NOVORAPID FLEXPEN (100IU/ML)

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Buy Novorapid Flexpen online Australia. Your doctor, diabetes education nurse or pharmacist will have given you advice on how to use your medicine. Carefully follow all the directions. They may differ from the information contained in this leaflet. Your doctor may also want you to use another insulin such as Protaphane® or Levemir®.

The insulin aspart, or “NovoRapid®”, in NovoRapid® FlexPen® is a rapid-acting insulin used to treat diabetes mellitus in adults and children. Diabetes mellitus is a condition where your pancreas does not produce enough insulin to control your blood sugar (glucose) level. Extra insulin is therefore needed.

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There are two types of diabetes mellitus:

Type 1 diabetes – also called juvenile onset diabetes
Type 2 diabetes – also called maturity onset diabetes

Patients with type 1 diabetes always require insulin to control their blood sugar levels and should be educated how to use novorapid flexpen

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Before you use NovoRapid® FlexPen®

When you must not use it

Knowing when and how to use novorapid flexpen in necessary.

Do not use NovoRapid® if:

1. you have an allergy to:

• any medicine containing insulin
• any of the ingredients listed in the “Ingredients” section of this leaflet.

Some of the symptoms of an allergic reaction may include:
– redness, swelling, rash and itching at the injection site
– rash, itching or hives on the skin
– shortness of breath
– wheezing or difficulty breathing
– swelling of the face, lips, tongue or other parts of the body.

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Before you start to use it

Tell your doctor if you have allergies to any other medicines, foods, preservatives or dyes.

Tell your doctor if you have or have had any medical conditions, especially the following:

• kidney problems
• liver problems
• adrenal, pituitary or thyroid gland problems.

Tell your doctor if you are pregnant or plan to become pregnant.

NovoRapid® can be used in pregnancy. Pregnancy may make managing your diabetes more difficult. Insulin needs usually decrease during the first three months of pregnancy and increase during the last six months. Your doctor can discuss with you the risks and benefits involved.

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Tell your doctor if you are breast-feeding or plan to breast-feed.

Your doctor or pharmacist can discuss with you the risks and benefits involved.

Inform your doctor as soon as possible if you experience signs of heart failure such as unusual shortness of breath or rapid increase in weight or localised swelling (oedema).

Some patients with long-standing type 2 diabetes mellitus and heart disease or previous stroke who are treated with thiazolidinediones in combination with insulin may develop heart failure.

If you have not told your doctor about any of the above, tell them before you use NovoRapid®.

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Taking other medicines

Tell your doctor if you are currently taking any other medicines, including any that you get without a prescription from your pharmacy, supermarket or health food shop.

Some medicines and NovoRapid® may interfere with each other and this may mean that your insulin dose has to change.

If you take any of the medicines listed below, your blood sugar may fall (hypoglycaemia):

• other medicines used for the treatment of diabetes
• monoamine oxidase inhibitors (MAOI) – used for the treatment of depression
• alpha-blocking agents – used for the treatment of high blood pressure and to relieve difficulty in passing urine caused by an enlarged prostate
• non-selective beta-blocking agents – used for the treatment of certain heart conditions and high blood pressure which may also mask the symptoms of hypoglycaemia and delay recovery from hypoglycaemia
• angiotensin converting enzyme (ACE) inhibitors – used for the treatment of certain heart conditions, high blood pressure or elevated protein/albumin in the urine
• salicylates e.g. aspirin – used to relieve pain and lower fever
• anabolic steroids – used to promote growth. how to use novorapid flexpen
• sulfonamides – used to treat bacterial infections
• quinine – used for the prevention of malaria and the relief of muscle cramps
• quinidine – used for the control of heart problems.

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If you take any of the medicines below, your blood sugar level may rise (hyperglycaemia)

• glucocorticoids (except when applied locally) – used to treat inflammatory conditions
• oral contraceptives (“the pill”) – used for birth control
• thiazides, frusemide or ethacrynic acid – used for the treatment of high blood pressure or fluid retention (oedema)
• thyroid hormones – used for the treatment of malfunction of the thyroid gland
• sympathomimetics – used for the treatment of asthma
• growth hormone – used to treat growth disorders
• danazol – used to treat endometriosis, menorrhagia, fibrocystic breast disease and hereditary angioedema
• oxymetholone – used to treat certain blood disorders
• diazoxide – used for the treatment of high blood pressure
• nicotinic acid – used for the treatment of high cholesterol levels in the blood
• asparaginase – used to treat leukaemia and lymph gland tumours.

If you take the following medicines, your blood sugar level may rise or fall:

• octreotide – used to treat gastrointestinal endocrine tumours and enlargement of parts of the body (e.g. hands, feet, head) caused by abnormal growth hormone levels
• lanreotide – used to treat enlargement of parts of the body (e.g. hands, feet, head) caused by abnormal hormone levels.

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Tell your doctor about any other medicines that you are taking.

This is very important. Your doctor will advise you if it is all right to keep taking them or if you should stop taking them.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while using this medicine.

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How how to use novorapid flexpen

how to use novorapid flexpen. Your doctor, diabetes education nurse or pharmacist will have given you advice on how to use your medicine. Carefully follow all the directions.

They may differ from the information contained in this leaflet.

Your doctor may also want you to use another insulin such as Protaphane® or Levemir®.

