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INSULIN ASPART

Brand Name :

(Novorapid, NovoMix 70/30) ®

Dosage form :

100 IU/ml.

Indication :

Treatment of type 1 diabetes mellitus (insulin dependent, IDDM) and
type 2 diabetes mellitus (noninsulin dependent, NIDDM) to improve
glycemic control.

Dosage :

Adult: diabetes mellitus, type 1:
SubQ: Initial total insulin dose: 0.2 to 0.6 units/kg/day in divided
doses.


Usual maintenance range: 0.5 to 1 units/kg/day in divided doses. An
estimate of anticipated needs may be based on body weight and/or
activity factors.


Pubescent Children and Adolescents: During puberty, requirements
may substantially increase to > 1 unit/kg/day and in some cases up to
2 units/kg/day.


Division of daily insulin requirement (“conventional therapy”):
Generally, 50% to 75% of the total daily dose (TDD) is given as an
intermediate- or long-acting form of insulin (in 1 to 2 daily
injections). The remaining portion of the TDD is then divided and
administered before or at mealtimes (depending on the formulation)
as a rapid-acting (eg, insulin aspart) or short-acting form of insulin.


Division of daily insulin requirement (“intensive therapy”): Basal
insulin delivery with 1 or 2 doses of intermediate- or long-acting
insulin formulations superimposed with doses of short- or rapid acting insulin (eg, insulin aspart) formulations 3 or more times daily.
Diabetes mellitus, type 2: SubQ

One injection of a rapid-acting insulin analog [lispro, aspart,
glulisine] initiated at a dose of 4 units or 0.1 units/kg or 10% basal
dose before largest meal; may progress to "basal-bolus" dosing of 3
injections of a rapid-acting insulin analog [lispro, aspart, glulisine]
per meal or dose by adding up the total current insulin dose, and
provide one-half of this amount as basal and one-half as mealtime
insulin (split evenly between 3 meals).


Children: Diabetic ketoacidosis (DKA), mild-to-moderate (off-label
use):

0.3 units/kg followed in 1 hour by 0.1 units/kg given every hour or
0.15 to 0.2 units/kg every 2 hours; continue until acidosis clears, then
decrease to 0.05 units/kg given every hour until maintenance SubQ
replacement dosing can be initiated.
Note: May be used IV in critically ill hyperglycemia.

Warning / precaution :

Adverse reactions :

Primarily symptoms of hypoglycemia: Pallor, palpitation,
tachycardia,
fatigue, headache, mental confusion, tremor, diaphoresis, nausea;
atrophy or hypertrophy of SubQ fat tissue; edema, itching.

Therapeutic class :

Medication safety issues :

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