NovoRapid Penfill (100IU/ml)

NovoRapid Penfill is used for the treatment of blood sugar control in people with type 1 and type 2 diabetes mellitus. It is a fast-acting type of insulin that helps to lower blood sugar levels after meals and reduce the chances of developing serious complications of diabetes. NovoRapid Penfill is normally prescribed along with a long-acting type of insulin or other diabetes medicines. Your doctor or nurse will teach you the correct way of injecting it under the skin. It should be taken 15 minutes before a meal or within 20 minutes after starting a meal. Check your blood sugar levels regularly, keep track of your results and share them with your doctor. This is very important to work out the correct dose of the medicine for you. Do not use this medicine when you have low blood sugar levels (hypoglycemia). Tell your doctor if you have ever had kidney, liver, or heart problems before starting treatment. Pregnant or breastfeeding women should also consult their doctor as the dose may need to be changed. Do not stop taking it unless your doctor tells you to. It is only part of a treatment program that should also include a healthy diet, regular exercise, and weight reduction as advised by your doctor. The most common side effect of this medicine is low blood sugar levels (hypoglycemia). To prevent this, it is important to always inject the correct dose of medicine only, have regular meals and monitor your blood sugar levels regularly. Drinking excessive alcohol can also lead to a fall in your blood sugar levels. Other side effects include allergy at the injection site like redness, swelling, or hard lumps (lipodystrophy). Some people gain weight while taking insulin.

Uses of NovoRapid Penfill

• Diabetes mellitus (Type 1 & Type 2)

Side effects of NovoRapid Penfill

Common

• Hypoglycemia (low blood glucose level)
• Lipodystrophy (skin thickening or pits at the injection site)
• Injection site allergic reaction
• Itching
• Rash

How to use NovoRapid Penfill

Your doctor or nurse will guide you how to use this medicine.

How NovoRapid Penfill works

NovoRapid Penfill is fast-acting insulin. It starts working within 10-20 minutes after injection. It works like your body's natural insulin. Insulin facilitates reuptake of glucose in muscles and fat cells and also blocks the release of glucose from the liver.

What if you forget to take NovoRapid Penfill?

If you have missed a dose of NovoRapid Penfill, your blood sugar level may become too high (hyperglycemia). Check your blood sugar and then take the next dose accordingly.

Quick Tips

• Take it 15 minutes before a meal or within 20 minutes after starting a meal.
• Hypoglycemia (low blood sugar level) is a common side effect. Monitor your blood sugar level regularly.
• Always carry some sugary food or fruit juice with you in case you experience hypoglycemia symptoms such as cold sweats, cool pale skin, tremors, weakness, and anxiety.
• Injection below the skin of the abdomen results in faster absorption than other injection sites.
• Injection sites must be rotated to prevent hard lumps from developing at one site.
• Opened vials/cartridges stay good at room temperature for up to 4 weeks, while unopened vials must be placed in the refrigerator (2°C–8°C).
• Do not use it if the preparation is no longer clear and colorless or if it contains particles.

Brief Description

Indication

Diabetes mellitus

Administration

SC injection Should be taken with food. Administer immediately within 5-10 minutes before a meal. When administered by SC injection, insulin aspart should generally be used in regimens with an intermediate- or long-acting insulin Administer subcutaneously in the upper arm, thigh or abdominal wall. A subcutaneous injection into the abdominal wall results in a faster absorption than from other injection sites. Injection sites should be rotated within the same region to reduce the risk of lipodystrophy

Adult Dose

Subcutaneous Type 1 Diabetes Mellitus Improvement of glycemic control in adults and children with diabetes mellitus May administer 0.2-0.6 unit/kg/day in divided doses; conservative doses of 0.2-0.4 unit/kg/day often recommended to reduce risk of hypoglycemia Total maintenance daily insulin requirement may vary; it is usually between 0.5 and 1 unit/kg/day; nonobese may require 0.4-0.6 unit/kg/day; obese may require 0.6-1.2 units/kg/day Type 2 Diabetes Mellitus Diabetes inadequately controlled by diet, weight reduction, exercise, or oral medication Initial: 0.2-0.4 units/kg/day SC divided q8hr-q12hr. And an intermediate (eg, NPH) or long-acting insulin at bedtime recommended; Hepatic impairment: Dosage reduction may be needed. Dosing Considerations When used in a meal-related SC injection treatment regimen, 50-75% of total insulin requirements may be provided by an intermediate-acting or long-acting insulin; the remainder is divided and provided before or at mealtimes as a rapid-acting insulin, such as insulin aspart Dosage must be individualized; blood and urine glucose monitoring is essential in all patients receiving insulin therapy

Child Dose

Subcutaneous Type 1 Diabetes Mellitus Improvement of glycemic control in adults and children with diabetes mellitus >2 years: May require 0.8-1.2 units/kg/day SC during growth spurts; adolescents may require <1.2 units/kg/day; otherwise, may use 0.5-1 unit/kg/day

Renal Dose

Renal impairment: Dose adjustments may be needed.

Contraindication

Hypoglycaemia. Hypersensitivity to any of the components.

Mode of Action

Insulin aspart, a rapid-acting analog of human insulin, lowers blood glucose levels; it regulates carbohydrate, protein and fat metabolism by inhibiting hepatic glucose production and lipolysis, and enhancing peripheral glucose disposal.

Precaution

Pregnancy (insulin requirements tend to fall during the 1st trimester, increase during the 2nd and 3rd) and lactation. Caution with decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment Hypokalemia may occur Use with caution in renal and hepatic impairment (dosage requirements may be reduced) Caution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery Lactation: Safe to use while breastfeeding

Side Effect

Allergic reactions. Injection site reaction, lipodystrophy, pruritus, rash, lipoatrophy, hypokalaemia, blurred vision. Hypoglycaemia, insulin resistance.

Interaction

Effects may be increased by: oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, propoxyphene, salicylates, somatostatin analog (e.g., octreotide), sulfonamide antibiotics. Effects may be decreased by: corticosteroids, niacin, danazol, diuretics, sympathomimetic agents, isoniazid, phenothiazine derivatives, somatropin, thyroid hormones, oral contraceptives, lithium. Signs of hypoglycaemia may be masked by beta-blockers, clonidine.