Protamine crystallised Insulin Aspart: Uses,Dosage,Side Effects

Generic Name
Protamine crystallised Insulin Aspart
Therapeutic Class:
 Anti Diabetic/Rapid Acting Insulin

Indications:
Protamine crystallised Insulin Aspart is an insulin analog indicated to improve glycemic control in patients with diabetes mellitus.

Presentation:
Each ml solution contains 100 IU (equivalent to 3.50 mg) Insulin Aspart (rDNA).

Description:
Insulin Aspart rDNA is a sterile, clear solution of Insulin Aspart human insulin analog for
subcutaneous injection/infusion or intravenous injection. Protamine crystallised Insulin Aspart is a blood glucose-lowering agent with an earlier onset of action. Protamine crystallised Insulin Aspart produces more rapid onset of action compared to soluble human insulin. Insulin Aspart is homologous with regular human insulin with the exception of a single substitution of the amino acid Proline by aspartic acid in position B28 and is produced by recombinant DNA technology.

Dosage :
Insulin Aspart has a faster onset and a shorter duration of action than soluble human insulin. Due to the faster onset of action, Insulin Aspart should generally be given immediately before a meal. When necessary Insulin Aspart may be given soon after a meal.

Dosage of Insulin Aspart is individual and determined on the basis of the physician's advice in accordance with the needs of the patient. It should normally be used in combination with long-acting insulin given at least once a day.

The individual insulin requirement is usually between 0.5 and 1.0 IU/kg/day in adults and children over 2 years of age. In a meal-related treatment 50-70% of this requirement may be provided by Insulin Aspart and the remainder by long-acting insulin. Adjustment of dosage may also be necessary if patients undertake increased physical activity or change their usual diet. Exercise taken immediately after a meal may increase the risk of hypoglycaemia.

Subcutaneous Injection: Insulin Aspart should be administered by subcutaneous injection in the abdominal region, buttocks, thigh, or upper arm. Because Insulin Aspart has a more rapid onset and a shorter duration of activity than human regular insulin, it should be injected immediately (within 5-10 minutes) before a meal Continuous Subcutaneous Insulin Infusion (CSII) by External Pump Insulin Aspart can also be infused subcutaneously by an external insulin pump. The initial programming of the external insulin infusion pump should be based on the total daily insulin dose of the previous regimen. Approximately 50% of the total dose is usually given as meal-related boluses of Insulin Aspart and the remainder is given as a basal infusion. When used with an infusion pump Insulin Aspart should not be mixed with any other insulin.

Intravenous Use: Insulin Aspart can be administered intravenously under medical supervision for glycemic control with close monitoring of blood glucose and potassium levels to avoid hypoglycemia and hypokalemia. For intravenous use, Insulin Aspart should be used at concentrations from 0.05 IU/mL to 1.0 IU/mL insulin aspart in infusion systems using polypropylene infusion bags. Insulin Aspart has been shown to be stable in infusion fluids such as 0.9% sodium chloride.

Administration:
Instructions to be given to the patient Before injecting this Insulin:
  • According to the instruction given with ConviPen, insert the cartridge into the pen correctly & equip the needle
  • Gently turn the pen upside down 8-10 times until the insulin in the cartridge becomes uniformly mixed suspension
  • Remove the needle cap, discharge air bubbles in the catridge
  • Adjust the dosage button to get the correct dose & inject to the specific site
  • In order to avoid cross-contamination, do not let the needle touch anything during the process of preparation.
Side Effects:
Side effects of Insulin Aspart are hypoglycemia, allergic reactions, injection site reaction,
lipodystrophy, pruritus, and rash.

Precautions:
Dose adjustment and monitoring: Blood glucose should be monitored in all patients treated with
insulin. Insulin regimens should be modified cautiously and only under medical supervision

Use in Pregnancy & Lactation:
Pregnancy: Pregnancy category B.
Lactation: There are no restrictions on treatment with Protamine crystallised Insulin Aspart during lactation. Insulin treatment of the nursing mother should not affect the baby. However, the dosage may need to be adjusted.

Interaction:
A number of drugs affect glucose metabolism and may require dose adjustment.
The following substances may reduce the Insulin as well as Insulin Aspart requirements:
Oral anti-diabetic products, angiotensin-converting enzyme (ACE) inhibitors, disopyramide, fibrates,
fluoxetine, monoamine oxidase inhibitors, propoxyphene, pentoxifylline, salicylates, and sulfonamide
antibiotics.
The following substances may increase the Insulin as well as Insulin Aspart requirements:
Thiazides, glucocorticoids, thyroid hormones, beta-sympathomimetics, growth hormone, and danazol.
Beta-blockers, clonidine, lithium salts, and alcohol may either potentiate or weaken the blood-glucose-lowering effect of insulin.

Overdose:
A specific overdose for insulin cannot be defined, however, hypoglycemia may develop over
sequential stages if too high doses relative to the patient’s requirement are administered.
Mild hypoglycaemic episodes can be treated by oral administration of glucose or sugary products.
Severe hypoglycaemic episodes, where the patient has become unconscious, can be treated by
glucagon (0.5 to 1 mg) given intramuscularly or subcutaneously. Glucose must also be given
intravenously if the patient does not respond to glucagon within 10 to 15 minutes.
Upon regaining consciousness administration of oral carbohydrate is recommended for the patient in
order to prevent relapse.

Storage:
Store at 2°C to 8°C in a refrigerator. Do not freeze. Protect from light.
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