Apidra
Insulin glulisine is a rapid-acting insulin that's available as a vial (Apidra) and a pre-filled pen (Apidra Solostar). It's used to control blood sugar from meals for people with either Type 1 diabetes (T1D) or Type 2 diabetes (T2D). Apidra (insulin glulisine) is given under the skin as either a quick injection or continuously through an insulin pump. It can also be given as an injection through the veins (IV) for people in the hospital. Side effects include low blood sugar (hypoglycemia) and common cold symptoms.
What is Apidra (insulin glulisine)?
What is Apidra (insulin glulisine) used for?
- Type 1 diabetes (T1D) in people ages 4 years and older
- Type 2 diabetes (T2D) in people ages 18 years and older
How Apidra (insulin glulisine) works
Apidra (insulin glulisine) is an insulin. Insulin is a natural hormone your body makes to control blood sugar levels. It helps your body absorb and store sugar from the bloodstream after a meal. Insulin also stops your liver from making glucose (sugar). But people with diabetes can't make insulin, don't make enough insulin, or their body doesn't respond to insulin as it should.
Apidra (insulin glulisine) is a rapid-acting insulin. It's injected within 15 minutes before, or 20 minutes after, a meal to prevent blood sugar levels from rising too high. It can also be used with the appropriate insulin pump.
Drug facts
More on Apidra (insulin glulisine) essentials
Side effects of Apidra (insulin glulisine)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Type 1 diabetes
- Common cold (11%)
- Low blood sugar (up to 7%)
- Upper respiratory tract infection (7%)
- Headache (7%) - children only
- Seizure from low blood sugar (6%) - children only
- Flu (4%)
Type 2 diabetes
- Upper respiratory tract infection (up to 11%)
- Common cold (8%)
- Swelling in the hands, ankles, or legs (8%)
- Flu (6%)
- Joint pain (6%)
Less Common Side Effects
- Weight gain
- Injection/infusion site reaction (such as pain, swelling, redness, itching)
Apidra (insulin glulisine) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severely low blood sugar: dizziness, shakiness, feeling confused, feeling irritable or anxious, feeling faint, sweating, extreme hunger, not able to think clearly
- Ketoacidosis (high ketone levels in the blood): nausea, vomiting, stomach pain, tiredness, feeling very thirsty, dry mouth, fruity breath, trouble breathing
- Severely low potassium levels: weakness, muscle cramps or twitches, constipation, abnormal heartbeat, tiredness, trouble breathing
- Severe allergic reactions: rash; hives; swelling of face, tongue, and throat; trouble breathing
More on Apidra (insulin glulisine) side effects
The following Apidra (insulin glulisine) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
blurred vision
body aches or pain
chills
cold sweats
confusion
cool, pale skin
difficulty with breathing
dizziness
ear congestion
fast heartbeat
headache
increased hunger
loss of consciousness
loss of voice
nightmares
runny or stuffy nose
seizures
shakiness
slurred speech
unusual tiredness or weakness
Less common
Pounding in the ears
slow heartbeat
Incidence not known
Bloating or swelling of face, arms, hands, lower legs, or feet
difficulty with swallowing
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fast, pounding, or irregular heartbeat or pulse
increased sweating
puffiness or swelling of the eyelids or around the eyes, face, lips or tongue
rapid weight gain
tightness in the chest
tingling of the hands or feet
unusual weight gain or loss
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Difficulty with moving
dry, red, hot, or irritated skin
ear congestion
loss of voice
muscle aches
muscle pain or stiffness
pain in the joints
Less common
Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
redistribution or accumulation of body fat
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Apidra (insulin glulisine)
Pros
- Works within 15 minutes to lower blood sugar
- Available as a prefilled pen, which might be easier to use than the vial
- Can be used with some insulin pumps
- Can be mixed with NPH insulin (e.g., Novolin N), if instructed by your care team
Cons
- Raises risk of dangerously low blood sugar levels
- Given as an injection
- Might need to inject multiple times a day
- Might cause weight gain
Pharmacist tips for Apidra (insulin glulisine)
- Apidra (insulin glulisine) is meant to quickly lower blood sugar from food. Don't use Apidra (insulin glulisine) if you plan to skip a meal unless your prescriber specifically told you to do so. Using Apidra (insulin glulisine) without a meal raises your risk for hypoglycemia (dangerously low blood sugar), which can be life-threatening.
