Actrapid HM
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Prices in online pharmacies:
from 309 rub.
Buy
Actrapid HM is a short-acting human insulin.
Release form and composition
Dosage form - solution for injection: colorless, transparent liquid (in glass vials of 10 ml, in a cardboard box 1 vial).
1 ml of solution contains:
- Active ingredient: soluble insulin (human genetically engineered) - 100 IU (international units), which corresponds to 3.5 mg of anhydrous human insulin;
- Additional components: water for injection, metacresol, glycerol, zinc chloride, hydrochloric acid and / or sodium hydroxide.
Indications for use
Actrapid HM is a drug for the treatment of diabetes mellitus, including emergency conditions accompanied by impaired glycemic control.
Contraindications
- Hypoglycemia;
- Hypersensitivity to any component of the drug.
Method of administration and dosage
Actrapid NM is administered intravenously (IV) or subcutaneously (SC) 30 minutes before meals or taking a snack containing carbohydrates.
The doctor selects the daily dose of the drug individually, depending on the patient's needs, usually it varies between 0.3-1 IU / kg. The daily requirement for insulin may be lower in patients with residual endogenous insulin production and higher in patients with insulin resistance (for example, with obesity or during puberty).
For patients with impaired renal or hepatic function, the dose of Actrapid NM is reduced.
Once optimal glycemic control has been achieved, complications of diabetes tend to develop later, so efforts should be made to optimize metabolic control, in particular by carefully monitoring blood glucose levels.
If necessary, Actrapid NM can be prescribed in combination with long-acting insulin.
The drug should be administered intravenously only by a medical specialist. For this, infusion systems are used containing human insulin at concentrations of 0.05-1 IU / ml in such infusion solutions as sodium chloride 0.9%, dextrose 5% and 10%, including potassium chloride at a concentration of 40 mmol / l. The intravenous system uses polypropylene infusion bags. During the infusion, it is necessary to control the blood glucose level.
The agent is usually injected subcutaneously into the area of the anterior abdominal wall; injections can also be made into the gluteal region, thigh area, or deltoid muscle of the shoulder. In the first case, faster absorption is achieved in comparison with other places of administration.
The introduction of the drug into the fold of the skin reduces the risk of the solution entering the muscle.
To prevent the development of lipodystrophies, it is recommended to alternate injection sites within the anatomical region.
The drug should be administered s / c only with the help of insulin syringes with a scale for measuring the dose in units of action. The vials are intended for individual use.
Before administering Actrapid NM, it is necessary to check the label to make sure the correct type of insulin is selected, and to disinfect the rubber stopper with a cotton swab.
It is forbidden to use Actrapid NM in the following cases:
- Loss of transparency, discoloration of the solution;
- Storage without observing the specified conditions, freezing the solution;
- Use in insulin pumps;
- The absence of a protective cap of the bottle or its loose sealing.
Injection technique using only Actrapid NM:
- Draw air into the syringe in an amount corresponding to the required dose of insulin;
- Introduce air into the vial with the drug; for this, pierce the rubber stopper with a needle and press the piston;
- Turn the bottle upside down;
- Draw the required dose of insulin into the syringe;
- Remove the needle from the bottle;
- Remove air from the syringe;
- Check the correct dose of the drug;
- Inject immediately.
Injection technique when using Actrapid NM in combination with long-acting insulin:
- Roll the vial of long-acting insulin (LID) between your palms until the solution becomes evenly cloudy and white;
- Draw a syringe into the air in an amount corresponding to the dose of IDD, insert it into the appropriate bottle and remove the needle;
- Draw air into the syringe in an amount corresponding to the dose of Actrapid NM and introduce air into the appropriate vial;
- Without removing the syringe, turn the bottle upside down and collect the required dose of Actrapid NM, remove the needle and remove air from the syringe, check the correct dose;
- Insert the needle into the vial with IDD;
- Turn the bottle upside down and dial the required dose of IDD;
- Remove the needle from the vial and air from the syringe, check the correctness of the dialed dose;
-
Immediately inject the short
-acting and long-acting insulin dial-up mixture.
Short-acting and long-acting insulins should always be taken in the sequence described above.
Drug administration rules:
- Take a fold of skin with two fingers;
- Insert the needle into the base of the fold at an angle of approximately 45º and inject insulin under the skin;
- Do not remove the needle within 6 seconds to ensure that the dose is fully delivered.
Side effects
The most common side effect of the drug is hypoglycemia, which develops when the dose of insulin significantly exceeds the patient's need for it. Severe hypoglycemia may result in seizures and / or loss of consciousness, possibly impaired brain function and even death.
Other possible adverse reactions:
- From the immune system: infrequently (> 1/1000, <1/100) - rash, urticaria; very rarely (<1/10000, including some spontaneous cases) - anaphylactic reactions, generalized hypersensitivity that threatens the patient's life (generalized skin rash, sweating, pruritus, angioedema, disorders of the gastrointestinal tract, lowering blood pressure, heart palpitations, fainting / loss of consciousness);
- From the nervous system: very rarely - peripheral neuropathy;
- From the side of the organ of vision: infrequently - refractive errors (usually occur at the beginning of treatment and are, as a rule, reversible); very rarely - diabetic retinopathy;
- From the subcutaneous tissues and skin: infrequently - lipodystrophy at the injection site (in cases where the drug is constantly injected into the same area);
- Local reactions at the injection site: swelling, redness of the skin, soreness, itching, hematoma formation (these reactions are usually transient and disappear with continued therapy).
special instructions
In the case of an incorrectly selected dose or when the drug is discontinued, there is a risk of developing hyperglycemia, especially in patients with type I diabetes mellitus. The first symptoms of this complication usually appear gradually, over several hours or days: nausea, severe drowsiness, dry mouth, vomiting, dry and reddened skin, loss of appetite, thirst, odor of acetone from the mouth, increased urine output.
