Insulin is a hormone that is naturally produced by the pancreas, an organ in the body located behind the stomach.
For those with type 1 and type 2 diabetes, the body does not produce enough insulin or use it to properly to manage blood glucose levels. As a result glucose accumulates in the blood stream which can eventually lead to serious health complications or death.
Diabetics will typically require insulin to be injected under the skin (subcutaneously) which helps move glucose from the blood into other body tissues where it can be used as energy.
Modern insulin products such as NovoRapid (NovoLog) are improved versions of human insulin.
What is the NovoRapid FlexPen?
NovoRapid® (known as NovoLog in the US) FlexPen® 100 U/ml Solution was developed by the company Novo Nordisk.
It is an injectable pen that contains insulin aspart which is a rapid-acting insulin used to treat adults, adolescents and children with diabetes mellitus.
As advised by your doctor, your diabetes treatment should also include a healthy diet and regular exercise with your Novorapid Flexpen 100U/ml Injection 3ml.
Typically the FlexPen starts working 10-20 minutes after injection, a maximum effect occurs between 1 to 3 hours and lasts up to 3-5 hours. Due to it’s short onset of action, this insulin is usually combined with an intermediate-acting or long-acting insulin preparations.
Insulin should be taken at least 5-10 minutes prior to meals or within 20 minutes after starting your meal.
This fast-acting insulin ensures a rapid and consistent glucose management after meals. As a result, it stimulates the recovery of glucose in the muscle and fat cells and suppresses the production of glucose in the liver.
How to use NovoRapid FlexPen
Novorapid Flexpen 100U/ml Injection 3ml should be used 5-10 minutes prior to having a mean and injected in the upper thigh or abdomen (waist). Injecting in the abdomen provides faster absorption compared to other injection sites.
If you suddenly stop taking Novorapid Flexpen 100U/ml Injection you may experience withdrawal symptoms. Consult with you doctor before adjusting, rationing or stop taking your prescription insulin.
Always follow NovoRapid® FlexPen® instructions and dosage carefully and as advised by your doctor or pharmacist. It can be taken with our without food.
As with taking any insulin, patients should monitor blood glucose levels regularly to achieve optimal glycemic control.
Consume a snack or meal within 10 minutes of injection to prevent hypoglycemia. Even though NovoRapid is administered before meals.
NovoRapid® can be used in children instead of soluble human insulin when a rapid onset effect is preferred. For example, when it is difficult to dose the child in relation to meals.
Before administering insulin, clean the surface area of the injection site to prevent an infection.
The dose requirement for NovoRapid is usually between 0.3 and 1.0 IU/kg per day.
A Novorapid Flexpen 100U/ml Injection 3ml should be followed by a meal/snack within 30 minutes containing sugar/glucose (carbohydrates).
Speak to a doctor, nurse, diabetes educator or pharmacist if you are not well trained in how to administer your medication.
How to Store NovoRapid FlexPens
Novorapid Flexpen is a cold chain medication that should be stored in a refrigerator between 2°C – 8°C and away from a cooling element.
Do not freeze medication.
Keep out of reach from children and pets.
Do not use NovoRapid® FlexPen® after the expiry date which is on the FlexPen® label and carton. The expiry date refers to the last day of that month.
NovoRapid® FlexPen® not being used or carried as a spare should not be kept in the refrigerator. You can carry it with you and keep it at room temperature for up to 4 weeks.
To protect it from direct light, always keep the cap on FlexPen® on when not in use.
NovoRapid® must be protected from direct sunlight or excessive heat.
Medication should not be disposed of via household trash or waste water (toilet or sink). Speak to your pharmacist about how to properly dispose of medication as this may be beneficial for the environment.
WARNINGS & PRECAUTIONS
Do not use this medication if:
- You have an allergy (hypersensitive) to insulin aspart or other ingredients contained in NovoRapid.
- If you feel hypoglycemia coming on (low blood sugar).
- If medication is damaged, dropped or crushed.
- If it insulin has been stored incorrectly or has been frozen.
- If insulin isn’t clear and colorless.
Monitor your symptoms closely such as weight gain, heart failure and oedema (fluid retention (fluid deposition in tissue).
It is recommended not to consume alcohol as it may decrease or increase blood glucose levels.
Your doctor may adjust your insulin and insulin schedule if you are travelling across different time zones. If you are travelling to another country, you should either bring extra insulin or ensure that the destination country carries your prescription medication.
Novorapid Flexpen may decrease potassium levels and lead to hypokalemia and if left untreated, may also lead to irregular heartbeat rhythm, respiratory paralysis, coma and become fatal.
Avoid taking NovoRapid Flexpen if you are currently experiencing low blood glucose levels, liver or kidney issues or problems with other prescription medication, recreational drugs or alcohol.
Avoid alcohol consumption, since it may also lead to a fall in your blood sugar levels.
