Insulin Glulisine

Insulin glulisine is a prescription medication used to treat type 1 and type 2 diabetes. Insulin glulisine is a fast-acting insulin, which helps control the spike in blood sugar levels after meals.

This medication comes in an injectable form and is usually injected just under the skin 15 minutes before meals or up to 20 minutes after starting a meal. Insulin glulisine is generally used with an intermediate or long-acting insulin.

Common side effects include low blood sugar, redness or swelling at the injection site, and weight gain. 

Insulin glulisine is a prescription medicine used to control high blood sugar in adults and children over 4 years with type 1 and type 2 diabetes.

This medication may be prescribed for other uses.  Ask your doctor or pharmacist for more information.

Insulin Glulisine may be found in some form under the following brand names:

• Apidra

Insulin glulisine can cause serious side effects, including:

• Low blood sugar (hypoglycemia). Symptoms of low blood sugar may include:
  • feeling anxious, or irritable, mood changes
  • trouble concentrating or feeling confused
  • tingling in your hands, feet, lips, or tongue
  • feeling dizzy, light-headed, or drowsy
  • nightmares or trouble sleeping
  • headache
  • blurred vision
  • slurred speech
  • a fast heart beat
  • sweating
  • shakiness
  • walking unsteady

  Very low blood sugar (hypoglycemia) can cause unconsciousness (passing out), seizures, and death. Talk to your healthcare provider about how to tell if you have low blood sugar and what to do if this happens while taking this insulin. Know your symptoms of low blood sugar. Follow your healthcare provider's instructions for treating your low blood sugar.

  Talk to your healthcare provider if low blood sugar is a problem for you. Your dose may need to be changed.

• Serious allergic reactions.

  Get medical help right away if you have any of these symptoms of a severe allergic reaction:

  • a rash all over your body
  • shortness of breath
  • trouble breathing (wheezing)
  • fast pulse
  • sweating
  • feel faint (due to low blood pressure)
• Low potassium in your blood. Your doctor will check you for this.

Common side effects include:

• Reactions at the injection site (local allergic reaction). You may get redness, swelling and itching at the injection site. If you keep having skin reactions or they are serious talk to your healthcare provider.
• Skin thickening or pits at the injection site. Do not inject insulin into skin where this has happened. Choose an injection area (upper arm, thigh, or stomach area). Change injection sites within the area you choose with each dose. Do not inject into the exact same spot for each injection.
• Weight gain

Tell your healthcare provider about any side effect that bothers you or that does not go away. These are not all of the possible side effects of insulin glulisine.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-332-1088.

Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• oral diabetes medicines
• ACE inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace)
• disopyramide (Norpace)
• pramlintide (Symlin)
• fibrates (cholesterol medicines) such as fenofibrate and gemfibrozil (Lopid)
• fluoxetine (Prozac)
• monoamine oxidase inhibitors (MAOIs) such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl), tranylcypromine (Parnate)
• propoxyphene (Darvon, Darvocet)
• pentoxifylline (Trental)
• salicylates such as aspirin, choline magnesium trisalicylate (Trilisate), diflunisal (Dolobid), salsalate (Salflex, Disalcid, Amigesic)
• somatostatin analogs
• sulfa drugs (sulfonamide antibiotics) such as sulfadiazine, sulfadoxine, sulfamethoxazole (Bactrim, Septra), sulfisoxazole (Gantrisin)

Drugs that may reduce the blood-glucose-lowering effect of insulin glulisine include:

• corticosteroids
• niacin
• danazol
• diuretics
• epinephrine
• albuterol
• terbutaline
• glucagon
• isoniazid
• phenothiazine derivatives
• somatropin
• thyroid hormones
• estrogens
• progestogens (in oral birth control)
• protease inhibitors
• atypical antipsychotics
• Beta-blockers, clonidine, lithium salts, and alcohol may either increase or decrease the blood-glucose-lowering effect of insulin.
• Pentamidine may cause hypoglycemia, which may sometimes be followed by hyperglycemia.
• The signs of hypoglycemia may be reduced or absent in patients taking anti-adrenergic drugs such as beta-blockers, clonidine, guanethidine, and reserpine.

This is not a complete list of insulin glulisine drug interactions. Ask your doctor or pharmacist for more information.

