insulin glulisine: clinical use

Prescribing considerations

• Prescribe and document the specific insulin product; verify the label before administration and supervise transfers between insulin products.
• Requirements may fall with renal impairment, hepatic impairment or declining renal function in older people.
• Evidence is insufficient for children younger than 6 years under the selected licence.
• Ensure pump users understand product-specific handling, can recognise delivery failure and have an alternative insulin-delivery method.
• Intravenous administration must be undertaken by healthcare professionals.

Contraindications and cautions

• Current hypoglycaemia
• Hypersensitivity to insulin glulisine or any excipient; metacresol may cause allergic reactions

Monitoring

• Blood glucose control and occurrence or awareness of hypoglycaemia
• Ketones and signs of ketoacidosis when pump delivery is interrupted or hyperglycaemia persists
• Renal and hepatic function where changes may alter insulin requirements
• Injection and infusion sites for lipodystrophy or cutaneous amyloidosis
• Heart-failure symptoms if used with pioglitazone

Clinical pharmacology

A recombinant human insulin analogue with glucose-lowering potency equivalent to regular human insulin unit for unit. It promotes peripheral glucose uptake, suppresses hepatic glucose output and has a faster onset and shorter duration after subcutaneous administration than regular human insulin.

Formulation and product differences

• The vial supports administration by an appropriate insulin syringe, compatible continuous subcutaneous infusion pump or intravenous infusion by healthcare professionals.
• The solution is clear and colourless and does not require resuspension.
• For subcutaneous injection it must not be mixed with medicines other than NPH human insulin; it must not be mixed with another insulin or diluent in a pump.
• The vial contains metacresol and is essentially sodium-free.

Injection

Route: Parenteral

Strengths: 100 units/mL