ProZinc Insulin U-40 for Dogs and Cats, slide 1 of 1

ProZinc Insulin U-40 for Dogs and Cats

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Size: 10-mL
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Description

ProZinc is a protamine zinc insulin prescribed by veterinarians to help support the insulin levels of diabetic cats and dogs. It typically effects your pet for 10-14 hours at a time, which helps to keep their blood glucose level consistent throughout the day. It contains recombinant DNA that mimics human insulin, so it helps to control your pet's diabetic symptoms and keeps them comfortable.

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Uses

PROZINC (protamine zinc recombinant human insulin) is an injectable insulin for cats and dogs. PROZINC is an aqueous suspension of protamine zinc recombinant human insulin that is indicated to reduce hyperglycemia (high blood glucose or high blood sugar) and clinical signs associated with hyperglycemia in cats and dogs with diabetes mellitus.

Possible Side Effects

Cats and dogs presenting with severe ketoacidosis, anorexia, lethargy, and/or vomiting should be stabilized with short-acting insulin and appropriate supportive therapy until their condition is stabilized. As with all insulin products, careful patient monitoring for hypoglycemia and hyperglycemia is essential to attain and maintain adequate glycemic control and to prevent associated complications. Overdose can result in profound hypoglycemia and death. Glucocorticoids, progestogens, and certain endocrinopathies can have an antagonistic effect on insulin activity. Glucocorticoid and progestogen use should be avoided. The safety and effectiveness of PROZINC in breeding, pregnant, and lactating cats and dogs has not been evaluated. The safety and effectiveness of PROZINC in kittens and puppies has not been evaluated.

Drug & Food Interactions

Talk to your veterinarian about any other drugs your cat or dog is taking before starting this medication.

Precautions

PROZINC (protamine zinc recombinant human insulin) is for use in cats and dogs only. Keep out of the reach of children. Avoid contact with eyes. In case of contact, immediately flush eyes with running water for at least 15 minutes. Accidental injection may cause hypoglycemia. In case of accidental injection, seek medical attention immediately. Exposure to product may induce a local or systemic allergic reaction in sensitized individuals. As with all insulin products, careful patient monitoring for hypoglycemia and hyperglycemia is essential to attain and maintain adequate glycemic control and to prevent associated complications. Overdose can result in profound hypoglycemia and death. The most common adverse reactions were lethargy, anorexia, hypoglycemia, vomiting, seizures, shaking (dogs only), diarrhea, and ataxia. Many of the adverse reactions, such as lethargy, seizures, shaking (dogs only), and ataxia, are associated with hypoglycemia. The safety and effectiveness of PROZINC in puppies, kittens, or breeding, pregnant, and lactating animals has not been evaluated. PROZINC is contraindicated during episodes of hypoglycemia and in animals sensitive to protamine zinc recombinant human insulin or any other ingredients in PROZINC. For additional information, please see full prescribing information.

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  1. Prescribing Information

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  • Item Number
    146872
  • Generic Name
    Protamine Zinc Recombinant Human Insulin
  • For Use With
    Dogs & Cats
  • Administration Form
    Injection
  • Common Brand Name(s)
    Protamine zinc recombinant human insulin
  • Lifestage
    Adult
  • Product Form
    Injectable
  • Health Condition
    Diabetes
  • Drug Type
    Insulin, Hormone
Ingredients

Insulin, Protamine Sulfate, Zinc Oxide, Glycerin, Dibasic Sodium Phosphate, Heptahydrate Phenol (added as a preservative), Hydrochloric Acid. Water for Injection (maximum).

