For subcutaneous injection only as advised by the doctor (commonly 1–2 times daily, usually 30 minutes before meals). Roll the vial gently to resuspend (do not shake vigorously). Use insulin syringe suitable for U-40 strength; rotate injection sites (abdomen, thigh, upper arm). Do not use if clumped/particles or if solution appears abnormal.

Hypoglycaemia (low blood sugar), injection site pain/redness/swelling, weight gain, lipodystrophy at injection site, allergic reactions (rash/itching), edema

Risk of severe hypoglycaemia—monitor blood glucose regularly and carry fast-acting glucose. Dose adjustments may be needed with changes in diet, exercise, illness, renal/hepatic impairment, or when switching insulin brands/strengths. Do not inject intravenously; not for insulin pumps. Use correct strength syringes (U-40) to avoid dosing errors. Seek urgent help for severe allergy (wheezing, swelling, generalized rash) or recurrent hypoglycaemia.

Other antidiabetics, ACE inhibitors, ARBs, salicylates, MAO inhibitors and alcohol may increase hypoglycaemia risk; corticosteroids, thiazide/loop diuretics, thyroid hormones, sympathomimetics and oral contraceptives may increase blood glucose; beta-blockers may mask hypoglycaemia symptoms; atypical antipsychotics may worsen glycaemic control

Store unopened vial refrigerated at 2–8°C; do not freeze. Protect from light. After opening, keep as per label guidance (often at room temperature below 25–30°C) and use within the recommended period; avoid heat and direct sunlight.

Huminsulin 50/50 40IU Injection (vial), Insugen 50/50 40IU Injection (vial), Actrapid + Insulatard mix equivalent 50/50 (U-40) (as prescribed), Human Mixtard 50/50 40IU Injection (vial)