Generic Name and Formulations:
Insulin glulisine (rDNA origin) 100 Units/mL; contains m-cresol.
Indications for APIDRA:
Type 1 diabetes (in adults and children) and type 2 diabetes (in adults).
Adults and Children:
<4yrs: not established. ≥4yrs: Give SC, either by injection or by external infusion pump. Rotate inj sites (abdomen, thigh, upper arm). SC inj: give 15mins before meal or within 20mins after starting meal; use with an intermediate or long-acting insulin. Or, may give by IV under medical supervision. Individualize; monitor and adjust as needed.
During episodes of hypoglycemia.
Instruct patients on diet, exercise, blood or urine testing, proper administration of insulin, and management of hypoglycemia. Do not reuse or share pens, needles, or syringes between patients. Monitor glucose, potassium levels (esp. by IV route). May need to adjust dose during infection, illness, stress, trauma, pregnancy. Monitor for heart failure. May need lesser dose with renal or hepatic dysfunction. Elderly. Pregnancy (Cat.C). Nursing mothers.
See full labeling. Concomitant thiazolidinediones (TZDs) may cause fluid retention and heart failure; consider dose reduction or discontinue TZDs. Potentiated by ACE inhibitors, oral antidiabetic agents, pramlintide, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates, somatostatin analogs, sulfonamide antibiotics. Antagonized by corticosteroids, niacin, danazol, diuretics, sympathomimetics, glucagon, isoniazid, phenothiazines, somatropin, protease inhibitors, atypical antipsychotics, thyroid hormones, estrogens, progestogens. Hypoglycemia with pentamidine; may be followed by hyperglycemia. Variable effects with β-blockers, clonidine, lithium, alcohol. β-blockers, clonidine, guanethidine, and reserpine may mask hypoglycemia. Caution with K+-depleting drugs or those sensitive to serum potassium concentrations; may cause hypokalemia. Do not mix with insulins other than NPH; draw insulin glulisine into syringe first, inject immediately after mixing. Do not dilute or mix with other insulins in pump.
Hypoglycemia, allergic reactions, inj site reactions, lipodystrophy, pruritus, rash, hypokalemia, weight gain, peripheral edema.
Vial (10mL)—1; Apidra SoloStar pen (3mL)—5 (prefilled, disposable inj device)