Instructions
Recommended Dosage

USE OF A SYRINGE OTHER THAN A U-40 SYRINGE WILL RESULT IN INCORRECT DOSING. FOR SUBCUTANEOUS INJECTION ONLY. DO NOT SHAKE OR AGITATE THE VIAL. PROZINC (protamine zinc recombinant human insulin) should be mixed by gently rolling the vial prior to withdrawing each dose from the vial. Once mixed, PROZINC suspension has a white, cloudy appearance. Clumps or visible white particles can form in insulin suspensions: do not use the product if clumps or visible white particles persist after gently rolling the vial. Using a U-40 insulin syringe, the injection should be administered subcutaneously on the back of the neck or on the side of the cat or dog. FOR CATS: The initial recommended PROZINC dose is 0.1 - 0.3 IU insulin/pound of body weight (0.2 - 0.7 IU/kg) every 12 hours. The dose should be given concurrently with or right after a meal. The veterinarian should re-evaluate the cat at appropriate intervals and adjust the dose based on both clinical signs and glucose nadirs until adequate glycemic control has been attained. In the effectiveness field study, glycemic control was considered adequate if the glucose nadir from a 9-hour blood glucose curve was between 80 and 150 mg/dL and clinical signs of hyperglycemia such as polyuria, polydipsia, and weight loss were improved. Further adjustments in the dosage may be necessary with changes in the cats diet, body weight, or concomitant medication, or if the cat develops concurrent infection, inflammation, neoplasia, or an additional endocrine or other medical disorder. FOR DOGS: Starting dose: The recommended starting dose for PROZINC is 0.2-0.5 IU insulin/pound of body weight (0.5- 1.0 IU/kg) once daily. The recommended starting dose for naïve dogs is the lower end of the dose range. The recommended starting dose for dogs with poorly controlled diabetes mellitus and transitioning from another insulin product is the mid to higher end of the dose range based on the veterinarians experience with the dogs medical history and previous insulin dose. When transitioning from another insulin, the dogs blood glucose and general condition should be closely monitored. When transitioning from another insulin, PROZINC should be started once daily, regardless of the frequency of prior insulin use. The dose should be given concurrently with or right after a meal. The veterinarian should reevaluate the dog at appropriate intervals and adjust the dose and frequency based on both clinical signs and laboratory test results (the blood glucose curve values and shape, nadir, and fructosamine) until adequate glycemic control has been attained. In the effectiveness field study, glycemic control was considered adequate if the glucose nadir from a 9-hour blood glucose curve was between 80 and 125 mg/dL, the maximum blood glucose was < 300 mg/dL, and clinical signs of hyperglycemia such as polyuria, polydipsia, or weight loss were improved. Changing to twice daily dosing: Twice daily dosing should be considered if the duration of insulin action is determined to be inadequate with once daily dosing. Use caution when adjusting from once daily to twice daily dosing because PROZINC may have prolonged duration of action in some dogs (see Clinical Pharmacology). The veterinarian should closely monitor the duration of action using blood glucose curves to avoid the increased risk of hypoglycemia. If twice daily dosing is initiated, the two doses should each be approximately 25% less than the once daily dose required to attain an acceptable glucose nadir. For example, if a dog receiving 10 units of PROZINC once daily has an acceptable nadir but inadequate duration of activity, the dose should be changed to 7 units twice daily (round down to the nearest whole unit). Further adjustments in the dosage may be necessary with changes in the dogs diet, body weight, or concomitant medication, or if the dog develops concurrent infection, inflammation, neoplasia, or an additional endocrine or other medical disorder.

Storage Instructions

Store in an upright position under refrigeration at 36-46 F (2-8 C). Do not freeze. Protect from light. Use the 10 mL vial within 60 days of first puncture. Use the 20 mL vial within 80 days of first puncture.

FAQ

What is Prozinc?

Prozinc is an aqueous protamine zinc suspension of recombinant human insulin that is used to reduce high blood sugar (hyperglycemia) in dogs or cats with diabetes mellitus. A veterinarian must prescribe Prozinc for your dog or cat. Prozinc should be given only to the dog or cat for which it is prescribed. Keep out of reach of children. Seek medical attention immediately if you accidentally inject yourself with Prozinc.

What is diabetes mellitus?

Diabetes mellitus occurs when a dog or cat has insufficient levels of, or an abnormal response to, insulin. The low insulin levels may result in high blood glucose that could produce the following changes in your dog or cat:

  • Increased thirst.
  • Increased urination.
  • Increased appetite .
  • Weight loss.
  • High levels of glucose in the urine (glycosuria).
  • Weakness in the back legs.

What kind of results can I expect when my dog or cat is on ProZinc insulin for diabetes mellitus?

Although ProZinc insulin is not a cure for diabetes mellitus, it can help reduce the levels of glucose in the blood, which can help alleviate the clinical signs.

