Novorapid (insulin): instructions for use, dosage, administration technique, reviews

The drug "NovoRapid" (insulin) is a completely new medicine. Replenishes the lack of human insulin and has several advantages over other kinds of hormones. Quickly absorbed and instantly reduces sugar. Can be used regardless of food intake. It is considered an ultrashort insulin.

Composition of the diabetic remedy

Diabetic remedy "NovoRapid" (insulin) is produced in two types - these are replaceable cartridges "Penfill" and ready-made handles "FlexPen".

The composition of the cartridge and pen is the same - a clear liquid for injection, where 1 ml contains the active component insulin aspart in the amount of 100 units. One removable cartridge, as well as one handle, includes about 3 ml of the solution, which is 300 units.

Cartridges are made of class I hydrolytic glass. Closed on one side with disks of polyisoprene and bromobutyl rubber, with the opposite - special rubber pistons. In the aluminum blister there are five replaceable cartridges, and one blister is enclosed in the cardboard box. Similarly, the "FlexPen" syringe pen is made. They are disposable and are designed for several doses. There are five pieces in a carton.

The drug is stored in a cold place at a temperature of 2-8 ° C. It can not be placed next to the freezer, and also frozen. Also replaceable cartridges and syringe-pens should be protected from heat exposure to sunlight. If the insulin "NovoRapid" (cartridge) is opened, it can not be stored in the refrigerator, but should be used within four weeks. The temperature regime of storage should not exceed 30 ° C. The shelf life of unopened insulin is 30 months.

Pharmacology

The drug "NovoRapid" (insulin) has a hypoglycemic effect, and the active component - insulin aspart - is an analog of a short-acting hormone produced by a person. This substance is produced by the use of special biotechnologies of recombinant DNA. Here, a strain of Saccharomyces cerevisiae is added, and the amino acid called proline is temporarily replaced by aspartic acid.

The drug comes into contact with the receptors of the outer cytoplasmic cell membrane, where it forms a whole complex of insulin ends, activates all the processes that take place inside the cells. After a decrease in the amount of glucose in the plasma, there is an increase in intracellular transport, an increase in digestibility of various tissues, activation of glycogenogenesis and lipogenesis. The rate of glucose production by the liver decreases.

The replacement of the amino acid proline with aspartic in the action of insulin aspart decreases the properties of the 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 quickly reduces the level of sugar in the plasma than soluble human hormone. But the effect of NovoRapid with subcutaneous injection is shorter than that of soluble human.

How much does Novorapid work? This question is of concern to most people with diabetes. So, the action of the medicine comes after 10-20 minutes after the injection. The greatest concentration of the hormone in the blood is observed 1-3 hours after the application of the drug. The agent acts on the body for 3-5 hours.

Studies of people with type I diabetes showed a decrease in the risk of nocturnal hypoglycemia several times when using NovoRapid, especially when compared with the administration of soluble human insulin. In addition, there was a significant decrease in postprandial glucose in the plasma when injected with insulin aspart.

Indications and contraindications

The drug NovoRapid (insulin) is intended for people with diabetes mellitus type 1, which is insulin-dependent, and for patients with type 2 diabetes - insulin-dependent (the 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 old because of the lack of necessary clinical studies.

NovoRapid Medication: instructions for use

The drug "NovoRapid" is an analog of insulin. Begins to act immediately after the injection. Dosage for each patient is individual and selected by a doctor. To achieve the best result, this hormone is combined with long-acting or long-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 the adult population and children varies between 0.5-1 U / kg.

When injecting with NovoRapid (instructions for use details the order of administration of the drug), the human need for insulin is provided by 50-70%. The rest is satisfied by the introduction of insulin long (prolonged) action. Increasing the physical activity of the patient and changing the diet, as well as the existing accompanying pathologies often cause the need to change the dose administered.

The hormone NovoRapid, unlike a soluble human, begins to act quickly, but not for a long time. The slow introduction of insulin is shown. 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 affects the body for a short time, the risk of hypoglycemia at night in patients with diabetes mellitus is significantly reduced.

