Before a long trip associated with the change of time zones, the patient should consult with his attending physician, as changing the time zone means that the patient must take food and inject insulin at another time.
Hyperglycaemia
Insufficient dose of the drug or discontinuation of treatment, especially in type 1 diabetes, can lead to the development of hyperglycemia and diabetic ketoacidosis.Typically, the symptoms of hyperglycemia appear gradually, within a few hours or days. Symptoms of hyperglycemia include nausea, vomiting, drowsiness, redness and dryness of the skin, dry mouth, increased urine output, thirst and loss of appetite, and the appearance of an odor of acetone in the exhaled air. Without proper treatment, hyperglycemia can lead to death.
Hypoglycaemia
Skipping meals, unplanned increased physical activity or too high a dose of insulin in relation to the patient's need may lead to hypoglycemia.
After compensating for carbohydrate metabolism, for example, with intensified insulin therapy, the symptoms typical for them, precursors of hypoglycemia, can change in patients, which patients should be informed about.
Common symptoms-precursors can disappear with prolonged course of diabetes.
A consequence of the pharmacodynamic characteristics of short-acting insulin analogs is that the development of hypoglycemia in their use can begin earlier than when using soluble human insulin.
Since NovoRapid® FlexPen® should be used in direct connection with food intake, the high rate of onset of the drug effect should be considered in the treatment of patients who have comorbid diseases or who take medications that slow food intake. Concomitant diseases, especially infectious and accompanied usually increase the body's need for insulin. Correction of the dose of the drug may also be required if the patient has concomitant diseases of the kidneys, liver, adrenal, pituitary or thyroid gland disorders.
When transferring the patient to other types of insulin, early symptoms-precursors of hypoglycemia may become less pronounced, compared with those with the previous type of insulin.
Transfer of a patient from other insulin preparations
Transfer of the patient to a new type of insulin or an insulin preparation of another manufacturer must be carried out under strict medical supervision. With a change in concentration, type, producer and species (human insulin, animal insulin,analog of human insulin) insulin preparations and / or manufacturing method, a dose change or an increase in injection frequency may be required compared to previously used insulin preparations. If it is necessary to adjust the dose, it can be done already at the first administration of the drug or during the first weeks or months of treatment.
Reactions at the site of administration
As with other insulin preparations, reactions at the injection site may develop, which is manifested by pain, redness, hives, inflammation, bruising, swelling and itching. Regular injection site changes in the same anatomical area can reduce symptoms or prevent the development of reactions. In very rare cases, it may be necessary to cancel NovoRapid® FlexPan®.
The simultaneous use of drugs of the thiazolidinedione group and insulin preparations
Cases of chronic heart failure in the treatment of patients with thiazolidinediones in combination with insulin preparations have been reported, especially if such patients have risk factors for developing chronic heart failure.This fact should be taken into account when appointing patients combination therapy with thiazolidinediones and insulin preparations. In the appointment of such combination therapy, it is necessary to conduct medical examinations of patients to identify signs and symptoms of chronic heart failure, increase in body weight and the presence of edema. If the symptoms of heart failure worsen in patients, treatment with thiazolidinediones should be discontinued.
Precautions for use
NovoRapid® FlexPlex® and needles are for personal use only. Do not refill the syringe pen cartridge. NovoRapid® FlexPan® can not be used if it has ceased to be clear and colorless, or if it has been frozen. Inform the patient of the need to discard the needle after each injection.
NovoRapid® can be used in insulin pumps (see "Method of administration and dose"). Pipes, the inner surface of which is made of polyethylene or polyolefin, have been checked and found suitable for use in pumps.
In emergency cases (hospitalization, failure of the insulin delivery device) NovoRapid® for administration to the patient can be extracted from FlexPen® using an insulin syringe U100.
Instructions for patients on the use of NovoRapid® FlexPen®
Do not use NovoRapid® FlexPlex®:
- In case of allergy (hypersensitivity) to insulin aspart or any other component of NovoRapid®.
- If you have hypoglycemia (low blood sugar).
- If FlexPen® is dropped, or it is damaged or crushed.
- If the storage conditions of the preparation have been violated or he was is frozen.
- If insulin has ceased to be transparent and colorless.
Before using NovoRapid® FlexPlex®:
- Check the label to make sure, that the correct type of insulin is selected.
- Always use a new needle for each injection to prevent infection.
- NovoRapid® FlexPlex® and needles are for personal use only.
