Insulin NovoRapid: instructions, dosage, use during pregnancy

The solution for sc / iv administration is transparent, colorless.

1 ml
insulin aspart100 PIECES (3.5 mg)

PRING glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinc chloride - 19.6 mg, sodium chloride - 0.58 mg, sodium hydrogen phosphate dihydrate - 1.25 mg, sodium hydroxide 2M - about 2.2 mg, hydrochloric acid 2M - about 1.7 mg water d / i - up to 1 ml.

3 ml (300 PIECES) - glass cartridges (1) - disposable multi-dose syringe pens for multiple injections (5) - packs of cardboard.

The solution for sc / iv administration is transparent, colorless.

1 ml
insulin aspart100 PIECES (3.5 mg)

PRING glycerol - 16 mg, phenol - 1.5 mg, metacresol - 1.72 mg, zinc chloride - 19.6 mg, sodium chloride - 0.58 mg, sodium hydrogen phosphate dihydrate - 1.25 mg, sodium hydroxide 2M - about 2.2 mg, hydrochloric acid 2M - about 1.7 mg water d / i - up to 1 ml.

3 ml (300 PIECES) - glass cartridges (1) - disposable multi-dose syringe pens for multiple injections (5) - packs of cardboard.

Pharmachologic effect

A hypoglycemic drug, an analogue of human short-acting insulin, produced by recombinant DNA biotechnology using a Saccharomyces cerevisiae strain in which the amino acid proline at position B28 is replaced by aspartic acid.

It interacts with a specific receptor on the outer cytoplasmic membrane of cells and forms an insulin-receptor complex that stimulates intracellular processes, including synthesis of a number of key enzymes (hexokinase, pyruvate kinase, glycogen synthetase). The decrease in glucose in the blood is due to an increase in its intracellular transport, increased absorption by tissues, stimulation of lipogenesis, glycogenogenesis, and a decrease in the rate of glucose production by the liver.

Substitution of the amino acid proline at position B28 with aspartic acid in insulin aspart reduces the tendency of molecules to form hexamers, which is observed in a solution of ordinary insulin. In this regard, insulin aspart is much faster absorbed from subcutaneous fat and begins to act much faster than soluble human insulin. Insulin aspart reduces blood glucose more strongly in the first 4 hours after a meal than soluble human insulin.

The duration of action of insulin aspart after sc administration is shorter than that of soluble human insulin.

After sc administration, the effect of the drug begins within 10-20 minutes after administration. The maximum effect is observed 1-3 hours after the injection. The duration of the drug is 3-5 hours.

Clinical trials involving patients with type 1 diabetes have shown a reduced risk of nocturnal hypoglycemia with insulin aspart compared with soluble human insulin. The risk of daytime hypoglycemia did not significantly increase.

Insulin aspart is equipotential soluble human insulin based on its molarity.

In clinical studies involving adult patients with type 1 diabetes mellitus, it was shown that with the administration of insulin aspart, lower postprandial blood glucose levels are observed compared to soluble human insulin.

A randomized, double-blind, cross-sectional study was conducted of the pharmacokinetics and pharmacodynamics of insulin aspart and soluble human insulin in elderly patients with type 2 diabetes mellitus (19 patients aged 65-83 years, average age 70 years). The relative differences in the pharmacodynamic properties between insulin aspart and soluble human insulin in elderly patients were similar to those in healthy volunteers and in younger patients with diabetes mellitus.

When using insulin aspart in children and adolescents, similar results are shown for prolonged monitoring of glucose levels compared with soluble human insulin.A clinical trial using soluble human insulin before meals and aspart aspart after eating was conducted in children 2 to 6 years old (26 patients), and a single dose pharmacokinetic / pharmacodynamic study was conducted in children 6-12 years and adolescents 13-17 years old. The pharmacodynamic profile of insulin aspart in children was similar to that in adult patients.

Clinical studies of the comparative safety and efficacy of insulin aspart and human insulin in the treatment of pregnant women with type 1 diabetes mellitus (322 patients: 157 received insulin aspart, 165 received human insulin) did not reveal any negative effect of insulin aspart on pregnancy or fetal health / a newborn. Additional clinical studies in 27 women with gestational diabetes mellitus who received insulin aspart (14 patients) and human insulin (13 patients) showed comparability of safety profiles along with a significant improvement in post-food glucose control with insulin aspart treatment.

Pharmacokinetics

After sc administration of insulin, aspart T max in plasma is on average 2 times less than after administration of soluble human insulin. C max in blood plasma averages 492 ± 256 pmol / L and is achieved 40 minutes after s / c administration at a dose of 0.15 U / kg body weight to patients with type 1 diabetes. The concentration of insulin returns to its original level after 4-6 hours after administration of the drug. The absorption rate is slightly lower in patients with type 2 diabetes mellitus, which leads to lower C max (352 ± 240 pmol / L) and later T max (60 min). The intraindividual variability in T max is significantly lower when using insulin aspart as compared with soluble human insulin, while the indicated variability in the value of C max for insulin aspart is greater.

Pharmacokinetics in special clinical cases

Children (6-12 years old) and adolescents (13-17 years old) with type 1 diabetes mellitus: insulin aspart absorption occurs rapidly in both age groups with T max similar to that in adults. However, there are differences With max in two age groups, which emphasizes the importance of individual dosage of the drug.

Elderly: the relative differences in pharmacokinetics between insulin aspart and soluble human insulin in elderly patients (65-83 years old, average age 70 years) of type 2 diabetes mellitus were similar to those in healthy volunteers and in younger patients with diabetes mellitus. In elderly patients, a decrease in the absorption rate was observed, which led to a slowdown in T max (82 (variability: 60-120 min), while C max was the same as that observed in younger patients with type 2 diabetes and slightly less than in patients type 1 diabetes.

Lack of liver function: a pharmacokinetics study was conducted with a single dose of aspart insulin in 24 patients whose liver function ranged from normal to severe impairment. In individuals with impaired liver function, the rate of absorption of insulin aspart was reduced and more variable, resulting in a slowdown from about 50 minutes in people with normal liver function to about 85 minutes in people with impaired liver function of moderate and severe severity. AUC, C max and general clearance of the drug were similar in individuals with reduced and normal liver function.

Renal failure: a study was conducted of the pharmacokinetics of insulin aspart in 18 patients whose renal function ranged from normal to severe impairment. No apparent effect of creatinine clearance on AUC, C max, T max insulin aspart was found. Data were limited to those with moderate and severe renal impairment.Individuals with renal failure requiring dialysis were not included in the study.

Preclinical Safety Data:

Preclinical studies did not reveal any danger to humans, based on data from generally accepted studies of pharmacological safety, toxicity of repeated use, genotoxicity and reproductive toxicity.

In in vitro tests, including binding to insulin receptors and insulin-like growth factor-1, as well as the effect on cell growth, the behavior of insulin aspart is very similar to that of human insulin. Studies have also shown that dissociation of the binding of insulin aspart to the insulin receptor is equivalent to that for human insulin.

Dosages of the drug NOVORAPID Flexpen

NovoRapid Flexpen is a fast-acting analogue of insulin. The dose of NovoRapid Flexpen is determined by the doctor individually in accordance with the needs of the patient.

Typically, the drug is used in combination with medium-duration or long-acting insulin preparations, which are administered at least 1 time / day. To achieve optimal glycemic control, it is recommended to regularly measure the concentration of glucose in the blood and adjust the dose of insulin. Typically, the individual daily requirement for insulin in adults and children is from 0.5 to 1 U / kg body weight. With the introduction of the drug before meals, the need for insulin can be provided by the drug NovoRapid Flexpen by 50-70%, the remaining need for insulin is provided by long-acting insulin.

An increase in the patient’s physical activity, a change in habitual nutrition, or concomitant illnesses may necessitate dose adjustment.

NovoRapid Flexpen has a faster onset and shorter duration of action than soluble human insulin. Due to the faster onset of action, NovoRapid Flexpen should be administered, as a rule, immediately before a meal, if necessary, can be administered shortly after a meal.

Due to the shorter duration of action compared to human insulin, the risk of developing nocturnal hypoglycemia in patients receiving NovoRapid Flexpen is lower.

As with the use of other insulins, in elderly patients and patients with renal or hepatic insufficiency, blood glucose concentration should be more carefully controlled and the dose of aspart aspart individually adjusted.

It is preferable to use NovoRapid Flexpen instead of soluble human insulin in children when it is necessary to quickly start the action of the drug, for example, when it is difficult for a child to observe the necessary time interval between injection and food intake.

When transferring a patient from other insulin preparations to NovoRapid Flexpen, dose adjustment of NovoRapid Flexpen and basal insulin may be required.

Precautions for use

NovoRapid Flexpen and needles are for personal use only. Do not refill the syringe pen cartridge.

NovoRapid Flexpen cannot be used if it has ceased to be transparent and colorless, or if it has been frozen. Caution patient to discard needle after each injection.

NovoRapid can be used in insulin pumps. The tubes, the inner surface of which is made of polyethylene or polyolefin, have been tested and found to be suitable for use in pumps. In urgent cases (hospitalization, malfunction of the device for administering insulin) NovoRapid for administration to the patient can be removed from Flexpen using an insulin syringe U100.

You should warn the patient about in which cases NovoRapid Flexpen cannot be used:

- with allergies (hypersensitivity) to insulin aspart or any other component of the drug,

- if hypoglycemia begins,

- if FlexPen is dropped, or it is damaged or crushed,

- if the storage conditions of the drug were violated or it was frozen,

- if insulin has ceased to be transparent and colorless.

Before using NovoRapid Flexpen, the patient should:

- check the label to make sure that the correct type of insulin is selected,

- always use a new needle for each injection to prevent infection,

- remember that NovoRapid Flexpen and needles are intended for individual use only,

- never inject an insulin preparation in oil,

- each time to change the injection site within the anatomical region, this will help reduce the risk of seals and ulcerations at the sites of administration,

- regularly measure the concentration of glucose in the blood.

The rules of drug administration

NovoRapid Flexpen is injected sc into the region of the anterior abdominal wall, thigh, shoulder, deltoid or gluteal region. The injection sites within the same body area should be regularly changed to reduce the risk of lipodystrophy. As with all insulin preparations, subcutaneous administration to the anterior abdominal wall provides faster absorption compared to administration to other places. The duration of action depends on the dose, place of administration, blood flow intensity, temperature and level of physical activity. However, a faster onset of action compared to soluble human insulin is maintained regardless of the location of the injection site.

