Insulin glulisine

Insulin is a hormone that helps lower glucose (sugar) levels in the blood. Insulin glulisine is a fast-acting insulin that begins to work about 15 minutes after injection, peaks in about 1 hour, and continues to work for 2 to 4 hours.

Insulin glulisine is used to help control blood sugar in adults and children with diabetes mellitus. It is used to treat type 1 or type 2 diabetes in adults, and type 1 diabetes in children who are at least 4 years old.

Insulin glulisine may also be used for other reasons not mentioned in this medication guide.

Never share an injection pen or syringe with another person, even if the needle has been changed.

You should not use insulin glulisine if you are allergic to it, or if you are having an episode of hypoglycemia (low blood sugar).

Insulin glulisine is not approved for use by anyone younger than 4 years old, and should not be used to treat type 2 diabetes in a child of any age.

Tell your doctor if you have ever had:

• liver or kidney disease;
• low levels of potassium in your blood (hypokalemia); or
• diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes found in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while using insulin may increase your risk of serious heart problems.

Tell your doctor if you are pregnant or breastfeeding.

Follow your doctor's instructions about using insulin if you are pregnant or become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications for both the mother and the baby.

Get emergency medical help if you notice signs of an insulin allergy: redness or swelling at the injection site, an itchy skin rash all over your body, trouble breathing, a fast heartbeat, feeling faint, or swelling in your tongue or throat.

Insulin glulisine can cause serious side effects. Contact your doctor immediately if you experience:

• fluid retention--weight gain, swelling in your hands or feet, trouble breathing; or
• low potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or a feeling of being limp.

Common side effects of insulin glulisine may include:

• low blood sugar;
• itching, mild skin rash; or
• thickening or hollowness of the skin where you injected the medicine.

This is not a complete list of side effects, and others may happen. Contact your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Insulin glulisine is injected under the skin, or given as an infusion into a vein. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.

Read and carefully follow any Instructions for Use provided with your medicine and injection pen or insulin pump. Ask your doctor or pharmacist if you don't understand all instructions.

Prepare an injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.

Your healthcare provider will show you where on your body to inject insulin glulisine. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

After using insulin glulisine, eat a meal within 15 minutes. If you did not use an injection before the meal, use the medicine within 20 minutes after you start eating.

If you use insulin glulisine with an IV or insulin pump, do not mix or dilute insulin glulisine with any other insulin.

If you use an injection pen, use only the pen that comes with insulin glulisine. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe or infusion pump.

Never share an injection pen or syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

Use a needle and syringe only once and then place them in a puncture-proof "sharps" container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Insulin glulisine is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Keep this medicine in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) insulin glulisine:

• Refrigerate and use until expiration date; or
• Store at cool room temperature (below 77 degrees F) and use within 28 days.

Storing opened (in use) insulin glulisine:

• Store the vial in a refrigerator or at cool room temperature and use within 28 days.
• Store the injection pen at cool room temperature (do not refrigerate) and use within 28 days. Do not store the injection pen with a needle attached.
• Store a prepared infusion bag at cool room temperature and use within 48 hours.

Do not use the medicine if it looks cloudy, has changed colors, or has any particles in it. Call your pharmacist for new medicine.

In case of emergency, wear or carry medical identification to let others know you have diabetes.

Since insulin glulisine is taken before meals, you might not have a set dosing schedule. Whenever you take insulin glulisine, make sure to eat a meal within 15 minutes. Do not take two doses at the same time.

Always keep insulin on hand. Get your prescription refilled before you completely run out of medicine.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222. An insulin overdose can lead to serious hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizures (convulsions), or loss of consciousness.

Insulin can lead to low blood sugar. Do not drive or operate machinery until you know how insulin glulisine will affect you.

Prevent medication errors by always checking the medicine label before injecting your insulin.

Do not drink alcohol. It can cause low blood sugar and may interfere with your diabetes treatment.

Many other medicines can influence your blood sugar levels, and some can make insulin work stronger or weaker. Certain drugs can also reduce the signs of low blood sugar (hypoglycemia), which can make it difficult to recognize when your blood sugar is low. Inform all your health care providers about every medicine you are currently taking and any new medicine you begin or stop taking. This includes prescription and over-the-counter medicines, vitamins, and herbal products.