Insulin Formulations – Novorapid

• Treatment of diabetes mellitus.
  For the latest PBS indications for glargine please see

https://www.pbs.gov.au/medicine/item/8435Y-8571D

• NovoRapid has a faster onset and a shorter duration of action than soluble human insulin. Injections should therefore be given just before a meal or, if needed, immediately after the beginning of a meal.
• The dose of insulin aspart is determined by the physician according to individualised needs. (Usually between 0.5 and 1.0 Units/kg/day in adults and children).
• Method of administration – Insulin aspart is administered by subcutaneous injection in the abdominal wall, the thigh, the deltoid region, or the gluteal region. Injection sites should be rotated within the same region to reduce the risk of lipodystrophy and cutaneous amyloidosis.
• When injected subcutaneously into the abdominal wall, the onset of action for insulin apart products will occur within 10-20 minutes of injection. For NovoRapid, the maximum effect is exerted between 1 and 3 hours after the injection, and the duration of action is 3 to 5 hours.
• Renal Impairment – As with all insulins, glucose monitoring should be intensified, and dosage adjustment should occur on an individual basis.
• Liver Impairment – As with all insulins, glucose monitoring should be intensified, and dosage adjustment should occur on an individual basis.

• As with all insulins, glucose monitoring should be intensified, and dosage adjustment should occur on an individual basis.

• Hypersensitivity to insulin aspart or any active ingredient
• Hypoglycaemia

• Hyperglycaemia: Inadequate dosing or discontinuation of treatment, especially in type 1 diabetes, may lead to hyperglycaemia and ketoacidosis. The first symptoms of hyperglycaemia usually developed gradually, over a period of hours or days. They include nausea, vomiting, drowsiness, flushed dry skin, dry mouth, increased frequency of urination, thirst, and loss of appetite as well as acetone breath. Untreated hyperglycaemic events maybe life threatening.
Note: Diabetes MedsCheck referral to healthcare team for sick day management plan.

• Hypoglycaemia: Hypoglycaemia is the most common adverse effect of insulins. As with all insulins, particular caution (including intensified blood glucose monitoring) should be exercised in individuals who are at greater risk of clinically significant sequelae from hypoglycaemic episodes. Note: Diabetes MedsCheck with counselling on hypoglycaemia, BG monitoring and side effect profile. May need referral back to prescriber for dose adjustment.
• Injection site and allergic reactions: As with any insulin therapy, lipodystrophy may occur at the injection site and delay insulin absorption. Other injection site reactions with insulin therapy include redness, pain, itching, hives, swelling and inflammation. Note: Diabetes MedsCheck with education about side effects with referral to healthcare team to establish correct injection technique.
• Insulin antibodies: Insulin administration may cause insulin antibodies to form. In rare cases, the presence of insulin antibodies may necessitate adjustment of the insulin dose to correct a tendency to hyper- or hypoglycaemia. Note: Diabetes MedsCheck referral to healthcare team for education.