Dosage
Talk about your insulin dose with your doctor and nurse. Follow their advice carefully. This leaflet is a general guide.
If your doctor has switched you from one type or brand of insulin to another, your dose may have to be adjusted by your doctor. Do not change your insulin unless your doctor tells you to.
Eat a meal or snack containing carbohydrates within 10 minutes of the injection to avoid
hypoglycaemia. When necessary, NovoRapid may be given soon after the meal, instead of before the meal.
Method of administration
NovoRapid is for injection under the skin (subcutaneously) or for continuous infusion in a pump system. NovoRapid may also be given directly into a vein (intravenously) by health care professionals under close supervision by a doctor. Never inject your insulin directly into a vein or muscle (intramuscular).
Always vary the sites you inject within the same region to avoid lumps (see 4 Possible side effects). The best places to give yourself an injection are: the front of your waist (abdomen), the upper arm or the front of your thighs. You should always measure your blood glucose regularly.
How to take NovoRapid
If you use only one type of insulin
1. Draw into the syringe the same amount of air as the dose of insulin you are going to inject. Inject the air into the vial.
2. Turn the vial and syringe upside down and draw the correct insulin dose into the syringe. Pull the needle out of the vial. Then expel the air from the syringe and check that the dose is correct.
If you have to mix two types of insulin
1. Just before use, roll the long-acting (cloudy) insulin between your hands until the liquid is uniformly white and cloudy.
2. Draw into the syringe the same amount of air as the dose of long-acting insulin. Inject the air into the vial containing long-acting insulin and pull out the needle.
3. Draw into the syringe the same amount of air as the dose of NovoRapid. Inject the air into the vial containing NovoRapid. Turn the vial and syringe upside down and draw up the prescribed dose of NovoRapid. Expel any air from the syringe and check that the dose is correct.
4. Push the needle into the vial of long-acting insulin, turn the vial and syringe upside down and draw out the dose you have been prescribed. Expel any air from the syringe and check the dose. Inject the mixture immediately.
5. Always mix NovoRapid and long-acting insulin in the same sequence.
How to inject this insulin
- Pinch your skin between two fingers, push the needle into the skin fold and inject the insulin under the skin
- Keep the needle under your skin for at least 6 seconds to make sure you have injected all theinsulin.
For use in an infusion pump system
NovoRapid should never be mixed with any other insulin when used in a pump.
Follow the instructions and recommendations from your doctor regarding the use of NovoRapid in a pump. Before use of NovoRapid in the pump system you must have received a comprehensive instruction in the use and information about any actions to be taken in case of illness, too high or too low blood sugar or failure of the pump system.
- Before inserting the needle, use soap and water to clean your hands and the skin where the needle is inserted so as to avoid any infection at the infusion site
- When you fill a new reservoir, be certain not to leave large air bubbles in either the syringe or the tubing
- Changing of the infusion set (tubing and needle) must be done according to the instructions in the product information supplied with the infusion set.
To get the benefit of insulin infusion, and to detect possible malfunction of the insulin pump, it is recommended that you measure your blood sugar level regularly.
What to do in case of pump system failure
You should always have alternative insulin available for injection under the skin in case of pump system failure.
If you take more insulin than you should
If you take too much insulin your blood sugar gets too low (this is called hypoglycaemia or hypo). This may also happen:
- If you eat too little or miss a meal
- If you exercise more than usual.
The warning signs of a hypomay come on suddenly and can include: cold sweat; cool pale skin; headache; rapid heart beat; feeling sick; feeling very hungry; temporary changes in vision; drowsiness; unusual tiredness and weakness; nervousness or tremor; feeling anxious; feeling confused; difficulty in concentrating.
If you feel a hypo coming on:take a high sugar snack and then measure your blood sugar.
If your blood sugar is too low: eat glucose tablets or another high sugar snack (sweets, biscuits, fruit juice), then rest. Always carry glucose tablets, sweets, biscuits or fruit juice with you, just in case.
When symptoms of hypoglycaemia have disappeared or when blood glucose level is stabilised continue insulin treatment.
Tell relevant people you have diabetes and what may be the consequences, including the risk of passing out due to a hypo.
Tell relevant people that if you pass out (become unconscious), they must turn you on your side and get medical help straight away. They must not give you any food or drink. It could choke you.
You may recover more quickly from unconsciousness with an injection of the hormone glucagon by someone who knows how to use it. If you are given glucagon you will need glucose or a sugary snack as soon as you are conscious. If you do not respond to glucagon treatment, you will have to be treated in a hospital. Contact your doctor or an emergency ward after an injection of glucagon: you need to find the reason for your hypo to avoid getting more.
- If prolonged severe hypoglycaemia is not treated, it can cause brain damage (temporary or permanent) and even death
- If you have a hypo that makes you pass out, or a lot of hypos, talk to your doctor. The amount or timing of insulin, food or exercise may need to be adjusted.
If you forget to take your insulin
If you forget to take your insulin your blood sugar may get too high (this is called hyperglycaemia). This may also happen:
- If you repeatedly take less insulin than you need
- If you get an infection or a fever
- If you eat more than usual
- If you exercise less than usual.
The warning signs appear gradually. They include: increased urination; feeling thirsty; losing your appetite; feeling sick (nausea or vomiting); feeling drowsy or tired; flushed, dry skin; dry mouth and a fruity (acetone) smell of the breath.
If you get any of these signs: test your blood sugar level, test your urine for ketones if you can, then seek medical advice immediately.
These may be signs of a very serious condition called diabetic ketoacidosis. If you do not treat it, this could lead to diabetic coma and eventually death.
If you stop taking your insulin
This could lead to severe hyperglycaemia (very high blood sugar) and ketoacidosis (build-up of acid in the blood because the body is breaking down fat instead of sugar). Do not stop taking your insulin without speaking to a doctor, who will tell you what needs to be done.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
