Insulin Glulisine

Apidra 

Apidra is FDA-approved for improving glycemic control in patients with type 1 and type 2 diabetes mellitus. It is typically used alongside an intermediate or long-acting insulin to manage blood sugar levels. Apidra (Insulin glulisine) comes in vials, cartridges, or Apidra solostar insulin pen. The medication dosage depends upon the patient’s condition, needs, and response to treatment. It is administered as a mealtime insulin within 15 before starting a meal or within 15 minutes of starting a meal. You should not use Apidra if you have hypersensitivity to the medication or if you have severe hypoglycemia. Taking this medicine, having a proper diet, and regular exercise can help you lead a healthy and long life. 

Product Overview

Apidra is the brand name of insulin glulisine, a rapid-acting insulin analog used to improve glycemic control in adults and children (6 years and older) with type 1 or type 2 diabetes. This medication helps regulate blood sugar levels and is typically used alongside long-acting basal insulin. Each Apidra product, whether in vials, cartridges or the Apidra SoloSTAR insulin pen, contains insulin glulisine as the main active ingredient, which works by facilitating the absorption of glucose into cells, reducing sugar production in the liver, and inhibiting the release of stored glucose into the bloodstream.

The recommended dosage of Apidra varies depending on individual needs and may require adjustments during periods of stress, illness, or changes in lifestyle. It is administered as a subcutaneous injection 15 minutes before or after starting a meal. The injection sites include the abdomen, buttocks, upper arm, or thigh, with a different site chosen for each injection to minimize the risk of injection site reactions. Common side effects of Apidra include hypoglycemia, allergic reactions, injection site reactions, and weight gain. 

It is essential to monitor blood sugar levels regularly while taking Apidra and to follow proper storage guidelines to maintain its effectiveness. In case of a missed dose, taking the prescribed dose as soon as possible is essential unless it is almost time for the next dose. In case of an overdose, seek medical assistance immediately. Apidra should be stored in the refrigerator or at room temperature for up to 28 days.

Uses

Targeted Treatment 

It is used to manage blood sugar levels in individuals with diabetes mellitus. 

Benefits

It may also be prescribed for treatment of the following conditions:

• Type 1 and type 2 diabetes mellitus (adults)
• Type 1 diabetes (children four years old and above)
• Diabetic ketoacidosis
• Diabetic coma
• Nonketotic hyperosmolar syndrome 
• Acidosis 

[Note: Do not take Apidra without consulting your doctor. They will determine whether you need this medication based on your conditions.]

Apidra Dosage

Forms & Strengths

Apidra comes in the following forms and strengths: 

Form 1: Prefilled Apidra SoloStar pen

Strength: 3 ml

Form 2: Vial 

Strength: 10 ml

Recommended Dosages

For Diabetes Mellitus Type 1 or 2

• Adults: The recommended daily dosage ranges between 0.5-1 unit per kilogram of body weight daily. 
• Children: Children may require 0.8 to 1.2 units of insulin per kilogram of body weight daily when administered via injection under the skin.
• Subcutaneous injection: It is essential to inject it within 15 minutes before starting a meal or within 20 minutes after starting a meal. 
• Continuous Subcutaneous Injection: When setting up the insulin pump for the first time, use the same daily dose as your previous treatment plan. 
• Intravenous Administration: Insulin should be used at concentrations between 0.05-1 unit/mL when administered through an IV with infusion systems that use PVC bags. The insulin remains stable only in a solution of 0.9% saltwater (normal saline).

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• Before taking Apidra, carefully read the information leaflet that comes with this prescription. 
• Before using Apidra, your doctor will show you how to administer it properly. Make sure to follow the instructions given by your doctor for the safe and effective use of the medication.
• Inject this insulin as directed by your doctor. You can inject it 15 minutes before starting a meal or within 15 minutes. 
• Check the insulin for discoloration or particles. Do not use it if it has any change in appearance. Safely discard it and get a new insulin from your pharmacist. 
• Before administration, clean the injection spot with rubbing alcohol. 
• While injecting subcutaneously, you can inject the medication under the skin of the abdomen, buttocks, upper arm, or front thigh. 
• Do not inject into skin that is torn, damaged, red, swollen, itchy, or if it has stretch marks. 
• Do not inject cold insulin, as it may be painful. The insulin that is in use may be kept at room temperature. 
• A medical practitioner in a hospital should administer insulin intravenously. 
• If you use an insulin pump, do not dilute or mix insulin glulisine with other insulin. 

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Apidra Work?

Insulin glulisine is a rapid-acting insulin that works within 10 to 15 minutes after injection, peaks in about 1 hour, and works for 2 to 4 hours after injection. When used as a mealtime insulin, Apidra should be injected within 15 minutes before starting a meal or within 20 minutes. It has a shorter duration of action compared to naturally occurring human insulin. It works by reducing blood sugar levels in the body. It inhibits glucose production by the liver and helps glucose get absorbed in the bloodstream so your body can utilize it for energy. 