NovoRapid can be used for continuous s / c insulin infusions (PPII) in insulin pumps designed for insulin infusions. FDI should be produced in the anterior abdominal wall. The place of infusion should be periodically changed. When using an insulin pump for infusion, NovoRapid should not be mixed with other types of insulin.

Patients using FDI should be fully trained in using the pump, the appropriate reservoir, and pump tubing system. The infusion set (tube and catheter) should be replaced in accordance with the user manual attached to the infusion set. Patients receiving NovoRapid with FDI should have extra insulin available in case of breakdown of the infusion system.

If necessary, NovoRapid can be entered in / in, but only by qualified medical personnel. For intravenous administration, infusion systems with NovoRapid 100 U / ml are used with a concentration of 0.05 U / ml to 1 U / ml insulin aspart in 0.9% sodium chloride solution, 5% dextrose solution or 10% dextrose solution containing 40 mmol / l potassium chloride using polypropylene infusion containers. These solutions are stable at room temperature for 24 hours. Despite the stability for some time, a certain amount of insulin is initially absorbed by the material of the infusion system. During insulin infusions, it is necessary to constantly monitor the concentration of blood glucose.

NovoRapid Flexpen is an insulin syringe pen with a dispenser and color coding. The administered dose of insulin, in the range from 1 to 60 units, can vary in increments of 1 unit. NovoRapid Flexpen is designed for use with NovoFayn and NovoTvist needles up to 8 mm long. As a precaution, you should always carry a spare system with you to administer insulin in case of loss or damage of NovoRapid Flexpen.

Before using the pen

1. Check the label to make sure NovoRapid Flexpen contains the right type of insulin.

2. Remove the cap from the syringe pen.

3. Remove the protective sticker from the disposable needle. Screw the needle gently and tightly onto the NovoRapid Flexpen. Remove the outer cap from the needle, but do not discard it. Remove and discard the inner cap of the needle.

Use a new needle for each injection to prevent infection.Do not bend or damage the needle before use. To avoid accidental injections, never put the inner cap back on the needle.

Insulin Check

Even with proper use of the pen, a small amount of air can accumulate in the cartridge before each injection. To prevent the entry of an air bubble and ensure the introduction of the correct dose of the drug should:

1. Dial 2 units of the drug by turning the dosage selector.

2. While holding the NovoRapid Flexpen with the needle up, tap lightly several times on the cartridge with your fingertip so that air bubbles move to the top of the cartridge.

3. While holding NovoRapid Flexpen with the needle up, press the start button all the way. The dosage selector will return to "0".

A drop of insulin should appear at the end of the needle. If this does not happen, replace the needle and repeat the procedure, but no more than 6 times. If insulin does not come from the needle, this indicates that the syringe pen is defective and should not be used again.

The dosage selector must be set to "0".

Collect the number of units needed for the injection. The dose can be adjusted by rotating the dosage selector in any direction until the correct dose is set in front of the dosage indicator. When rotating the dosage selector, be careful not to accidentally press the start button to prevent the release of a dose of insulin. It is not possible to set a dose exceeding the number of units remaining in the cartridge.

Do not use a residue scale to measure insulin doses.

1. Insert the needle sc. The patient should use the injection technique recommended by the doctor. To make an injection, press the start button all the way until “0” appears in front of the dosage indicator. When administering the drug, only the start button should be pressed. When the dosage selector is rotated, dose administration will not occur.

2. When removing the needle from under the skin, hold the start button fully depressed. After the injection, leave the needle under the skin for at least 6 seconds. This will ensure the introduction of a full dose of insulin.

3. Guide the needle into the outer cap of the needle without touching the cap. When the needle enters, put on the cap and unscrew the needle. Discard the needle, observing safety precautions, and close the syringe pen with a cap.

The needle should be removed after each injection and never store NovoRapid Flexpen with the needle attached. Otherwise, liquid may leak from NovoRapid Flexpen, which may lead to incorrect dosage.

Carers should be careful when removing and throwing out needles in order to avoid the risk of accidental needle sticks.

Discard used NovoRapid Flexpen with the needle disconnected.

NovoRapid Flexpen is intended for individual use only.

Storage and care

NovoRapid Flexpen is designed for effective and safe use and requires careful handling. In the event of a drop or strong mechanical stress, the syringe pen may be damaged and insulin may leak. The surface of NovoRapid Flexpen can be cleaned with a cotton swab dipped in alcohol. Do not immerse the syringe pen in alcohol, do not wash or lubricate it, as it may damage the mechanism. Re-filling of NovoRapid Flexpen is not allowed.

Drug interaction

Hypoglycemic effect of insulin enhance oral hypoglycemic drugs, MAO inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, selective beta-blockers, bromocriptine, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, drugs lithium salicylates.

Oral contraceptives, corticosteroids, thyroid hormones, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, somatropin, danazole, clonidine, calcium channel blockers, diazoxide, morphine, phenytoin, weaken the hypoglycemic effect of insulin.

Beta-blockers can mask the symptoms of hypoglycemia.

Octreotide / lanreotide can both increase and decrease the need for insulin. Alcohol can both enhance and reduce the hypoglycemic effect of insulin.

Medicines containing thiol or sulfite groups, when added to the drug NovoRapid Flexpen, can cause the destruction of insulin aspart. NovoRapid Flexpen should not be mixed with other drugs. The exceptions are insulin-isophan and the infusion solutions listed above.

The use of NOVORAPID Flexpen during pregnancy

NovoRapid Flexpen can be prescribed during pregnancy. Two randomized controlled clinical trials (157 + 14 pregnant women examined) did not reveal any adverse effects of aspart aspart on pregnancy or the health of the fetus / newborn compared to human insulin.

Careful monitoring of blood glucose levels and monitoring of pregnant women with diabetes mellitus (type 1, type 2 or gestational diabetes) throughout the pregnancy, as well as during the possible pregnancy, are recommended. The need for insulin, as a rule, decreases in the first trimester and gradually increases in the second and third trimesters of pregnancy. Shortly after birth, the need for insulin quickly returns to the level that was before pregnancy.

During breastfeeding, NovoRapid Flexpen can be used without restrictions, because administering insulin to a nursing woman is not a threat to the baby. However, it may be necessary to adjust the dose of the drug.

NOVORAPID Flexpen - side effects

Adverse reactions observed in patients receiving NovoRapid Flexpen are mainly dose-dependent and are due to the pharmacological effect of insulin. The most common adverse event with insulin is hypoglycemia.

At the initial stage of insulin therapy, refractive errors, edema and reactions may occur at the injection site (pain, redness, hives, inflammation, hematoma, swelling and itching at the injection site). These symptoms are usually transient in nature. A rapid improvement in glycemic control can lead to a state of acute pain neuropathy, which is usually reversible. Intensification of insulin therapy with a sharp improvement in the control of carbohydrate metabolism can lead to a temporary deterioration in the state of diabetic retinopathy, while a long-term improvement in glycemic control reduces the risk of progression of diabetic retinopathy.

All adverse reactions presented in the table, based on data obtained during clinical trials, are divided into groups according to the frequency of development in accordance with MedDRA and organ systems. Determination of the frequency of adverse reactions: very often (≥1 / 10), often (≥1 / 100 to

Allergic reactions
infrequentlyhives
skin rash
very rarelyanaphylactic reactions
From the side of metabolism
Oftenhypoglycemia
From the nervous system
seldomperipheral neuropathy (acute pain neuropathy)
On the part of the organ of vision
infrequentlyrefractive errors, diabetic retinopathy
On the part of the skin and subcutaneous tissue
infrequentlylipodystrophy
Other
infrequentlyedema, reactions at the injection site

Very rare reactions of generalized hypersensitivity (including generalized skin rash, itching, increased sweating, gastrointestinal disturbances, angioedema, breathing difficulties, rapid heartbeat, decreased blood pressure), which are potentially life-threatening, have been noted.

Hypoglycemia is the most common side effect. It can develop if the dose of insulin is too high in relation to the need for insulin. Severe hypoglycemia can lead to loss of consciousness and / or convulsions, temporary or irreversible impairment of brain function, even death. Symptoms of hypoglycemia, as a rule, develop suddenly. These may include “cold sweat”, pallor of the skin, increased fatigue, nervousness or tremor, anxiety, unusual tiredness or weakness, disorientation, decreased attention span, drowsiness, severe hunger, blurred vision, headache, nausea, and heart palpitations . Clinical studies have shown that the incidence of hypoglycemia varies depending on the patient population, dosing regimen, and glycemic control. In clinical trials, there was no difference in the overall incidence of hypoglycemia episodes between patients receiving aspart insulin therapy and patients receiving human insulin preparations.

Infrequent cases of lipodystrophy have been reported. Lipodystrophy can develop at the injection site.

Terms and conditions of storage of the drug NOVORAPID Flexpen

The drug should be stored at a temperature of 2 ° to 8 ° C (in the refrigerator), but not near the freezer, do not freeze. To protect from light, store NovoRapid ® FlexPen ® with the protective cap on. Shelf life - 30 months.

NovoRapid ® FlexPen ® should be protected from excessive heat and light.

Do not store or use the syringe pen with the preparation used or transferred as a spare syringe in the refrigerator. Store at a temperature not exceeding 30 ° C. Use within 4 weeks.

The drug should be stored out of the reach of children.

The composition of the diabetic

The NovoRapid diabetic product (insulin) is produced in two forms - these are replaceable Penfill cartridges and ready-made FlexPen pens.

The composition of the cartridge and pen is the same - it is a clear liquid for injection, where 1 ml contains the active component insulin aspart in an amount of 100 PIECES. One replaceable cartridge, like one pen, contains about 3 ml of solution, which is 300 units.

Cartridges are made of hydrolytic glass of the I class. Closed on one side with polyisoprene and bromobutyl rubber disks, on the other hand with special rubber pistons. There are five replaceable cartridges in an aluminum blister, and one blister is embedded in a cardboard box. In a similar way the FlexPen syringe pens are made. They are disposable and are designed for several doses. In a cardboard box there are five of them.

The drug is stored in a cold place at a temperature of 2-8 ° C. It must not be placed near the freezer, nor should it be frozen. Also, replaceable cartridges and syringe pens should be protected from the heat of the sun. If NovoRapid insulin (cartridge) is opened, it cannot be stored in the refrigerator, but should be used within four weeks. Storage temperature should not exceed 30 ° C. Shelf life of unopened insulin is 30 months.

Description of the hormone

NovoRapid is an analogue of short human insulin. The active ingredient is insulin Aspart. The medicine is synthesized by genetic engineering, replacing proline with an aspartic amino acid. This does not allow the formation of hexamers, the hormone is absorbed at a higher rate from subcutaneous fat. It manifests its effect in 10-20 minutes, the effect does not last as long as with ordinary insulin, only 4 hours.

