ACTRAPID ® - Insulin

ACTRAPID ® a drug based on human insulin.

THERAPEUTIC GROUP: Rapid-acting human insulin for injectable use.

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications ACTRAPID ® - Insulin

ACTRAPID ® is used in the treatment of diabetes mellitus and intravenously in the treatment of diabetic keto acidosis and non-ketosic hyperosmolar syndrome.

Action mechanism ACTRAPID ® - Insulin

ACTRAPID ® is a drug based on human insulin obtained through recombinant DNA technology from Saccaromices Cerevisiae.

With a structure similar to that of the hormone synthesized in vivo by pancreatic beta cells in response to the increased plasma glucose concentration, insulin acts at the level of cells in sensitive insulin tissues, mainly adipose and muscle tissue, facilitating, through induction expression of GLUT4 (glucose transporter), the entry of glucose into cells.

At this point the glucose penetrated and subtracted from the circulatory stream is directed towards different metabolic pathways depending on the type of tissue and its needs.

It can in fact be accumulated in the form of glycogen (glucose polymer), can be oxidized and used for energy purposes and can for example be used by adipose tissue for the synthesis of glycerol, therefore of fatty acids and triglycerides, remembering how insulin can actively participate in these metabolic pathways by inducing and inhibiting specific enzymes.

In fact, this hormone can act at the level of the liver, central organ in the integrated metabolism, facilitating glycogen synthesis and inhibiting glycogenolysis and gluconeogenesis, useful to facilitate the release of glucose into the circulation.

The action of insulin therefore represents the hypoglycemic hormone par excellence, fundamental in the management of glycemic control in the diabetic patient.

The mode of absorption and release of insulin characterizes the pharmacokinetic properties of the various drugs present on the market, ensuring more or less long action times.

In the case of ACTRAPID ® the action is rapid enough to guarantee, following subcutaneous administration, a start of action around the thirtieth minute, an optimum of activity between the first and third hours and a persistent effect for about 8 hours.

Studies carried out and clinical efficacy

1. PREPRANDIAL INSULIN AND GLUCOSE COMPOUND IN BLOOD AFTER A MEAL

This interesting study has evaluated how the administration of preprandial insulin acts on glycemic variations during a meal. More precisely, it has been demonstrated that despite the administration of preprandial insulin, it determines a decidedly more significant blood insulin peak than the basal treatment, the blood glucose concentrations after a meal, are almost unchanged.

2. INSULIN, NEW REVIEWS

Recent evidence suggests that low-dose infusion of insulin in patients undergoing hemodialysis may significantly reduce the concentration of some inflammatory markers such as C-reactive protein, lowering cardiovascular risk.

3. ROLE OF SNACK IN GLYCEMIC CONTROL

Patients suffering from type I diabetes and treated with preprandial insulin (Actrapid), were subjected to an interesting study, useful for understanding the importance of snacks in proper glycemic control. More precisely, this study shows how the ingestion of a snack two hours after breakfast and the administration of insulin can guarantee a slight glycemic increase, reducing the risk of hypoglycemia.

Method of use and dosage

ACTRAPID ® 100 IU / ml solution for injection 10 ml bottles; ACTRAPID ® NOVOLET 100 IU / ml solution for injection in pre-filled pen 5 cartridges of 3 ml; ACTRAPID ® PENFILL 100 IU / ml 3 ml cartridge :

the dosage of ACTRAPID ® varies considerably from patient to patient.

In general, in the treatment of type I diabetes, the therapeutic range remains between 0.5 and 1 IU per kg of body mass, while it drops from 0.3 to 0.6 IU / kg in type II diabetes.

It is of fundamental importance that the dosage is established by the doctor, based on the physical condition of the patient, his clinical status and glycemic control.

ACTRAPID ® should be taken 15-30 minutes before a meal containing carbohydrates via subcutaneous injections.

Different purposes related to the use of ACTRAPID ® are exclusively of medical relevance for the hospital.

Warnings ACTRAPID ® - Insulin

It is of fundamental importance that all the therapeutic treatment is set up on the actual needs and on the general state of health of the patient and therefore punctuated by periodic monitoring of the glycemic levels useful to better manage the diabetic pathology.

It is clear that a wrong formulation of the dosage could lead to serious consequences for the patient's health, with hypoglycemic crises in case of too high dosages and accompanied hyperglycemia in the most serious cases from diabetic ketoacidosis in too low dosages.

For the same reason, suspensions, changes or dosage adjustments should be supervised by your doctor.

In the case of reduced kidney function it may be necessary to reduce the dose of drug used.

The possible onset of hypoglycaemia could reduce the patient's perceptive capacities, making it dangerous to use machinery and drive vehicles.

PREGNANCY AND BREASTFEEDING

ACTRAPID ® and insulin in general is currently the most widely used and safest drug for the health of the unborn child, for the treatment of gestational diabetes.

It is however essential that the doses of drug used take into account the gestation period and the patient's clinical conditions.

Interactions

There are numerous possible interactions with other active ingredients that could alter the normal therapeutic properties of insulin.

In summary the concomitant administration of oral hypoglycemic agents, octreotide, anti-MAO, beta-blocking agents, ACE inhibitors, salicylates, alcohol and anabolic steroids, could increase the hypoglycemic effect of insulin sometimes even masking the signs of hypoglycemia (beta-blockers ).

Conversely, the use of oral contraceptives, thiazides, glucocorticoids, thyroid hormones and sympathomimetics could reduce the therapeutic effect of ACTRAPID ® requiring an adjustment of the dosage.

Contraindications ACTRAPID ® - Insulin

ACTRAPID ® is contraindicated in case of hypoglycemia and hypersensitivity to human insulin or its excipients.

Undesirable effects - Side effects

Insulin therapy may be accompanied by local and systemic side effects.

More precisely, it is possible that redness, swelling, transient pruritus and lipoatrophy occur at the injection site following multiple injections in the same site.

The systemic effects, on the other hand, may be due to generalized hypersensitivity reactions with gastro-intestinal disorders, edema, breathing difficulties, palpitations and hypotension or hypoglycemia.

The risk of hypoglycaemia is particularly high in the early stages of therapy or following adjustments in the dosage and could be characterized by cold sweating, skin pallor, nervousness, tremors, anxiety, fatigue, weakness, confusion, difficulty concentrating, headache, nausea, palpitations, visual disturbances and in severe cases loss of consciousness and death.