Insulin Glulisine

DEA Class; Rx

Common Brand Names; Apidra, Apidra Solostar

Diabetes Mellitus Type I or II

Indicated to improve glycemic control in adults and children with diabetes mellitus

During episodes of hypoglycemia

Documented hypersensitivity

Adjust dosage and monitoring when medically warranted

Decreased insulin requirements: Diarrhea, N/V, malabsorption, hypothyroidism, renal impairment, hepatic impairment

Increased insulin requirements: fever, hyperthyroidism, trauma, infection, surgery

May cause a shift in potassium from extracellular to intracellular space, possibly leading to hypokalemia; untreated hypokalemia may cause respiratory paralysis, ventricular arrhythmia, and death; use caution in patients who may be at risk for hypokalemia (eg, patients using potassium-lowering medications, patients taking medications sensitive to serum potassium concentrations)

Frequent glucose monitoring and insulin dose reduction may be required with renal or hepatic impairment

Thiazolidinediones are peroxisome proliferator-activated receptor (PPAR)-gamma agonists and can cause dose-related fluid retention, particularly when used in combination with insulin; fluid retention may lead to or exacerbate heart failure, monitor for signs and symptoms of heart failure and treat accordingly and consider discontinuing thiazolidinediones if heart failure develops

Never share a pen between patients even if needle is changed; patients using vials should never reuse them and must never share needles or syringes with another person; sharing of needles or pens poses a risk for transmission of blood-borne pathogens

Accidental mix-ups between insulin products reported; to avoid medication errors between APIDRA and other insulin therapy, instruct patients to always check insulin label before each injection

If hypersensitivity reactions occur, discontinue therapy; treat per standard of care and monitor until symptoms and signs resolve; drug is contraindicated in patients who have had a hypersensitivity reaction to it or any of its excipients

Do not mix SC injection with insulin preparations other than NPH insulin

Available pharmacovigilance data have not established an association with insulin glulisine use during pregnancy and major birth defects, miscarriage or adverse maternal or fetal outcomes

Available data from published literature suggest that human insulin products are transferred into human milk

Insulin Glulisine

injectable solution (as 10 mL vial and 3 mL cartridge for OptiClick SC device)

• 100 units/mL

prefilled 3 mL pen (Solostar)

• 100 units/mL