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)
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Adjunctive Therapies for Bipolar Disorder Show Promise, Need More Evidence
- Improving Performance of Everyday Activities Is Critical in Schizophrenia
- Analysis Finds Lithium Maintenance Most Effective as Monotherapy in Bipolar Disorder
- Web-Based Intervention Targets Parental Behaviors That May Affect Adolescent Anxiety, Depression
- Abnormalities of Cortical Thickness in Bipolar Disorder With Auditory Hallucinations
- The Way to the Head May Be Through the Gut: Probiotics for Depression
- Suicide-Screening Toolkit Can Help Identify Youths at High Risk for Suicide
- Agoraphobia: An Evolving Understanding of Definitions and Treatment
- Parental Pressure to Diet Linked With Long-term Harm in Adolescents
- Does Access to Medical Cannabis Reduce Risk for Opioid Abuse?
- Antidepressants Increase Seizure Risk in Youth and Severely Depressed
- Examining Associations Between Diabetes and Effects on Cognition
- Untreated Depression Common in Women of Childbearing Age
- Incidence of Psychiatric Disorders in Rheumatoid Arthritis
- Effect of Antidepressant Class, Dose on Pediatric Anxiety Disorders