Insulin regular

Hypersensitivity. Episodes of hypoglycaemia.

Patient with risk factors for hypoglycaemia, including changes in meal pattern, level of physical activity, concurrent illness (particularly infection, conditions with fever, or accidental/surgical trauma), emotional stress, and concomitant drugs; cardiac disease; adrenal, pituitary or thyroid disease. Symptoms of hypoglycaemia may be less pronounced in patients with long history of diabetes, intensified insulin treatment, recurrent hypoglycaemia, diabetic neuropathy, diabetic nerve disease, and those who switched from animal insulin to human insulin or receiving β-blockers. Some available brands cannot be used in insulin pumps for continuous SC insulin infusion (refer to specific product information). Concomitant use with peroxisome proliferator-activated receptor (PPAR)-γ agonists. Renal and hepatic impairment. Neonates, children and elderly. Pregnancy and lactation. Patient Counselling This drug may impair your ability to concentrate and react due to hypoglycaemia; if affected, do not drive or operate machinery. SC: Continuously rotate inj sites within the same body region to prevent inj site reactions. Monitoring Parameters Monitor serum glucose levels (frequency is individualised based on therapy regimen and hypoglycaemia risk), electrolytes (particularly serum K levels), renal and hepatic function, and weight; HbA_1c (at least twice yearly in patients with stable glycaemic control; quarterly in patients not meeting treatment goals or with treatment change). For diabetic ketoacidosis: Closely monitor serum electrolytes (e.g. Na, K, bicarbonate, phosphate), serum glucose levels, venous pH, anion gap, serum osmolality, serum BUN and creatinine, fluid status and mental status.

Significant: Hypoglycaemia, hypokalaemia; lipodystrophy, lipoatrophy, lipohypertophy, and localised cutaneous amyloidosis at the inj site; development of insulin antibodies. General disorders and administration site conditions: Inj site reactions (e.g. erythema, pruritus, inflammation). Investigations: Weight gain. Metabolism and nutrition disorders: Peripheral oedema. Skin and subcutaneous tissue disorders: Rash, urticaria.
Potentially Fatal: Severe allergic reactions, including anaphylaxis; severe and prolonged hypoglycaemia resulting in unconsciousness, convulsion, or brain damage (temporary or permanent); untreated hypokalaemia which may lead to respiratory paralysis and ventricular arrhythmia.

May cause dose-related fluid retention and heart failure with PPAR-γ agonists, including thiazolidinediones (e.g. pioglitazone). May increase the risk of hypoglycaemia with other antidiabetic agents (e.g. oral hypoglycaemic agents), sulfonamide antibiotics, anabolic steroids, salicylates, fibrates, ACE inhibitors, angiotensin II receptor blockers, MAOIs, and disopyramide. May mask signs and symptoms of hypoglycaemia with β-blockers, clonidine and guanethidine. May decrease the hypoglycaemic effects with corticosteroids, thyroid hormones, thiazide or loop diuretics, atypical antipsychotics (e.g. clozapine, olanzapine), sympathomimetic agents (e.g. epinephrine, salbutamol, terbutaline), oral contraceptives, glucagon, danazol, and isoniazid. May either increase or decrease the blood glucose-lowering effect with β-blockers, clonidine, octreotide, lithium salts and pentamidine.

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