What should I discuss with my veterinarian before giving ProZinc insulin?

Talk to your veterinarian about:

  • The signs of diabetes mellitus you have observed (for example, increased thirst and urination).
  • The importance of proper insulin storage, handling, and administration techniques (for example, how to gently roll the vial prior to each use, the proper appearance of the product after mixing, how to fill the U-40 syringe with the proper amount of insulin, and where and how to inject the insulin).
  • The importance of maintaining the dog or cat under the same conditions for diet, exercise, environment, etc.
  • The importance of follow-up visits for testing to determine if dose adjustments of ProZinc insulin are necessary. Tell your veterinarian about:
  • Any side effects your dog or cat has had when receiving other insulin products.
  • Any medical problems or allergies that your dog or cat has now or has had in the past.
  • All medications that you are giving your dog or cat or plan to give your dog or cat, including those you can get without a prescription.
  • If your dog or cat is pregnant, nursing, or if you plan to breed your dog or cat.

What are the possible side effects that may occur in my dog or cat during ProZinc therapy?

ProZinc insulin, like other drugs, may cause some side effects. Serious side effects can occur with or without warning. Please contact your veterinarian immediately if you think your dog or cat has a medical problem or side effect of ProZinc therapy. The most common insulin-related side effect is low blood glucose (hypoglycemia). Signs of hypoglycemia may occur suddenly and can include:

  • Weakness.
  • Depression, lethargy, sluggishness.
  • Staggering gait.
  • Behavioral changes.
  • Muscle twitching.
  • Seizures.
  • Coma.
  • Death.

What actions do I take if my dog or cat shows signs of hypoglycemia?

  • If your dog or cat is unconscious or having a seizure, this is a medical emergency. Take your dog or cat to the veterinarian immediately.
  • If your dog or cat is conscious, rub approximately 1 tablespoon of corn syrup or honey on your cat’s gums. When it is able to swallow, give corn syrup or honey by mouth until your dog or cat is alert enough to eat. Feed the usual meal and contact your veterinarian.

When should my dog or cat not be given ProZinc insulin?

Do not give your dog or cat its prescribed dose of ProZinc insulin if it:

  • Is experiencing an episode of low blood glucose (hypoglycemia). Common causes for hypoglycemia include excessive doses of insulin, failure to eat, strenuous exercise, changes in the body’s need for insulin, diabetes-inducing disease or drug effects.
  • Is not eating or is vomiting.
  • Is sensitive to protamine zinc recombinant human insulin or any other ingredients in ProZinc product.
  • Do not give your dog or cat its prescribed dose of ProZinc insulin if you see clumps or visible white particles in the vial after gently rolling.

How should I give ProZinc insulin to my dog or cat?

Give ProZinc insulin with U-40 syringes only. Use of a syringe other than a U-40 syringe will result in incorrect dosing. Gently roll the vial until the ProZinc has a uniformly cloudy, white appearance. If there are clumps or visible white particles in the vial after gently rolling, do not use the ProZinc and you’re your veterinarian. ProZinc insulin should be given according to your veterinarian’s instructions. Your veterinarian will tell you what amount of ProZinc insulin is right for your dog or cat and instruct you on techniques for administration.

Can ProZinc insulin be given with other medications?

ProZinc insulin can be given with other medications, but the dose may need to be adjusted due to the medication resulting in either increased or decreased insulin requirements. Tell your veterinarian about all medications you have given your cat in the past, and any medications that you are planning to give with ProZinc insulin. This should include medications that you can get without a prescription. Your veterinarian may want to ensure that all of your dog or cat’s medications can be given together.

What should I do if I inject more than the prescribed amount of ProZinc insulin?

Contact your veterinarian immediately and, if your veterinarian is not available, seek other veterinary advice at once.

What should I do if my dog or cat receives less than the prescribed dose, or I miss an injection?

  • Contact your veterinarian as soon as possible for advice on your dog or cat’s next dose.
  • If you cannot reach your veterinarian and your dog or cat is eating and acting normally, give your cat the usual dose at the next regularly scheduled injection time.

How should I store ProZinc insulin?

ProZinc insulin should be stored in an upright position under refrigeration at 36 - 46°F (2 - 8°C). Do not freeze. Protect from light.

