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Insulin Aspart (rDNA Origin) Injection



(in' su lin) (as' part)

Fiasp®
NovoLog®
NovoLog® Mix 70/30

Insulin detemir is used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). It is also used to treat people with type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood) who need insulin to control their diabetes. In patients with type 1 diabetes, insulin detemir may be used with another type of insulin (a short-acting insulin). In patients with type 2 diabetes, insulin detemir also may be used with another type of insulin or with oral medication(s) for diabetes. Insulin detemir is a long-acting, man-made version of human insulin. Insulin detemir works by replacing the insulin that is normally produced by the body and by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar.
Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

Insulin lispro comes as a solution (liquid) and a suspension (liquid with particles that will settle on standing) to inject subcutaneously (under the skin). Insulin lispro solution (Admelog, Humalog) is usually injected within15 minutes before a meal or immediately after a meal. Insulin lispro suspension (Humalog Mix 75/25 or Humalog Mix 50/50) should be injected 15 minutes before a meal. Your doctor will tell you how many times you should inject insulin lispro each day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use insulin lispro exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
Insulin lispro solution may also be injected intravenously (into a vein) by a doctor or nurse in a healthcare setting.A doctor or nurse will carefully monitor you for side effects.
Never use insulin lispro when you have symptoms of hypoglycemia (low blood sugar) or if you have checked your blood sugar and found it to be low. Do not inject insulin into a skin area that is red, swollen, itchy, or thickened.
Insulin lispro controls diabetes but does not cure it. Continue to use insulin lispro even if you feel well.Do not stop using insulin lispro without talking to your doctor. Do not switch to another brand or type of insulin or change the dose of any type of insulin you are using without talking to your doctor. Always check the insulin label to make sure you received the right type of insulin from the pharmacy.
Insulin lispro comes in vials, cartridges that contain medication and are to be placed in dosing pens, and dosing pens that contain cartridges of medication. Be sure you know what type of container your insulin lispro comes in and what other supplies, such as needles, syringes, or pens you will need to inject your medication.
If your insulin lispro comes in vials, you will need to use syringes to inject your dose.Ask your doctor or pharmacist to show you how to inject insulin lispro using a syringe. Ask your doctor or pharmacist if you have questions about the type of syringe you should use.
If your insulin lispro comes in cartridges, you will need to purchase an insulin pen separately. Check the manufacturer's information for the patient to see what type of pen is right for the cartridge size you are using. Carefully read the instructions that come with your pen, and ask your doctor or pharmacist to show you how to use it. Ask your doctor or pharmacist if you have questions about the type of pen you should use.
If your insulin lispro comes in pens, be sure to read and understand the manufacturer's instructions. Ask your doctor or pharmacist to show you how to use the pen. Follow the directions carefully, and always prime the pen before use.
Never reuse needles or syringes and never share needles, syringes, cartridges, or pens. If you are using an insulin pen, always remove the needle right after you inject your dose.Dispose of needles and syringes in a puncture-resistant container.Ask your doctor or pharmacist how to dispose of the puncture-resistant container.
Your doctor may tell you to mix your insulin lispro solution with another type of insulin (NPH insulin) in the same syringe. Your doctor will tell you exactly how to do this. Always draw insulin lispro into the syringe first, always use the same brand of syringe, and always inject the insulin immediately after mixing. Insulin lispro solution should not be mixed with insulin preparations other than NPH insulin. Insulin lispro suspension should not be mixed with any other insulin preparations.
Your doctor may tell you to dilute insulin lispro before injection to allow easier measurement of your dose.Your doctor will tell you exactly how to do this.
You can inject your insulin lispro in your thighs, stomach, upper arms, or buttocks. Each time you inject insulin lispro you should choose a spot that is at least 1/2 inch (1.25 centimeters) away from the spot where you gave your last injection.
Always look at your insulin lispro before you inject it. If you are using insulin lispro solution, the insulin should be clear and colorless. Do not use this type of insulin lispro if it is colored, cloudy, or contains solid particles. If you are using insulin lispro suspension, the insulin should appear cloudy or milky after you mix it. Do not use this type of insulin if there are clumps in the liquid or if there are solid white particles sticking to the bottom or walls of the bottle. Do not use any type of insulin after the expiration date printed on the bottle has passed.
Insulin lispro suspension must be gently shaken or rolled between your hands to mix before use. Ask your doctor or pharmacist if the type of insulin you are using should be mixed and how you should mix it if necessary.
Insulin lispro in vials or cartridges also can be used with an external insulin pump.Before using insulin lispro in a pump system, read the pump label to make sure the pump can be used for continuous delivery of fast-acting insulin. Read the pump manual for recommended reservoir and tubing sets, and ask your doctor or pharmacist to show you how to use the insulin pump.Do not dilute insulin lispro or mix it with any other type of insulin when using it with an external insulin pump.When using insulin lispro with an external insulin pump, replace the insulin in the reservoir at least every 7 days, and change the infusion set and infusion set insertion site at least every 3 days.If the infusion site is red, itchy, or thickened, tell your doctor and use a different infusion site.

