NovoRapid Flexpen - Injection Insulin Aspart - 100IU/ml 1 3ml Pen(s) / 3ml Pen Novo Nordisk Introduction: NovoRapid Flexpen 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 Flexpen 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... Uses of NovoRapid Flexpen: Diabetes mellitus (Type 1 & Type 2) Side effects of NovoRapid Flexpen: Hypoglycemia (low blood glucose level)Lipodystrophy (skin thickening or pits at the injection site)Injection site allergic reactionItchingRash How to use NovoRapid Flexpen: Your doctor or nurse will guide you how to use this medicine. How NovoRapid Flexpen works: NovoRapid Flexpen 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 Flexpen?: If you have missed a dose of NovoRapid Flexpen, your blood sugar level may become too high (hyperglycemia). Check your blood sugar and then take the next dose accordingly. 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... 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.