► Actrapid Penfill (human insulin, neutral insulin) - Medycyna Praktyczna

Actrapid Penfill (human insulin, neutral insulin) - solution for injection

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Actrapid Penfill solution for injection; 100 IU / ml; 5 cartridges 3 ml Novo Nordisk 101.53 0.00

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:human insulin, neutral insulin

The drug is available on prescription

What is Actrapid Penfill?

An antidiabetic medicine that reduces blood Glucose (a hypoglycaemic agent). The preparation contains short-acting human insulin .

What does Actrapid Penfill contain and how does it work?

The active substance of the preparation is human insulin, produced by genetic engineering (the human insulin gene is introduced into the yeast cell)Saccharomyces cerevisaeusing the recombinant DNA method). Insulin is identical in terms of chemical composition, physical properties and Biol ogical action with endogenous human insulin. Insulin is used to reduce blood glucose in the course of diabetes. It reduces blood glucose, exerts anabolic effects and reduces catabolism. Insulin binds to the appropriate receptors on the surface of liver cells, muscle tissue cells and adipose tissue and facilitates the uptake of glucose by these cells. Increases glycogen synthesis in muscle tissue and in the liver. It also inhibits the process of glucose release by the liver (reduces glycogenolysis and glyconeogenesis). Increases fat synthesis in adipose tissue and liver, reduces lipolysis. Increases amino acid uptake and protein synthesis. It increases the transport of potassium to the cells. Endogenous insulin is secreted by beta-cells of the pancreas in a glucose-dependent manner. When the blood glucose is high, the stimulation of insulin secretion occurs and when the glucose concentration decreases, insulin secretion is suppressed. The effect of the preparation in diabetic patients improves glycemic control by reducing fasting blood glucose and after a meal.
The product contains insulin characterized by a rapid onset and short duration of action. After subcutaneous administration, the onset of action occurs within 30 minutes, maximal effect between 1.5-3.5 hours and the total duration of action is about 7-8 hours. The speed and duration of action of the insulin preparation are determined by the characteristics of its absorption from the subcutaneous tissue (the half-life of insulin in the blood is several minutes). The absorption is influenced by many factors, such as: insulin dose, route and site of administration, thickness of subcutaneous fat, type of diabetes. Pharmacokinetics of the preparation is variable for one person and differs between persons.

When should I use Actrapid Penfill?

The preparation is indicated for the treatment of patients with diabetes.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the preparation if you are allergic (you are hypersensitive) to any of the ingredients.

Take special care with Actrapid Penfill?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
The product should be used strictly according to the doctor's instructions and it must not be interrupted abruptly. Discontinuation of therapy, particularly in the treatment of type 1 diabetes, use of too low doses or skipping doses may lead to hyperglycaemia and diabetic ketoacidosis. The first symptoms of hyperglycaemia usually occur gradually over several hours or days and may include: increased thirst, frequent urination, nausea, vomiting, drowsiness, redness and dryness of the skin, dry mouth, loss of appetite and the smell of acetone in the exhaled breath. In the course of type 1 diabetes, untreated hyperglycemia may lead to ketoacidosis, which is life-threatening.
Using too much insulin, skipping a meal or heavy physical exercise may lead to hypoglycaemia. Do not use the preparation if you have or suspect hypoglycaemia.
Obtaining glycemic control (eg after intensive treatment with insulin) may alter the early symptoms of hypoglycaemia or they may be less pronounced. In people who are long-term with diabetes, symptoms that predict hypoglycaemia may not occur at all.
After any change in the insulin preparation, early symptoms of hypoglycaemia may be less pronounced or different from those experienced with the previous type of insulin.
It may be necessary to adjust the insulin dosage after achieving good glycemic control.
Concurrent diseases, especially infections and febrile states increase the need for insulin. Co-morbidities and kidney or liver problems, thyroid, adrenal and pituitary disease may require adjustment of insulin dosage.
Any change in the way diabetes is treated, including any change in the insulin preparation used to another, requires close medical supervision. Such a change may involve the need to adjust the dose. Your doctor will advise you how to proceed and adjust the dose accordingly; you should follow the doctor's instructions.
At the injection site, a reaction may occur with pain, pruritus, rash, swelling, bruising or inflammation. Symptoms of local reactions usually disappear within a few days or weeks, they rarely require discontinuation of the preparation. Changing the injection site within a given anatomical area may reduce the occurrence of this type of reaction.
You should consult your doctor before traveling to another time zone because the times of insulin injections may change as the meal times change.
Combination therapy with insulin and pioglitazone may result in heart failure , especially in those with risk factors for its development. If the doctor recommends the use of insulin in combination with pioglitazone, it is necessary to observe the patient for signs of heart failure, including edema or weight gain. If you get heart symptoms, talk to your doctor immediately, because it may be necessary to stop using pioglitazone.
Proper control of blood glucose delays the occurrence of late diabetes complications. Blood glucose should be carefully monitored.

Does this preparation affect the ability to drive vehicles?
It should be taken into account that in the case of hypoglycaemia, psychophysical fitness, including the speed of reaction, may be impaired. This can be a hazard when driving or operating equipment / machines. The possibility of hypoglycaemia should be prevented. This is particularly important in patients who have frequent episodes of hypoglycaemia or when the early symptoms of hypoglycaemia are low or absent. In such cases, you should consult a doctor and determine if it is possible to drive vehicles and operate equipment / machines in your case.