Pharmacological features

NovoRapid has the appearance of a colorless transparent solution. 1 ml contains 100 units (3.5 mg) of insulin Aspart. Biological effects are based on the interaction of the hormone with cell membrane receptors. This stimulates the formation of major enzymes:

  • Hexokinase.
  • Pyruvate kinase.
  • Glycogen synthases.

They participate in the metabolism of glucose, help to accelerate its utilization and reduce the concentration in the blood. It is also provided by the following mechanisms:

  • Enhanced lipogenesis.
  • Stimulation of glycogenogenesis.
  • Speeding up tissue use.
  • Inhibition of glucose synthesis in the liver.

Using only NovoRapid is impossible, it is administered on Levemir, which ensures the maintenance of the natural amount of insulin in between meals.

Clinical studies of the effect of flekspennogo drug showed that in adults, the likelihood of hypoglycemia at night is reduced in comparison with traditional insulin. The medicine has proven effective in maintaining normoglycemia in elderly patients with type 2 diabetes and when prescribed to children.

In women with type 1 diabetes diagnosed before pregnancy, it does not negatively affect the fetus or gestation. The use of NovoRapid Flekspen insulin for the treatment of gestational diabetes (diagnosed for the first time during pregnancy) can improve control over the level of glycemia after eating.

It should be remembered that the action of ultrashort insulin is much stronger than that of the usual. For example, 1 Unit NovoRapida is 1.5 times stronger than short insulin. Therefore, the dosage should be reduced for a single administration.

Novorapid begins to act in 10-20 minutes, the effect lasts 4 hours

Who is prescribed a hormone, and to whom it is contraindicated

To prescribe NovoRapid, the patient needs to be diagnosed:

  • Type 1 diabetes.
  • Type 2 diabetes mellitus requiring a combination of insulin and tablets.
  • Gestational diabetes.

This drug reliably safely reduces sugar in pregnant women, as confirmed by clinical trials.

Treatment is contraindicated in case of individual hypersensitivity to the components of the drug, as well as in children under 2 years of age: clinical trials for small children have not been performed. During breastfeeding, he does not bear a danger to the baby, but the number of units must be adjusted.

Side effects

Undesirable effects of the NovoRapid insulin preparation in the form of a Flekspen cartridge are due to the action of insulin itself. It is able to lower glucose to a state of hypoglycemia.

When therapy is started, transient side effects may appear, which eventually disappear:

  • Refraction disorders.
  • Pain, hyperemia and swelling at the injection site.
  • Hematomas at the injection site.
  • Acute pain neuropathy.

Gradually, these manifestations disappear. Other effects develop infrequently:

  1. On the part of the immune system - urticaria, skin rash, anaphylactic reactions.
  2. From the viewpoint - retinopathy, refractive errors.
  3. Partial or complete disappearance of adipose tissue at the injection site.

Wrong choice and excess dosage lead to the development of a dangerous condition - hypoglycemia. Her symptoms appear suddenly. Concerned about weakness, dizziness, pallor, nausea, drowsiness. The patient is thrown into a sweat, attention and vision are disturbed. In severe cases, loss of consciousness occurs, irreversible changes in the brain and death. Therefore, it is important to choose the right dosage, to administer the drug on time.

Dosage and administration

How many units of fleksponny hormone is necessary, the doctor decides individually. How much insulin is needed is calculated based on the fact that a person needs an average of half or one unit per kilogram of weight per day. Treatment is consistent with meals. At the same time, ultrashort hormone covers up to 70% of the hormone requirement, the remaining 30% is covered with long insulin.

Penfill insulin NovoRapid should be used 10-15 minutes before meals

Penofill insulin NovoRapid is administered 10-15 minutes before meals. If the injection was missed, then it can be entered without delay after eating.How many hours the action lasts depends on the injection site, the number of units of the hormone in the dose, physical activity and the carbohydrates taken.

According to the indications, this drug can be used intravenously. An insulin pump (pump) is also used for administration. With its help, a hormone is administered for a long time under the skin of the anterior abdominal wall, periodically changing the injection points. It is impossible to dissolve in other preparations of the hormone of the pancreas.

For intravenous use, a solution is taken that contains insulin up to 100 U / ml, diluted in 0.9% sodium chloride, 5% or 10% dextrose. During the infusion period, they control blood glucose.

NovoRapid is available in the form of a Flekspen syringe pen and replaceable Penfill cartridges for it. One pen contains 300 units of the hormone in 3 ml. The syringe is used only individually.

Unopened packaging is kept in the refrigerator at 2-8 degrees, but in no case is it frozen. After opening it is stored at room temperature, protecting from direct sunlight and heating above 30 degrees.

The handle is used with disposable needles and is equipped with a dispenser. To make an injection, you need to remove the cap, the sticker from the needle and screw it to the syringe. Each injection requires a needle change. To release air bubbles, using the selector dial 2 units of hormone. The handle is placed upside down with a needle, tapped lightly on it. When the bubbles move up, press the start button. A drop of solution should appear on the cut of the needle. If this does not happen, the procedure is repeated up to 6 times. Lack of result indicates a malfunction of the syringe.

After that, the dose prescribed by the doctor is established. To administer the drug, press the start button and hold until the selector is in the zero position. After the injection, a cap is put on the needle and discarded.

Ultrashort insulin analogues and cost

NovoRapid has modern analogues that are similar to it in action and development of the effect. These are Apidra and Humalog drugs. Humalog is faster: 1 unit acts 2.5 times faster than the same amount of short hormone. Apidra's effect develops at about the same speed as NovoRapida.

The cost of 5 Flexpen syringe pens is about 1930 rubles. A replacement Penfill cartridge costs up to 1800 rubles. The cost of analogues, which are also available in syringe pens, is approximately identical and ranges from 1700 to 1900 rubles in various pharmacies.

Conclusion

Therapy of diabetes is aimed at maintaining normoglycemia. To achieve the desired glucose values, the patient is prescribed basic bolus therapy. The choice of specific drugs is made by the doctor based on monitoring glucose concentrations at different times of the day. Due to their short action, ultra-short insulins are prescribed to patients who do not know exactly what time they will eat. For most, short insulins are prescribed first.

For the treatment of diabetes, pharmacologists have invented a large number of different drugs. Insulin is the most effective drug in the treatment of this disease. Like many drugs, it is divided into several pharmacological groups. Especially effective is insulin Novorapid. There are various analogues of Novorapid insulin: Flekspen, Aspart.

What doctors say about diabetes

Doctor of Medical Sciences, Professor Aronova S. M.

For many years I have been studying the problem of DIABETES. It is scary when so many people die, and even more become disabled due to diabetes.

I hasten to tell the good news - the Endocrinological Research Center of the Russian Academy of Medical Sciences has managed to develop a medicine that completely cures diabetes mellitus. At the moment, the effectiveness of this drug is approaching 100%.

Another good news: the Ministry of Health has secured the adoption of a special program that compensates for the entire cost of the drug.In Russia and the CIS countries diabetics before can get a remedy IS FREE .

Composition and form of release

This type of drug is similar to the physiological analogue of insulin. It is because of this that this drug is famous for its high quality. The basis of this drug is the pharmacological drug Aspart. The medicine has two methods of application: by intravenous injection,

Novorapid has no color, is a transparent liquid without impurities. This drug is produced in the form of cartridges made of colorless glass.

Be careful

According to the WHO, every year in the world 2 million people die from diabetes and its complications. In the absence of qualified support for the body, diabetes leads to various kinds of complications, gradually destroying the human body.

The most common complications are: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can also lead to the development of cancerous tumors. In almost all cases, a diabetic either dies, struggling with a painful disease, or turns into a real person with a disability.

What do people with diabetes do? The Endocrinological Research Center of the Russian Academy of Medical Sciences has succeeded in making a remedy that completely cures diabetes mellitus.

The Federal program "Healthy Nation" is currently underway, within the framework of which this drug is given to every resident of the Russian Federation and the CIS IS FREE . For more information, see the official website of MINZDRAVA.

For some factors, the doctor may change the dosage:

  • increased physical activity,
  • other chronic diseases that aggravate the symptoms of diabetes,
  • deterioration of the patient
  • taking drugs, another pharmacotherapeutic group.

The drug is administered under the skin using a special syringe. Medical personnel may administer insulin intravenously.

Use carefully

Any drug has certain indications, in which it must be used carefully, or eliminated altogether:

  • each cartridge is used once. It is forbidden to reuse an already open drug. With a new injection, use a disposable sterile syringe,
  • do not use this medicine if the solution is cloudy or has a shade,
  • for urgent insulin use, use a syringe U100.

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Novorapid is stored at a temperature of 2-8 degrees. It is better to put the medicine in the refrigerator, but avoid freezing. Eliminate direct exposure to sunlight and keep track of the storage date.

Insulin aspart

For Aspart insulin, individual instructions for use. Observing it, you will avoid many problems associated with taking Astarta.

This type of insulin is a biphasic fluid consisting of soluble insulin astart by 30% and crystalline astart by 70%. Aspart is similar to human insulin, but has a short action. It has high adsorption, which allows you to quickly normalize, even the critical condition of the patient.

Pharmacology

The NovoRapid medication (insulin) has a hypoglycemic effect, and the active component, insulin aspart, is an analogue of the short-acting hormone produced by humans. This substance is obtained by using special biotechnology of recombinant DNA. A strain of Saccharomyces cerevisiae is added here, and an amino acid called "proline" is temporarily replaced by an aspartic one.

The medicine comes into contact with the receptors of the outer cytoplasmic membrane of the cells, where it forms a whole complex of insulin endings, activates all the processes that occur inside the cells. After reducing the amount of glucose in plasma, an increase in intracellular transport, an increase in the digestibility of various tissues, an increase in glycogenogenesis and lipogenesis occur. The rate of glucose production by the liver decreases.

Replacing the amino acid proline with aspartic acid when exposed to insulin aspart reduces the ability of molecules to create hexamers. This type of hormone is better absorbed by subcutaneous fat, affects the body faster than the effect of soluble standard human insulin.

In the first four hours after a meal, insulin aspart reduces plasma sugar levels faster than soluble human hormone. But the effect of NovoRapida with subcutaneous administration is shorter than that of soluble human.

How long does NovoRapid work? This question worries most people with diabetes. So, the effect of the drug occurs after 10-20 minutes after the injection. The highest concentration of the hormone in the blood is observed 1-3 hours after the use of the drug. The tool affects the body for 3-5 hours.