Before using NovoRapid FlexPen:
- Check Label to ensure it’s the correct insulin
- Always use a new needle for each injection
- NovoRapid FlexPen and needles should never be shared
- If you have issues with your liver or kidneys; adrenal, pituitary or thyroid glands
- If you exercise more than regular or make big changes to your diet as this can impact blood glucose levels
- If you are ill. Continue your insulin regimen as usual and consult your doctor
Let your doctor know if you are pregnant as your dosage may need to be adjusted. However, NovoRapid is found to be safe for pregnant women. Let your doctor know if you are planning on becoming pregnant.
Let your doctor know if you are breastfeeding. NovoRapid is considered safe for breastfeeding mothers.
Driving & Operating Heavy Machinery
Do not drive or operate heavy machinery while taking NovoRapid as it may cause hypoglycemia. Consult with your doctor if its safe for you to drive or use heavy machinery after using insulin.
It is not recommended to consume alcohol during insulin treatment as it can cause severe fluctuations to blood sugar levels.
Patients with active kidney diseases should be cautious when using NovoRapid. Speak to your doctor about how to proceed.
Patients suffering from liver diseases should proceed with caution. Consult with your doctor for advice.
Notify you doctor if you experience any allergic reactions to insulin aspart or any of its ingredients.
Let your doctor know if you’ve had or have any of the following conditions:
Let your doctor know if you are taking any other medications including over-the-counter medications, herbal supplements, vitamins, minterals and other prescription medications.
The following medications may interact with insulin medication:
- Angiotensin converting enzyme (ACE) inhibitors
- Anabolic steroids
- Beta-blockers or thiazides
- Epinephrine, salbutamol, terbutaline
- Growth hormone
- Monoamine oxidase inhibitors
- Octreotide and lanreotide
- Oral contraceptives
- Thyroid hormones
Do not share this medication with others as it may harm them, even if they share similar symptoms.
A side effect is any unwanted symptom that results from taking normal doses of medication.
The following side effects are rare and typically go away with time however if they persist you should consult your doctor.
- Hypokalemia (low potassium)
- Hypoglycemia (low blood sugar)
- Local injection site reactions
- Lipodystrophy (fat deposit under the skin)
- Pruritus (itch skin)
- Skin rashes
- Allergic reactions
- Difficulty breathing
- Rapid heartbeat
How to manage side effects:
Take a glucose tablet or consume sugary snack like hard candy, jelly beans or sugary beverage or pop (non-diet). Measure blood sugar levels and get some reason.
Drink ice-cold or clear drinks. Have a diet of light, bland foods. Avoid greasy fried or sugary foods.
Take small naps to to edge off the sleepiness. Rest your eyes to avoid fatigue. Get and and take a short walk. Eat healthier foods to boost energy.
If you experience any side effects not listed, please tell your doctor, diabetes educator or pharmacist.
Hypoglycamia (low blood sugar)
Hypoglycemia (or hypo for short) can be experienced if your blood sugar drops too low.
This may happen if:
- you skip a meal or eat too little
- you exercise more than usual
Warning signs of hypoglycemia may include:
- cold sweats
- cool pale skin
- changes in vision
- drowsiness or tiredness
- feeling ill
- rapid heart beat
- difficulty concentrating
If you feel an episode of hypoglycemia coming on consume a glucose tablet, sugary snack (hard candy, jelly beats, biscuits) or sugary beverage such as fruit juice or pop (non diet). Always carry these with you just in case you experience a hypo.
When symptoms of hypoglycemia have gone away consume a snack. When blood sugar levels have stabilized continue insulin treatment as usual.
Educate family and friends on what to do if you experience a severe hypoglycemic episode and lose consciousness. They must not give you any food or drink if you are unconscious as you make choke.
If you lose consciousness, a trained family or friend must administer an injection of the hormone glucagon. Once you regain consciousness you must consume a sugary snack.
If you do not respond to the glucagon treatment you should be taken to the hospital immediately where they need to find the reason for your hypos.
If hypoglycemia is not treated it can lead to temporary or permanent brain damage, or even death.
If you are experiencing hypos regularly, your doctor may need to adjust your insulin regimen such as timing and dosage; and life style (diet and exercise).
Hyperglycemia (sugar levels are too high)
If sugar levels are too high, patients may experience hyperglycemia.
This may happen if:
- you repeatedly take less insulin than required
- you get a fever or infection
- you eat more than usual
- you exercise less than usual
Warning signs of hyperglycemia may come on gradually. They may include:
- increased urination
- loss of appetite
- increased thirst
- feeling ill (nausea and vomiting)
- drowsiness or tiredness
- dry skin
- dry mouth and fruity (acetone) breath
Hyperglycemia may lead to a very serious condition called ketoacidosis which is a build up of acid in the blood. This happens when the body breaks down fats instead of sugar.
If untreated, can result in diabetic coma and eventually death.
If you experience any of the symptoms mentioned above, it’s important that you monitor blo