Actrapid HM Penfill (insulin regular): Uses, Dosage & Side Effects

What it's for (Indications)

Insulin regular, an exogenous form of human insulin, is primarily indicated for the treatment of hyperglycemia in individuals with diabetes mellitus.
Its principal application is in patients diagnosed with Type 1 Diabetes Mellitus (T1DM), where the body produces little to no insulin, necessitating lifelong insulin replacement therapy for glycemic control and prevention of ketoacidosis.
Furthermore, it is widely utilized in the management of Type 2 Diabetes Mellitus (T2DM) when endogenous insulin secretion is insufficient to maintain normoglycemia, or when oral antidiabetic agents prove inadequate or are contraindicated.
This often includes patients with T2DM experiencing significant hyperglycemia, symptomatic diabetes, or those undergoing periods of increased metabolic stress such as severe infection, major surgery, or acute illness where insulin therapy is temporarily or permanently required.
Insulin regular also plays a crucial role in the emergency management of acute hyperglycemic states, including Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS), often administered intravenously in these critical care settings to rapidly lower blood glucose levels and resolve metabolic derangements.
Additionally, it may be used in the management of gestational diabetes mellitus when dietary modifications and exercise are insufficient to achieve target blood glucose levels, ensuring optimal maternal and fetal outcomes.
Its rapid onset and relatively short duration of action make it suitable for mealtime coverage (bolus insulin) or for correction of acute hyperglycemia.

Dosage Information

Type	Guideline
Standard	For AFREZZA (insulin human) inhaled powder: Administer via oral inhalation using the AFREZZA inhaler at the beginning of each meal. Initial mealtime dosage for insulin-naïve patients and those transitioning from subcutaneous mealtime or pre-mixed insulin should refer to full prescribing information. Dosage must be modified based on patient's metabolic needs, blood glucose monitoring results, and glycemic control goal. Discontinuation should be considered if blood glucose control is not achieved with increased dosages. Prior to initiation, a medical history, physical examination, and spirometry (FEV1) are required to assess lung function due to the risk of acute bronchospasm.

Type

Guideline

Standard

For AFREZZA (insulin human) inhaled powder: Administer via oral inhalation using the AFREZZA inhaler at the beginning of each meal. Initial mealtime dosage for insulin-naïve patients and those transitioning from subcutaneous mealtime or pre-mixed insulin should refer to full prescribing information. Dosage must be modified based on patient's metabolic needs, blood glucose monitoring results, and glycemic control goal. Discontinuation should be considered if blood glucose control is not achieved with increased dosages. Prior to initiation, a medical history, physical examination, and spirometry (FEV1) are required to assess lung function due to the risk of acute bronchospasm.

Safety & Warnings

Common Side Effects

Hypoglycemia (low blood glucose), headache, indigestion, pharyngitis (sore throat), cough, and throat pain or irritation.
Serious adverse reactions observed with AFREZZA include acute bronchospasm, decline in pulmonary function, lung cancer, diabetic ketoacidosis, and hypersensitivity reactions.

Serious Warnings

Black Box Warning: RISK OF ACUTE BRONCHOSPASM IN PATIENTS WITH CHRONIC LUNG DISEASE. Acute bronchospasm has been observed in AFREZZA-treated patients with asthma and Chronic Obstructive Pulmonary Disease (COPD). AFREZZA is contraindicated in patients with chronic lung disease such as asthma or COPD. A detailed medical history, physical examination, and spirometry (FEV1) should be performed before initiating AFREZZA to identify potential lung disease.
Hypersensitivity reactions (severe, life-threatening, generalized allergy, including anaphylaxis, can occur).
Patients are at risk of hypoglycemia, which can be severe.
Acute bronchospasm, decline in pulmonary function, and diabetic ketoacidosis have been observed.
Caution is advised regarding lung cancer.
Patients with chronic lung disease such as asthma or COPD are at increased risk of acute bronchospasm.
A detailed medical history, physical examination, and spirometry (FEV1) are required before initiating inhaled insulin products like AFREZZA.
Driving and operating machinery should be avoided as this medicine may affect ability due to the risk of hypoglycemia.
Alcohol consumption should be avoided.
Consult a doctor before use during pregnancy or lactation.

How it Works (Mechanism of Action)

Insulin lowers blood glucose levels by stimulating peripheral glucose uptake by skeletal muscle and fat, inhibiting hepatic glucose production, inhibiting lipolysis in adipocytes, inhibiting proteolysis, and enhancing protein synthesis.