- Make sure you and your family members know how to recognize and treat low blood sugar levels, like shakiness, anxiety, and hunger. Keep fast-acting sugar, such as glucose tablets, with you at all times so you can take it if your blood sugar level drops too low.
- Ask your prescriber how often you should check your blood sugar levels during the day as you use Apidra (insulin glulisine). Use a blood sugar log to help keep track of your readings. This can help make sure you're on the right dose of Apidra (insulin glulisine) or if dose adjustments are needed.
- Apidra (insulin glulisine) can only be mixed with NPH insulin (Novolin N or Humalin N) within the same syringe when giving it as an injection under the skin. Make sure to draw up Apidra (insulin glulisine) first, then inject immediately after mixing. Don't mix Apidra (insulin glulisine) with any other types of insulin.
- Never share Apidra (insulin glulisine) pens and vials, or insulin supplies with anyone else. Doing so puts you and others at risk of spreading germs and getting serious infections.
Tips on how to use Apidra (insulin glulisine):
- Your care team will train you to administer Apidra (insulin glulisine). Make sure you know how to use the medication to avoid accidentally hurting yourself or wasting the medication. Read the instructions for use for either the vial or the pen. Contact a member of your care team if you have any questions.
- Before injecting Apidra (insulin glulisine), make sure the solution is clear and colorless without any particles (solid chunks). Otherwise, don't inject Apidra (insulin glulisine) and ask your prescriber or pharmacist if it's possible to get a replacement.
- For under-the-skin injections: Inject Apidra (insulin glulisine) within 15 minutes before a meal or within 20 minutes after a meal. It should be injected under the skin (subcutaneously) of your stomach area, thighs, or upper arms. Be sure to rotate injection sites to prevent hard lumps from forming in your skin.
- For continuous infusion pumps: Be sure to infuse into an area of the body recommended by the manufacturer of the pump. Rotate injection sites to prevent skin irritation. Change the medication in the pump at least every 2 days or according to the user manual, whichever is shorter. Also, replace any Apidra (insulin glulisine) in the pump that's been exposed to temperatures above 98.6°F.
- After injecting Apidra (insulin glulisine), throw the needle or syringe away in a sharps container or something made of heavy-duty plastic (e.g., empty milk carton, laundry detergent bottle). This helps lower the risk of needle-stick injuries. Don't throw away needles or syringes in your trash can. Visit the FDA's website for guidance on how to throw away your sharps container safely in your specific state.
Common questions about Apidra (insulin glulisine)
Apidra (insulin glulisine) is a rapid-acting (or fast-acting) insulin. It starts to work about 15 minutes after the injection. If you're using Apidra (insulin glulisine) as meal-time insulin, you should give the injection within 15 minutes before a meal or within 20 minutes after a starting a meal.
If your diabetes care team prescribes Apidra (insulin glulisine) as a meal-time insulin, you can inject it either within 15 minutes before a meal or within 20 minutes after starting a meal. However, your care team will likely advise you to skip your mealtime dose of Apidra (insulin glulisine) if you plan to skip a meal, as this is important to prevent your blood sugar levels from dropping to a dangerously low level.
Yes, some insulin pumps are compatible with Apidra (insulin glulisine). You can check the manufacturer's website or manual to see if you can use Apidra (insulin glulisine) with a particular pump. Talk to your diabetes specialist if you have more questions about infusing insulin through a pump.
Yes, weight gain can be a side effect of any insulin, including Apidra (insulin glulisine). This happens because insulin helps lower your blood sugar by allowing cells to absorb sugar from your bloodstream. When your body absorbs this sugar, it can store it as fat, which might lead to weight gain. To help prevent weight gain while using Apidra (insulin glulisine), try to stick to a balanced diet that’s low in sugar and fat, and make sure to get regular exercise. These habits can help manage your body weight and help Apidra (insulin glulisine) work better to control your blood sugar levels. Contact your care team if you're concerned about any weight gain while you're taking this medication.