Before using insulin lispro,

tell your doctor and pharmacist if you are allergic to insulin (Humulin, Novolin, others), any of the ingredients of insulin lispro, or any other medications. Ask your pharmacist or check the manufacturer's patient information for a list of the ingredients.

tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: angiotensin converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril, (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); angiotensin receptor blockers such as azilsartan (Edarbi),candesartan (Atacand, in Atacand HCT), eprosartan (Teveten, in Teveten HCT), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, Benicar HCT), telmisartan (Micardis, in Micardis HCT), and valsartan (Diovan, in Diovan HCT, Exforge); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); certain cholesterol-lowering medications such as fenofibrate (Antara, Lofibra, TriCor, Triglide), gemfibrozil (Lopid), and niacin (Niacor, Niaspan, in Advicor);certain medications for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) including atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase), and tipranavir (Aptivus); clonidine (Catapres, in Clorpres);danazol;digoxin (Digitek, Lanoxin); disopyramide (Norpace); diuretics ('water pills'); fluoxetine (Prozac, Serafem, in Symbyax); hormone replacement therapy; isoniazid (INH, Nydrazid); lithium (Eskalith, Lithobid); medications for asthma and colds; medications for mental illness and nausea; monoamine oxidase inhibitors including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl) and tranylcypromine (Parnate); octreotide (Sandostatin); oral contraceptives (birth control pills); oral medications for diabetes such as pioglitazone (Actos, in Actoplus Met and others) and rosiglitazone (Avandia, in Avandamet and others); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); patiromer (Veltassa); pentamidine (NebuPent, Pentam); pentoxifylline (Trental); pramlintide (Symlin); reserpine; salicylate pain relievers such as aspirin, choline magnesium trisalicylate (Trisalate), choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan's, others), and salsalate (Argesic, Disalcid, Salgesic); sodium polystyrene sulfonate (Kalexate, Kionex, SPS); somatropin (Nutropin, Serostim, others); sulfa antibiotics; and thyroid medications. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

tell your doctor if you have or have ever had nerve damage caused by your diabetes; heart failure; or if you have any other medical conditions, including heart, liver, or kidney disease. Also tell your doctor if you frequently have episodes of hypoglycemia.

tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using insulin lispro, call your doctor.

if you are having surgery, including dental surgery, tell the doctor or dentist that you are using insulin lispro.

Alcohol may cause a change in blood sugar. Ask your doctor about the safe use of alcoholic beverages and prescription or over the counter medications that contain alcohol while you are using insulin lispro.

ask your doctor what to do if you get sick, experience unusual stress, or change your diet, exercise, or activity schedule. These changes can affect your dosing schedule and the amount of insulin you will need.

you should know when you first start using insulin lispro or have a large dose increase you may experience blurry vision or other vision problems, or a painful, burning, weak or numb sensation in your hands, arms, feet, or legs. These side effects should go away, but tell your doctor if these effects continue.

ask your doctor how often you should check your blood sugar. Be aware that hypoglycemia may affect your ability to perform tasks such as driving and ask your doctor if you need to check your blood sugar before driving or operating machinery.

high blood sugar may occur quickly if an insulin pump or infusion set stops working properly or if the insulin in the pump reservoir becomes inactive (degraded).Problems can include pump malfunction or tubing problems such as blockage, leaking, disconnection, or kinking. If the problem cannot be found quickly and corrected, call your doctor. Temporary use of insulin by subcutaneous injection (using syringes or an insulin pen) may be needed. Make sure you have back-up insulin and any necessary supplies on hand, and ask your doctor or pharmacist to show you how to use them.

Be sure to follow all dietary recommendations made by your doctor or dietitian. It is important to eat a healthful diet, and to eat about the same amounts of the same kinds of food at about the same times each day. Skipping or delaying meals or changing the amount or kind of food you eat can cause problems with your blood sugar control.

If you remember your dose shortly after the time you were supposed to use it, inject the missed dose as soon as you remember it. If some time has passed since your regular dosing time, follow the directions provided by your doctor or call your doctor to find out whether you should inject the missed dose. Do not inject a double dose to make up for a missed one.

This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.

Insulin detemir injection may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:



redness, swelling, or itching at the site of the injection

changes in the feel of your skin, skin thickening (fat build-up), or a little depression in the skin (fat breakdown)

vision changes

weight gain

constipation

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency treatment:



rash and/or itching over the whole body

shortness of breath

wheezing

dizziness

low blood pressure

blurred vision

fast heartbeat

sweating

weakness

muscle cramps

abnormal heartbeat

large weight gain in a short period of time

swelling of the hands, feet, ankles, or lower legs
Insulin detemir may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

Keep this medication in the container it came in and out of reach of children. Store unopened insulin glargine vials and pens in the refrigerator. Never allow insulin glargine to freeze; do not use insulin glargine that has been frozen and thawed. Unopened refrigerated insulin glargine can be stored until the date shown on the company's label.
If a refrigerator is unavailable (for example, when on vacation), store the vials or pens at room temperature and away from direct sunlight and extreme heat. Unrefrigerated vials or pens can be used within 28 days; after that time they must be discarded. Opened vials can be stored for 28 days at room temperature or in the refrigerator. Opened pens must be stored at room temperature and may be used for up to 28 days after the first use. Dispose of any insulin that has been exposed to extreme heat or cold.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.  However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community.  See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Keep all appointments with your doctor and the laboratory. Your blood sugar and glycosylated hemoglobin (HbA1c) should be checked regularly to determine your response to insulin aspart. Your doctor will also tell you how to check your response to this medication by measuring your blood sugar levels at home. Follow these instructions carefully.
You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.