Insulin degludec

Thông tin thuốc gốc
Chỉ định và Liều dùng
Diabetes mellitus
Adult: Type 1: Insulin-naive patient: Initially, 1/3 to 1/2 the total daily insulin dose, given once daily; remainder of total daily dose should be given as a short- or rapid-acting insulin. General recommendation for initial total daily insulin dose is 0.2-0.4 units/kg. Insulin-experienced patient: Start at same dose as the total daily long- or intermediate-acting insulin unit dose from which the patient is being converted. Type 2: Insulin-naive patient: Initially, 10 units once daily. Insulin-experienced patient: Start at the same dose as the total daily long- or intermediate-acting insulin unit dose. Individualise and titrate dose every 3-4 days based on patient’s metabolic needs, blood glucose monitoring results, and glycaemic control goal. Administer missed dose as soon as possible, ensure at least 8 hours between consecutive doses.
Child: ≥1 year Type 1 or 2: Insulin-naive patient: Same as adult dose. Insulin-experienced patient: Start at 80% of the total daily long- or intermediate-acting insulin unit dose.
Renal Impairment
Dosage reduction may be needed.
Hepatic Impairment
Dosage reduction may be needed.
Chống chỉ định
Hypersensitivity. Hypoglycaemic episodes.
Thận trọng
Patient with infections, fever, diseases affecting the adrenal, pituitary and thyroid gland, and those at risk for hypokalaemia. Not intended for treatment of diabetic ketoacidosis. Hepatic and renal impairment. Children. Lactation.
Phản ứng phụ
Significant: Lipodystrophy, hypoglycaemia, hypokalaemia, formation of insulin antibodies.
Gastrointestinal disorders: Gastroenteritis, diarrhoea.
General disorders and administration site conditions: Inj site reactions (e.g. haematoma, swelling, erythema), peripheral oedema.
Immune system disorders: Urticaria.
Investigations: Weight gain.
Nervous system disorders: Headache.
Respiratory, thoracic and mediastinal disorders: Nasopharyngitis, upper respiratory infection, sinusitis.
Potentially Fatal: Severe hypoglycaemia, severe allergic reactions, including anaphylaxis.
Thông tin tư vấn bệnh nhân
Rotate injection sites within the same body region and use a new needle for each injection. This drug may cause hypoglycaemia which may impair ability to concentrate or react, if affected, do not drive or operate machinery.
Closely monitor plasma glucose levels (especially during transfer from other insulin product); HbA1c (at least twice yearly), electrolytes, lipid profile, renal and hepatic function, weight. Assess for signs of hypoglycaemia.
Quá liều
Symptoms: Severe hypoglycaemia and hypokalaemia. Management: Administer oral glucose or other sugar-containing products to treat mild hypoglycaemia. For severe hypoglycaemic episodes, treatment includes IM or SC administration of glucagon 0.5-1 mg, or concentrated IV glucose if patient does not respond to glucagon within 10-15 minutes. Oral carbohydrates may be given to the patient upon regaining consciousness to prevent relapse.
Tương tác
Risk of fluid retention and CHF when given with peroxisome proliferator-activated receptor (PPAR)-γ agonists (e.g. pioglitazone). Increased risk of hypoglycaemia with oral antidiabetic agents, glucagon-like peptide-1 (GLP-1) receptor agonists, ACE inhibitors, MAOIs, salicylates, sodium-glucose cotransporter 2 (SGLT2) inhibitors, sulfonamides, and anabolic steroids. Decreased glucose lowering effect with oral contraceptives, glucocorticoids, thiazides, thyroid hormones, growth hormone, sympathomimetics, glucagon, niacin, protease inhibitors, danazol. Somatostatin analogues (e.g. octreotide, lanreotide) may either increase or decrease insulin requirement. Beta-blockers, clonidine, guanethidine, lithium and reserpine may mask the symptoms of hypoglycaemia.
Food Interaction
Alcohol may enhance or reduce the hypoglycaemic effect of insulin.
Tác dụng
Description: Insulin degludec is a biosynthetic (rDNA origin), long-acting human insulin analogue that binds specifically to human insulin receptor, resulting in the same pharmacological effects as the human insulin. It lowers blood glucose concentrations by stimulating peripheral glucose uptake in skeletal muscle and adipose tissue and by inhibiting hepatic glucose production. It also inhibits lipolysis and proteolysis, and enhances protein synthesis.
Onset: Approx 1 hour.
Duration: >42 hours.
Absorption: Time to peak plasma concentration: 9 hours.
Distribution: Plasma protein binding: >99%, to albumin.
Excretion: Elimination half-life: Approx 25 hours.
Đặc tính

Chemical Structure Image
Insulin degludec

Source: National Center for Biotechnology Information. PubChem Database. Insulin degludec, CID=118984462, (accessed on Jan. 21, 2020)

Bảo quản
Unopened preparation: Store between 2-8°C. Do not freeze. Protect from light. Once opened, cartridge or prefilled syringe may be stored between 2-8°C or below 30°C up to 56 days. Do not freeze. Protect from direct heat and light.
Phân loại MIMS
Phân loại ATC
A10AE06 - insulin degludec ; Belongs to the class of long-acting insulins and analogues for injection. Used in the treatment of diabetes.
Anon. Insulin Degludec. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 01/03/2018.

Joint Formulary Committee. Insulin Degludec. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. Accessed 01/03/2018.

McEvoy GK, Snow EK, Miller J et al (eds). Insulin Degludec. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). Accessed 01/03/2018.

Tresiba Injection, Solution (Novo Nordisk). DailyMed. Source: U.S. National Library of Medicine. Accessed 01/03/2018.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Insulin degludec từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2021 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in