Hypoglycaemia
If you miss a meal or an unplanned intensive physical exertion, the patient may develop hypoglycemia. Hypoglycemia can also develop if the insulin dose is too high in relation to the patient's need (see "Side effect" and "Overdose").
After the compensation of carbohydrate metabolism (for example, with intensified insulin therapy), the symptoms typical for them-precursors of hypoglycemia may change in patients, which patients should be informed about.Common symptoms-precursors can disappear with prolonged course of diabetes.
Concomitant diseases, especially infectious and accompanied by fever, 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 or disorders of the adrenal, pituitary or thyroid gland function.
As with the use of other basal insulin preparations or drugs with a basal component, recovery from hypoglycemia with the use of Raizodeg® FlexTech® can be delayed.
Hyperglycaemia
An insufficient dose of the drug or discontinuation of treatment can lead to the development of hyperglycemia or diabetic ketoacidosis. In addition, concomitant diseases, especially infectious diseases, can promote the development of hyperglycemic conditions and, accordingly, increase the body's need for insulin.
Typically, the first symptoms of hyperglycemia appear gradually, within a few hours or days. These symptoms include: thirst, rapid urination, nausea, vomiting, drowsiness, redness and dryness of the skin, dry mouth, loss of appetite, odor of acetone in the exhaled air.With type 1 diabetes mellitus without appropriate treatment, hyperglycemia leads to the development of diabetic ketoacidosis and can lead to death.
For the treatment of severe hyperglycemia, it is recommended that rapid insulin be administered.
Transfer of the patient from other insulin preparations
Transfer of the patient to a new type or preparation of insulin of a new brand or other manufacturer should occur under strict medical supervision. The translation may require a dose adjustment.
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 Rizodeq® FlexTech® preparation. 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 peripheral edema.If the symptoms of heart failure worsen in patients, treatment with thiazolidinediones should be discontinued.
Disturbances on the part of the organ of sight
Intensification of insulin therapy with a sharp improvement in carbohydrate metabolism control may lead to a temporary deterioration in the state of diabetic retinopathy, while a prolonged improvement in glycemic control reduces the risk of progression of diabetic retinopathy.
Prevention of accidental entanglement of insulin preparations
The patient should be instructed to check the labeling on each label before each injection to avoid accidentally mistaking the preparation Rhizodeg® FlexTech® with other insulin preparations.
Patients should check the dose on the injector dose counter.
It is necessary to inform visually impaired or visually impaired people that they always need help from those who do not have vision problems and are trained to work with the injector.
Antibodies to insulin
With the use of insulin, the formation of antibodies is possible. In rare cases, the formation of antibodies may require a dose adjustment of insulin to prevent cases of hyperglycemia or hypoglycemia.
Instructions for use
The pre-filled Rhizodeg® Flex-Tach® pen has been developed for use with NovoFine® or NovoTvist® needles up to 8 mm in length. Rizodeg® FlexTech® allows the administration of doses ranging from 1 to 80 units in 1-step increments. Follow the detailed instructions contained in the attached instructions for the use of the FlexShack® syringe pen.
Rhizodeg® FlexTech® and needles are for personal use only.
Do not refill the syringe pen cartridge.
Do not use the drug if the solution has ceased to be clear and colorless. Do not use if it has been frozen.
Discard the needle after each injection.
Instructions for patients on the use of the drug Rizodeq® FlexTech®
Read this manual carefully before using the pre-filled Rhizodeg® FlexTech® syringe pen.
Use a syringe pen only after you learn to use it under the guidance of a doctor or nurse. Check the label on the label of the pen syringe to make sure it contains the Rhizodeg® FlexTech® 100 U / ml preparation, and then carefully examine the illustrations below, which show the details of the syringe pen and needle.
If you are visually impaired or you have serious vision problems and you can not distinguish the numbers on the dose counter, do not use a syringe pen without help. You can be helped by a person without visual impairment, trained in the correct use of a pre-filled Flex-Tach® pen. Rhizodeg® FlexTech® is a pre-filled syringe pen containing 300 units of insulin. The maximum dose that you can set is 80 units in 1-step increments. The Rhizodeg® FlexSac® pen is designed for use with NovoFine® or NovoTvist® disposable needles up to 8 mm long. Needles are not included in the packaging.
(!) Important information
Pay attention to the information marked with such icons (!), it is very important for safe use of the syringe pen.
Rhizodeg® FlexTech® and the needle (see Figure 4 for an example)
1. Preparing the syringe pen for use
A.
- Check the name and dosage on the label of the syringe pen to make sure that it contains the preparation Rhizodeg® Flex Tach® 100 U / ml. This is especially important if you use insulin preparations of different types.
- Remove the cap from the syringe pen.
AT.
- Make sure that the insulin solution in the syringe pen is clear and colorless. Look at the scale of the insulin balance. If the insulin solution is cloudy, the syringe pen can not be used.
FROM.
- Take a new disposable needle and remove the protective sticker.
D.
- Put the needle on the syringe pen and rotate it so that the needle fits tightly on the syringe handle.
- Remove the outer cap of the needle, but do not throw it away.
You will need it after the injection is completed to safely remove the needle.
F.
- Remove and discard the inner needle cap. To avoid accidental pricks, do not try to put the inner cap back on the needle (see Figure 5 A-F).
At the end of the needle, a drop of insulin may appear. This is normal, but you still need to check the intake of insulin.
(!) For each injection, use a new needle to avoid clogging the needle, infecting, infecting and injecting the wrong dose of the drug.
(!) Never use the needle if it is bent or damaged.
2. Insulin intake check
A.
- Before each injection, check the intake of insulin, so you can be sure that the dose of insulin is introduced completely.