Do not take insulin glulisine:

• when your blood sugar is too low (hypoglycemia)
• if you are allergic to any of the ingredients in insulin glulisine

Alcohol may affect your blood sugar when you take this insulin.

You may have trouble paying attention or reacting if you have low blood sugar (hypoglycemia). Be careful when you drive a car or operate machinery. Ask your healthcare provider if it is alright for you to drive if you have:

• low blood sugar (hypoglycemia)
• decreased or no warning signs of low blood sugar

If using an infusion pump that is not working correctly, you may not get the right amount of insulin that can cause:

• low blood sugar (hypoglycemia)
• high blood sugar (hyperglycemia)
• high amounts of sugar and ketones in your blood or urine

Follow dietary (food) recommendations made by your doctor and dietitian which should include a healthy diet. Skipping meals should be avoided as this can cause problems maintaining blood sugar control. There are no specific foods to avoid while using insulin glulisine.

Tell your healthcare provider about all of your medical conditions, including if you:

• have liver or kidney problems
• are pregnant or breastfeeding

Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Insulin glulisine falls into category C. In animal studies, pregnant animals were given insulin glulisine, and some babies had problems.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known whether insulin glulisine passes into your milk. Many medicines, including insulin, pass into human milk, and could affect your baby. Talk to your doctor about the best way to feed your baby.

• Take insulin glulisine exactly as prescribed.
• Do not make any changes to your dose or type of insulin unless told to do so by your healthcare provider.
• Know your insulin. Make sure you know:
  • the type and strength of insulin prescribed for you
  • the amount of insulin you take
  • the best time for you to take your insulin. This may change if you take a different type of insulin or if the way you give your insulin changes for example, using an insulin pump instead of giving injections under the skin (subcutaneous injections).
• Insulin glulisine starts working faster than regular insulin, but does not work as long.
• Insulin glulisine is usually used with a longer-acting insulin when given by injection under the skin (subcutaneous), or by itself when using an insulin pump.
• Read the instructions for use that come with your insulin glulisine. Talk to your healthcare provider if you have any questions. Your healthcare provider should show you how to inject insulin glulisine before you start taking it.
• Your healthcare provider will prescribe the best type of insulin glulisine for you. Insulin glulisine is available in:
  • 3 mL cartridge system for use in OptiClik Insulin Delivery Device
  • 3 mL SoloStar prefilled pen
  • 10 mL vials
  You need a prescription to get insulin glulisine. Always be sure you receive the right insulin from the pharmacy.
• Check your blood sugar level before each use of insulin glulisine. Ask your healthcare provider what your blood sugars should be and when you should check your blood sugar levels.
• Check the label to make sure you have the correct insulin type. This is especially important if you also take long-acting insulin.
• Insulin glulisine should look clear and colorless. Do not use insulin glulisine if it looks cloudy, colored, or has particles in it. Talk with your pharmacist or healthcare provider if you have any questions.
• If you take to much insulin glulisine, your blood sugar may fall low (hypoglycemia). You can treat mild low blood sugar (hypoglycemia) by drinking or eating something sugary right away.
• Do not share needles, insulin pens or syringes with others.

Take insulin glulisine exactly as prescribed. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you based on several factors. 

Your dose of insulin glulisine may need to be changed because of:

Do not adjust your dose unless your doctor tell you to do so. 

If you take too much insulin glulisine, your blood sugar may fall low (hypoglycemia). You can treat mild low blood sugar (hypoglycemia) by drinking or eating something sugary right away.

Very low blood sugar (hypoglycemia) can cause unconsciousness (passing out), seizures, and death. Talk to your healthcare provider about how to tell if you have low blood sugar and what to do if this happens while taking insulin glulisine. Know your symptoms of low blood sugar. Follow your healthcare provider's instructions for treating your low blood sugar. The effects of an insulin glulisine overdose can be severe and life-threatening and may require emergency medical attention.

• Do not use insulin glulisine after the expiration date stamped on the label.
• Keep all unopened insulin glulisine in the refrigerator between 36°F to 46°F (2°C to 8°C).
• Do not freeze. Do not use insulin glulisine if it has been frozen.
• Keep insulin glulisine away from direct heat and light.
• Unopened vials, cartridge systems and SoloStar that were not kept in a refrigerator must be used within 28 days after opening.