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

Children "NovoRapidom" replace human soluble insulin, but only if you need a drug with a quick effect. It is used when the child does not maintain the required interval between injections and food. If the patient is transferred to NovoRapid from other preparations containing insulin, dose adjustment is required, as well as basal insulin.

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

With the introduction of the hormone into the anterior region of the peritoneum, the drug is absorbed more quickly, as compared to injections into other parts of the body. The duration of the effect of the hormone affects the dose, the injection site, the degree of blood flow, body temperature, the level of physical activity of the patient.

"NovoRapid" is also used for long subcutaneous infusions, which are carried out by a special pump. Introduce the drug in the anterior peritoneum, but the places are periodically changed. If an insulin pump is used, NovoRapid should not mix with other types of insulin. Patients receiving a hormone with the help of an infusion system should have a supply of medicine in case the device breaks down.

NovoRapid may be used for intravenous administration, but the procedure should be performed by a qualified health professional. For this type of administration, infusion complexes are sometimes used, where insulin is contained in an amount of 100 U / ml, and its concentration is 0.05-1 U / 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 said products are stored at room temperature for not more than a day. When infusions of insulin need to regularly give blood for the content of glucose in it.

How to calculate the dose of insulin?

To calculate the dosage, you need to know that insulin is combined, long (prolonged), medium, short and ultra-short. The first leads to normal blood sugar. It is administered 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 sharp jumps of glucose. Short, long insulin can be used simultaneously in the treatment of diabetes, but inject them at different times. To some patients only combined use of drugs helps to achieve the desired effect.

When choosing an extended insulin, you should consider some of the nuances. For example, it is necessary that, without injecting a short hormone and basic meals, the sugar stayed on the same level throughout the day only due to the action of a long insulin.

Selection of the dose of prolonged insulin is as follows:

• In the morning, not having breakfast, measure the level of sugar.
• The second breakfast is eaten, and after three hours the level of glucose in the plasma is determined. Further, the measurements are carried out every hour before going to bed. On the first day of dose selection, lunch is skipped, but dinner is served.
• On the second day you are allowed to have breakfast and lunch, but you can not have dinner. Sugar, as well as the first day, you need to monitor every hour, including at night.
• On the third day they continue to make measurements, eat normally, but do not inject short insulin.

The ideal morning indicators are:

• In the 1st day - 5 mmol / l;
• On the 2nd day - 8 mmol / l;
• In the third day - 12 mmol / l.

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

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

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

To determine the time for which you should enter a hormone, you need to measure glucose first 45 minutes before eating. Next, monitor the sugar every five minutes, until its level reaches 0.3 mmol / l, only after that it should be trapeznichat. This approach will prevent the onset of hypoglycemia. If sugar does not decrease after 45 minutes, wait until the glucose drops to the desired level.

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

Ultra-short insulin is administered 5-15 minutes before meals. How to calculate the dose of insulin "NovoRapid" 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 the dose of the short hormone. It is possible to determine the norm more precisely only by experiment.

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

The basic rules for determining the dose for diabetics:

• At the early stage of type 1 diabetes, the dose of the hormone should not exceed 0.5 U / kg.
• In type 1 diabetes, which is observed in a patient for a year or more, the single dose of insulin administered is 0.6 U / kg.
• If type 1 diabetes mellitus is accompanied by a number of serious illnesses and has unstable blood glucose levels, then the amount of the hormone is 0.7 U / kg.
• With decompensated diabetes, the amount of insulin is 0.8 U / kg.
• If diabetes is associated with ketoacidosis, then it is required to administer about 0.9 U / kg of the hormone.
• 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 the body weight and divided into two, and the final indicator rounded.

Application of NovoRapid FlexPen

The introduction of the hormone can be carried out using a syringe-handle "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 NovoRapid preparation, the needles are TM Novotvist or Novofine 8 mm long. If you use a syringe pen, remember: you always need to have a spare injection system for yourself, in case the syringe is damaged or lost.

Before the introduction of the hormone, the syringe-pen needs:

• Read the label and make sure that Novorapid is exactly the insulin you need.
• Remove the cap from the syringe handle.
• Remove the sticker that is on the disposable needle.
• Screw the needle to the handle. For each injection, a new needle is needed to prevent bacteria from multiplying. The needle can not be bent or damaged.
• To prevent accidental pricks on the needle after the introduction of insulin cap is not worn.

