Indications for APIDRA:
Adults and Children:
<4yrs: not established. ≥4yrs: Individualize. Rotate inj sites (abdomen, thigh, upper arm). For SC inj: give 15mins before meal or within 20mins after starting meal; use with an intermediate or long-acting insulin. For continuous SC infusion pump: do not dilute or mix insulins in pump; change Apidra in the reservoir and infusion sets at least every 48 hours. For IV inj: dilute Apidra; give only under medical supervision; closely monitor blood glucose and potassium.
During episodes of hypoglycemia.
Instruct patients on proper administration of insulin, type of insulin, and management of hypoglycemia. Do not reuse or share pens, needles, or syringes between patients, even if the needle is changed. Do not inject into areas of lipodystrophy or localized cutaneous amyloidosis. Increased risk of hyperglycemia or hypoglycemia if changes in physical activity, meal patterns, renal or hepatic function, insulin regimen, administration site, and if acute illness occurs: monitor glucose more frequently and may need to adjust dose. Monitor potassium levels in patients at risk for hypokalemia (eg, concomitant K+-lowering or K+-sensitive drugs). 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. 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.
Generic Drug Availability:
Vial (10mL)—1; Apidra SoloStar prefilled pen (3mL)—5