ACTRAPID ® a drug based on human insulin.
THERAPEUTIC GROUP: Human insulin for fast-acting injectable use.
Indications ACTRAPID ® - Insulin
ACTRAPID ® is used in the treatment of diabetes mellitus and intravenously in the treatment of diabetic keto acidosis and non-ketotic hyperosmolar syndrome.
ACTRAPID ® Mechanism of Action - Insulin
ACTRAPID ® is a human insulin-based drug obtained by recombinant DNA technology from Saccaromices Cerevisiae.
With a structure similar to that of the hormone synthesized in vivo by pancreatic beta cells in response to the increased plasma glucose concentration, insulin acts at the level of insulin sensitive tissue cells, mainly adipose and muscle tissue, facilitating, through induction of the expression of GLUT4 (glucose transporter), the entry of glucose into cells.
At this point the glucose penetrated and subtracted from the bloodstream is directed towards different metabolic pathways depending on the type of tissue and its needs.
It can in fact be accumulated in the form of glycogen (glucose polymer), it can be oxidized and used for energy purposes and can for example be used by adipose tissue for the synthesis of glycerol, therefore of fatty acids and triglycerides, remembering how insulin can actively participate in these metabolic pathways by inducing and inhibiting specific enzymes.
In fact, this hormone can act at the level of the liver, a central organ in integrated metabolism, facilitating glycogen synthesis and inhibiting glycogenolysis and gluconeogenesis, useful for facilitating the release of glucose into the circulation.
The action of insulin therefore represents the hypoglycemic hormone par excellence, fundamental in the management of glycemic control in the diabetic patient.
The method of absorption and release of insulin characterizes the pharmacokinetic properties of the various drugs on the market, guaranteeing more or less long action times.
In the case of ACTRAPID ® the action is rapid enough to guarantee, following subcutaneous administration, an onset of action around the thirtieth minute, an optimum of activity between the first and third hour and a persistent effect for about 8 hours.
Studies carried out and clinical efficacy
1. PREPRANDIAL INSULIN AND THE APPEARANCE OF GLUCOSE IN THE BLOOD AFTER A MEAL
Diabetes Care. 2008 Nov; 31: 2183-7. Epub 2008 Jul 23.
Insulin administration and rate of glucose appearance in people with type 1 diabetes.
Pennant ME, Bluck LJ, Marcovecchio ML, Salgin B, Hovorka R, Dunger DB.
This interesting study evaluated how preprandial insulin administration affects glycemic changes during a meal. More precisely, it has been shown that despite the administration of preprandial insulin, it determines a much more significant blood insulin peak than the basal treatment, the blood glucose concentrations after a meal are practically unchanged.
2. INSULIN, NEW FINDINGS
Nephrology (Carlton). 2011 Jan; 16: 68-75.
Anti-inflammatory effect of an insulin infusion in patients on maintenance haemodialysis: a randomized controlled pilot study.
Vos FE, Manning PJ, Sutherland WH, Schollum JB, Walker RJ.
Recent evidence suggests that low-dose infusion of insulin in patients undergoing hemodialysis can significantly reduce the concentration of some inflammatory markers such as C-reactive protein, lowering cardiovascular risk.
3. ROLE OF SNACK IN GLYCEMIC CONTROL
J Intern Med. 1999 Jan; 245: 41-5.
The snack is critical for the blood glucose profile during treatment with regular insulin preprandially.
Orre-Pettersson AC, Lindström T, Bergmark V, Arnqvist HJ.
Patients suffering from type I diabetes and treated with preprandial insulin (Actrapid), were subjected to an interesting study, useful for understanding the importance of snacks in correct glycemic control. More precisely, this study shows how the ingestion of a snack two hours after breakfast and insulin administration, can ensure a slight glycemic increase, reducing the risk of hypoglycemia.
Method of use and dosage
ACTRAPID ® 100 IU / ml solution for injection 10 ml bottles; ACTRAPID ® NOVOLET 100 IU / ml solution for injection in pre-filled pen 5 cartridges of 3 ml; ACTRAPID ® PENFILL 100 IU / ml 3 ml cartridge:
the dosage of ACTRAPID ® varies significantly from patient to patient.
In general, in the treatment of type I diabetes, the therapeutic range is maintained between 0.5 and 1 IU per kg of body mass, while it drops 0.3 / 0.6 IU / kg in type II diabetes.
It is of fundamental importance that the dosage is established by the doctor, based on the physical condition of the patient, his clinical status and glycemic control.
ACTRAPID ® should be taken 15-30 minutes before a carbohydrate-containing meal via subcutaneous injections.
Different purposes relating to the use of ACTRAPID ® are exclusively of hospital medical relevance.
ACTRAPID ® Warnings - Insulin
It is of fundamental importance that all therapeutic treatment is based on the actual needs and general state of health of the patient and therefore punctuated by periodic monitoring of glycemic levels useful for better managing the diabetic pathology.
It is evident that an incorrect dosage formulation could cause serious consequences for the patient's health, with hypoglycemic crises in the case of too high dosages and hyperglycemia accompanied in the most serious cases by diabetic ketoacidosis in too low dosages.
For the same reason, suspensions, changes or adjustments of the dosage should be supervised by the physician.
In case of impaired renal function it may be necessary to reduce the dose of the drug used.
The possible onset of hypoglycemia could reduce the patient's perceptive abilities, making the use of machinery and driving cars dangerous.
PREGNANCY AND BREASTFEEDING
ACTRAPID ® and insulin in general is currently the most widely used and safest drug for the health of the unborn child, for the treatment of gestational diabetes.
However, it is essential that the doses of drug used take into account the gestation period and the clinical condition of the patient.
Interactions
There are numerous possible interactions with other active ingredients that could alter the normal therapeutic properties of insulin.
In summary, the concomitant administration of oral hypoglycemic agents, octreotide, anti-MAO, beta blocking agents, ACE inhibitors, salicylates, alcohol and anabolic steroids, could increase the hypoglycemic effect of insulin, sometimes also masking the signs of hypoglycemia (beta-blockers ).
Conversely, the intake of oral contraceptives, thiazides, glucorticoids, thyroid hormones and sympathomimetics could reduce the therapeutic effect of ACTRAPID ® requiring a dosage adjustment.
Contraindications ACTRAPID ® - Insulin
ACTRAPID ® is contraindicated in case of hypoglycemia and hypersensitivity to human insulin or its excipients.
Undesirable Effects - Side Effects
Insulin therapy can be accompanied by local and systemic side effects.
More precisely, it is possible that redness, swelling, transient itching and lipoatrophy may occur at the injection site following multiple injections in the same site.
The systemic effects, on the other hand, may be due to generalized hypersensitivity reactions with gastrointestinal disorders, edema, breathing difficulties, palpitations and hypotension or hypoglycemia.
The risk of hypoglycaemia is particularly high in the initial stages of therapy or following dosage adjustments and could be characterized by cold sweats, skin paleness, nervousness, tremors, anxiety, tiredness, weakness, confusion, difficulty concentrating, headache, nausea, palpitations, visual disturbances and in the most serious cases loss of consciousness and death.
Note
ACTRAPID ® sold only under medical prescription.
ACTRAPID ® falls within the doping class: Hormones and related substances (prohibited in and out of competition).
The ACTRAPID ® - Insulin information published on this page may be out of date or incomplete. For a correct use of this information, see the Disclaimer and useful information page.
