Insulin glulisine

When ATH: A10AB06

Pharmacological action

Insulin glulisine is a recombinant human insulin analog, which is the power of action is normal human insulin. Insulin glulisine It starts acting faster and has a shorter duration of action, than soluble human insulin.

When administered subcutaneously action of insulin glulisine, lowering blood glucose, It begins in 10-20 minutes.

Insulin glulisine is administered by subcutaneous injection or by continuous infusion into the subcutaneous fat using the pumping system, shortly before (for 0-15 min) or shortly after a meal.

Testimony

Diabetes, requiring insulin treatment, in adults.

Dosage regimen

Insulin glulisine should be administered shortly (for 0-15 m) before or shortly after a meal.

Insulin glulisine should be used in the therapy, including insulin average duration or long-acting, or basal insulin analogue. The drug can be used in combination with oral hypoglycemic agents.

Insulin glulisine administered by, or s / c injection or by continuous infusion in subcutaneous fat via the pumping system.

P / to the injection should be made in the abdomen, shoulder or hip, and the introduction of the drug by continuous infusion in subcutaneous fat is made in the abdomen.

Side effects

Local reactions: often - Local hypersensitivity reactions (hyperemia, swelling and itching at the injection site). These reactions are usually transitory and disappear during continued treatment. The rare - lipodystrophy (a breach of alternating beds of insulin within the same field).

Allergic reactions: occasionally - urticaria, chest tightness, bronchospasm, atopic dermatitis, itch. Severe cases of generalized allergy (including anaphylactic) It can be life-threatening.

Contraindications

Hypersensitivity to insulin glulisine or to any component of the drug; gipoglikemiâ.

Pregnancy and lactation

Caution should be used in pregnant women.

Not enough information on the use of insulin glulisine in pregnant women.

Reproductive studies in animals have not revealed any differences between insulin glulisine and human insulin with respect to pregnancy, embryonic / fetal development, childbirth and post-natal development.

In appointing the drug to pregnant women should be careful. Mandatory careful monitoring of blood glucose.

Patients with existing prior to pregnancy, or gestational diabetes need throughout pregnancy to maintain an optimal metabolic control. During the first trimester of pregnancy, insulin requirements may be reduced, and during the second and third trimesters it, usually, may increase. Immediately after delivery insulin requirement rapidly declining.

Lactation. Unknown, supplied whether insulin glulisine in human milk, insulin but generally does not penetrate into breast milk and is not absorbed when administered.

Nursing mothers may require dose adjustment of insulin and diet.

Cautions

Transfer the patient to a new type of insulin or insulin another manufacturer must be used under strict medical supervision, tk. may require correction throughout therapy. The use of inadequate doses or discontinuation of insulin treatment, especially in patients with diabetes mellitus type 1, It can lead to the development of hyperglycemia and diabetic ketoacidosis – states, which are potentially life threatening.

Time potential of hypoglycemia depends on the speed of onset of effect used insulin, concerning, may change when the treatment regimen. For conditions, that can change or make less pronounced harbingers of hypoglycemia, concern the continued existence of diabetes, intensification of insulin therapy, the presence of diabetic neuropathy, taking certain medications (such as beta-blockers), or transfer of the patient from animal insulin to human insulin.

Correction doses of insulin may also be required when changing modes of motor activity or meals. Exercise stress, performed immediately after a meal, may increase the risk of hypoglycemia. Compared to soluble human insulin after injection speed of the insulin analogs may develop hypoglycemia before.

Nekompensirovannыe gipoglikemicheskaя or giperglikemicheskaя reactions Mughals hello k Potter soznaniя, coma or death.

Insulin requirements may change with concomitant diseases or emotional overload.

Drug Interactions

When combined oral hypoglycemic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAO inhibitors, pentoxifylline, propoksyfen, salitsilatы and sulyfanilamidnыe protivomikrobnыe means Mughals usilivaty gipoglikemicheskoe insulin action and povыshaty predraspolozhennosty k gipoglikemii.

At joint application Valium, danazol, diazoksid, Diuretic, Isoniazid, phenothiazines, somatropin, sympathomimetic (eg, epinephrine, salbutamol, terbutaline), thyroid hormones, Estrogens, progestins (eg, oral contraceptives), protease inhibitors and antipsychotic drugs (eg, olanzapine and clozapine) may reduce the hypoglycemic effect of insulin.

Beta-blockers, klonidin, lithium salts or ethanol, or may potentiate or weaken the hypoglycemic effect of insulin. Pentamidine may cause hypoglycemia followed by hyperglycemia c.

When using products with sympatholytic activity (beta-blockers, klonidin, guanethidine and reserpine) Symptoms reflex adrenergic activation during hypoglycemia may be less pronounced or absent.