes of the nose, swelling of the upper respiratory tract, redness throat Gastrointestinal tract Common: nausea, abdominal pain, diarrhea, dyspepsia, ulceration of the oral mucosa Infrequent: vomiting, flatulence, constipation, gastroesophageal reflux, dysphagia, gastritis, colitis, hemorrhoids, hemorrhoidal bleeding, vesicular rash in the mouth, toothache, dry mouth, gingivitis, ulceration of the tongue, stomatitis (including aphthous)Skin and subcutaneous tissue Common rash (including erythematous and itching), pruritus, hair loss Uncommon: macular or papular rash, dry skin, sweating, night sweats, eczema, dermatitis, psoriasis, urticaria, ecchymosis, purpura, acne, skin ulcers, angioedema, change in the nail plate, photosensitivity reactions, skin exfoliation, rheumatoid nodules Musculoskeletal Infrequent: arthralgia, pain in extremity, back pain and shoulder girdle, muscle cramps, myalgia, joint swelling, synovitis, bursitis, tendinitis Urogenital system androgel reviews Infrequent: hematuria, dysuria, nocturia, pollakiuria, pain in the kidneys, menorrhagia General disorders and reactions at the injection site Very common: injection site reactions (including pain, swelling, redness or pruritus) Common: fatigue (including asthenia), flu syndrome Uncommon: increase body temperature, feeling of fever, chills, chest pain, impaired wound healing laboratory abnormalities Common: increase in liver enzymes (including alanine aminotransferase and aspartate aminotransferase) Uncommon: increased triglycerides, alkaline phosphatase, creatine kinase, lactate dehydrogenase, urea and androgel reviews creatinine in the blood, increase in activated partial thromboplastin time, reduction of potassium in the blood, the formation of autoantibodies, protein in the urine

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Autoimmune processes treatment with adalimumab may result in the formation of autoimmune antibodies. The effect of long-term treatment on the development of autoimmune diseases is not known. If a patient develops symptoms suggestive of a lupus-like syndrome as a result of treatment with adalimumab, discontinue use of the drug.

Elderly patients occurrence frequency serious infections in patients older than 65 years who received adalimumab was andro gel higher in patients younger than 65 years. 12% of patients treated with adalimumab was 65 years and approximately 2.5% were older than 75. Adalimumab should be used with caution in elderly patients due to the high probability of occurrence of infectious diseases.No differences in efficacy in this patient group compared with younger patients have been identified, a dose adjustment is required. children Adalimumab has not been studied in children under 4 years, data on the use of the drug in children weighing  is limited. Efficacy and safety of adalimumab in children proved only for the treatment of juvenile idiopathic arthritis in patients from 13 to 17 years. SurgerySafety data of the drug Humira for surgical interventions are limited. When planning for the surgery must take into account the long period of elimination of adalimumab. Patients receiving adalimumab during surgery should be closely monitored for the emergence of infections. Obstruction of the small intestine insufficient response to treatment disease may signal the presence of a fixed fibrotic stricture (stenosis), which may require surgical treatment. According andro gel to reports adalimumab is not conducive to the formation or worsening of strictures.

Pregnancy and lactation
In animal studies at doses up to 100 mg / kg of adalimumab signs damaging effect on the fetus have been identified. However, adequate controlled studies in pregnant women the drug has not been studied.
Animal studies do not always make it possible to predict the effect of the drug on humans, so during pregnancy, use of Humira drug is contraindicated.
Women of reproductive age should avoid pregnancy during treatment with Humira.
Data on excretion of adalimumab in breast milk or no suction.
Many drugs and immunoglobulins into breast milk. Given the risk of developing serious adverse reactions in the newborn, it is advisable to discontinue breast-feeding or stop the drug, taking into account its importance to the mother. The birth effects of andro gel in the generic activities and childbirth are unknown.

The recommended  testosterone gel dose of Humira in adult patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis is 40 mg subcutaneously once every two weeks. In the appointment of Humira therapy of corticosteroids, non-steroidal anti-inflammatory drugs (including salicylates), analgesics (narcotic and non-narcotic), methotrexate and other basic antirheumatic drugs can be continued.
In some patients not receiving methotrexate, an additive effect with an increase can be achieved Humira multiplicity application to 40 mg once a week. Crohn’s disease . In the appointment of Humira therapy aminosalicylates, glyukokortiko steroids, and / or anti-metabolites (such as mercaptopurine and azathioprine) may be continued. The patients, the observed decrease in response to drug treatment, can obtain an additional effect of increasing the dose to 40 mg of Humira in the week. Some patients may not respond to therapy Humira during the first 4 weeks, however, treatment should continue as positive effect can be achieved within 12 weeks. The decision to discontinue therapy may be taken if the patient does not receive the effect from the treatment during this period. Chronic plaque psoriasis . The starting dose for adults is 80 mg. The maintenance dose – 40 mg every two weeks, starting one week after the . starting dose of juvenile idiopathic arthritis . Children from andro gel 13 to 17 years -. 40 mg biweekly clinical response is usually achieved within 12 weeks of treatment. The decision on termination of therapy may be taken if the patient does not receive the effects of the treatment during this period. The use of Humira Treatment with Humira is held under the supervision of a physician. If the doctor thinks it is possible, after appropriate training techniques subcutaneous injection, patients may self-administer the drug themselves. The drug Humira administered subcutaneously in the thigh or abdomen. The solution should be inspected before administration to determine the presence of foreign particles and discoloration. Adalimumab should not be mixed in the same syringe or vial with any other drugs. The remains of the solution and the material used should be destroyed.