Important Safety Information

Side Effects

Common side effects of Apidra may include: 

• Hypoglycemia 
• Allergic reaction
• Injection site reactions 
• Lipodystrophy 
• Weight gain
• Itching
• Rash
• Upper respiratory tract infection

Serious Side Effects of Apidra may include:

• Severe allergic reaction
• Severe hypoglycemia 
• Severe hypokalemia 
• Rapid heartbeat
• Severe infection
• Peripheral edema

[Note: This list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

• Do not share your Apidra solostar pens or needles with others, as infection may spread from one person to another. 
• The most common side effect of Apidra is hypoglycemia, which may become life-threatening if not treated. Look for signs and symptoms of severe low blood sugar levels. 
• Apidra may cause hypokalemia, which, if not treated, can further cause ventricular arrhythmia, respiratory paralysis, and ultimately death. 
• Before using the insulin, check it for any change in appearance. Do not use it if it appears to be cloudy, discolored, or has particles in it. 
• Only start, stop, or change insulin after consulting your doctor. 

Precautions

• Patients’ blood sugar levels should be carefully monitored while receiving treatment with Apidra. 
• Before using Apidra, let your doctor know if you have known hypersensitivity to insulin glulisine or any inactive ingredient in the medication. 
• Avoid consuming alcohol alongside Apidra, as it may lower your blood sugar levels and make your condition worse. 
• Consult your doctor before use if you think you are pregnant, are breastfeeding a baby, or are planning to get pregnant. 
• Apidra should be used with caution in patients who have had or currently have problems related to their kidneys, liver, or heart. 
• You should continue to exercise regularly and maintain a nutritious, balanced diet along with Apidra. 
• Rotate your injection spots to prevent lipodystrophy each time you inject the medication.

Contraindications 

Apidra is contraindicated for use in patients: 

• During episodes of hypoglycemia
• Who have hypersensitivity to Apidra, insulin glulisine, or other inactive ingredients in the medication.

Missed Dose

• To control blood sugar levels, taking your medication on time is essential. 
• If you have missed a dose of Apidra, check your blood sugar levels and take it accordingly. 
• You may skip it if it is normal, but if it is high, taking the prescribed dose as soon as possible is essential. 
• If it is almost time for your next dose, you may skip the missed dose and take the next dose as per schedule. 
• Do not take two doses of the same medication to compensate for the missed dose.

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

Taking Apidra more than recommended may cause hypoglycemia and hypokalemia. Symptoms of an overdose may include dizziness, confusion, headache, and loss of consciousness. If the person has overdosed on the medication and is unconscious, having seizures, or can’t be woken up, immediately seek medical assistance. 

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

Storage

• You may store unopened Apidra in the refrigerator between 2- 8°C. When kept this way, you can use it till the expiration date. 
• You can also keep Apidra at a cool room temperature and use it within 28 days. 
• Do not freeze the medication. Safely discard the frozen insulin and get a new one from your pharmacist. 
• You may store opened Apidra vials at cool room temperature, away from direct sunlight, excess heat, and moisture. Use it within 28 days. 
• Keep the Apidra solostar pen at room temperature and use it within 28 days. Do not freeze the pen, and remove the needle before storing it. 
• Keep the medication in a safe place, away from the sight and reach of children.  

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Apidra Interactions

A potential interaction between insulin glulisine and any of the following drugs may be possible:

• ACE Inhibitors
• Alcohol
• Atypical Antipsychotics
• Beta-Blockers
• Clarithromycin
• Inhaled Corticosteroids
• Oral Corticosteroids
• Danazol
• Diabetes Medications
• Disopyramide
• Diuretics
• Epinephrine
• Estrogens
• Glucagon
• Hepatitis C Antivirals
• HIV Protease Inhibitors 
• Isoniazid
• Lanreotide
• Mifepristone
• Monoamine Oxidase Inhibitors
• Octreotide
• Oral Contraceptives
• Pasireotide
• Pegvisomant
• Progestins
• Quinine
• Quinolone Antibiotics 
• Selective Serotonin Reuptake Inhibitors
• Somatostatin
• Somatropin
• Sulfamethoxazole
• Sunitinib
• Tacrolimus
• Testosterone
• Thyroid Replacement Hormones

[Note: This isn’t a complete list, and there could be other drugs that interact with Apidra. Tell your doctor about prescription, over-the-counter medicines, and herbal products.]

Apidra Alternatives

• Humulin R (insulin R)
• Novolog (insulin aspart)
• Humalog (insulin lispro)
• Toujeo (insulin glargine)
• Levemir (insulin detemir)
• Tresiba (insulin degludec)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions 

1. Is it necessary to refrigerate Apidra?

In the case of unopened Apidra vials & Apidra SoloSTAR Pen, keep them in a refrigerator between 36°F & 46°F (2°C and 8°C). Protect them from light. Do not freeze Apidra. If it has frozen, discard it.

2. Are there any side effects associated with Apidra insulin?

The following are common side effects:

• Blood sugar levels are low
• The skin may itch or develop a mild rash.
• Where the medicine was injected, the skin thickened or hollowed out.

3. What is the fast-acting nature of Apidra insulin?

Only one mealtime insulin is approved for use within 15 minutes before or within 20 minutes after a meal begins, called Apidra SoloSTAR. Apidra is the only mealtime insulin approved for use within 15 or 20 minutes after starting a meal.

4. How long does Apidra take to act?

A rapid-acting insulin analog called Apidra has been shown to improve glycemic control in patients with diabetes, both adults and children. Apidra’s use during mealtime should be performed within 15 minutes after starting a meal or 20 minutes after starting a meal if used between meals.

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