Actrapid 100 international units/ml, Solution for injection in a vial

  • Name:

    Actrapid 100 international units/ml, Solution for injection in a vial

  • Company:
    info
  • Active Ingredients:

    Human Insulin

  • Legal Category:

    Product subject to medical prescription which may be renewed (B)

Patient Information Leaflet Patient Information Leaflet last updated on medicines.ie: 12/08/19

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Summary of Product Characteristics last updated on medicines.ie: 3/9/2019

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Novo Nordisk Limited

Novo Nordisk Limited

Company Products

Medicine NameActive Ingredients
Medicine Name Activelle Active Ingredients Estradiol Hemihydrate, Norethisterone acetate
Medicine Name Actrapid 100 international units/ml, Solution for injection in a vial Active Ingredients Human Insulin
Medicine Name Estrofem 2mg Active Ingredients Estradiol Hemihydrate
Medicine Name Fiasp 100 units-mL solution for injection in Cartridge Penfill Active Ingredients Insulin aspart
Medicine Name Fiasp 100 units-mL solution for injection in pre-filled FlexTouch pen Active Ingredients Insulin aspart
Medicine Name Fiasp 100 units-mL solution for injection in vial Active Ingredients Insulin aspart
Medicine Name GlucaGen HypoKit 1 mg powder and solvent for solution for injection Active Ingredients Glucagon hydrochloride
Medicine Name Insulatard 10 ml Vial Active Ingredients Human Insulin
Medicine Name Insulatard InnoLet Active Ingredients Human Insulin
Medicine Name Insulatard Penfill Active Ingredients Human Insulin
Medicine Name Insulatard, Insulatard Penfill, Insulatard InnoLet Active Ingredients Human Insulin
Medicine Name Kliogest 2 mg/1 mg film-coated tablets Active Ingredients Estradiol Hemihydrate, Norethisterone acetate
Medicine Name Levemir FlexPen (Insulin detemir) 100 units/ml solution for injection in pre-filled pen Active Ingredients insulin detemir
Medicine Name Levemir InnoLet (Insulin detemir) 100 units/ml solution for injection in pre-filled pen Active Ingredients insulin detemir
Medicine Name Levemir Penfill (Insulin detemir) 100 units/ml solution for injection in cartridge Active Ingredients insulin detemir
Medicine Name Norditropin FlexPro 10 mg/1.5 ml solution for injection in pre-filled pen Active Ingredients Somatropin
Medicine Name Norditropin FlexPro 15 mg/1.5 ml solution for injection in pre-filled pen Active Ingredients Somatropin
Medicine Name Norditropin FlexPro 5 mg/1.5 ml solution for injection in pre-filled pen Active Ingredients Somatropin
Medicine Name Norditropin SimpleXx 10 mg/1.5 ml, solution for injection Active Ingredients Somatropin
Medicine Name Norditropin SimpleXx 15 mg/1.5 ml, solution for injection Active Ingredients Somatropin
Medicine Name Norditropin SimpleXx 5 mg/1.5 ml, solution for injection in cartridge Active Ingredients Somatropin
Medicine Name Novofem film-coated tablets Active Ingredients Estradiol Hemihydrate, Norethisterone acetate
Medicine Name NovoMix 30 FlexPen Active Ingredients Insulin aspart
Medicine Name NovoMix 30 Penfill Active Ingredients Insulin aspart
Medicine Name NovoNorm 0.5 mg, 1 mg and 2 mg tablets Active Ingredients Repaglinide
1 - 0 of 40 items.Total: Infinity pages

When a pharmaceutical company changes any document, a new version is published on medicines.ie. For each version, we show the dates it was published on medicines.ie and the reasons for change.

Updated on 3 September 2019 SmPC

Reasons for updating

  • Change to section 4.4 - Special warnings and precautions for use
  • Change to Section 4.8 – Undesirable effects - how to report a side effect
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

Section 4.4:

Text added: "

Avoidance of accidental mix-ups/medication errors

Patients must be instructed to always check the insulin label before each injection to avoid accidental mix-ups between Actrapid and other insulin products."

 

Section 4.8:

UK reporting details removed - not applicable to IE SPC.