Your diabetes care team will help you figure out the units of Apidra (insulin glulisine) needed to keep your blood sugar levels within a safe range. Your dose depends on different factors, such as whether you have T1D or T2D, your diet, and what other medications you're taking. Your care team might also adjust your dose based on changes in your diet or lifestyle. Contact your diabetes specialist if you're not sure how much Apidra (insulin glulisine) you should be using.
You can store unopened vials and unopened pens of Apidra (insulin glulisine) in the refrigerator until the expiration date on the box, or at room temperature for up to 28 days. For opened vials of Apidra (insulin glulisine) that you're currently using, you can store it at room temperature or in the refrigerator up to 28 days. For opened pens of Apidra (insulin glulisine) that you're currently using, it's fine to store it at room temperature for 28 days, don't put it back in the refrigerator.
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Risks and warnings for Apidra (insulin glulisine)
Apidra (insulin glulisine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Spread of infections from sharing injection supplies
Never share Apidra (insulin glulisine) pens with anyone, even if you use a new needle. Also, never share Apidra (insulin glulisine) vials, syringes, or needles with anyone else. Sharing insulin or insulin supplies with others can raise the risk of spreading dangerous infections to other people and yourself.
Risk of high and low blood sugar levels
- Risk factors: Changes in diet and exercise | Switching to Apidra (insulin glulisine) from a different type of insulin | Drinking alcohol | Taking other medications for diabetes together with Apidra (insulin glulisine) | Liver or kidney problems
Changing your insulin or insulin routine, such as where you inject Apidra (insulin glulisine) or switching to a different brand of insulin, can affect how your body responds to insulin. This can lead to either high or low blood sugar levels. In addition, injecting Apidra (insulin glulisine) repeatedly into skin areas that shows signs of lipodystrophy, such as pitting or thickened skin, can also result in high blood sugar levels.
Don't make changes to your Apidra (insulin glulisine) dose or routine without first checking in with your diabetes care team. Make sure to avoid injecting into skin areas that show signs of lipodystrophy. If your care team instructs you to make any changes to your insulin routine, they'll also ask you to check your blood sugar levels more often to see how the changes affect your blood sugar levels.
Dangerously low blood sugar levels (hypoglycemia)
- Risk factors: Changes in diet and exercise | Drinking alcohol | Taking other medications for diabetes together with Apidra (insulin glulisine) | Liver or kidney problems | Not using Apidra (insulin glulisine) as directed
Using Apidra (insulin glulisine) alone or together with other medications that lower blood sugar can lead to hypoglycemia, which is dangerously low blood sugar levels. If not treated in time, it can be life-threatening.
Check your blood sugar level regularly to make sure it's within a safe range. If your diabetes care team instructs you to mix different insulins together, read the label of the insulins carefully to make sure you're using the right products. If you make any changes to your diet or meal patterns, other medications, or how much you exercise, let your care team know because they might need to adjust your dose of Apidra (insulin glulisine).
Be familiar with symptoms of hypoglycemia, such as feeling shaky, being nervous or anxious, sweating or body chills, and excessive hunger. Keep fast-acting sugars, such as glucose tablets, with you at all times so you can treat an episode of hypoglycemia. If your blood sugar levels don't improve even after you take fast-acting sugars, get medical help right away.
Allergic reaction
In some rare cases, Apidra (insulin glulisine) can cause an allergic reaction. Get medical help right away if you experience trouble breathing, swelling of your face, lips, tongue, or throat, or a rash.
Low blood potassium levels
- Risk factors: Taking other medications that lower potassium levels
Apidra (insulin glulisine) can lower the levels of potassium in your blood, which can be dangerous. You're at higher risk if you're already taking medications that lower your potassium, like certain diuretics (water pills). Your prescriber will check your potassium levels regularly and might give you medications to keep your potassium in the normal range. Tell your prescriber if you have symptoms of low potassium, such as weakness, muscle cramps or twitches, nausea, vomiting, or abnormal heartbeats.
