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Administrating Insulin and Insulin Analogues

Insulin Glulisine (Apidra)

What is Apidra?

Apidra is a new addition to a family of rapid acting insulin analogues which have come into use over the past decade. Analogues are ‘man-made’ insulins which are different to human insulin in their chemical composition. It is similar in action to the other short acting insulin analoges, Insulin Lyspro (Humalog) and Insulin Aspart (Novorapid).

How is it different from Soluble Human insulin?

Rapid acting analogues have special properties which influence the speed and duration of action. These properties offer several key advantages to the users of these new insulins.

  • Injectable at mealtime rather than half an hour before
  • Less likely to cause hypos
  • Better blood glucose control after meals

 Chart showing a comparison between Apidra and ‘Regular’ or soluble human insulin.

The diagram shows a comparison between Apidra and ‘Regular’ or soluble human insulin. Note the early peak and rapid tail off with Apidra compared to the flatter curve of the human insulin. Therefore Apidra starts to work sooner and does not last as long as rapid acting human insulin.

When is it injected?

Apidra is injected at mealtimes. It may be taken up to fifteen minutes before a meal or up to fifteen minutes after. This is the main difference when compared with rapid acting Human insulin which has to be injected 20-30 minutes before a meal.

What preparations are available?

Apidra 100 units/ml 10 ml vials

Apidra cartridges for use with Opti Clik pen device – 3ml cartridge containing 300 units of Apidra, supplied in packs of five.

What is the pen device used?

Apidra is available in the form of prefilled pens using the disposable OptiSet device or as cartridges which can be used with the Optipen Pro pen device.  Both are available on the NHS.

Are there any precautions I should take?

The solution should be crystal clear. Do not use Apidra if it is cloudy.

What are the side effects of Apidra?

The side effects of Apidra are exactly the same as other short acting insulins. The most important side effect is hypoglycaemia or low blood sugar. Rarely allergic reactions or injection site reactions may occur. As with other insulins, fat reactions such as lipohypertrophy or lipo-atrophy may occur.

Who manufactures Apidra?

Apidra is produced by Sanofi-Aventis, a large pharmaceutical company which also manufactures Insulin Glargine or Lantus.

 

Dr Nishan Wijenaike MD, FRCP
Consultant Physician (Diabetes and Endocrinology)
West Suffolk Hospital NHS Trust
Bury St Edmunds
October 2007