Indications
Acilog SC Injection is used for:
Diabetes mellitus
Adult Dose
Subcutaneous
Type 1 Diabetes Mellitus
Improvement of glycemic control in adults and children with diabetes mellitus
May administer 0.2-0.6 unit/kg/day in divided doses; conservative doses of 0.2-0.4 unit/kg/day often recommended to reduce risk of hypoglycemia
Total maintenance daily insulin requirement may vary; it is usually between 0.5 and 1 unit/kg/day; nonobese may require 0.4-0.6 unit/kg/day; obese may require 0.6-1.2 units/kg/day
Type 2 Diabetes Mellitus
Diabetes inadequately controlled by diet, weight reduction, exercise, or oral medication
Initial: 0.2-0.4 units/kg/day SC divided q8hr-q12hr.
And an intermediate (eg, NPH) or long-acting insulin at bedtime recommended;
Hepatic impairment: Dosage reduction may be needed.
Dosing Considerations
When used in a meal-related SC injection treatment regimen, 50-75% of total insulin requirements may be provided by an intermediate-acting or long-acting insulin; the remainder is divided and provided before or at mealtimes as a rapid-acting insulin, such as insulin aspart
Dosage must be individualized; blood and urine glucose monitoring is essential in all patients receiving insulin therapy
Child Dose
Subcutaneous
Type 1 Diabetes Mellitus
Improvement of glycemic control in adults and children with diabetes mellitus
>2 years: May require 0.8-1.2 units/kg/day SC during growth spurts; adolescents may require <1.2 units/kg/day; otherwise, may use 0.5-1 unit/kg/day
Renal Dose
Renal impairment: Dose adjustments may be needed.
Administration
SC injection
Should be taken with food. Administer immediately within 5-10 minutes before a meal.
When administered by SC injection, insulin aspart should generally be used in regimens with an intermediate- or long-acting insulin
Administer subcutaneously in the upper arm, thigh or abdominal wall. A subcutaneous injection into the abdominal wall results in a faster absorption than from other injection sites.
Injection sites should be rotated within the same region to reduce the risk of lipodystrophy
Contra Indications
Hypoglycaemia. Hypersensitivity to any of the components.
Precautions
Pregnancy (insulin requirements tend to fall during the 1st trimester, increase during the 2nd and 3rd) and lactation. Caution with decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment
Hypokalemia may occur
Use with caution in renal and hepatic impairment (dosage requirements may be reduced)
Caution with increased insulin requirements: Fever, hyperthyroidism, trauma, infection, surgery
Lactation: Safe to use while breastfeeding
Pregnancy-Lactation
Pregnancy
Available information from published randomized controlled trials during second trimester of pregnancy have not reported association with insulin aspart and major birth defects or adverse maternal or fetal outcomes
Poorly controlled diabetes in pregnancy increases the maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, stillbirth and delivery complications
Poorly controlled diabetes also increases fetal risk for major birth defects, and macrosomia related morbidity
Animal data
In animal reproduction studies, administration of subcutaneous insulin aspart to pregnant rats and rabbits during period of organogenesis did not cause adverse developmental effects at exposures 8-times and equal to human subcutaneous dose of 1 unit/kg/day, respectively; pre- and post-implantation losses and visceral/skeletal abnormalities were seen at higher exposures, which are considered secondary to maternal hypoglycemia; these effects were similar to those observed in rats administered regular human insulin
Lactation
There are no data on presence of insulin in human milk, effects on breastfed infant, or on milk production; one small published study reported that exogenous insulin, including insulin aspart, was present in human milk; however, there is insufficient information to determine effects of insulin aspart on breastfed infant; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy, and any potential adverse effects on breastfed infant from drug, or from underlying maternal condition
Interactions
Effects may be increased by: oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, propoxyphene, salicylates, somatostatin analog (e.g., octreotide), sulfonamide antibiotics. Effects may be decreased by: corticosteroids, niacin, danazol, diuretics, sympathomimetic agents, isoniazid, phenothiazine derivatives, somatropin, thyroid hormones, oral contraceptives, lithium. Signs of hypoglycaemia may be masked by beta-blockers, clonidine.
Side Effects
Side effects of Insulin Aspart :
Allergic reactions. Injection site reaction, lipodystrophy, pruritus, rash, lipoatrophy, hypokalaemia, blurred vision. Hypoglycaemia, insulin resistance.
Mode of Action
Insulin aspart, a rapid-acting analog of human insulin, lowers blood glucose levels; it regulates carbohydrate, protein and fat metabolism by inhibiting hepatic glucose production and lipolysis, and enhancing peripheral glucose disposal.
Note
Acilog 100IU/ml SC Injection generic name is Insulin Aspart. Acilog 100IU/ml SC Injection is manufactured by ACI LimitedAcilog is availble in all over Bangladesh.
Mes BD drug index information on Acilog SC Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.
Some other brands of Insulin Aspart :
Injection
NovoRapid Penfill
100IU/ml
Novo Nordisk A/S Denmark
Injection
NovoRapid Flexpen
100IU/ml
Novo Nordisk A/S Denmark
Injection
Insulet ASP
100 IU/ml
Aristopharma Limited
Injection
Glyset Penset R
300IU/ml
Incepta Pharmaceuticals Ltd.
Injection
Glyset Penset Mix
100IU/ml
Incepta Pharmaceuticals Ltd.