Swelling from fluid buildup and risk of heart failure
- Risk factors: Taking glitazones together with Apidra (insulin glulisine) | History of heart failure
Taking Apidra (insulin glulisine) with medications called glitazones (also known as thiazolidinediones), like pioglitazone (Actos), can cause your body to hold onto fluid. This can worsen or lead to heart failure. Let your prescriber know if you've noticed sudden weight gain or if you have symptoms of heart failure, such as trouble breathing, tiredness, or headache. They might need to make changes to your blood sugar medications.
Dangerously high blood sugar levels or buildup of ketones (for people who use insulin pump)
- Risk factors: Insulin pump not working properly
If you're using an insulin pump to inject Apidra (insulin glulisine), check that your insulin isn't expired and that your pump is working and set to the proper settings. When the pump isn't working properly, you're at risk of having extremely high blood sugar levels or a serious complication of diabetes called ketoacidosis. Call your prescriber right away if you can't fix your pump quickly. Your prescriber might recommend that you inject Apidra (insulin glulisine) in other ways in the meantime. Seek medical help if you have symptoms of ketoacidosis, such as tiredness, fruity-smelling breath, or vomiting.
Apidra (insulin glulisine) dosage
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5 solostar pens of 3ml | 1 carton | $35.00 | $35.00 |
| 5 cartridges of 3ml | 1 carton | $35.00 | $35.00 |
Cartridge| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 3ml of 100 units/ml | 5 cartridges | $35.00 | $7.00 |
Solostar pen| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 3ml of 100 units/ml | 5 solostar pens | $35.00 | $7.00 |
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10ml of 100 units/ml | 1 vial | $35.00 | $35.00 |
Typical dosage for Apidra (insulin glulisine)
Your diabetes care team will determine your dose of Apidra (insulin glulisine) based on different factors, such as your blood sugar level and what other medications you're taking.
- Injections under the skin: Inject Apidra (insulin glulisine) under the skin in the stomach, thigh, or upper arm, within 15 minutes before a meal or within 20 minutes right after a meal.
- Continuous insulin pumps: Use the insulin pump according to your prescriber's instructions. Follow the directions from your insulin pump manufacturer to set up and use the pump.
- Injections through the vein: Apidra (insulin glulisine) can be given as an injection into the vein by a healthcare professional (HCP), typically in a hospital setting.
Interactions between Apidra (insulin glulisine) and other drugs
More on Apidra (insulin glulisine) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Balofloxacin
- Besifloxacin
- Chloroquine
- Ciprofloxacin
- Enoxacin
- Fleroxacin
- Flumequine
- Gatifloxacin
- Gemifloxacin
- Hydroxychloroquine
- Lanreotide
- Levofloxacin
- Liraglutide
- Lomefloxacin
- Macimorelin
- Metoclopramide
- Metreleptin
- Moxifloxacin
- Nadifloxacin
- Norfloxacin
- Octreotide
- Ofloxacin
- Pasireotide
- Pazufloxacin
- Pefloxacin
- Pioglitazone
- Pramlintide
- Prulifloxacin
- Rosiglitazone
- Rufloxacin
- Sparfloxacin
- Thioctic Acid
- Tosufloxacin
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Albiglutide
- Atenolol
- Betaxolol
- Bisoprolol
- Bitter Melon
- Carteolol
- Carvedilol
- Celiprolol
- Dulaglutide
- Esmolol
- Exenatide
- Fenugreek
- Furazolidone
- Glucomannan
- Guar Gum
- Iproniazid
- Isocarboxazid
- Labetalol
- Levobunolol
- Linezolid
- Lixisenatide
- Methylene Blue
- Metipranolol
- Metoprolol
- Moclobemide
- Nadolol
- Nebivolol
- Nialamide
- Oxprenolol
- Penbutolol
- Phenelzine
- Pindolol
- Practolol
- Procarbazine
- Propranolol
- Psyllium
- Rasagiline
- Safinamide
- Saxagliptin
- Selegiline
- Sotalol
- Timolol
- Tranylcypromine
How much does Apidra (insulin glulisine) cost?
$35.00
Apidra (insulin glulisine) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Apidra (insulin glulisine) will not be safe for you to take.
- Currently experiencing low blood sugar (hypoglycemia)
What are alternatives to Apidra (insulin glulisine)?
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