Actrapid HM Penfill (Soluble Insulin Injection)-100IU/ml

✔️ Uses of Actrapid HM Penfill

Diabetes (Type 1 diabetes mellitus, Type 2 diabetes mellitus)

✔️ How does Actrapid HM Penfill work?

Human insulin is a rapid-acting type that begins its effects around 30 minutes post-injection. It mimics the body's natural insulin, aiding sugar absorption into cells while reducing liver sugar production.

✔️ Side Effects of Actrapid HM Penfill

The potential side effects of Actrapid HM 100IU/ml Penfill 3 ml include:

• Hypokalaemia: Low levels of potassium in the blood.
• Hypoglycaemia: Low blood sugar levels.
• Local Injection Site Reactions: Reactions like pain, redness, or swelling at the site of injection.
• Lipodystrophy: Deposition of fat under the skin at the injection site.
• Rash: Development of skin rashes.
• Pruritus: Itchy skin sensation.
• Weight Gain: Increase in body weight.
• Constipation: Difficulty or infrequent bowel movements.
• Redness, Swelling, and Itching: These reactions can occur at the injection site.

✔️ Quick Suggestions:

• Take Actrapid HM Penfill 20 to 30 minutes before a meal.
• Hypoglycemia (low blood sugar level) is a common side effect. Learn how to identify and manage its symptoms (sweating, rapid heartbeat, weakness, blurry vision, headache) and teach your family as well.
• Injection below the skin of the abdomen results in faster absorption than other injection sites.
• Injection sites must be rotated to prevent hard lumps from developing at one site.
• Opened vials/cartridges are good at room temperature for up to 4 weeks, while unopened vials must be placed in the refrigerator  (2°C–8°C).

✔️ Indication

Actrapid HM 100IU/ml Penfill 3ml ensures swift and steady sugar regulation. This fast-acting insulin lowers blood sugar levels promptly after eating.

✔️ Pharmacology

The reduction in blood glucose levels caused by insulin is primarily attributed to the enhanced uptake of glucose by muscle and fat cells after insulin binds to receptors on these cells. Simultaneously, insulin inhibits the liver's glucose production. Insulatard is classified as a long-acting insulin. Its action commences within about 1½ hours, reaches its peak effect within 4-12 hours, and its overall duration extends to approximately 24 hours.

Insulin circulating in the bloodstream has a short half-life of several minutes. Consequently, the time-action profile of an insulin formulation is solely determined by its absorption characteristics. Several factors influence this process, including insulin dosage, injection technique, site of administration, subcutaneous fat thickness, and type of diabetes. The pharmacokinetics of insulin are therefore subject to significant variations among individuals and even within the same person over time.

✔️ Dosage & Administration of Actrapid HM Penfill

Adult Dosage:

Subcutaneous Type 1 Diabetes Mellitus:

• Initial: 0.2-0.4 units/kg/day SC divided q8hr or more frequently
• Maintenance: 0.5-1 unit/kg/day SC divided q8hr or more frequently
• Insulin-resistant patients may require higher doses
• 50-75% of total daily insulin given as intermediate- or long-acting insulin, rest with rapid- or short-acting insulin at mealtimes

Type 2 Diabetes Mellitus:

• Inadequately controlled by diet, exercise, or oral medication
• Initial: 0.2-0.4 units/kg/day SC divided q8hr-q12hr

Intramuscular Diabetic Ketoacidosis:

• Initial loading dose of 20 units, followed by 6 units/hr until blood glucose drops
• The dose is given 2 hourly

Intravenous Diabetic Ketoacidosis:

• Initially infuse at a rate of 6 units/hr
• Adjust infusion rate based on blood glucose concentration
• Maintain 3 units/hr with 5% glucose when blood glucose is around 10 mmol/l

Hyperkalemia:

• 5-10 units IV insulin in 50 mL D50W infused over 15-30 min
• Combined with NPH/Intermediate-acting insulin: Morning - two-thirds, Evening - one third

Child Dosage:

Subcutaneous Type 1 Diabetes Mellitus:

• Initial: 0.2-0.4 unit/kg/day SC divided q8hr or more frequently
• Maintenance: 0.5-1 unit/kg/day SC divided q8hr or more frequently
• Adolescents may require up to 1.5 mg/kg/day during puberty
• Prepubertal children: 0.7-1 unit/kg/day

Renal Impairment:

• Dose adjustments may be needed

✔️ Directions for Use:

• Administer under the skin of the thigh, upper arm, or abdomen
• Do not inject in veins or muscles
• Pull and fold the skin before injection
• Wait 6 seconds before removing the needle
• Rotate injection sites
• Follow the doctor's or nurse's technique

✔️ Missed Dose:

• A missed dose could lead to high blood sugar levels, resulting in symptoms like excessive thirst, frequent urination, loss of appetite, drowsiness, and fruity breath odor.
• Take the missed dose as soon as you remember.
• If it's close to the time for your next dose, skip the missed dose and resume your regular dosing schedule.
• Do not take a double dose to compensate for the missed one, as this can cause a dangerous drop in blood glucose.