Studies of individuals with type I diabetes have shown a several-fold reduction in the risk of nocturnal hypoglycemia when using NovoRapida, especially compared with the administration of soluble human insulin. In addition, there was a significant decrease in postprandial glucose in plasma when injected with insulin aspart.

Indications and contraindications

The drug NovoRapid (insulin) is intended for people with type 1 diabetes, which is insulin-dependent, and for patients with type 2 diabetes - insulin-independent (stage of resistance to hypoglycemic drugs taken orally, as well as intercurrent pathologies) .

Contraindication to the use of the drug is hypoglycemia and excessive sensitivity of the body to insulin aspart, excipients of the drug.

Do not use NovoRapid for children under six years of age due to a lack of necessary clinical studies.

The medicine "NovoRapid": instructions for use

The drug NovoRapid is an analogue of insulin. It begins to act immediately after the injection. The dosage for each patient is individual and is selected by the doctor. To achieve the best result, this hormone is combined with prolonged or medium-acting insulin.

In order to control glycemia, the amount of glucose in the blood is constantly measured and the dose of insulin is carefully selected. As a rule, the daily dose for adults and children ranges from 0.5-1 U / kg.

When injected with NovoRapid medicine (the instructions for use describe in detail the order of administration of the drug), the human need for insulin is provided by 50-70%. The rest is satisfied by the administration of long-acting (prolonged) insulin.An increase in the patient’s physical activity and a change in diet, as well as existing concomitant pathologies, often necessitate a change in the administered dose.

The hormone NovoRapid, in contrast to the soluble human, begins to act quickly, but not continuously. Slow administration of insulin is indicated. The injection algorithm involves the use of medication immediately before a meal, and if there is an urgent need, the drug is used immediately after a meal.

Due to the fact that NovoRapid acts on the body for a short time, the risk of hypoglycemia at night in patients with diabetes is significantly reduced.

In elderly patients, as well as in people with renal or hepatic insufficiency, monitoring of blood glucose concentration should occur more often, and the amount of aspart insulin is selected individually.

Subcutaneous administration of insulin (the hormonal injection algorithm is described in detail in the instructions for use) involves the injection in the anterior abdomen, thigh, brachial and deltoid muscles, as well as in the buttocks. The area in which injections are made should be changed to prevent lipodystrophy.

With the introduction of the hormone in the anterior region of the peritoneum, the drug is absorbed faster than injections in other parts of the body. The duration of the hormone effect is affected by the dose, injection site, degree of blood flow, body temperature, level of physical activity of the patient.

Means "NovoRapid" is used for long subcutaneous infusions, which are carried out by a special pump. The drug is injected into the anterior peritoneum, but places are periodically changed. If an insulin pump is used, NovoRapid should not be mixed with other types of insulin in it. Patients receiving a hormone using an infusion system should have a supply of medicine in case of a breakdown of the device.

NovoRapid can be used for intravenous administration, but the procedure should be carried out by a qualified health professional. For this type of administration, infusion complexes are sometimes used, where insulin is contained in an amount of 100 PIECES / ml, and its concentration is 0.05-1 PIECES / ml. The drug is diluted in 0.9% sodium chloride, 5- and 10% dextrose solution, which contains potassium chloride up to 40 mmol / L. The funds mentioned are stored at room temperature for no more than a day. With insulin infusions, you need to regularly donate blood for glucose in it.

How to calculate the dose of insulin?

To calculate the dosage, you need to know that insulin is combined, long (extended), medium, short and ultrashort. The first normalizes blood sugar. It is introduced on an empty stomach. It is indicated for persons with type 1 and type 2 diabetes. There are people who use only one type of insulin - extended. Some people use only NovoRapid to avoid sudden surges in glucose. Short, long insulins can be used simultaneously in the treatment of diabetes, but they are administered at different times. For some patients, only the combined use of drugs helps to achieve the desired effect.

When choosing prolonged insulin, some nuances should be taken into account. For example, it is necessary that without injecting a short hormone and basic meals, the sugar should remain at the same level throughout the day only due to the action of long insulin.

The selection of a dose of prolonged insulin is as follows:

  • In the morning, without breakfast, measure the sugar level.
  • Lunch is eaten, and after three hours, the plasma glucose level is determined. Further measurements are carried out every hour before going to bed. On the first day of dose selection, skip lunch, but have dinner.
  • On the second day, breakfast and lunch are allowed, but dinner is not allowed. Sugar, as well as on the first day, needs to be controlled every hour, including at night.
  • On the third day, they continue to take measurements, eat normally, but do not administer short insulin.

Ideal morning indicators are:

  • on the 1st day - 5 mmol / l,
  • on the 2nd day - 8 mmol / l,
  • on the 3rd day - 12 mmol / l.

Such glucose indicators should be obtained without a short-acting hormone. For example, if in the morning blood sugar is 7 mmol / l, and in the evening - 4 mmol / l, then this indicates the need to lower the dose of the long hormone by 1 or 2 units.

Often, patients use the Forsham formula to determine the daily dose. If glycemia ranges from 150-216 mg /%, then 150 is taken from the measured blood sugar level and the resulting number is divided by 5. As a result, a single dose of a long hormone is obtained. If glycemia exceeds 216 mg /%, 200 is subtracted from the measured sugar, and the result is divided by 10.

To determine the dose of short insulin, you need to measure the level of sugar throughout the week. If all the daily values ​​are normal, except for the evening, then short insulin is administered only before dinner. If the sugar level jumps after each meal, then injections are given immediately before meals.

To determine the time for which the hormone should be administered, glucose must first be measured 45 minutes before meals. Next, you should control the sugar every five minutes until its level reaches the level of 0.3 mmol / l, only after that you should eat. This approach will prevent the onset of hypoglycemia. If after 45 minutes the sugar does not decrease, you must wait with food until the glucose drops to the desired level.

To determine the dose of ultrashort insulin, people with type 1 and type 2 diabetes are advised to follow a diet for a week. Keep track of how much and what foods they consume. Do not exceed the allowed amount of food. You should also take into account the physical activity of the patient, medication, the presence of chronic diseases.

Ultrashort insulin is administered 5-15 minutes before a meal. How to calculate the dose of NovoRapid insulin in this case? It should be remembered that this drug reduces the glucose level by 1.5 times more than its short substitutes. Therefore, the amount of NovoRapid is 0.4 of a dose of a short hormone. The norm can be determined more precisely only by experiment.

When selecting an insulin dose, the degree of the disease should be taken into account, as well as the fact that the need for any diabetic in the hormone does not exceed 1 U / kg. Otherwise, an overdose may occur, which will cause a number of complications.

Basic rules for determining the dose for diabetics:

  • At an early stage of type 1 diabetes mellitus, the dose of the hormone should be no more than 0.5 U / kg.
  • In type 1 diabetes, which is observed in the patient for a year or more, the one-time rate of insulin administered is 0.6 U / kg.
  • If type 1 diabetes is accompanied by a number of serious diseases and has unstable indicators of blood glucose, the amount of the hormone is 0.7 U / kg.
  • In decompensated diabetes mellitus, the amount of insulin is 0.8 U / kg.
  • If diabetes is with ketoacidosis, then about 0.9 U / kg of the hormone is required.
  • During pregnancy, a woman in the third trimester needs 1.0 U / kg.

To calculate a single dose of insulin, the daily dose should be multiplied by body weight and divided by two, and the final indicator should be rounded.

The use of the drug "NovoRapid Flexpen"

The introduction of the hormone can be carried out using a syringe pen "NovoRapid Flexpen." It has a color coding and a dispenser. The dose of insulin administered can be from 1 to 60 units, one step of the syringe is 1 unit. In the drug "NovoRapid" needles are used TM "Novotvist" or "Novofine" with a length of 8 mm. If you use a pen-syringe, remember: you always need to have a spare system for injection with you - in case the syringe is damaged or lost.

Before introducing the hormone with a syringe pen, you need to:

  • Read the label and make sure that NovoRapid is exactly the insulin you need.
  • Remove the cap from the pen.
  • Remove the sticker that is on the disposable needle.
  • Screw the needle to the handle. A new needle is needed for each injection to prevent the growth of bacteria. The needle must not be bent or damaged.
  • To avoid accidental injections on the needle after insulin administration, the cap is not worn.

The NovoRapid syringe pen may contain a small amount of air inside. So that oxygen bubbles do not accumulate, and the dose is correctly administered, certain rules should be followed:

  • Dial 2 PIECES of hormone by turning the dosage selector.
  • Position the syringe pen with the needle up and tap the cartridge with your fingertip. So the air bubbles will move to the upper region.
  • Holding the FlexPen syringe upside down with the needle, press the start button all the way. The dosing selector at this time will return to the "0" position. One drop of the hormone will appear on the needle. If this does not happen, the procedure can be repeated six times. If insulin does not flow, then the syringe is defective.

Before setting the dose, you need to make sure that the dosing selector is in the "0" position. Next, you need to dial the required number of units, the volume of the drug is regulated by a selector in both directions. When setting the dose, you need to be careful and try not to accidentally hit the start button, otherwise a premature release of the hormone will occur. It is impossible to establish a norm more than that which is in the preparation "NovoRapid". Also, do not use the residue scale to determine the dose of the hormone.

During the administration of insulin, the technique recommended by the attending physician is followed subcutaneously. To perform an injection, press the start button. Hold it until the dosage selector is in position “0”. During the injection, only the start button is held. During normal rotation of the dosage indicator, insulin delivery does not occur.

After the injection, the needle under the skin should be held for another six seconds, without releasing the start button. So the dose of insulin is introduced completely. After the injection, the needle is sent to the outer cap, and when it enters it, it is unscrewed and thrown away, taking all precautions. Then the syringe is closed with a cap. The needle is removed after each injection and cannot be stored with a syringe pen. Otherwise, fluid will leak, which may lead to the introduction of the wrong dose. The instructions for use will tell you more about how to inject NovoRapid insulin.

Side effects

The drug "NovoRapid" can cause a number of side effects. This is hypoglycemia, which manifests itself in the form of excessive sweating, pallor of the skin, nervousness, unreasonable feelings of anxiety, tremor of the extremities, weakness in the body, impaired orientation and decreased concentration. Dizziness, hunger, malfunction of the visual apparatus, nausea, headache, tachycardia also occur. Glycemia can lead to loss of consciousness, cramps, impaired brain activity and death.

Infrequently, patients talk about such allergic manifestations as urticaria, rashes. Perhaps a violation of the stomach and intestines, the appearance of angioedema, tachycardia, shortness of breath. Patients experienced a decrease in blood pressure.