- Dial 2 units of the drug by turning the dose selector. Make sure that the dose counter shows "2".
AT.
- Holding the syringe handle with the needle upwards, tap the upper part of the syringe handle several times with the tip of the finger, so that the air bubbles move upwards.
FROM.
- Press the start button and hold it in this position until the dose counter returns to zero.
"0" should stand in front of the dose indicator. At the end of the needle, a drop of insulin should appear (see Figure 6A, B, C).
Sometimes a small air bubble may remain at the end of the needle, but it will not be injected.
If a drop of insulin does not appear at the end of the needle, repeat steps 2A to 2C, but no more than 6 times. If a drop of insulin did not appear, change the needle and repeat operations 2A - 2C again.
(!) Do not use a syringe pen if a drop of insulin at the end of the needle has not appeared.
(!) Before each injection, make sure that a drop of insulin appears on the tip of the needle. If a drop of insulin does not appear, the dose will not be given, even if the dose counter moves.
3. Setting the dose
A.
- Before starting the injection, make sure that the dose counter is set to "0".
"0" should stand in front of the dose indicator.
- Rotate the dose selector set the dose assigned by the doctor.
If you have set the wrong dose, you can turn the dose selector forwards or backwards until the correct dose is set. The maximum dose that you can set is 80 units (see Figure 7A).
The dose selector sets the number of units. Only the dose counter and dose indicator show the number of units of insulin in the selected dose.
The maximum dose you can set is 80 units. If the insulin residue in the syringe pen is less than 80 units, the dose counter will stop on the number of units of insulin that remains in the syringe pen.
At each turn of the dose selector, clicks are heard, the sound of clicks depends on which way the dose selector is rotating (forward, backward or if the dialed dose exceeds the number of units of insulin remaining in the syringe pen). Do not count these clicks.
(!) Before each injection, check how many units of insulin you have typed on the dose counter and dose indicator.
Do not set the dose by the number of clicks.
The scale of the insulin residue shows the approximate amount of insulin remaining in the syringe,so it can not be used to measure the dose of insulin.
4. Introduction of insulin
A.
- Insert the needle under the skin using the injection technique recommended by the doctor.
- Make sure that the dose counter is in your field of vision.
Do not touch the dose counter with your fingers - this may interrupt the injection.
- Press the start button all the way down and hold it in this position until the dose counter shows "0".
"0" must be exactly opposite the dose indicator. You can hear or feel a click.
- After injection, leave the needle under the skin for at least 6 seconds. This will ensure the introduction of a full dose of insulin (see Figure 8A).
AT.
- Remove the needle from under the skin by pulling the syringe handle upwards (see Figure 8B).
If blood appears at the injection site, gently press a cotton swab into the injection site. Do not massage the injection site.
After the injection is complete, you can see a drop of insulin at the end of the needle.
This is normal and does not affect the dose of the drug you entered.
(!) Always check with the dose counter to know how many insulin units you have entered.
Do not count the number of clicks. The dose counter will show the exact number of units.
5. After the injection is completed
A.
- After placing the outer needle cap on a flat surface, insert the end of the needle into the cap, without touching it or until the tip of the needle.
AT.
- When the needle enters the cap, carefully put on the cap.
- Unscrew the needle. Throw out the needle, observing the precautionary measures.
FROM.
- After each injection, put a cap on the syringe pen to protect the insulin contained in it from exposure to light (see Fig. 9 A, B, C).
Discard the needle after each injection, this will ensure a comfortable injection of insulin and prevent clogging of the needle. If the needle is clogged, you can not inject insulin.
Dispose of the used syringe pen with the needle disconnected, according to the recommendations given by the doctor, nurse, pharmacist or according to local requirements.
(!) To avoid accidental pricking with a needle, never try to put the inner cap back on the needle.
(!) Remove the needle after each injection.
This will prevent clogging of the needle, infection, infection, leakage of insulin from the syringe pen and incorrect dosing.
6. How much insulin is left?
A.
- The scale of the insulin residue shows an approximate amount of insulin,left in the syringe-pen.
AT.
- To find out how much insulin remains in your syringe pen, use the dose counter (see Figure 10A, B).
Rotate the dose selector until the dose counter stops.
If the dose counter shows a figure of 80, this means that at least 80 insulin units remain in the syringe pen.
If the dose counter shows less than 80, this means that exactly the number of insulin units that was displayed on the dose counter remained in the syringe pen.
- Rotate the dose selector in the opposite direction until the dose counter shows "0".
- If the insulin remaining in the syringe-pen is not enough to introduce the full dose, you can enter the required dose for two injections using two syringes.
(!) Be very careful when calculating the remainder of the insulin dose you need to prevent an error.
If you have doubts, better enter a full dose of insulin with a new syringe pen.
(!) Important information
- Always carry a syringe pen with you.
- Always carry a spare syringe pen and new needles in case they are lost or damaged.
- Keep the syringe pen and needle out of reach of all, and especially for children.
- Never give your syringe pen and needle to it to others.
- Persons caring for the patient should handle the used needles with extreme care to avoid accidental injections and infection.
Care of the syringe pen
- Do not leave a syringe pen in the car or any other place where it can be exposed to too high or too low temperatures.
- Protect the syringe handle from getting on it dust, dirt and all kinds of liquids.
- Do not wash the syringe pen, do not immerse it in liquid and do not lubricate it. If necessary, the syringe handle can be cleaned with a damp cloth moistened with a mild detergent.
- Do not drop or hit the syringe handle on a hard surface.
If you drop a syringe pen or doubt its serviceability, attach a new needle and check the intake of insulin before you inject.
- Do not refill the syringe pen. Do not reuse an empty syringe pen.
- Do not attempt to repair the syringe pen by itself or dismantle it.