Insulin glulisine

Should be taken with food. Administer w/in 15 min before a meal or w/in 20 min after starting a meal.

Hypersensitivity. Episodes of hypoglycaemia.

Patient with risk factors for hypoglycaemia, including changes in meal pattern, level of physical activity, insulin regimen, concurrent illness, emotional distress and medications used; conditions that may make hypoglycaemia symptom awareness less pronounced (e.g. long-standing diabetes, recurrent hypoglycaemia, diabetic nerve disease, intensified insulin treatment, use of β-blockers); cardiac disease, risk factors for developing heart failure and hypokalaemia (e.g. taking loop diuretics). Renal and hepatic impairment. Children. Pregnancy and lactation. Patient Counselling This drug may impair the patient's ability to concentrate and react due to hypoglycaemia; if affected, do not drive or operate machinery. SC: Continuously rotate inj site within the same region to the next to prevent long-term site reactions. Monitoring Parameters Monitor blood glucose (usually before meals and snacks, and at night, then as required); electrolytes; HbA_1c (at least twice yearly in patients with stable glycaemic control; quarterly in patients not meeting treatment goals or with treatment change); renal and hepatic function; weight. When administered via IV, closely monitor blood glucose and serum K.

Significant: Hypoglycaemia, hypokalaemia; inj site reactions (e.g. lipodystrophy, localised cutaneous amyloidosis); hyperglycaemia, ketosis and diabetic ketoacidosis (if handling errors or pump system failure occur via CSII). Immune system disorders: Local hypersensitivity reactions at the inj site (e.g. redness, pain, itching, swelling). Infections and infestations: Influenza. Investigations: Weight gain. Metabolism and nutrition disorders: Peripheral oedema. Musculoskeletal and connective tissue disorders: Arthralgia. Nervous system disorders: Headache, hypoglycaemic seizure. Respiratory, thoracic and mediastinal disorders: Nasopharyngitis, upper respiratory tract infection. Vascular disorders: Hypertension.
Potentially Fatal: Hypersensitivity reactions, including anaphylaxis; severe and prolonged hypoglycaemia episodes resulting in unconsciousness, convulsion, or brain damage (temporary or permanent); untreated hypokalaemia leading to respiratory paralysis and ventricular arrhythmia.

May cause dose-related fluid retention and exacerbate heart failure with peroxisome proliferator-activated receptor (PPAR)-γ agonists, including thiazolidinediones (e.g. pioglitazone). May increase the risk of hypoglycaemia with other antidiabetic agents, ACE inhibitors, angiotensin II receptor blockers, MAOIs, fibrates, fluoxetine, pentoxifylline, salicylates, and sulfonamides. Hypoglycaemic effects of insulin glulisine may be decreased by glucagon, corticosteroids, diuretics, danazol, isoniazid, atypical antipsychotics (e.g. olanzapine), phenothiazine derivatives, sympathomimetic agents (e.g. salbutamol, epinephrine, terbutaline), protease inhibitors, estrogens, oral contraceptives, and thyroid hormones. May either enhance or reduce the risk of hypoglycaemia with β-blockers, lithium salts, and clonidine. Hypoglycaemic symptoms may be reduced or blunted by β-blockers, clonidine, guanethidine, and reserpine.

Insulin Preparations

A10AB06 - insulin glulisine ; Belongs to the class of fast-acting insulins and analogues. Used in the treatment of diabetes.