Indications for APIDRA:
Adults and Children:
<4yrs: not established. ≥4yrs: Give SC, either by injection or by external infusion pump. Rotate inj sites (abdomen, thigh, upper arm). SC inj: give 15mins before meal or within 20mins after starting meal; use with an intermediate or long-acting insulin. Or, may give by IV under medical supervision. Individualize; monitor and adjust as needed.
During episodes of hypoglycemia.
Increased risk of hypoglycemia if changes in physical activity, meal patterns, renal or hepatic function, insulin regimen and if acute illness occurs: monitor glucose more frequently and may need to adjust dose. Do not reuse or share pens, needles, or syringes between patients. Discontinue if hypersensitivity reactions occur. Visual impairment. Renal or hepatic impairment; monitor more frequently and adjust dose if needed. Elderly. Pregnancy. Nursing mothers.
Do not mix with insulins other than NPH; draw insulin glulisine into syringe first, inject immediately after mixing. Do not dilute or mix with other insulins in pump. Caution with K+-depleting drugs or those sensitive to serum potassium concentrations; may cause hypokalemia. Concomitant thiazolidinediones (TZDs) may cause fluid retention and heart failure; consider dose reduction or discontinue TZDs. Potentiated by antidiabetic agents, ACEIs, ARBs, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, pramlintide, salicylates, somatostatin analogs (eg, octreotide), sulfonamide antibiotics. Antagonized by atypical antipsychotics, corticosteroids, isoniazid, niacin, danazol, diuretics, glucagon, phenothiazines, sympathomimetics, somatropin, thyroid hormones, estrogens, progestogens, protease inhibitors. Variable effects with β-blockers, clonidine, lithium salts, alcohol, pentamidine. Concomitant β-blockers, clonidine, guanethidine, reserpine may blunt hypoglycemia.
Hypoglycemia, allergic reactions, inj site reactions, lipodystrophy, pruritus, rash, weight gain; hypokalemia (monitor esp. by IV route).
Vial (10mL)—1; Apidra SoloStar prefilled pen (3mL)—5