Any change in dose or type of insulin should be made cautiously and only under medical supervision.

If you change the type of insulin that you use, you may have to use more or less than before. This may happen with the first dose or over a period of time.

If you do not understand the instructions, ask your doctor, diabetes education nurse or pharmacist for help.

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How much to use

Your doctor or diabetes education nurse will tell you how much of this medicine you need to use.

It is very important that you manage your diabetes carefully. Too much or too little insulin can cause serious effects.

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When to use it

NovoRapid® should normally be used immediately (up to 10 minutes) before your meal or carbohydrate snack. When necessary NovoRapid® may be used immediately after the meal.

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how to use novorapid flexpen

• Inject NovoRapid® under the skin (subcutaneous injection) as shown to you by your doctor or diabetes education nurse.
• NovoRapid® may be injected into the abdomen, thighs, buttocks or upper arms.
• Remember to change your injection site regularly as shown to you by your doctor or diabetes education nurse.
• In an emergency, the insulin contained within NovoRapid® FlexPen® is suitable for intravenous administration, under medical supervision only. For emergency use, the insulin must first be withdrawn from FlexPen® into a syringe. Discard your FlexPen® after emergency use.
• If you use NovoRapid® and another type of insulin, you must use a separate insulin delivery system for each type of insulin.

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How long to use it

Do not stop using NovoRapid® FlexPen® unless your doctor tells you to.

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If you use too much (overdose) – Hypoglycaemia

Your blood sugar level may become too low (you may experience hypoglycaemia or a “hypo”) if you:

• accidentally use too much of this medicine
• have too much or unexpected exercise
• delay eating meals or snacks
• eat too little food
• are ill.

The first symptoms of mild to moderate hypos can come on suddenly. They may include:

• cold sweat, cool pale skin
• fatigue, drowsiness, unusual tiredness and weakness
• nervousness, anxious feeling, tremor, rapid heart beat
• confusion, difficulty concentrating
• excessive hunger
• vision changes
• headache, nausea.

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Always carry some sugary food or fruit juice with you.

If you experience any of these symptoms of a hypo, immediately eat some sugary food or have a sugary drink e.g. lollies, biscuits or fruit juice, and measure your blood sugar level.

Tell your relatives, friends, close workmates or carers that you have diabetes. It is important that they recognise the signs and symptoms of a hypo.

Make sure they know to give you some sugary food or fruit juice for mild to moderate symptoms of a hypo.

If you lose consciousness, make sure they know:

• to turn you on your side and get medical help immediately
• not to give you anything to eat or drink.
  This is because you could choke.

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If you miss a dose – Hyperglycaemia

Do not use a double dose of your insulin.

If it is almost time for your next dose, skip the dose you missed and use your next dose when you are meant to.

Otherwise, use it as soon as you remember -how to use novorapid flexpen don’t forget to eat some carbohydrate within 10 minutes of your injection – and then go back to using it as you would normally.

Your blood sugar levels may become high (hyperglycaemia) if you:

• miss doses of insulin or use less insulin than you need
• have uncontrolled diabetes
• exercise less than usual
• eat more carbohydrates than usual
• are ill or stressed.

High blood sugar levels over a long period of time can lead to too much acid in the blood (diabetic ketoacidosis).

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Contact your doctor immediately if your blood sugar level is high or you recognise any of the following symptoms.

Symptoms of mild to moderate hyperglycaemia include:

• drowsy feeling
• flushed face
• thirst, loss of appetite
• fruity odour on the breath
• blurred vision
• passing larger amounts of urine than usual
• getting up at night more often than usual to pass urine
• high levels of glucose and acetone in the urine.

Symptoms of severe hyperglycaemia include:

• heavy breathing
• fast pulse
• nausea, vomiting
• dehydration
• loss of consciousness.

Severe hyperglycaemia can lead to unconsciousness and in extreme cases death if untreated.

Discuss any worries you may have about this with your doctor, diabetes education nurse or pharmacist.

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Side effects

Tell your doctor, diabetes education nurse or pharmacist as soon as possible if you do not feel well while you are using NovoRapid® FlexPen®.

This medicine helps most people for whom it is prescribed, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Do not be alarmed by the following lists of side effects. You may not experience any of them.

Ask your doctor, diabetes education nurse or pharmacist to answer any questions you may have.

The most common side effect when using insulin is low blood sugar levels (a hypo).

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Tell your doctor if you notice any of the following and they worry you:

• hypos (mild to moderate)
• pain, redness, hives, bruising, swelling or itching at the injection site. Usually these symptoms disappear within a few weeks during continued use. If you have serious or continuing reactions, you may need to stop using NovoRapid® and use another insulin.
• a depression or thickening of the skin around the injection site (lipodystrophy).
• when you first start your insulin treatment you may get visual problems or swollen hands and feet

This list includes the more common side effects of your medicine. They are usually mild and short-lived.

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If any of the following happen, tell your doctor immediately or go to Accident and Emergency at your nearest hospital:

More severe symptoms of low blood sugar levels, including:

• disorientation
• seizures, fits or convulsions
• loss of consciousness.

If a severe hypo is not treated, it can cause brain damage and death.

Tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice any of the following:

• skin rashes over a large part of the body
• shortness of breath, wheezing
• swelling of the face, lips or tongue
• fast pulse
• sweating.