The syringe handle "NovoRapid" can contain a small amount of air inside. To oxygen bubbles do not accumulate, and the dose was correctly introduced, it is necessary to adhere to certain rules:

• Type 2 units of hormone by turning the metering selector.
• Position the syringe handle with the needle up and tap with the tip of the finger on the cartridge. So the air bubbles will move to the upper area.
• Holding the Flexple syringe up with a needle, press the start button until it stops. At this time the dosing selector will return to the "0" position. One needle of a hormone will appear on the needle. If this does not happen, the procedure can be repeated six times. If insulin does not come, then the syringe is defective.

Before you set the dose, you need to make sure that the metering selector is in the "0" position. Next, you need to dial the required number of units, the volume of the drug is regulated by the selector in both directions. When setting the dose, you need to be careful and try not to accidentally touch the start button, otherwise premature ejection of the hormone will occur. You can not set a higher rate than the one that is in the drug NovoRapid. Also, do not use the residue scale to determine the dose of the hormone.

During the introduction of insulin subcutaneously follow the technique recommended by the doctor in charge. To perform the injection, press the start button. Hold it until the dosage selector has reached the "0" position. During the injection, only the start button is held. At normal turn of the index of a dosage of submission of an insulin does not occur.

After the injection, the needle under the skin should be held for six more seconds without releasing the trigger button. So the dose of insulin will be introduced completely. After the injection, the needle is directed into the outer cap, and when it enters it, it is unscrewed and discarded, taking all precautions. Then the syringe is closed with a cap. The needle is removed after each injection and is not stored with a syringe-pen. Otherwise, fluid will leak out, which may lead to the introduction of an incorrect dose. On how to prick insulin "NovoRapid", more details will tell the instructions for use.

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, limb tremors, weakness in the body, impaired orientation and reduced concentration of attention. Also there are dizziness, hunger, a malfunction in the work of the visual apparatus, nausea, pain in the head, tachycardia. Glycemia can cause loss of consciousness, seizures, brain damage and death.

Infrequently, patients talk about such allergic manifestations as hives, rashes. Possible disruption of the stomach and intestines, the appearance of angioedema, tachycardia, difficulty breathing. The patients had a decrease in blood pressure.

Among local reactions, there was itching in the injection zone, redness, swelling of the skin. Symptoms of lipodystrophy were rare. The medicine can cause edema at the initial stage of treatment, as well as refraction failure.

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

Analogues

If the hormone does not work, you can always replace the drug NovoRapid FlexPen. Analogues, of course, should choose a doctor. The most popular are:

• "Novomix".
• The Apidra.
• "Humalog".
• "Actrapid."
• "Raizodeg".
• Protafan.
• "Gensulin N".

The cost of a hormone

The medicine "NovoRapid" is released strictly according to the doctor's prescription. The price of five "Penfill" cartridges fluctuates around 1800 rubles. The cost of the hormone "FlexPen" is 2000 rubles. One package contains five "Novorapid" insulin pens. The price may vary slightly depending on the network.

Patient Reviews

What are the reviews about NovoRapid? People say that it is a good and soft insulin. Acts quickly. Suitable for the treatment of type 1 diabetes, in which sugar in the blood is difficult to reduce. Many patients use it in the treatment of type 2 diabetes. Most diabetics consider very comfortable "FlexPen" syringes. They eliminate the need to buy syringes separately.

As a rule, patients use the drug NovoRapid against the background of the action of long insulin, which helps maintain a normal level of sugar throughout the day. It helps to lower blood glucose after a meal, which greatly facilitates the life of many diabetics and allows you to eat during out-of-hours. Some people advise at the initial stage of the disease to use only this hormone.

There are people who say that the drug - when administered to young children - causes sudden sharp drops in blood sugar in the latter, which makes the kids feel bad. To prevent this, many parents prefer NovoRapidu long-term insulin.

Still patients notice, that the correctly picked up dose often provokes occurrence of a hypoglycemia and worsens state of health. To avoid such effects, do not self-medicate, but ask for help from specialists.