Apidra SoloStar

Indications

Insulin Glulisine is a rapid-acting insulin used to control blood sugar in adults and children with diabetes mellitus who need insulin. It is mainly used to cover the rise in blood sugar after meals and is usually combined with a longer-acting (basal) insulin.

How It Works

Insulin Glulisine is a man-made form of human insulin with small changes that let it be absorbed faster after injection. It starts working within about 15 minutes, peaks in about 1 hour and lasts a few hours. Like natural insulin, it helps muscle and fat cells take up glucose from the blood and reduces the amount of glucose released by the liver.

Dosage and Administration

The dose is set by your doctor and adjusted to your blood sugar readings, meals and activity. It is injected under the skin of the abdomen, thigh or upper arm, usually within 0 to 15 minutes before a meal or within 20 minutes after starting a meal. Change the injection spot each time to avoid lumps under the skin. In hospital it may also be given into a vein by a doctor or nurse. Never share pens or needles, even if the needle is changed.

Interactions

Many medicines change insulin needs. Blood sugar may drop further with other diabetes medicines, ACE inhibitors, Fluoxetine, MAO inhibitors, salicylates and some antibiotics. Blood sugar may rise with corticosteroids, thiazide diuretics, thyroid hormones, oral contraceptives, Olanzapine, Clozapine and some HIV medicines. Beta blockers such as Propranolol can hide the warning signs of low blood sugar. Alcohol can cause low blood sugar. Using Pioglitazone with insulin may cause fluid retention and heart failure. Tell your doctor about every medicine you use.

Contraindications

Do not use during an episode of low blood sugar (hypoglycaemia) or if you are allergic to Insulin Glulisine or any ingredient of the product.

Side Effects

The most common side effect is low blood sugar, with sweating, shaking, fast heartbeat, hunger, headache, blurred vision or confusion. Other effects include redness, swelling or itching at the injection site, thickening or hollowing of the skin where it is injected too often, weight gain and, rarely, low potassium.

Get urgent medical help for severe low blood sugar (confusion, fits, fainting or being unable to swallow), or signs of a serious allergic reaction such as widespread rash, swelling of the face or difficulty breathing. Someone with a low sugar who is awake should take sugar, glucose or a sweet drink straight away.

Pregnancy and Lactation

Good blood sugar control is very important in pregnancy. Insulin can be used in pregnancy and breastfeeding under close medical supervision, but insulin needs change during pregnancy and after delivery, so doses must be reviewed by your doctor.

Precautions and Warnings

• Check your blood sugar regularly, especially when changing dose, diet, exercise or during illness.
• Always eat a meal soon after injecting.
• Carry a source of sugar with you at all times.
• Kidney or liver disease, infection, stress and missed meals can change insulin needs.
• Take care driving or using machines if you are at risk of low blood sugar.
• Always check the insulin type and strength before injecting to avoid mix-ups.

Overdose

Too much insulin causes low blood sugar. Mild cases are treated with sugar or a sweet drink followed by a snack. Severe cases with unconsciousness or fits need emergency treatment with Glucagon injection or glucose into a vein, followed by monitoring because low sugar can come back.

Therapeutic Class

Rapid-acting insulin analogue (antidiabetic)

Storage

Store unopened pens and vials in a refrigerator at 2 to 8°C, do not freeze, and keep in the carton away from light. A pen or vial in use can be kept below 25°C for up to 28 days; do not put an in-use pen back in the fridge if the pack says so. Do not use insulin that has been frozen or looks cloudy or contains particles. Keep out of the reach of children.