Among local reactions, itching in the injection zone, redness, and swelling of the skin were noted. Infrequently, symptoms of lipodystrophy have occurred. The medicine can cause edema at the initial stage of treatment, as well as a violation of refraction.

Doctors say that all manifestations are temporary and are observed mainly in dose-dependent patients and are caused by the drug effect of insulin.

If the hormone does not work, then you can always replace the NovoRapid Flexpen drug. Analogues, of course, should be selected by the doctor. The most popular are:

Hormone cost

The medicine NovoRapid is released strictly according to the doctor’s prescription.The price of five Penfill cartridges is around 1800 rubles. The cost of the hormone Flexpen is 2,000 rubles. One package contains five Novorapid insulin pens. The price depending on the distribution network may vary slightly.

For the treatment of diabetes, pharmacologists have invented a large number of different drugs. Insulin is the most effective drug in the treatment of this disease. Like many drugs, it is divided into several pharmacological groups. Especially effective is insulin Novorapid. There are various analogues of Novorapid insulin: Flekspen, Aspart.

What doctors say about diabetes

Doctor of Medical Sciences, Professor Aronova S. M.

For many years I have been studying the problem of DIABETES. It is scary when so many people die, and even more become disabled due to diabetes.

I hasten to tell the good news - the Endocrinological Research Center of the Russian Academy of Medical Sciences has managed to develop a medicine that completely cures diabetes mellitus. At the moment, the effectiveness of this drug is approaching 100%.

Another good news: the Ministry of Health has secured the adoption of a special program that compensates for the entire cost of the drug. In Russia and the CIS countries diabetics before can get a remedy IS FREE .

Instructions for use

pharmachologic effectLike other types of insulin, Novorapid lowers blood sugar, blocks the breakdown of adipose tissue and the conversion of proteins into glucose. This drug is used so that sugar does not increase after eating, as well as in urgent cases when you need to quickly bring down the increased glucose level.
Indications for useType 1 and type 2 diabetes with significantly impaired glucose metabolism, in which diet and pills do not help enough. It can be prescribed to children starting from 2 years. To keep your glucose levels stable and normal, check out the article “Treating Type 1 Diabetes” or “Insulin for Type 2 Diabetes”. Find out also here at what rates of sugar insulin starts to be injected.

When injecting NovoRapid, like any other type of insulin, you need to follow a diet.

ContraindicationsAllergy to the active substance or auxiliary components of the drug. Also, Novorapid should not be injected if the diabetic has low blood sugar.
special instructionsColds and other infectious diseases require a temporary increase in insulin dosages. Read here about the factors that influence sensitivity to this hormone - stress, physical activity, weather, etc. Learn also how to combine insulin injections with alcohol consumption. Starting to inject ultrashort insulin before meals, continue to avoid harmful prohibited foods.



DosageDo not use standard insulin therapy regimens that do not take into account the particular course of diabetes in each patient. Doses and schedule of injections of insulin need to be selected individually for each diabetic. Study the articles “Selection of doses of short and ultrashort insulin before meals”, as well as “Introduction of insulin: where and how to prick”.
Side effectsCheck out the article “Low Blood Sugar (Hypoglycemia)”. Find out about her symptoms. Understand how to increase sugar to normal with glucose tablets. Hypoglycemia is the most common side effect of Novorapid insulin. You need to be able to fight it. There may also be allergic reactions. Also, lipohypertrophy is a hardening of the skin in places of frequent injections.

Many diabetics who inject fast insulin find it impossible to avoid bouts of hypoglycemia. In fact, this is not so. You can keep stable normal sugar even with severe autoimmune disease. And even more so, with relatively mild type 2 diabetes. There is no need to artificially increase your blood glucose level to insure yourself against dangerous hypoglycemia.Watch a video in which Dr. Bernstein discusses this issue with the father of a child with type 1 diabetes. Learn how to balance nutrition and insulin doses.

Interaction with other medicinesSome drugs weaken the effects of insulin injections, while others, on the contrary, strengthen it. Beta blockers can muffle symptoms of hypoglycemia before they become unconscious. Talk with your doctor about all the medications you are taking with your diabetes insulin therapy regimen.
OverdoseSevere hypoglycemia can occur with loss of consciousness, irreversible brain damage, and even death. Read here how to provide the patient with emergency care at home and in a hospital. In case of impaired consciousness, call an ambulance.
Release formInsulin NovoRapid is available in 3 ml cartridges. These cartridges can be sealed in FlexPen disposable syringe pens with a dosage step of 1 IU. This step is inconvenient for diabetics who require low doses of insulin. A penless drug is sold under the name Penfill.
Terms and conditions of storageLike other types of insulin, NovoRapid is very fragile. It can easily deteriorate without changing its appearance. To avoid damage, study the storage rules and carefully follow them. Each opened cartridge must be used within 4 weeks. The shelf life of a drug that has not yet begun to be used is 30 months.
CompositionThe active substance is insulin aspart. Excipients - glycerol, phenol, metacresol, zinc chloride, sodium chloride, sodium hydrogen phosphate dihydrate, sodium hydroxide, hydrochloric acid, water for injection.

Many diabetics are looking for ways to buy Novorapid insulin from their hands, according to private announcements. Website endocrin-patient.com strongly recommends that you do not. Insulin is a very fragile hormone. It spoils at the slightest violation of storage rules. Moreover, its quality cannot be determined by appearance. Spoiled insulin Novorapid may remain as clear as fresh.

Buying with your hands, you are highly likely to get spoiled or even fake insulin. At the same time, you are wasting your time and money, breaking the control of your diabetes. Buy Novorapid and other types of insulin only in reliable, trusted pharmacies. Avoid private advertisements for the sale of valuable medicines.

Novorapid - what is the action of insulin?

Novorapid is an ultrashort drug. Scientists slightly changed its structure compared to ordinary human insulin, so that it begins to act faster, almost immediately after an injection. It is necessary to take food no later than 10-20 minutes after administration of the drug. This may be the fastest insulin in the world. Although hormonal injections act differently for every diabetic. Someone Humalog may seem faster.

How to prick it?

Check out your type 1 diabetes control program or step-by-step type 2 diabetes treatment plan. Properly use fast-acting insulin as part of a set of measures to maintain normal blood sugar. In the treatment of diabetes, nutrition plays a major role, and then the choice of the types of insulin used, the selection of dosages and the schedule of injections.

For diabetics who follow a low-carb diet, Novorapid and its analogues are not very suitable as fast insulin before meals. Because they act faster than the permitted products are absorbed. There may be episodes of low blood sugar (hypoglycemia), as well as jumps in glucose levels. It may be worth using short insulin, such as Actrapid. Moreover, it costs less.

It is necessary for several days to observe the indicators of blood sugar. Determine before which meals you need an injection of fast insulin.It may turn out that there is no need to inject Novorapid 3 times a day, but 1-2 injections are enough or you can do without it at all. For more details, see the article “Selection of fast-acting insulin doses before meals”. An injection of Novorapid is done 10-20 minutes before a meal. Do not try to skip a meal after you injected this insulin. Eat sure.

Indications for use

It is prescribed to people suffering from diabetes mellitus of varying degrees. Approved for use from 2 years.

Pharmachologic effect

Novorapid interacts with cell membrane receptors, stimulating the production of physiological hormone.

During the use of this drug, a decrease in blood sugar is possible, this is usually caused by:

  • transportation and production of insulin in the patient’s blood,
  • absorption of the drug by body tissues,
  • decreased liver glucose production.

While taking any type of insulin, measure your blood glucose to avoid a diabetic coma.

It is thanks to its actions that this type of insulin is highly effective.

The dose of the drug is assigned individually to each patient. The average daily dose for aunts and adults is: 0.5-1 per kg of body weight. To make a diagnosis and prescribe a drug, you need to see a doctor. The specialist will make the correct diagnosis and prescribe drugs, taking into account your lifestyle.

Be careful

According to the WHO, every year in the world 2 million people die from diabetes and its complications. In the absence of qualified support for the body, diabetes leads to various kinds of complications, gradually destroying the human body.

The most common complications are: diabetic gangrene, nephropathy, retinopathy, trophic ulcers, hypoglycemia, ketoacidosis. Diabetes can also lead to the development of cancerous tumors. In almost all cases, a diabetic either dies, struggling with a painful disease, or turns into a real person with a disability.

What do people with diabetes do? The Endocrinological Research Center of the Russian Academy of Medical Sciences has succeeded in making a remedy that completely cures diabetes mellitus.

The Federal program "Healthy Nation" is currently underway, within the framework of which this drug is given to every resident of the Russian Federation and the CIS IS FREE . For more information, see the official website of MINZDRAVA.

For some factors, the doctor may change the dosage:

  • increased physical activity,
  • other chronic diseases that aggravate the symptoms of diabetes,
  • deterioration of the patient
  • taking drugs, another pharmacotherapeutic group.

The drug is administered under the skin using a special syringe. Medical personnel may administer insulin intravenously.

Use carefully

Any drug has certain indications, in which it must be used carefully, or eliminated altogether:

  • each cartridge is used once. It is forbidden to reuse an already open drug. With a new injection, use a disposable sterile syringe,
  • do not use this medicine if the solution is cloudy or has a shade,
  • for urgent insulin use, use a syringe U100.

Application methods

Novorapid is intended for subcutaneous administration. Perhaps intravenous administration, during the injection of a qualified specialist. For the introduction of insulin, the following places are best suited:

Inject insulin under the skin according to the technique your doctor advised.

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Novorapid is stored at a temperature of 2-8 degrees. It is better to put the medicine in the refrigerator, but avoid freezing. Eliminate direct exposure to sunlight and keep track of the storage date.

Insulin aspart

For Aspart insulin, individual instructions for use. Observing it, you will avoid many problems associated with taking Astarta.

This type of insulin is a biphasic fluid consisting of soluble insulin astart by 30% and crystalline astart by 70%. Aspart is similar to human insulin, but has a short action. It has high adsorption, which allows you to quickly normalize, even the critical condition of the patient.

Indications for use

  • Chronic diseases that accompany diabetes.
  • Diabetes mellitus of the first and second degree.

How long is the injection of this drug?

Each administered dose of Novorapid insulin lasts approximately 4 hours. No need to measure sugar 1-2 hours after the injection, because during this time the drug will not have time to fully act. Wait 4 hours, then measure your blood glucose and inject the next dose if necessary. It is better not to allow two doses of fast insulin to act simultaneously in the body. To do this, administer Novorapid at intervals of at least 4 hours.

What to do if Novorapid does not reduce sugar?

