NovoRapid has a faster onset and a shorter duration of action than soluble human insulin.
Due to the faster onset of action, NovoRapid should generally be given immediately before a meal.
When necessary, NovoRapid can be given soon after the meal.
Dosage is individual and determined on the basis of the physician's advice in accordance with the needs of the patient. It should normally be used in combination with intermediate-acting or long-acting insulin given at least once a day.
The individual insulin requirement is usually between 0.5 and 1 unit/kg/day. In a meal-related treatment, 50-70% of this requirement may be provided by NovoRapid and the remainder by intermediate-acting or long-acting insulin.
NovoRapid is administered SC in the abdominal wall, the thigh, the deltoid region or the gluteal region. Injection sites should be rotated within the same region.
When injected SC into the abdominal wall, the onset of action will occur within 10-20 min of injection. Therefore, a meal or snack containing carbohydrate should be taken within 10 min.
The maximum effect is exerted 1-3 hrs after the injection. The duration of action is 3-5 hrs. As with all insulins, the duration of action will vary according to the dose, injection site, blood flow, temperature and level of physical activity. As with all insulins, SC injection in the abdominal wall ensures a faster absorption than other injection sites. However, the faster onset of action compared to soluble human insulin is maintained regardless of injection site.
NovoRapid may be administered IV under medical supervision. In case of emergency, use of NovoRapid from a Penfill/FlexPen, NovoRapid must first be withdrawn into an insulin syringe. No studies have been conducted in critically ill people with diabetes who are likely to require IV administration. There is no pharmacokinetic or pharmacodynamic advantage in using NovoRapid over soluble human insulin when these insulins are given IV.
NovoRapid may be used for Continuous Subcutaneous Insulin Infusion (CSII) in pump systems suitable for insulin infusion. CSII should be administered in the abdominal wall. Infusion sites should be rotated.
When used with an insulin infusion pump, NovoRapid should not be mixed with any other insulin. Patients using CSII should be comprehensively instructed in the use of the pump system and use the correct reservoir and tubing for the pump. The infusion set (tubing and cannula) should be changed in accordance with the instructions in the product information supplied with the infusion set. Patients administering NovoRapid by CSII must have alternative insulin available in case of pump system failure. Renal or hepatic impairment may reduce the patient's insulin requirements.
NovoRapid should be used in children in preference to soluble human insulin when a rapid onset of action might be beneficial. For example, in the timing of the injections in relation to meals.