Actrapid is a fast-acting insulin and may be used in combination with long-acting insulin products.
Dosage: Dosage is individual and determined in accordance with the needs of the patient. The individual insulin requirement is usually between 0.3 and 1.0 IU/kg/day. The daily insulin requirement may be higher in patients with insulin resistance (e.g. during puberty or due to obesity) and lower in patients with residual, endogenous insulin production.
An injection should be followed within 30 minutes by a meal or snack containing carbohydrates.
Dosage adjustment: Concomitant illness, especially infections and feverish conditions, usually increases the patient's insulin requirement. Concomitant diseases in the kidney, liver or affecting the adrenal, pituitary or thyroid gland can require changes in the insulin dose. Adjustment of dosage may also be necessary if patients change physical activity or their usual diet. Dosage adjustment may be necessary when transferring patients from one insulin preparation to another.
Administration: For subcutaneous or intravenous use.
Actrapid is administered subcutaneously in the abdominal wall. If convenient, the thigh, the gluteal region or the deltoid region may also be used.
Subcutaneous injection into the abdominal wall ensures a faster absorption than from other injection sites.
Injection into a lifted skin fold minimises the risk of unintended intramuscular injection. The needle should be kept under the skin for at least 6 seconds to make sure the entire dose is injected. Injection sites should always be rotated within the same region in order to reduce the risk of lipodystrophy.
Intramuscular administrations are possible under guidance by a physician.
Actrapid may also be administered intravenously, which should only be carried out by healthcare professionals.
The intravenous use of Actrapid from any pen or cartridge should be an exception only in situations where vials are not available. In this case, Actrapid should be drawn into an insulin syringe, provided air is avoided, or infused with an infusion system. This procedure should only be carried out by healthcare professionals.
Actrapid Penfill: Actrapid Penfill is designed to be used with Novo Nordisk delivery systems and NovoFine or NovoTwist needles.
Actrapid Flexpen: Actrapid FlexPen is a pre-filled pen designed to be used with NovoFine or NovoTwist disposable needles of up to a length of 8 mm. FlexPen delivers 1-60 units in increments of 1 unit.
The pens should be primed before injection so that the dose selector returns to zero and a drop of insulin appears at the needle top.
The dose is set by turning the selector, which returns to zero during the injection.
Actrapid is accompanied by a package leaflet with detailed instructions for use to be followed.