Most likely, the drug deteriorated due to a violation of the rules for storage of insulin. Do not try to inject spoiled insulin in high doses in the hope that it will work. This is deadly. Throw away your current cartridge or bottle, start using a new one. Wait 4-5 hours from the moment of the previous injection. Only then put a new dose of fresh quick-acting insulin. Learn the rules for storing hormonal drugs and follow them carefully.

Where can I find a comparison of Novorapid and Levemir insulin?

Novorapid and Levemir are not at all similar types of insulin. They can not be compared, because they solve completely different problems in controlling diabetes. They can be used at the same time. Many diabetics do this. You already know that Novorapid is an ultra-short-acting insulin. He is pricked before meals, as well as in emergency cases when you need to quickly bring down high sugar.

Levemir is a long-acting drug. It is used so that there is a background concentration of insulin in the blood continuously 24 hours a day. This improves blood sugar and also prevents the breakdown of muscles and internal organs. Levemir is not intended to quickly lower glucose levels after meals.

In type 1 and type 2 diabetes, in severe cases, 2 types of insulin must be used simultaneously - long and short (ultrashort). It can be Levemir and Novorapid or analogues that compete with them. Recommended drugs listed in the article “Types of insulin and their action”. Pay attention to the new long insulin Treshiba, which in many ways is better than Levemir.

Novorapid insulin analogues are Humalog and Apidra. They are produced by competing pharmaceutical companies. All these types of insulin are very similar to each other.Dr. Bernstein says Humalog is a little faster and stronger than Apidra and Novorapid. However, in diabetic forums, many publications disprove this information.

For practice, the difference in the effect of competing ultrashort insulin preparations is not very important. As a rule, diabetics inject the insulin they give them for free. Without extreme necessity, it is better not to switch from Novorapid to one of its analogues. Such transitions inevitably worsen blood sugar control for several days or weeks.

It might be worth switching to short-acting human insulin. For example, on Actrapid. This recommendation is for diabetics who are on a low-carb diet. The profile of action of short insulin coincides with the rate of assimilation of permitted and recommended products. And Novorapid and other ultrashort drugs act too quickly.

NovoRapid during pregnancy

Insulin Novorapid can be used to control high blood sugar in women during pregnancy. It does not create special problems for either the mother or the fetus. Please note that Novorapid is an ultrashort drug. It acts faster and stronger than regular short insulin. The risk of hypoglycemia (low blood sugar) for the patient increases, especially in the first half of pregnancy, when the body's sensitivity to insulin is highest.

This does not mean that you should abandon the use of Novorapid insulin during pregnancy. The specified drug can be used as directed by a doctor. Make sure that the pregnant woman understands how to calculate the appropriate dosage. You need not to be lazy to measure your blood sugar several times every day. Adjust your insulin dosage based on these measurements. You will find a lot of interesting information in the articles Pregnant Diabetes and Gestational Diabetes. Usually, with the right diet, you can do without Novorapid insulin and other powerful ultra-short drugs.

6 comments on NovoRapid

Hello! We recently got sick with type 1 diabetes, started to be treated with insulin. We are studying your site, now we are just changing the nutrition of the whole family, but much remains to be seen. For example, such a situation. The son is 8 years old. He checked his sugar with a glucometer at 22:00 - showed 16.2. Made NovoRapid 2 units. An hour later, they measured again - the result was 17.3. Why did glucose rise? Did the quick insulin injection not work?

The son is 8 years old. He checked his sugar with a glucometer at 22:00 - showed 16.2. Made NovoRapid 2 units. An hour later, they measured again - the result was 17.3. Why did glucose rise?

Your child’s sugar did not rise, but remained the same as it was, plus a statistical error. Of course, this is still not good.

For an 8-year-old child, the dose of fast insulin 2 units is very high. If it did not work, the drug is most likely spoiled.

Hello! I need your help - to compensate for diabetes in my 10-year-old daughter. Has been sick for 2 years. Insulin: long - Protafan, food - NovoRapid. Doses: Protafan in the morning and at night for 2 PIECES, NovoRapid - 2 PIECES before each meal. Since the new year, we have started terrible jumps in sugars in the range from 2-3 to 20 within 2-3 hours. The child complains of a headache, sometimes even her legs do not obey her. With glucose values ​​of 1.8, there were cramps. Why such jumps? We follow a diet, we consider bread units. What to do.

Why such jumps? We follow a diet, we consider bread units.

Judging by the mention of bread units, you follow the wrong (inappropriate) diet, hence all the problems.

At first, everything was fine, because the child retained the residual production of its own insulin. This is called a honeymoon. Now it's over - and the effects of the standard diabetes treatment show up in all its glory.

Join our sect.in the sense, to transfer the whole family to a low-carb diet - http://endocrin-patient.com/dieta-pri-saharnom-diabete/ - and carefully observe it. Explain to daughter the consequences of eating harmful foods.

Protafan in the morning and at night in 2 units, NovoRapid - in 2 units before each meal.

Both of these drugs are not optimal, it is desirable to replace them with other types of insulin, for more details see http://endocrin-patient.com/vidy-insulina/

I emphasize that without switching to a low-carb diet, this will not work.

For more than 10 years, my husband has been sick, six months ago they switched to NovoRapid and Levemir insulin, we take them as directed by a doctor. The husband goes in for sports 3 times a week: swimming, volleyball. We try to keep a diet. But for some reason always high blood sugar - somewhere 11-12, sometimes 13. Maybe give advice.

Tip - carefully read the materials on the site before writing comments.

Composition and release forms

In 1 ml of insulin solution contains:

  • Active ingredient: 100 IU aspart (identical to 3.5 mg)
  • Additional substances: glycerol, phenol, metacresol, zinc chloride, sodium chloride, sodium hydroxide, hydrochloric acid, water d / and etc.

The drug in the form of a liquid for s / c and iv injection is an unpainted or slightly yellowish solution without suspensions. It is placed in a glass cartridge of a refillable syringe pen. In 1 remedy - 3 ml of aspart. In a pack of thick cardboard - 5 n-pens, a guide to the drug.

In addition to syringe pens, asparts also come in the form of individual cartridges. Available under the name Novorapid Penfill.

Healing properties

The drug is an analogue of human insulin quick and short action. Compared to other soluble insulins, aspart is more likely to lower the level of glucose: its maximum efficiency develops during the first 4 hours after the injection, and the sugar content is at a lower level. But after administration under the skin, its duration of action is shorter compared to human insulin.

The patient feels the relief after Novorapid Flexpen after 10-15 minutes, the effect of the drug lasts from 3 to 5 hours.

Clinical studies of the effect of the drug on glycemia in type 1 diabetics have shown that after aspart, the risk of hypoglycemia at night is much lower compared to similar drugs of human origin. The frequency of cases is identical for these substances.

The hypoglycemic effect of the drug is achieved thanks to insulin aspart - a substance that is identical in properties to human insulin. Aspart is produced by genetic engineering, which provides for the replacement of proline with aspartic acid in a strain of Saccharomyces cerevisiae. Thanks to this, aspart penetrates the circulatory system with a higher speed and has the desired effect.

Features of the use of insulin

Average price: (5 pcs.) - 1852 rubles.

If a diabetic has to travel to places with a different time zone, he should consult in advance how to take the medicine: at what time, in what quantity, to find out other aspects of the administration.

If Novorapid Flexpen is not administered in sufficient quantity or for some reason the patient has stopped injecting it, this can provoke hyperglycemia and diabetic ketoacidosis. Type 1 diabetics are especially prone to this. Symptoms develop gradually, constantly worsening. You can judge a dysfunctional state by nausea, bouts of vomiting, drowsiness, dry skin and mucous membranes of the oral cavity, increased urination, constant thirst, and decreased appetite. Hyperglycemia can also be judged by the characteristic smell of acetone during breathing.

If hypoglycemia is suspected, appropriate treatment should be urgently applied, otherwise an aggravation of the condition can lead to the death of the diabetic. It should be borne in mind that intensively conducted insulin therapy can distort the characteristic symptoms of hypoglycemia.

In diabetics, with normal control of metabolic processes, complications of the disease slow down and progress at a slower rate. Therefore, it is advisable to carry out appropriate measures aimed at normalizing metabolic control, including monitoring blood sugar levels.

It should be borne in mind that hypoglycemic processes are formed at a faster pace if the diabetic has concomitant diseases or is undergoing therapy with drugs that inhibit the absorption of food. With concomitant pathologies, especially if they are of infectious origin, the need for the drug increases. If a diabetic has problems with the liver and / or kidneys, then the body's need for insulin is reduced.

After the transition of the diabetic to other types of the drug, the early signs of hypoglycemia may be distorted or become less intense, compared with the previously used insulin.

The transition to a different type of insulin should be monitored by doctors. Changing the dosage may be required not only when changing the type of drug, but also the manufacturer, production method.

The dosage should be adjusted if the diabetic switched to a different diet, changed his diet, started or stopped experiencing physical activity. The patient must remember that skipping meals or unforeseen physical activity can cause hypoglycemia.

Continued proper glycemic control reduces the risk of worsening diabetic retinopathy. An intensive course of insulin and a rapid improvement in glycemia can provoke a temporary deterioration in retinopathy.

Does Novorapid Flexpen insulin affect the reaction rate

The conditions characteristic of hypo- and hyperglycemia affect the speed of reaction and the ability to concentrate, can contribute to the occurrence of dangerous situations when driving vehicles or complex mechanisms. Patients should take measures in advance to prevent their development. This is especially true for those diabetics in whom the symptoms of the pathology are blurred, are weakly manifested. In these cases, diabetics are encouraged to consider abandoning this type of activity.

Cross drug interactions

It must be borne in mind that some drugs can affect blood glucose. Therefore, if a diabetic is forced to take other drugs, he should inform the doctor about them in advance in order to know how to correctly inject the medicine.

  • Drugs that reduce the body's need for insulin: oral sugar-lowering drugs, MAOIs, beta-blockers, drugs of the salicylates and sulfonamide groups, anabolics.
  • Drugs that increase the need for insulin: oral contraceptives, GCS, thiazide diuretics, thyroid hormones, indirect action adrenomimetics, growth hormone, Danazole, lithium-based drugs, morphine, nicotine.
  • If it is necessary to combine insulin with beta-blockers, it must be borne in mind that the latest drugs can hide the manifestations of hypoglycemia.
  • Alcohol-containing liquids (drinks or drugs), Oktreotid, Lantreoyt when combined with insulin can unpredictably change its effect: to strengthen or reduce.
  • If a diabetic, in addition to insulin, must take other drugs, he should discuss the features of taking medications with his treating doctor.

