Apidra Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Apidra Injection (insulin glulisine) is a rapid-acting human insulin analogue used to help control blood sugar in adults and children with type 1 or type 2 diabetes. It starts working quickly after injection and has a shorter duration of action than regular human insulin. Apidra can be given by injection, insulin pen, or insulin pump, and is often used together with a longer-acting insulin.

What is Apidra Injection

Apidra is a fast-acting, man-made insulin used to help control blood sugar in people with diabetes. It is similar to the insulin your own body makes, and it works more quickly and for a shorter time than regular human insulin.

Apidra Injection uses

• Improving blood sugar control in adults and children with diabetes mellitus (type 1 or type 2)
• Treats diabetes mellitus
• Controls mealtime blood glucose
• Reduces post-meal glucose spikes
• Used in type 1 diabetes
• Used in type 2 diabetes when rapid-acting insulin is needed

Benefits of Apidra Injection

• Starts working quickly after injection, matching it to mealtime blood sugar rises
• Shorter duration of action than regular human insulin, which may lower the risk of blood sugar dropping too low later
• Can be used by injection, insulin pen, or insulin pump, and combined with longer-acting insulin for overall control

How Apidra Injection works

Apidra works like natural insulin by helping muscle and fat cells take up sugar from the blood and by telling the liver to make less sugar. It also helps slow the breakdown of fat and protein, which helps lower blood sugar levels.

Apidra Injection dosage

Inject Apidra within 15 minutes before a meal or within 20 minutes after starting a meal. It is usually given together with an intermediate- or long-acting insulin to maintain overall blood sugar control.

Apidra can be injected under the skin of the abdomen, thigh, or upper arm, or given by continuous infusion through an insulin pump. Change (rotate) injection or infusion sites within the same body area each time to lower the risk of skin changes such as thickened or pitted skin. Do not inject into skin that has pits, is thickened, has lumps, is tender, bruised, scaly, hard, or into scars or damaged skin.

If mixing with NPH insulin, draw Apidra into the syringe first and inject right after mixing; do not mix with other insulins. Do not dilute or mix Apidra with other insulins when using it in an insulin pump.

Always check the insulin label before each injection to make sure you have the right insulin, especially if you use more than one type. Use a new needle or syringe for every injection; never reuse or share needles, syringes, or pens.

Check that the solution looks clear and colorless before use; do not use it if it looks cloudy, colored, or has particles in it. When using an insulin pump, change the insulin in the reservoir at least every 2 days, or sooner if the pump manual says so, and have a backup way to give insulin by injection in case the pump fails.

Available forms and strengths

• Injection solution, 100 units/mL (U-100)
• 10 mL multiple-dose vial
• 3 mL single-patient-use SoloStar prefilled pen
• 3 mL cartridges for use with certain reusable insulin pens (outside the US)

Side effects of Apidra Injection

Common

• Low blood sugar (hypoglycemia)
• Weight gain
• Itching
• Rash
• Swelling at the injection site
• Redness, swelling, or thickened/pitted skin at the injection site (lipodystrophy)
• Upper respiratory tract infection
• Nasopharyngitis (common cold-type symptoms)
• Headache
• Nausea

Serious

• Severe low blood sugar that can cause seizures, loss of consciousness, or death
• Severe, whole-body allergic reaction (anaphylaxis), including rash, trouble breathing, fast pulse, sweating, or feeling faint
• Low potassium levels in the blood (hypokalemia), which can be life-threatening
• Heart failure or worsening heart failure, especially when combined with certain diabetes pills called TZDs (thiazolidinediones)
• High blood sugar and ketoacidosis if an insulin pump malfunctions

Warnings and precautions

• Never share an Apidra SoloStar pen, syringe, or needle with another person, even if you change the needle, because this can spread serious infections.
• Any change to your insulin routine—such as switching insulin type, strength, brand, injection site, or method—should be done carefully and only with your doctor's guidance, along with more frequent blood sugar checks.
• Low blood sugar is the most common and potentially life-threatening side effect of this medicine, and may impair your ability to concentrate, which can be dangerous during activities like driving.
• Mix-ups between different insulin products can happen by accident, so always check the label before every injection.
• This medicine can lower blood potassium levels, which can be life-threatening if not treated.
• Severe, life-threatening whole-body allergic reactions, including anaphylaxis, can occur with this medicine.
• Taking this medicine along with certain diabetes pills called TZDs can cause fluid buildup and heart failure, even in people without prior heart problems.
• If your insulin pump malfunctions, it can quickly lead to high blood sugar and a dangerous condition called ketoacidosis; monitor your glucose closely and be ready to switch to injections if needed.
• It is not known for certain if Apidra can harm an unborn baby, though available data have not shown a clear link to major birth defects or pregnancy problems. Poorly controlled diabetes during pregnancy raises risks for both mother and baby, so good blood sugar control is important. Tell your healthcare provider if you are pregnant or planning to become pregnant.
• Insulin products like Apidra can pass into breast milk, but no harmful effects have been reported in breastfed babies. Talk to your healthcare provider about the benefits of breastfeeding along with your need for this medicine.
• People with kidney problems may be more likely to have low blood sugar and may need more frequent dose changes and blood sugar checks.
• People with liver problems may be more likely to have low blood sugar and may need more frequent dose changes and blood sugar checks.
• Alcohol can change how this medicine affects your blood sugar, making it go higher or lower than expected. Avoid drinking alcohol or using over-the-counter products containing alcohol while on this medicine, and discuss alcohol use with your healthcare provider.
• Low or high blood sugar can affect your ability to concentrate and react, which can be dangerous while driving or using machinery. Be cautious with these activities until you know how this medicine affects you, especially if you have frequent low blood sugar or don't notice warning signs of it.

Storage

• Store unopened vials, cartridges, and pens in a refrigerator between 36°F-46°F (2°C-8°C); do not freeze; throw away if it has been frozen
• Keep away from direct heat and light
• Unopened vials and pens may be kept at room temperature (up to 77°F/25°C) and must be thrown away after 28 days if stored this way
• Once opened (in-use), vials can be kept in the refrigerator or at room temperature for up to 28 days, then must be thrown away even if insulin remains
• Once opened, SoloStar pens should be kept at room temperature (not refrigerated) and thrown away after 28 days
• Throw away insulin in a pump reservoir if it has been exposed to temperatures above 98.6°F (37°C)
• Do not use after the expiration date printed on the carton or label
• Dispose of used needles and syringes right away in an FDA-cleared sharps disposal container, or a sturdy household container with a tight, puncture-proof lid if one is not available; follow your community's rules for throwing away the full container
• Do not throw loose needles or syringes in household trash, and do not recycle a sharps container

When to see a doctor

• Get emergency medical help right away if you have signs of a severe allergic reaction, such as trouble breathing, a whole-body rash, fast pulse, sweating, or feeling faint.
• Get emergency help if you have trouble breathing, a fast heartbeat, swelling of your face, tongue, or throat, heavy sweating, extreme drowsiness, dizziness, or confusion.
• Tell your healthcare provider if you notice new or worsening signs of heart failure, such as shortness of breath, swelling in your ankles or feet, or sudden weight gain, especially if you are also taking TZD diabetes pills.
• Contact your healthcare provider if the skin at your injection or infusion site becomes red, itchy, or thickened, and choose a new site.

Alternatives

• NovoLog / NovoRapid
• Fiasp
• Humalog