Dosage of Actrapid Penfill

The preparation is a solution for injection in cartridges; It is intended for subcutaneous administration. The preparation in cartridges is intended for administration using Novo Nordisk pre-filled pens (reusable devices) and NovoFine or NovoTwist needles. The packaging is accompanied by detailed instructions on how to proceed from the manufacturer.The preparation in the cartridges is given subcutaneously, in the abdominal wall, in the thigh, in the gluteal region or in the deltoid region. Injection into the abdominal wall provides faster absorption of insulin than when injected elsewhere. The beginning and duration of the preparation may vary depending on many factors (injection site, dose, temperature, blood flow, physical activity). Injection into the raised skin fold reduce the risk of intramuscular injection. After a subcutaneous injection, the needle should remain under the skin for at least 6 seconds to ensure that the entire insulin dose is given.
The injection site should be changed within the same anatomical area to avoid lipodystrophy (loss of fat at the site of insulin injection).
The product contains fast-acting insulin and can be used with long-acting insulin preparations or long-acting insulin.
Do not exceed the recommended doses because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts regarding the use of the preparation, consult a physician.
The doctor will recommend the dosage individually; the recommended dose of insulin should be given up to 30 minutes before a meal or a snack containing carbohydrates.
The potency of human insulin is expressed in international units (IU). The individual requirement for insulin is usually 0.3-1.0 IU / kg body weight per day.
Close monitoring of blood glucose is recommended. Adaptation of dosage may be necessary if an infection, fever, condition, renal or liver dysfunction, change in diet, change in physical activity occur. Any change to a different preparation requires that the doctor adjust the dosage. During the change of the type of insulin used and a few weeks after the change, close monitoring of blood glucose is recommended. The need to adjust the dose may also apply to other types of insulins used in parallel.
The preparation can be used in children and adolescents.
In the elderly (after the age of 65), the blood glucose should be monitored with particular care. The doctor will individually adjust the dosage.
People with kidney or liver problems should be monitored carefully for their blood glucose; individual dosage adjustments are required.
Do not use in insulin pumps for continuous subcutaneous administration due to the risk of precipitation of the preparation inside the drains.

Can I use Actrapid Penfill during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or plan to become pregnant, please inform the doctor prescribing the prescription for this medicine.
The preparation can be used by pregnant women because insulin does not penetrate the placental barrier. Both hypoglycaemia and hyperglycemia occurring in the course of maladjusted diabetes can be a threat to the health and life of the fetus. Therefore, during pregnancy and during its planning period regular blood glucose control and appropriate dosage adjustment are recommended - strictly according to the doctor's instructions. During the first trimester of pregnancy, the insulin requirement usually decreases and then gradually increases during the second and third trimester of pregnancy. After delivery, insulin requirements return rapidly to pre-pregnancy values.
The use of the preparation during breastfeeding does not pose a threat to the child. During this period, it may be necessary to adjust the insulin dose.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter. During the period of application, taking any other medicines can only take place with the consent of the doctor or on his recommendation.
Other medicines may increase or decrease the need for insulin and may need to be adjusted by your doctor.
Insulin requirements may be reduced by medicines such as: oral antidiabetic agents, monoamine oxidase inhibitors (MAO inhibitors), beta-blockers, angiotensin converting enzyme inhibitors (eg Captopril , Enalapril ), salicylates (e.g., Acetylsalicylic acid ) , anabolic steroids and sulfonamides.
Insulin requirements may increase under the influence of medicines such as oral contraceptives, thiazide diuretics, glucocorticosteroids, thyroid hormones, sympathomimetics (eg Salbutamol ), growth hormone (somatotropin) and danazol.
Beta-blockers may mask the symptoms of hypoglycaemia and delay the resolution of hypoglycaemia.
Somatostatin analogs (octreotide, lanreotide) may reduce or increase the need for insulin.
Alcohol may increase and prolong the hypoglycemic effect of insulin, as well as reduce the need for insulin.

What side effects can occur?

Like all medicines, Actrapid Penfill can cause side effects, although it will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
The most common side effect is hypoglycaemia, occurring when the insulin dose is too high in relation to the need. Severe hypoglycaemia may lead to unconsciousness, convulsions, impaired brain function and even death.
Uncommon: peripheral neuropathy, refractive disorders (a type of blurred vision), lipodystrophy (disappearance of fat at the site of insulin injection), injection site reactions (redness, swelling, itching, pain, hematoma), edema, urticaria, rash.
Very rare: diabetic retinopathy (intensive diabetes treatment and sudden improvement in blood glucose control may be associated with temporary worsening of diabetic retinopathy) and Anaphylactic reactions , including rash, urticaria, profuse sweating, nausea, vomiting, angioneurotic edema , respiratory, increased heart rate, hypotension, loss of consciousness; anaphylactic reactions can be an immediate threat to life.

Other preparations on the Polish market containing human insulin, neutral insulin

Gensulin R (solution for injection)
Humulin R (solution for injection)
Insuman Rapid (solution for injection)
Insuman Rapid SoloStar (solution for injection)
Polhumin R (solution for injection)