Overdose

As such, the concept of an overdose after injections of insulin is not formed. The introduction of high doses of any drug with its content can lead to the development of hypoglycemia. The degree of intensity in this case depends not only on the dosage, but also how often it was used, especially the state of the diabetic, the presence or absence of aggravating factors.

Symptoms of hypoglycemia develop in stages, worsening in the absence of adequate control of glucose levels.

If the pathology manifests itself in a mild form, then to eliminate it, the patient is recommended to eat a carbohydrate product or sugar, drink sweet tea or juice. Patients should always have something sweet with them so that there is always the opportunity to help themselves in a timely manner.

In severe condition, the patient loses consciousness, and specialists or people with similar experience can help him.In order for the diabetic to regain consciousness, they inject him under the skin or inject glucagon into the muscle. In an extreme case, if previous measures did not give the desired result, and the patient continues to faint, he is poured into / in a saturated solution of dextrose. When a diabetic comes to his senses, then to prevent a repeated sharp drop in glucose in the blood, he is given to eat sweets or foods high in carbohydrates.

Only the attending endocrinologist can select analogues or substitutes for the drug, who can accurately calculate the correct dosage of insulin and select the right injection schedule. Drugs that can be prescribed: Actrapid (MS, NM, NM-Penfill), Apidra, Biosulin R, Insuman Rapid GT, Rinsulin R, Rosinsulin R, Humalog, Humulin Regular.

Novo Nordisk PF do Brasil (Brazil)

Average cost: (5 pcs.) - 1799 rub.

Short-acting aspartic insulin preparation for hypoglycemic control in type 1 diabetes and, if necessary, for use in type 2 diabetics, if the previous use of other drugs was ineffective or the patient has partial or complete resistance to the substance.

Penfill is made in the form of a solution for s / c and iv injection. Packaged in glass cartridges. In one capacity - 100 PIECES of aspart. The medicine is used in Novo Nordisk systems.

The pattern of injections and the multiplicity of procedures by Penfill is determined by the attending specialist.

  • Fast acting
  • One of the best for cleaning impurities.

  • Not suitable for everyone
  • It takes a long adaptation after switching from another insulin.

Depending on the type of diabetes and its course, the patient is prescribed appropriate medications. It can be tablets or insulin of varying degrees of action. The last category of medicines includes the injection drug of a new sample of Novorapid.

General information about the drug

Insulin Novorapid is a new generation medicine that is used in medical practice to treat diabetes. The tool has a hypoglycemic effect by filling in the deficiency of human insulin. It has a short effect.

The drug is characterized by good tolerance and rapid action. With proper use, hypoglycemia occurs less frequently than with human insulin.

Available as an injection. The active substance is insulin aspart. Aspart has a resemblance to the hormone that is produced by the human body. It is used in combination with longer-acting injections.

Available in 2 variations: Novorapid Flexpen and Novorapid Penfil. The first view is a syringe pen, the second is a cartridge. Each of them has the same composition - insulin aspart. The substance is transparent without turbidity and third-party inclusions. During prolonged storage, a fine precipitate may form.

Overdose symptoms

  • chills,
  • temperature rise
  • tremor of the lower extremities,
  • fainting,
  • tachycardia,
  • increased nervousness
  • hypoglycemia.

In the event of one or more of these symptoms, you must consult a doctor or call an ambulance. Untimely access to a doctor can lead to serious consequences.

Contraindications

  • Hypoglycemia.
  • Individual intolerance to the components of the drug.
  • The period of pregnancy and lactation.
  • Children under 6 years old.

Pharmachologic effect

Aspart interacts with cell membrane receptors, improving its function. Adsorbed faster than physiological insulin, but has a short effect.

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Defeated diabetes at home. It has been a month since I forgot about the jumps in sugar and taking insulin. Oh, how I used to suffer, constant fainting, emergency calls. How many times have I gone to endocrinologists, but they say only one thing there - "Take insulin."And now 5 weeks have gone, as the blood sugar level is normal, not a single injection of insulin and all thanks to this article. Everyone with diabetes must read!

Dosage and proper administration

The dosage is prescribed by the attending physician, individually for each patient. It is introduced under the skin in certain areas:

  • anterior abdominal wall
  • shoulder,
  • outer thigh.

Overdose symptoms

  • chills,
  • temperature rise
  • tremor of the lower extremities,
  • fainting,
  • tachycardia,
  • increased nervousness
  • hypoglycemia.

In the event of one or more of these symptoms, you must consult a doctor or call an ambulance. Untimely access to a doctor can lead to serious consequences.

Storage method

Insulin flekspen

Before taking Flekspen Insulin, read the instructions.

Composition and form of release

Flekspen is a long-acting insulin similar to human counterparts. This gives an advantage among other types of this drug. Quickly adsorbed, improving cell function. The body quickly gets used to the drug, during the use of "Flekspen" there is no dependence.

This medication is: a clear liquid with no impurities. The composition of "Flexpen" includes the following excipients:

Indications for use

  • Diabetes mellitus, of varying degrees.
  • Diseases associated with diabetes.

Contraindications

This drug has certain contraindications:

  • lactation and pregnancy,
  • individual intolerance to the components of the drug,
  • age up to 2 years.

Dosage and route of administration

The dose is prescribed by the doctor, individually for each patient. When calculating the dosage, the following factors are taken into account:

  • patient age
  • the patient’s condition, at the time of drug administration,
  • the needs and lifestyle of the patient,
  • taking other medications.

"Flekspen" is injected under the skin with a special insulin syringe. Also, the drug can be administered intravenously, but an injection should be carried out by qualified medical personnel. In no case, do not inject the drug into muscle tissue.

The introduction of the drug is made in certain places:

  • gluteal cavity
  • anterior abdominal wall
  • hip,
  • shoulder.

Side effect

If the dose is exceeded, the following symptoms may occur:

  • feeling of fear,
  • tachycardia,
  • limb tremor,
  • headache,
  • fainting.

This symptom can occur, not only with an overdose, but also while taking other drugs, because they can enhance the effect of insulin. Before you start using a new drug, consult with a specialist.

Flekspen insulin must be stored at a temperature of 2-8 degrees. Direct sunlight is not recommended. Dispose of used containers with the medicine, re-use of open insulin is prohibited. Keep track of expiration dates.

Dosage and administration

For an adequate result of therapy, the drug is combined with longer-acting insulin. In the process of treatment, constant monitoring of sugar is carried out to keep glycemia under control.

Novorapid can be used both subcutaneously and intravenously. Most often, patients administer the drug in the first way. Intravenous injections are done only by a healthcare provider. The recommended injection area is the thigh, shoulder, and front of the abdomen.

Attention! To reduce the risks associated with lipodystrophy, the injection site should only be changed within one zone.

The tool is injected using a syringe pen. It is designed for safe and accurate solution incorporation. The medicine can be used if necessary in infusion pumps. Throughout the process, indicators are monitored. In the event of a system failure, the patient must have spare insulin.A detailed guide is in the instructions for use attached to the drug.

The drug is used before meals or after. This is due to the speed of the drug. The dosage of Novorapid is determined for each patient individually, taking into account the personal need for a remedy and the course of the disease. Usually prescribed daily dosage Special patients and indications

During pregnancy, the use of the drug is allowed. In the process of testing the harmful effects of the substance on the fetus and woman were not detected. During the entire period, the dosage is adjusted. With lactation, there are also no restrictions.

Absorption of the substance in the elderly is reduced. When determining the dose, the dynamics of sugar levels is taken into account.

When Novorapid is combined with other antidiabetic drugs, sugar levels are constantly monitored to prevent cases of hypoglycemia. In case of impaired functioning of the kidneys, pituitary gland, liver, thyroid gland, it is required to carefully select and adjust the dose of the medication.

Untimely food intake can provoke a critical condition. Incorrect use of Novorapid, a sudden cessation of admission can provoke ketoacidosis or hyperglycemia. When changing the time zone, the patient may have to change the time of taking the drug.

Before a planned trip, you need to consult a doctor. In infectious, concomitant diseases, the patient's need for medicine changes. In these cases, dose adjustment is performed. When transferring from another hormone, you will definitely need to adjust the dose of each antidiabetic drug.

Attention! When switching to Novorapid, the precursors of increased glycemia may not be as pronounced as in previous cases.

Side effects and overdose

A common unwanted post-effect is hypoglycemia. Temporary adverse reactions may occur in the injection zone - pain, redness, slight bruising, swelling, inflammation, itching.

The following adverse events may also occur during administration:

With an exaggeration of the dose, hypoglycemia of varying severity may occur. A slight overdose can be eliminated independently by taking 25 g of sugar. Even the recommended dosage of the drug in some cases can provoke hypoglycemia. Patients should always carry glucose with them.

In severe cases, the patient is injected with glucagon intramuscularly. If the body does not respond to the drug after 10 minutes, then glucose is administered intravenously. For several hours, the patient is monitored to prevent a second attack. If necessary, the patient is hospitalized.

Interaction with other medicines and analogues

The effect of Novorapid may decrease or increase under the influence of different drugs. It is not recommended to mix Aspart with other medicines. If it is not possible to cancel another non-diabetic medication, you must inform your doctor. In such cases, the dose is adjusted and enhanced monitoring of sugar indicators is carried out.

Destruction of insulin is caused by drugs containing sulfites and thiols. The effect of Novorapid is enhanced by antidiabetic agents, ketoconazole, preparations containing ethanol, male hormones, fibrates, tetracyclines, and lithium preparations. Weaken the effect - nicotine, antidepressants, contraceptives, epinephrine, glucocorticosteroids, heparin, glucagon, antipsychotic drugs, diuretics, Danazole.

When combined with thiazolidinediones, heart failure can develop. Risks increase if there is a predisposition to the disease. With combined therapy, the patient is under medical supervision. If the heart function worsens, the drug is canceled.

Alcohol can change the effect of Novorapid - increase or decrease the sugar-lowering effect of Aspart. It is necessary to abstain from alcohol in the treatment of hormones.

Similar drugs with the same active substance and principle of action include Novomix Penfil.

Actrapid Hm, Vosulin-R, Insuvit N, Gensulin R, Insugen R, Insuman Rapid, Insular Aktiv, Rinsulin R, Humodar R, Farmasulin, Humulin are referred to preparations containing another type of insulin.

The medicine with animal insulin is Monodar.

Attention! Switching to another remedy is carried out only under the supervision of a doctor.

Syringe pen video tutorial:

Patient opinions

From the reviews of diabetics who used Novorapid insulin, it can be concluded that the medicine is well-perceived and quickly reduces sugar, but there is also a high price for it.