✔️ Overdosage:

• In case of an accidental overdose of Actrapid HM Penfill, seek medical attention immediately or go to the nearest hospital.

✔️ Interaction

Drug-Drug Interactions:

Before using Actrapid HM Penfill , inform your doctor if you are taking any of the following medications:

• Other diabetes medications (e.g., glimepiride, glyburide, gliclazide, rosiglitazone, pioglitazone)
• Asthma medications (e.g., salbutamol, terbutaline)
• Corticosteroids (pain and inflammation treatment; e.g., hydrocortisone, prednisolone)
• Thyroid hormones (thyroid deficiency treatment; e.g., thyroxine, levothyroxine)
• Thiazide diuretics (edema and hypertension treatment; e.g., hydrochlorothiazide, chlorothiazide)
• Pain and inflammation medications (e.g., aspirin)
• High blood pressure medications (e.g., atenolol, propranolol, captopril, enalapril, ramipril, lisinopril, losartan, valsartan, olmesartan, telmisartan)
• Growth hormone (growth enhancement)
• Octreotide (diarrhea treatment)
• Lanreotide (abnormal growth treatment)
• Danazol (uterine problem treatment)
• Beta-blockers (heart problem treatment; e.g., atenolol, propranolol, labetalol)
• Depression medications (e.g., moclobemide, isocarboxazid, phenelzine, selegiline, tranylcypromine)

Drug-Food Interactions:

• Actrapid Hm 100Iu/ml Penfill 5 x 3 ml may interact with ayurvedic, homeopathy, Unani, herbal supplements, or over-the-counter items. Inform your doctor if you are using these products.
• Avoid consuming alcoholic beverages with Actrapid Hm 100Iu/ml Penfill 5 x 3 ml as it may affect your blood sugar levels.

Drug-Disease Interactions:

• Actrapid Hm 100IU/ml Penfill 3ml should not be used by patients with kidney disease, liver disease, low blood sugar (hypoglycemia), or low potassium levels (hypokalemia).

✔️ Contraindications

• If you are allergic to insulin or any of the ingredients of Actrapid HM 100IU/ml Penfill.
• If you have hypoglycemia (low blood sugar level).

✔️ Pregnancy & Lactation

Before starting Actrapid HM 100IU/ml Penfill 3 ml, it's crucial to consult your doctor if you are pregnant, suspects you might be pregnant, or are planning to conceive. This medication is generally considered safe for use during pregnancy. However, it's important to note that your insulin requirements may change during pregnancy and after giving birth, so adjustments to your insulin dose may be necessary.

Maintaining proper diabetes management is of utmost importance during pregnancy to prevent episodes of hypoglycemia and ensure the well-being of your baby. It's recommended to closely monitor your blood sugar levels and work closely with your healthcare provider to manage your diabetes effectively.

There are usually no restrictions on breastfeeding while using Actrapid HM 100IU/ml Penfill 3ml. However, it's still advisable to discuss this with your healthcare provider, as they can provide personalized guidance based on your specific health situation.

Overall, when considering pregnancy, during pregnancy, and while breastfeeding, it's crucial to work in partnership with your doctor to ensure the best outcomes for both you and your baby.

✔️ Precautions & Warnings

• Actrapid Hm 100IU/ml Penfill 3 ml is specifically designed for subcutaneous (under the skin) administration. While certain insulin types can be given intravenously (IV) using a saline solution of 0.9%, any changes in insulin brand or administration method should be carried out under strict medical supervision.
• It's noteworthy that using pioglitazone alongside insulin, especially in patients at high risk of heart failure, has been associated with reported cases of heart failure. It's important to be vigilant for symptoms such as excessive thirst, dry mouth, frequent urination, nausea, vomiting, drowsiness, flushed dry skin, loss of appetite, and a breath odor resembling acetone – these could be indicative of hyperglycemia (high blood sugar levels). Symptoms like heart failure, weight gain, and fluid retention should not be ignored.
• Avoid alcohol consumption while using Actrapid HM 100IU/ml Penfill 3ml, as it can have varying effects on your blood glucose levels. When traveling across more than two time zones, exercise caution and consult your doctor, as adjustments to your insulin schedule might be necessary.
• Keep in mind that Actrapid Hm 100IU/ml Penfill 3ml has the potential to lower potassium levels, leading to hypokalemia. If not treated, hypokalemia can result in respiratory paralysis, irregular heart rhythm, coma, and even fatal outcomes.
• It's crucial to avoid taking Actrapid Hm 100IU/ml Penfill 3ml if you have low blood glucose levels, kidney, liver, or heart problems, or if you face issues with alcohol or other prescription recreational drugs. Always adhere to medical advice and closely monitor your health while using this medication.

✔️ Storage Conditions

• Store between 2°C to 8°C in the refrigerator.
• Do not freeze it.
• Keep it out of the reach of children.
• Do not open the carton of vials to protect it from light.
• Any unused portion should not be stored and should be appropriately discarded.