Do not administer via IV. Avoid IM administration. Do not use in insulin infusion pumps. Inj site reactions may occur. Always rotate inj sites w/in the same region to reduce risk of lipodystrophy & cutaneous amyloidosis. Caution in patients travelling between different time zones. Risk of hyperglycaemia & diabetic ketoacidosis w/ inadequate dosing or treatment discontinuation, especially in type 1 diabetes. Risk of hypoglycaemia w/ excessive insulin dose, omitted meal, or unplanned, strenuous physical exercise. Do not inj in case of hypoglycaemia or if hypoglycaemia is suspected. May have a more pronounced glucose-lowering effect up to 6 hr after inj. Consider rapid onset of action in patients w/ concomitant diseases or treatment where a delayed absorption of food might be expected. Change in usual warning symptoms of hypoglycaemia in patients w/ greatly improved blood glucose control (eg, by intensified insulin therapy); disappearance of usual warning symptoms in patients w/ longstanding diabetes. Dose adjustment may be necessary if patients undertake increased physical activity, change their usual diet, or during concomitant illness (especially infections & feverish conditions; concomitant diseases in the kidney, liver or affecting the adrenal, pituitary or thyroid gland). Close glucose monitoring is recommended when transferring from other insulin medicinal products (change in strength, brand, type, origin &/or method of manufacture) & in the initial wk thereafter. Reports of cardiac failure when used in combination w/ pioglitazone, especially in patients w/ risk factors for development of cardiac heart failure. Insulin Ab formation. May impair ability to drive or operate machinery. Intensify glucose monitoring & adjust dose on an individual basis in patients w/ renal or hepatic impairment, & elderly patients. Pregnancy & lactation. Limited clinical experience in childn 6-9 yr.
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