Dosage
The dosage of Actrapid® depends on the size, age, weight and individual metabolism of the patient. The strength of the effect of an insulin drug is given in International Units. The dosage of Actrapid® depends on whether it is used alone or simultaneously with long-acting insulin.
In total, an average of 0.3 to 1.0 International Units of Insulin per kilogram of patient body weight are required per day. The dosage to be individually adjusted should always be discussed with the doctor. The dosage may change in case of strong physical performance or a change in eating habits.
With age the metabolism changes and therefore also the insulin requirement. For this reason, blood sugar levels should always be closely monitored in patients over 65 years of age. In most cases, the dosage of Actrapid® has to be readjusted with age.
Furthermore, diseases of the kidney and liver can influence the body’s insulin requirements. Here too, blood sugar should be well monitored and the dosages of Actrapid® adjusted if necessary. In order to avoid a too strong effect of Actrapid® and to prevent hypoglycaemia, a carbohydrate-containing meal should be taken 30 minutes after the application. The size of the meal should be chosen depending on the injected dose.
Side effects
The relatively most frequently occurring side effects are mentioned, but there is no claim to completeness. Detailed information can be found in the package insert. There is a risk of hypoglycaemia (low blood sugar), so the general rule is to eat a carbohydrate-rich meal no more than half an hour after ingestion and to pay attention to side meals.
Since the ability to concentrate suffers from hypoglycaemia, the ability to operate a vehicle or machine may be limited in this case. As a further possible side effect, visual disturbances have occasionally occurred. Skin changes may develop at the injection site, but this is mitigated by frequent variation of the injection site. In addition, temporary nerve pain (neuropathy) and, especially at the beginning of insulin therapy, water retention in joints with swelling may occur. In rare cases, interaction with the drug pioglitazone results in heart failure.
Interactions
The insulin requirement of the body can be influenced by taking the following medications: Parallel therapy with pioglitazone (an oral antidabetic for the treatment of type 2 diabetes mellitus) has been shown in rare cases to cause heart failure in patients with long-standing type 2 diabetes mellitus and a history of stroke. – Oral antidiabetics,
- Monoamine oxidase inhibitors (MAO inhibitors),
- Beta-receptor blockers,
- Angiotensin Converting Enzyme (ACE) inhibitors,
- Acetylsalicylic acid,
- Anabolic steroids,
- Sulfonamides,
- Oral contraceptives,
- Thiazides,
- Glucocorticoids,
- Thyroid hormones,
- Betasympathomimetics,
- Growth hormone,
- Danazol,
- Octreotide or lanreotide
Contraindications
Actrapid® must not be taken if allergies or increased reactions to this insulin or one of the other components of the preparation, e.g. metacresol, are known. If a low blood sugar level already exists, there is a high risk of hypoglycaemia. This is one of the signs of hypoglycaemia and can result in unconsciousness if there is a massive lack of sugar in the brain.
The risk of hypoglycaemia also increases after alcohol consumption. A further exclusion criterion for the administration of Actrapid® is a functional disorder. Since the administration of Actrapid® is weight-dependent, caution is also required in the case of rapid weight loss. – Shakiness,
- Paleness and palpitations
- Of the kidneys,
- Of the liver,
- Of the adrenal glands,
- Of the pituitary gland or the thyroid.