If hyperglycemia is left untreated in patients with type I diabetes mellitus, life-threatening diabetic ketoacidosis may develop. With a significant improvement in glycemic control (for example, due to intensified insulin therapy), the usual symptoms-precursors of hypoglycemia may change, which must be warned patients about. It should be borne in mind that the precursors of hypoglycemia may become less pronounced in patients who are transferred from one type of insulin to another.
Patients planning to travel across time zones should consult with their doctor about the regimen for using Actrapid NM, as they will have to change the timing of meals and administration of the drug.
In case of a change in the type of insulin (human, animal or human analog), its type, biological activity, manufacturer and / or manufacturing method, it may be necessary to change the dosage regimen of the drug. For this reason, the transfer of patients to another type of insulin or insulin produced by another pharmaceutical company must be carried out under the close supervision of a physician.
If it is necessary to adjust the dose, this can be done both with the introduction of the first dose and in the first weeks / months of therapy.
The need for insulin usually increases in patients with concomitant diseases, especially with febrile conditions and infections.
With skipping meals or unplanned strenuous exercise, hypoglycemia can develop.
Actrapid NM should not be used for continuous subcutaneous insulin infusions (PSII) in insulin pumps, since it is impossible to predict how much insulin will be absorbed by the infusion system.
Metacresol, which is part of the drug, can cause allergic reactions.
Insulin does not cross the placental barrier, so there are no restrictions on its use during pregnancy. Moreover, if a pregnant woman is not treated for diabetes, there is a danger to the fetus. Given this, therapy for the disease during pregnancy should be continued. However, women, including those planning a pregnancy, should be under constant medical supervision with increased control of blood glucose levels, since hyperglycemia and hypoglycemia, which can develop with an incorrectly selected dose of insulin, increase the risk of fetal malformations and intrauterine death. It should be borne in mind that in the first trimester of pregnancy, the need for insulin usually decreases, and in the second and third trimester, it gradually increases. After childbirth, the need for insulin quickly returns to the levelwhich was before pregnancy.
Similarly, there are no restrictions on the use of Actrapid NM during breastfeeding, since the drug does not pose a danger to the child. However, a woman may need to adjust her insulin dose and / or diet.
Hyperglycemia and hypoglycemia can disrupt the speed of reactions and the ability of a patient with diabetes mellitus to concentrate, which is dangerous in cases where these reactions are necessary, for example, when driving a car or working with mechanisms. Patients should be advised to take measures to prevent the development of hyperglycemia / hypoglycemia. This is especially important for people suffering from frequent episodes of hypoglycemia, who have no or only mild symptoms that predict the development of hypoglycemia. In these cases, the feasibility of performing potentially hazardous activities is assessed.
Drug interactions
The hypoglycemic effect of insulin is enhanced by angiotensin-converting enzyme inhibitors, monoamine oxidase inhibitors, anabolic steroids, nonselective beta-blockers, carbonic anhydrase inhibitors, lithium preparations, oral hypoglycemic drugs, tetracyclines, sulfonamides, cyclopolyphosphamide, cephalophosphamide, cephalophosphamide, preparations containing ethanol.
The hypoglycemic effect of insulin is weakened by thyroid hormones, oral contraceptives, tricyclic antidepressants, calcium channel blockers, sympathomimetics, thiazide diuretics, glucocorticosteroids, morphine, diazoxide, phenytoin, danazol, heparin, clonidine, nicotine.
Salicylates, reserpine, lanreotide, octreotide can both weaken and enhance the action of Actrapid NM.
Concurrently used beta-blockers can mask the symptoms of hypoglycemia and make it difficult to eliminate it.
Alcohol can enhance and lengthen the hypoglycemic effect of Actrapid NM.
Some drugs (for example, containing sulfites or thiols), when added to a solution of insulin, can cause its degradation, therefore Actrapid NM can only be combined with those drugs with which it has been reliably established to be compatible.
Analogs
Analogues of Actrapid HM are: Vozulim-R, Biosulin R, Humodar R 100 Rek, Gensulin R, Insuman Rapid GT, Insuran R, Humulin Regular, Rinsulin R, Monoinsulin CR, Rosinsulin R.
Terms and conditions of storage
Store out of reach of children, protected from sunlight and heat, in a cardboard box at a temperature of 2-8 ºС (in the refrigerator, not too close to the freezer). Do not freeze.
The shelf life is 30 months.
The opened bottle can be stored for 6 weeks at temperatures up to 25 ºС, in a cardboard box (to protect from light). It is not recommended to store the opened bottle in the refrigerator.
The prepared solution for intravenous administration is stable for 24 hours at room temperature.
Terms of dispensing from pharmacies
Dispensed by prescription.
Actrapid HM: prices in online pharmacies
|
Drug name Price Pharmacy |
|
Actrapid HM 100 IU / ml solution for injection 10 ml 1 pc. 309 r Buy |
|
Actrapid HM Penfill 100 IU / ml solution for injection 3 ml 5 pcs. RUB 625 Buy |
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