Mode of application
NovoRapid® is intended for subcutaneous injections or prolonged infusions in the insulin pump system (PPII). NovoRapid® can also be administered intravenously under the strict supervision of a physician.Never administer an insulin drug intramuscularly.
Each time, change the injection site within the anatomical area. it will help reduce the risk of formation of seals and ulcers at the site of administration. It is best to inject the drug into the front abdominal wall, shoulder or front surface of the thigh. Insulin will act faster if it is injected into the anterior abdominal wall. Regularly measure the concentration of glucose in the blood.
How to use NovoRapid® FlexPen®
Carefully read the attached Instruction for Patients on NovoRapid® FlexPen®.
Use your syringe pen in strict accordance with this instruction.
Instructions for patients on the use of NovoRapid® FlexPen®
Read these instructions carefully before using NovoRapid® FlexPlex®.
NovoRapid® FlexPen® is a unique insulin syringe pen with a dispenser and color coding. The injected dose of insulin, ranging from 1 to 60 units, can vary in steps of 1 unit. NovoRapid® FlexPlex® is designed for use with NovoFine® and NovoTvist® disposable needles up to 8 mm in length.As a precaution, always carry a spare insulin delivery system in case you lose or damage your NovoRapid® FlexPan® (see Figures 1, 2).
Getting Started
Check the label to make sure that NovoRapid® FlexPan® contains the type of insulin you need.
A. Remove the cap from the syringe pen.
B. Remove the protective sticker from the new disposable needle. Carefully and tightly screw the needle onto NovoRapid® FlexPlex®.
FROM. Remove the outer cap from the needle, but do not throw it away.
D. Remove and discard the inner needle cap.
- For each injection, use a new needle to prevent infection.
- Be careful not to bend or damage the needle before use.
- To avoid accidental injections, never put the inner cap back on the needle.
Insulin intake check
Even with the correct use of the syringe pen, a small amount of air can accumulate in the cartridge before each injection.
To prevent the ingress of air bubbles and ensure the introduction of the correct dose of the drug:
E. Type 2 units of the drug by turning the dose selector.
F. Holding NovoRapid® FlexPan® with the needle up, tap the cartridge lightly with your fingertip several times to allow air bubbles to move to the top of the cartridge.
G. While holding NovoRapid® FlexPan® with the needle up, press the start button all the way.
The dosage selector will return to zero.
At the end of the needle should appear a drop of insulin. If this does not happen, replace the needle and repeat the procedure, but no more than 6 times.
If insulin does not come from the needle, this indicates that the pen syringe is faulty and is not subject to further use.
Dose setting
Make sure the dose selector is set to "O".
H. Dial the number of units needed for the injection.
The dose can be adjusted by rotating the dose selector in any direction until the correct dose is established opposite the dosing indicator. When rotating the dose selector, be careful not to accidentally press the start button to avoid dosing the insulin dose.
It is not possible to set a dose that exceeds the number of units remaining in the cartridge.
- You can not use a residue scale to measure the dose of insulin.
Introduction of insulin
Insert the needle under the skin. Use the injection technique recommended by your doctor.
I. To do the injection, press the start button all the way until "O" appears opposite the dosing indicator. Be careful: when you inject the drug, you should only press the start button.
When the selector is rotated, the dose will not enter the dose.
J. When removing the needle from under the skin, hold the start button all the way down.
After injection, leave the needle under the skin for at least 6 seconds. This will ensure the introduction of a full dose of insulin.
C. Point the needle into the outer cap of the needle without touching the cap. When the needle goes inside, put on the cap and unscrew the needle (see pictures AK).
Discard the needle, observing the precautionary measures, and close the syringe handle with a cap.
- Remove the needle after each injection and never store NovoRapid® FlexPen® with the attached needle. Otherwise, it is possible to drain liquid from NovoRapid® FlexPan®, which can lead to incorrect dosage.
- Persons caring for the patient should be careful when removing and disposing of needles to avoid the risk of accidental needle pricking.
- Dispose of used NovoRapid® FlexPan® with the needle disconnected.
- Needles and NovoRapid® FlexPlex® are for personal use only.
Storage and Care
NovoRapid® FlexPlex® is designed for effective and safe use and requires careful handling. In the event of a fall or strong mechanical impact, it is possible to damage the syringe handle and leakage of insulin. The surface of NovoRapid® FlexPen® can be cleaned with a cotton swab dipped in alcohol. Do not immerse the syringe handle in a liquid, do not wash or lubricate it, this may damage the mechanism.
Do not refill NovoRapid® FlexPan®.