Insulin glulisine Subcutaneous

IN-su-lin GLOO-lis-een

Commonly used brand name(s)

In the U.S.

• Apidra

Available Dosage Forms:

• Solution

Therapeutic Class: Antidiabetic

Pharmacologic Class: Insulin, Ultra Rapid Acting

Uses For insulin glulisine

Insulin glulisine is a fast-acting type of human insulin. Insulin is used by people with diabetes mellitus to help keep blood sugar levels under control. If you have diabetes, your body cannot make enough insulin or does not use insulin properly. So, you must take additional insulin to regulate your blood sugar and keep your body healthy. This is very important as too much sugar in the blood can be harmful to your health. Since insulin glulisine acts faster than regular human insulin, you should normally use insulin glulisine with a longer-acting insulin.

insulin glulisine is available only with your doctor's prescription.

Before Using insulin glulisine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For insulin glulisine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to insulin glulisine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on insulin glulisine have been done only in adult patients, and there is no specific information comparing use of insulin glulisine in children with use in other age groups.

Geriatric

insulin glulisine has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking insulin glulisine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using insulin glulisine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alatrofloxacin


• Balofloxacin


• Ciprofloxacin


• Clinafloxacin


• Enoxacin


• Fleroxacin


• Flumequine


• Gatifloxacin


• Gemifloxacin


• Grepafloxacin


• Levofloxacin


• Lomefloxacin


• Moxifloxacin


• Norfloxacin


• Ofloxacin


• Pefloxacin


• Prulifloxacin


• Rufloxacin


• Sparfloxacin


• Temafloxacin


• Tosufloxacin


• Trovafloxacin Mesylate

Using insulin glulisine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Acebutolol


• Alprenolol


• Atenolol


• Betaxolol


• Bevantolol


• Bisoprolol


• Bitter Melon


• Bucindolol


• Carteolol


• Carvedilol


• Celiprolol


• Clorgyline


• Dilevalol


• Esmolol


• Fenugreek


• Glucomannan


• Guar Gum


• Iproniazid


• Isocarboxazid


• Labetalol


• Levobunolol


• Mepindolol


• Metipranolol


• Metoprolol


• Moclobemide


• Nadolol


• Nebivolol


• Nialamide


• Oxprenolol


• Pargyline


• Penbutolol


• Phenelzine


• Pindolol


• Procarbazine


• Propranolol


• Psyllium


• Selegiline


• Sotalol


• Talinolol


• Tertatolol


• Timolol


• Toloxatone


• Tranylcypromine

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of insulin glulisine. Make sure you tell your doctor if you have any other medical problems, especially:

• Hypoglycemia (low blood sugar)—If you have low blood sugar and use insulin, your blood sugar may go even lower.

• Kidney disease or


• Liver disease—The effects of insulin glulisine may be increased or decreased. Your doctor may need to change the dose.

Proper Use of insulin glulisine

The dose of insulin glulisine will be different for different patients. Follow your doctor's orders. You will give yourself injections of insulin glulisine every day.

It is best to use a different place on the body for each injection (e.g., abdomen, thigh, or upper arm). If you have questions about this, contact a member of your health care team.

When used as a mealtime insulin, insulin glulisine should be taken within 15 minutes before the meal or within 20 minutes after starting a meal.

Follow carefully the special meal plan your doctor gave you. This is the most important part of controlling your diabetes, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

insulin glulisine can also be given as an intravenous (IV) infusion only by a healthcare professional in a clinic or hospital.

Dosing

The dose of insulin glulisine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of insulin glulisine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

As of July 1, 2010 the cartridges will no longer be available for the OptiClik® insulin delivery device system. Please contact your doctor or pharmacist if you have any questions about this.

• For injection dosage form:
  
  • For diabetes mellitus:
    
    • Adults—The dose is based on your blood sugar and must be determined by your doctor.
    
    
    • Children—Use and dose must be determined by your doctor.
    
    
  
  

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store unused vials, SoloStar® prefilled pens, or cartridges in the refrigerator. Do not freeze.

The vials that you are currently using may be kept in the refrigerator or at room temperature in a cool place, away from sunlight and heat, and must be used within 28 days.

The cartridge or SoloStar® prefilled pen that you are currently using should not be refrigerated and must be stored at room temperature, away from direct heat and light. Throw away any opened cartridge or prefilled pen after 28 days. Do not store the OptiClik® insulin delivery device, with or without the cartridge system, in the refrigerator.

Precautions While Using insulin glulisine

Never share insulin pens or cartridges with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles or pens can result in transmission of hepatitis viruses, HIV, or other blood-borne illnesses.

Your doctor will want to check your progress at regular visits, especially during the first few weeks you take insulin glulisine.

It is very important to follow carefully any instructions from your health care team about:

• Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.


• Other medicines—Do not take other medicines during the time you are taking insulin glulisine unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.


• Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.


• Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to:

• Wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.

Too much insulin glulisine can cause hypoglycemia (low blood sugar). Symptoms of low blood sugar include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; depression; difficulty in thinking; dizziness or light-headedness; drowsiness; excessive hunger; fast heartbeat; headache; irritability or abnormal behavior; nervousness; nightmares; restless sleep; shakiness; slurred speech; and tingling in the hands, feet, lips, or tongue.

Low blood sugar also can occur if you use insulin glulisine with another antidiabetic medicine, delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting or have diarrhea.

If symptoms of low blood sugar occur, eat glucose tablets or gel to relieve the symptoms. Also, check your blood for low blood sugar. Get to a doctor or a hospital right away if the symptoms do not improve. Someone should call for emergency help immediately if severe symptoms such as convulsions (seizures) or unconsciousness occur . Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your household also should know how to use it.

Symptoms of high blood sugar include blurred vision; drowsiness; dry mouth; flushed, dry skin; fruit-like breath odor; increased urination; ketones in urine; loss of appetite; stomachache, nausea, or vomiting; tiredness; troubled breathing (rapid and deep); unconsciousness; and unusual thirst.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

insulin glulisine Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

• Convulsions (seizures)


• unconsciousness

Check with your doctor as soon as possible if any of the following side effects occur:

More common

• Low blood sugar, including anxiety; blurred vision; chills; cold sweats; confusion; cool pale skin; depression; dizziness; fast heartbeat; headache; increased hunger; nervousness; nightmares; shakiness; slurred speech; and unusual tiredness or weakness

Less common

• Accumulation of body fat


• bleeding, blistering, burning, coldness, discoloration of skin


• decrease in blood pressure


• depression of the skin at the place of injection


• feeling of pressure


• hives


• infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the place of injection


• rapid pulse


• shortness of breath


• skin rash or itching over the entire body


• sweating


• wheezing

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: insulin glulisine Subcutaneous side effects (in more detail)

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More insulin glulisine Subcutaneous resources

• Insulin glulisine Subcutaneous Side Effects (in more detail)
• Insulin glulisine Subcutaneous Use in Pregnancy & Breastfeeding
• Insulin glulisine Subcutaneous Drug Interactions
• Insulin glulisine Subcutaneous Support Group
• 1 Review for Insulin glulisine Subcutaneous - Add your own review/rating

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