The drug makes my life easier. Quickly reduces sugar, does not cause side effects, unplanned snacks are possible with it. Only the price is higher than that of similar drugs.

Antonina, 37 years old, Ufa

The doctor prescribed Novorapid treatment along with “long” insulin, which keeps sugar normal for a day. The prescribed remedy helps to eat at an unplanned diet time, it reduces sugar well after eating. Novorapid is a good mild quick-acting insulin. Very convenient syringe pens, no need for syringes.

Tamara Semenovna, 56 years old, Moscow

The drug is prescription.

The cost of Novorapid Flekspen (100 units / ml in 3 ml) is about 2270 rubles.

Insulin Novorapid is a medicine with a short hypoglycemic effect. It has advantages over other similar means. The risk of developing hypoglycemia is less common than when using the human hormone. The syringe pen as part of the medication provides convenient use.

The information is valid for 2011 and is provided for reference purposes only. Please consult a doctor to select a treatment regimen and be sure to first read the instructions for the drug.

Latin name: NOVORAPID FlexPen

Registration certificate holder: registered NOVO NORDISK A / S (Denmark); produced by NOVO NORDISK A / S (Denmark) or Novo Nordisk Producao Farmaceutica do Brasil Ltda (Brazil)

The photo of the drug "NOVORAPID Flexpen" is for guidance only. The manufacturer does not notify us of a change in packaging design.

Instructions for use of the drug NOVORAPID Flexpen (NOVORAPID FlexPen)

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During the day, the amount of insulin in the blood is not at the same level. During a meal, a peak release of the hormone occurs. To mimic this in diabetics, ultra-short insulin, such as NovoRapid, is used. It is included in the baseline bolus regimen for diabetes mellitus in order to better control sugar levels and avoid the development of diabetes complications.

NovoRapid Flexpen side effects

  • From the endocrine system: adverse reactions observed in patients using NovoRapid® FlexPen® are mainly dose-dependent and are due to the pharmacological effect of insulin. The most common adverse event with insulin is hypoglycemia. Hypoglycemia develops if too high a dose of insulin is administered relative to the body's need for insulin. Symptoms of hypoglycemia usually develop suddenly. These may include cold sweat, pallor of the skin, nervousness or tremor, anxiety, unusual tiredness or weakness, disorientation, impaired attention, dizziness, severe hunger, temporary visual impairment, headache, nausea, tachycardia. Severe hypoglycemia can lead to loss of consciousness and / or convulsions, temporary or irreversible disruption of the brain and death. The incidence of side effects associated with the use of NovoRapid® Flexpen® is presented below. Incidence of side effects: infrequently (> 1/1000, 1/10 000,

Storage conditions

  • keep in a dry place
  • Store in the cold (t 2 - 5)
  • keep out of reach of children
  • store in a dark place
Information provided by the State Register of Medicines.
  • 1 unit corresponds to 35 mcg of anhydrous insulin aspart

NovoRapid begins to act much faster than a solution of human insulin, and more strongly lowers glucose levels in the first 4 hours after a meal. The duration of action after sc administration is shorter than the solution of human insulin. The effect develops 10–20 min after s / c administration to the abdominal wall, reaches a maximum after 1-3 hours and lasts 3-5 hours.

Interactions of the drug NovoRapid Flexpen with other drugs

MAO inhibitors, non-selective beta-blockers, ACE inhibitors, salicylates, anabolic steroids, oral hypoglycemic agents, octreotide, sulfonamides, alcohol can reduce the need for insulin, oral contraceptives, corticosteroids, thyroid hormones, and you need to increase the need for simonolase and simatolamine.

Precautions While Taking NovoRapid Flexpen

An insufficient dose or interruption of treatment, especially with insulin-dependent diabetes mellitus (type 1), can lead to hyperglycemia and diabetic ketoacidosis.

There is no clinical experience in children under 6 years of age. NovoRapid should be used in children instead of the usual short-acting insulin only in cases where a quick onset of action can have a better effect - for example, if it is difficult for the child to observe the necessary interval between injections and food intake.

Concomitant diseases, in particular infections, usually increase, and damage to the kidneys or liver reduces the need for insulin. The transfer of the patient to a new type or brand of insulin should be carried out under strict medical supervision. When using NovoRapid Penfill, a larger number of injections per day or a dose change may be required compared with those using conventional insulin preparations. If there is a need for dose adjustment, this can happen already at the first injection or in the first few weeks or months after the transfer. After compensating for carbohydrate metabolism in patients, their typical symptoms of precursors of hypoglycemia may change, which they should be informed about. Skipping meals or unplanned exercise can lead to hypoglycemia. Use with particular caution during work of drivers of vehicles and people whose profession is associated with increased concentration of attention, because hypoglycemia may develop, especially in patients with mild or absent symptoms, precursors of hypoglycemia or its frequent episodes.In such cases, you should seriously consider whether it is advisable for the patient to drive a car. The Penfill cartridge is for personal use only. After injection for at least 6 s, the needle should remain under the skin for a full dose.

Cautions for use

Concomitant diseases, especially infections and fevers, usually increase the patient's need for insulin.

The transfer of patients to a new type or type of insulin should be carried out under strict medical supervision. If you change the concentration, type, type, origin of the insulin preparation (animal, human, human insulin analogue) and / or its production method, it may be necessary to adjust the dose. Patients taking NovoRapid Flexpen may need to increase the number of injections or change the dose compared to the usual insulin. The need for dose selection may arise both during the first administration of a new drug, and during the first few weeks or months of its use.

Skipping meals or unforeseen intense physical activity can lead to hypoglycemia. Exercise immediately after eating increases the risk of hypoglycemia. NovoRapid Flexpen contains metacresol, which in rare cases can cause allergic reactions.

Use during pregnancy and lactation. The experience of using the drug NovoRapid Flexpen during pregnancy is limited. Animal studies have shown that insulin aspart, like human insulin, has no embryotoxic and teratogenic effects. Increased control is recommended in the treatment of pregnant women with diabetes throughout the pregnancy, as well as in cases of suspected pregnancy. The need for insulin usually decreases in the first trimester of pregnancy and increases significantly in the second and third trimester. There are no restrictions on the treatment of diabetes with NovoRapid Flexpen during breastfeeding. Treatment during pregnancy does not pose a risk to the baby. However, during this period, it may be necessary for the mother to adjust the dose.

Influence on the ability to drive vehicles and mechanisms. The patient's response and his ability to concentrate may be impaired with hypoglycemia. This can be a risk factor in situations where increased attention is required (for example, when driving a car or operating machinery). Patients should be advised to take measures to prevent hypoglycemia before driving. This is especially important for patients who have weakened or no symptoms - precursors of hypoglycemia or episodes of hypoglycemia occur frequently. Under such circumstances, the appropriateness of driving should be weighed.

Drug Interactions

Drugs that can reduce the need for insulin: oral hypoglycemic agents, octreotide, MAO inhibitors, non-selective β-adrenergic receptor blockers, ACE inhibitors, salicylates, alcohol, anabolic steroids, sulfonamides.

Drugs that can increase the need for insulin: oral contraceptives, thiazides, glucocorticosteroids, thyroid hormones, sympathomimetics, danazol.

Β-adrenergic blockers can mask the symptoms of hypoglycemia.

Alcohol can enhance and prolong the hypoglycemic effect of insulin.

Incompatibility. The addition of certain drugs to insulin may cause its inactivation, for example, drugs containing thiols or sulfites.

Dosage and administration Novorapid

The individual need for insulin is usually 0.5–1.0 U / kg / day.When the frequency of use in accordance with food intake is 50–70%, insulin requirements are satisfied with NovoRapid Flexpen, and the rest with medium-duration or long-acting insulins.

The method of use of the drug NovoRapid Flexpen is characterized by a faster onset and a shorter duration of action compared to soluble human insulin. Due to the faster onset of action, NovoRapid Flexpen should usually be administered immediately before meals. If necessary, this drug can be administered shortly after meals.

NovoRapid is administered under the skin of the anterior abdominal wall, thigh, in the deltoid muscle of the shoulder or buttocks. The injection site should be changed even within the same area of ​​the body. With subcutaneous injections in the anterior abdominal wall, the effect of the drug begins in 10–20 minutes. The maximum effect is between 1–3 hours after injection. The duration of action is 3-5 hours. As with all insulins, subcutaneous administration into the anterior abdominal wall provides faster absorption than when introduced into other places. Nevertheless, the more rapid onset of the action of the drug NovoRapid Flexpen compared with soluble human insulin is maintained regardless of the injection site. If necessary, NovoRapid Flexpen can be administered iv, these injections can be performed only under the supervision of a doctor. NovoRapid can be used for continuous sc administration with the help of appropriate infusion pumps. Continuous sc administration is carried out in the anterior abdominal wall, the injection site should be periodically changed. When used in infusion pumps, NovoRapid should not be mixed with any other insulin preparations. Patients using infusion pumps should undergo detailed instruction on the use of these systems and use appropriate containers and tubes. The infusion set (tubes and cannulas) should be changed in accordance with the requirements of the attached instructions. Patients using NovoRapid in the pumping system should have insulin in case of failure. Impaired liver and kidney function can reduce the patient's need for insulin. Instead of soluble human insulin, children should be administered NovoRapid FlexPen in cases where it is desirable to obtain a quick action of insulin, for example, before meals. NovoRapid Flexpen is a pre-filled syringe pen designed for use with NovoFine® short-cap needles. The packaging with NovoFine® needles is marked with the symbol S. Flexpen allows you to enter from 1 to 60 units of the drug with an accuracy of 1 unit. You must follow the instructions for medical use of the drug, which is in the package. NovoRapid Flexpen is intended for individual use only, it cannot be reused.

Instructions for use of the drug NovoRapid Flexpen

NovoRapid is intended for subcutaneous injection or continuous injection using infusion pumps. NovoRapid can also be administered intravenously under the strict supervision of a physician.

Use in infusion pumps

For infusion pumps, tubes are used whose inner surface is made of polyethylene or polyolefin. Some insulin is initially absorbed on the inner surface of the infusion tank.

Uses for iv administration

Infusion systems with NovoRapid 100 IU / ml at an insulin aspart concentration of 0.05 to 1.0 IU / ml in an infusion solution containing 0.9% sodium chloride, 5 or 10% dextrose and 40 mmol / l chloride potassium, are in polypropylene infusion containers, are stable at room temperature for 24 hours. During the insulin infusion, it is necessary to monitor the concentration of glucose in the blood.

Watch the video: A Guide to Using Your Insulin Pen (April 2020).