What else should I know about ProZinc insulin?

If you have any questions or concerns about the product or diabetes mellitus, talk to your veterinarian. As with all prescribed medications, ProZinc insulin should only be given to the dog or cat for which it is prescribed and for the condition for which it was prescribed. It is important to periodically discuss your dog or cat’s response to ProZinc insulin at regular checkups that may include blood glucose monitoring. Your veterinarian will best determine if your dog or cat is responding as expected and should continue receiving ProZinc insulin.

What is the best number to call regarding any specific product questions?

For any specific product questions, please call Boehringer Ingelheim Animal Health’s customer service line number at 1-888-637-4251.

About Prozinc

The Importance of Insulin

The hormone, insulin, gets glucose into cells so it can be used as an energy source. Diabetic pets either can’t produce enough insulin or don’t respond to it properly, and if they don’t get the insulin injections they need, they can suffer from serious health issues caused by high blood glucose. Closely follow your vet’s guidance on how to give PROZINC (protamine zinc recombinant human insulin). 

Prozinc
Dog Walking

Once Daily Use In Dogs

PROZINC was designed to help regulate blood glucose in dogs with just one injection each day.¹ You may not see results immediately, as it can take up to 6 weeks for insulin to regulate blood glucose. Talk to your vet about what to expect when you begin PROZINC and ask how long it may take for your dog to achieve regulation.

Fast in Cats and Affordable

FDA-approved PROZINC helps control diabetic symptoms quickly in cats, and you may see improvement in as little as 7 days. It can help decrease the excessive thirst and urination caused by diabetes,² with overall results comparable to human insulin products³ at a much lower cost.

Cat Resting
Dog and Cat

You Can Do This

Getting a diabetes diagnosis can feel overwhelming, but you are not alone—hundreds of thousands of pets in America are living with diabetes.⁴ You can help keep your diabetic pet healthy by maintaining a set insulin routine, following vet recommendations on diet, activity and play, and bringing your pet in for regular checkups. Call your vet for advice if you’re ever uncertain. 

References:

1. Ward CR, Christiansen K, Li J, et al. Field efficacy and safety of protamine zinc recombinant human insulin in 276 dogs with diabetes mellitus. Dom Anim Endocrin. 2021;75.
2. HNelson RW, Henley K, Cole C, et al. Field safety and efficacy of protamine zinc recombinant human insulin for treatment of diabetes mellitus in cats. J Vet Intern Med. 2009;23:787-793.
3.Gostelow R, Scudder C, et al. One-year prospective randomized trial comparing efficacy of glargine and protamine zinc insulin in diabetic cats. Abstract format. ACVIM Forum 2017.
4.State of Pet Health Report. Banfield Pet Hospital website. https://www.banfield.com/state-of-pet-health. Accessed October 27, 2020.

Important Safety Information

PROZINC is for use in dogs and cats only. Keep out of the reach of children. Owners should be advised to observe for signs of hypoglycemia (low blood sugar). Signs may include weakness, depression, behavioral changes, muscle twitching, and anxiety. In severe cases of hypoglycemia, seizures and coma can occur. Hypoglycemia can be fatal if an affected animal does not receive prompt treatment. PROZINC should not be used during episodes of hypoglycemia (low blood sugar). Appropriate veterinary monitoring of blood glucose, adjustment of insulin dose and regimen as needed, and stabilization of diet and activity help minimize the risk of hypoglycemic episodes. The attending veterinarian should evaluate other adverse reactions on a case-by-case basis to determine if an adjustment in therapy is appropriate, or if alternative therapy should be considered. The safety and effectiveness of PROZINC in puppies, kittens, or breeding, pregnant, and lactating animals has not been evaluated. For more information, see full prescribing information.

About PROZINC

PROZINC is an FDA-approved insulin created for veterinary use in the treatment of diabetes. PROZINC comes from Boehringer Ingelheim, the same company that manufactures HEARTGARD Plus (ivermectin/pyrantel), NexGard (afoxolaner) and FRONTLINE Brand products, plus other leading animal vaccines and medicines. They offer a number of helpful resources for people caring for diabetic pets, including educational and administration videos, treatment diaries and more.

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