Talk about your insulin dose with your doctor and nurse. Make sure you get the NovoRapid Penfill that your doctor and nurse have told you to use and follow their advice carefully. This leaflet is a general guide.
If your doctor has switched you from one type or brand of insulin to another, your dose may have to be adjusted by your doctor. Do not change your insulin unless your doctor tells you to.
Eat a meal or snack containing carbohydrates within 10 minutes of the injection to avoid
hypoglycaemia. When necessary, NovoRapid may be given soon after the meal, instead of before the meal.
Method of administration
NovoRapid is for injection under the skin (subcutaneously) or for continuous infusion in a pump system. NovoRapid may also be given directly into a vein (intravenously) by health care professionals under close supervision by a doctor. Never inject your insulin directly into a vein or muscle (intramuscular).
Always vary the sites you inject within the same region to avoid lumps (see 4 Possible side effects
). The best places to give yourself an injection are: the front of your waist (abdomen), the upper arm or the front of your thighs. You should always measure your blood glucose regularly.
- Inject the insulin under the skin.Use the injection technique advised by your doctor or nurse and described in your delivery system manual
- Keep the needle under your skin for at least 6 seconds to make sure that the full dose has been delivered
- After each injection be sure to remove and discard the needle and store NovoRapid without the needle attached. Otherwise, the liquid may leak out, which can cause inaccurate dosing.
Do not refill the cartridge.
NovoRapid Penfill cartridges are designed to be used with Novo Nordisk insulin delivery systems and NovoFine or NovoTwist needles.
If you are treated with NovoRapid Penfill and another insulin Penfill cartridge, you should use two insulin delivery systems, one for each type of insulin.
For use in an infusion pump system
NovoRapid should never be mixed with any other insulin when used in a pump.
Follow the instructions and recommendations from your doctor regarding the use of NovoRapid in a pump. Before use of NovoRapid in the pump system you must have received a comprehensive instruction in the use and information about any actions to be taken in case of illness, too high or too low blood sugar or failure of the pump system.
- Before inserting the needle, use soap and water to clean your hands and the skin where the needle is inserted so as to avoid any infection at the infusion site
- When you fill a new reservoir, be certain not to leave large air bubbles in either the syringe or the tubing
- Changing of the infusion set (tubing and needle) must be done according to the instructions in the product information supplied with the infusion set.
To get the benefit of insulin infusion, and to detect possible malfunction of the insulin pump, it is recommended that you measure your blood sugar level regularly.
What to do in case of pump system failure
You should always have alternative insulin available for injection under the skin in case of pump system failure.
If you take more insulin than you should
If you take too much insulin your blood sugar gets too low (this is called hypoglycaemia or hypo). This may also happen:
- If you eat too little or miss a meal
- If you exercise more than usual.
The warning signs of a hypo may come on suddenly and can include: cold sweat; cool pale skin; headache; rapid heart beat; feeling sick; feeling very hungry; temporary changes in vision; drowsiness; unusual tiredness and weakness; nervousness or tremor; feeling anxious; feeling confused; difficulty in concentrating.
If you feel a hypo coming on: take a high sugar snack and then measure your blood sugar.
If your blood sugar is too low: eat glucose tablets or another high sugar snack (sweets, biscuits, fruit juice), then rest.
Always carry glucose tablets, sweets, biscuits or fruit juice with you, just in case.
When symptoms of hypoglycaemia have disappeared or when blood glucose level is stabilised continue insulin treatment.
Tell relevant people you have diabetes and what may be the consequences, including the risk of passing out due to a hypo.
Tell relevant people that if you pass out (become unconscious), they must turn you on your side and get medical help straight away. They must not give you any food or drink. It could choke you.
You may recover more quickly from unconsciousness with an injection of the hormone glucagon by someone who knows how to use it. If you are given glucagon you will need glucose or a sugary snack as soon as you are conscious. If you do not respond to glucagon treatment, you will have to be treated in a hospital. Contact your doctor or an emergency ward after an injection of glucagon: you need to find the reason for your hypo to avoid getting more.
- If prolonged severe hypoglycaemia is not treated, it can cause brain damage (temporary or permanent) and even death
- If you have a hypo that makes you pass out, or a lot of hypos, talk to your doctor. The amount or timing of insulin, food or exercise may need to be adjusted.
If you forget to take your insulin
If you forget to take your insulin your blood sugar may get too high (this is called hyperglycaemia). This may also happen:
- If you repeatedly take less insulin than you need
- If you get an infection or a fever
- If you eat more than usual
- If you exercise less than usual.
The warning signs appear gradually. They include: increased urination; feeling thirsty; losing your appetite; feeling sick (nausea or vomiting); feeling drowsy or tired; flushed, dry skin; dry mouth and a fruity (acetone) smell of the breath.
If you get any of these signs: test your blood sugar level, test your urine for ketones if you can, then seek medical advice immediately.
These may be signs of a very serious condition called diabetic ketoacidosis. If you do not treat it, this could lead to diabetic coma and eventually death.
If you stop taking your insulin
This could lead to severe hyperglycaemia (very high blood sugar) and ketoacidosis (build-up of acid in the blood because the body is breaking down fat instead of sugar). Do not stop taking your insulin without speaking to a doctor, who will tell you what needs to be done.
If you have any further questions on the use of this product, ask your doctor or pharmacist.