Clinical and pharmacological group: & nbsp
Insulins
Included in the formulation
Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):VED
ONLS
АТХ:A.10.A.D.06 Insulin degludec and insulin aspart
Pharmacodynamics:Combination of long-acting and medium-acting insulins in combination: 70/30 (2.56 mg insulin degludec and 1.05 mg insulin aspart in 1 ml, which corresponds to 100 units).
Insulin Degloudek
The basal analogue of human insulin of super-long action, interacts with insulin receptors of fat and muscle tissues, increasing the intracellular transport of glucose, simultaneously inhibits the formation of glucose in the liver. Due to the assimilation of glucose by cells, a reduction in its level in the blood plasma is achieved.
Insulin aspart
It interacts with insulin receptors of fat and muscle tissues, increasing intracellular transport of glucose, simultaneously inhibits the formation of glucose in the liver. Due to the assimilation of glucose by cells, a reduction in its level in the blood plasma is achieved.
The combination of ultra-long-acting insulin preparations and a moderate action makes it possible to provide a prandial insulin requirement shortly after injection.
Pharmacokinetics:Insulin Degloudek
After subcutaneous administration, he forms multi-hexameres in the subcutaneous tissue, from which subsequently insulin is sucked into the blood plasma continuously in the prolonged mode. Equilibrium distribution of the drug in the blood plasma is achieved within 2-3 days after subcutaneous injection. The connection with plasma proteins is more than 99%.
The therapeutic effect lasts for 42 hours. Metabolism in the liver before the formation of inactive metabolites.
The half-life is 25 hours, regardless of the dose.
Insulin aspart
After subcutaneous administration quickly absorbed from the subcutaneous tissue. The replacement of the amino acid proline at position 28 of the B chain of the insulin molecule with aspartic acid reduces the formation of hexamers that form in preparations of soluble human insulin. As a result, aspartate insulin absorption is faster. The maximum concentration in the blood plasma is reached after 60 minutes. The connection with plasma proteins is 0.9%. The drug starts in 10-20 minutes, reaches a maximum in 1-3 hours and lasts for 3-5 hours.
The elimination half-life is 80 minutes.
Indications:It is used for the purpose of hormone replacement therapy with insulin dependent, as well as non-insulin-dependent diabetes mellitus, in order to ensure a continuous and continuous intake of insulin into the total blood flow.
IV.E10-E14.E11.5 Non-insulin-dependent diabetes mellitus with peripheral circulatory disorders
IV.E10-E14.E11 Non-insulin-dependent diabetes mellitus
IV.E10-E14.E10.5 Insulin-dependent diabetes mellitus with peripheral circulatory disorders
IV.E10-E14.E10.0 Insulin-dependent diabetes mellitus with coma
IV.E10-E14.E10 Insulin-dependent diabetes mellitus
Contraindications:Hypoglycemia, individual intolerance, children under 18 years.
Carefully:
Hypersensitivity.
Pregnancy and lactation:Recommendations for FDA - Category C. Contraindicated in pregnancy and lactation.
Dosing and Administration:Subcutaneously once a day, preferably at the same time. The dose is calculated individually according to the level of glucose in the blood plasma.
For patients with insulin-dependent diabetes, an initial dose of 10 units is recommended, followed by titration.
In patients with insulin-dependent diabetes, the initial dose is 60-70% of the total daily requirement for insulin.
Side effects:Central and peripheral nervous system: rapid stabilization of blood glucose levels at the beginning of therapy can lead to acute pain neuropathy, which is transient.
Dermatological reactions: lipodystrophy at the injection site.
Sense organs: violation of refraction, reduced visual acuity - is also associated with the rapid stabilization of blood glucose at the beginning of therapy, is transient.
Allergic reactions.
Overdose:Hypoglycemia.
With the development of hypoglycemic coma intravenously struino inject 20-40 (up to 100 ml) 40% dextrose solution until the patient does not come out of the coma.
Interaction:Hypoglycemic action increases α- and β-adrenoblockers, salicylates, disopyramide, tetracyclines, monoamine oxidase inhibitors, ACE inhibitors, alcohol, sulfonamides, anabolic steroids.
Weaken the action of insulin β-adrenomimetics, glucocorticoids, sympathomimetics, thiazide diuretics.
Special instructions:If the dose of the drug is missed, the patient may enter the next dose on the same day with the next main meal, and then return to his usual injection time.It is not recommended to introduce an additional dose of the drug in order to compensate for the missed dose.
The drug can not be administered intravenously and intramuscularly, since in this case the absorption of the drug is altered and can lead to hypoglycemic coma. The drug can not be used in insulin pumps.
Intensive physical activity, as well as concomitant infectious and inflammatory processes require an additional amount of insulin.
At the beginning It is not recommended to drive vehicles and work with moving mechanisms due to visual impairment. With constant intake of the drug should be careful in connection with the possible development of hypoglycemia.