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Indications and Dosage
Subcutaneous
Diabetes mellitus Adult: Dose should be individualised and depends on patient's needs. By Inj: Admin within 15 minutes before a meal or within 20 minutes after starting a meal into the abdominal wall, thigh, or upper arm. By continuous infusion: Admin into the abdominal wall. To be used in conjunction with a longer-acting insulin or basal insulin analogue. Inj site should be rotated from one inj to the next.
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Renal Impairment
Dose reduction may be needed.
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Hepatic Impairment
Dose reduction may be needed.
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Administration
Should be taken with food. Administer w/in 15 min before a meal or w/in 20 min after starting a meal.
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Incompatibility
Do not mix with any preparations other than NPH human insulin.
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Contraindications
Hypoglycaemia.
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Special Precautions
Renal or hepatic impairment. Regular monitoring of blood glucose and HbA1c. Rotate Inj sites to reduce lipodystrophy . Pregnancy, lactation.
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Adverse Reactions
Hypoglycaemia, Inj site reactions, lipodystrophy, local and systemic hypersensitivity reactions.
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IV/SC: C
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Overdosage
Symptoms: Hypoglycaemia. Management: In mild hypoglycaemic episodes, treat with oral glucose. In severe hypoglycaemic episodes, where the patient has become unconscious, treat with IM/subcutaneous glucagon (0.5-1 mg) or IV glucose. If the patient does not respond to glucagon within 10-15 minutes, IV glucose must be given. Once consciousness is regained, admin oral carbohydrates to prevent a relapse.
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Drug Interactions
Possible absence of hypoglycaemic warning symptoms with β-blockers. Decreased hypoglycaemic effect with corticosteroids, danazol, diazoxide, diuretics, glucagon, isoniazid, phenothiazine derivatives, somatropin, sympathomimetic agents, thyroid hormones, oestrogens, progestins (e.g. in oral contraceptives), protease inhibitors and atypical antipsychotics (e.g. olanzapine and clozapine). Increased hypoglycaemic effect with oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates and sulfonamide antibiotics. Decreased insulin resistance with octreotide and lanreotide. Increased risk of wt gain and peripheral oedema with pioglitazone, rosiglitazone. Decreased effect of sermorelin.
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Action
Description: Insulin glulisine is a rapid acting human insulin analog produced by recombinant DNA technology using a non-pathogenic laboratory strain of Escherichia coli (K12). Insulin glulisine and insulin human are equipotent on a unit-for-unit basis. Insulin glulisine has a more rapid onset and shorter duration of action compared with insulin human after subcutaneous admin.
Pharmacokinetics: Absorption: Absolute bioavailability after subcutaneous admin: 70%. Max plasma concentration: 55 minutes. Distribution: Protein binding: Low. Apparent half-life: 42 minutes |
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Storage
Unopened vial: Store in a refrigerator (2-8°C). Protect from light. Do not freeze. Once opened, it may be stored for a max of 4 wk <25°C.
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MIMS Class
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