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All about: Insulin Glulisine

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Some commonly used brand names are:

In the U.S.—

  • Apidra

Not commercially available in Canada.

Category

  • Antidiabetic agent

Description

Insulin glulisine (IN-soo-lin gloo-LIS-een) is a fast-acting type of human insulin. Insulin is used by people with sugar diabetes to help keep blood sugar levels under control. If you have sugar diabetes, your body cannot make enough 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 your blood can be harmful to your health. Since insulin glulisine acts faster than regular human insulin, you normally should use insulin glulisine with a longer-acting insulin.

This medicine is available only with your doctor's prescription, in the following dosage forms:

  • Parenteral
  • Injection (U.S.)

Before Using This Medicine

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. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—The amount of insulin or insulin glulisine you need changes during pregnancy. It is especially important for your health and your baby's health that your blood sugar be closely controlled before you become pregnant and throughout pregnancy.

Breast-feeding—It is not known whether insulin glulisine passes into human breast milk. Although most medicines, including human insulin, pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Studies on this medicine 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.

Older adults—This medicine 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.

Other 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 doctor and pharmacist know if you are taking any of the following:

  • Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], bisoprolol [e.g., Zebeta], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne, Trandate], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Betapace], timolol [e.g., Blocadren]) or
  • Clonidine (e.g., Catapres, Duraclon) or
  • Guanethidine (e.g., Ismelin) or
  • Reserpine —These medicines may hide symptoms of low blood sugar (such as fast heartbeat). Thus, a person with diabetes might not recognize that he or she has low blood sugar and might not take immediate steps to treat it

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 take insulin, your blood sugar may reach dangerously low levels
  • Kidney disease or
  • Liver disease—Effects of insulin glulisine may be increased or decreased; your doctor may need to change your insulin dose

Proper Use of This Medicine

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 condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

The dose of insulin glulisine will be different for different patients. Follow your doctor's orders.

  • For injection dosage form:
    • For diabetes mellitus (sugar diabetes):
      • 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—To store this medicine:

  • Keep out of the reach of children.
  • Store away from heat and direct light.
  • Store in the refrigerator. However, keep the medicine from freezing.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

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

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 .

Side Effects of This Medicine

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 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 site of injection; rapid pulse; shortness of breath; skin rash or itching over the entire body; sweating; wheezing

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

Developed: 07/29/2004

The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

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