 

Section 10: revision date updated to 07/2019

Updated on 12 August 2019

Updated on 24 May 2018

Updated on 21 May 2018

Updated on 4 May 2018 PIL

Reasons for updating

  • Improved presentation of PIL

Updated on 24 April 2018

Updated on 26 March 2018 PIL

Reasons for updating

  • New PIL for new product

Updated on 26 March 2018 SmPC

Reasons for updating

  • Change to section 4.8 - Undesirable effects
  • Change to section 6.6 - Special precautions for disposal and other handling
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

Key: Addition of text = in red     Deletion of text = crossed out

 

4.8  Undesirable effects

 

Reporting of suspected adverse reactions

 

United Kingdom

Yellow Card Scheme

Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store

 

 

6.6 Special precautions for disposal and other handling

 

Do not use this medicinal product if you notice that the solution is not clear, colourless and aqueous.

 

Actrapid which has been frozen must not be used.

 

The patient should be advised to discard the needle and syringe after each injection.

 

Any unused medicinal product or waste material should be disposed of in accordance with local requirements.

 

Needles, syringes, cartridges and pre-filled-pens must not be shared.

 

The cartridge must not be refilled.

  

In case of emergency in current Actrapid users (hospitalisation or insulin pen malfunction), Actrapid can be withdrawn with an U100 insulin syringe from a cartridge or pre-filled pen.

 

10. DATE OF REVISION OF THE TEXT

 

03/2018

Updated on 26 March 2018 SmPC

Reasons for updating

  • New SmPC for new product

Legal category: Product subject to medical prescription which may be renewed (B)

Updated on 26 March 2018 PIL

Reasons for updating

  • Change to section 6 - manufacturer
  • Change to section 6 - date of revision

Updated on 30 March 2017 SmPC

Reasons for updating

  • Change to section 1 - Name of medicinal product
  • Change to section 4.2 - Posology and method of administration
  • Change to Section 4.8 – Undesirable effects - how to report a side effect
  • Change to section 6.6 - Special precautions for disposal and other handling
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

In section 1 'in vial' has been added to the name of the medicinal product 'Actrapid 100 international units/ml solution for injection in vial.'

 In section 4.2 the text has undergone minor formatting changes and the section concerning intravenous use for method of administration has been clearly subtitled.

In section 4.8 the adverse event reporting information has been updated for Malta.

In section 6.6 information on the use of Actrapid in an emergency has been added: ' In case of emergency in current Actrapid users (hospitalisation or insulin pen malfunction), Actrapid can be withdrawn with an U100 insulin syringe from a cartridge or pre-filled pen.'
 
Section 10: the date of revision is now 03/2017.

In section 4.2 the text has undergone minor formatting changes and the section concerning intravenous use for method of administration has been clearly subtitled.In section 4.8 the adverse event reporting information has been updated for Malta.In section 6.6 information on the use of Actrapid in an emergency has been added: '

Updated on 28 March 2017 PIL

Reasons for updating

  • Change to section 2 - what you need to know - warnings and precautions
  • Change to section 6 - what the product contains
  • Change to section 6 - what the product looks like and pack contents
  • Change to section 6 - date of revision

Updated on 29 July 2014 PIL

Reasons for updating

  • Change to date of revision
  • Change due to harmonisation of PIL
  • Addition of information on reporting a side effect.

Updated on 29 July 2014 SmPC

Reasons for updating

  • Change to section 1 - Name of medicinal product
  • Change to section 2 - Qualitative and quantitative composition
  • Change to section 4.1 - Therapeutic indications
  • Change to section 4.2 - Posology and method of administration
  • Change to section 4.4 - Special warnings and precautions for use
  • Change to section 4.8 - Undesirable effects
  • Change to section 6.2 - Incompatibilities
  • Change to section 6.3 - Shelf life
  • Change to section 8 - MA number
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

1.         NAME OF THE MEDICINAL PRODUCT

 

Actrapid 100 international units/ml solution for injection.

 

 

2.         QUALITATIVE AND QUANTITATIVE COMPOSITION

 

1 vial contains 10 ml equivalent to 1,000 international units. 1 ml solution contains 100 iuinternational units insulin human* (equivalent to 3.5 mg). 1 vial contains 10 ml equivalent to 1,000iu.

 

*Human insulin is produced in Saccharomyces cerevisiae by recombinant DNA technology.

 

Excipient with known effect:

 

100 iu of Actrapid contains approximately 5 mcmol sodium, i.e. Actrapid contains less than 1 mmol sodium (23 mg) per dose, i.e.  Actrapidand is therefore considered essentially ‘sodium-free’.

 

For the full list of excipients, see section 6.1.

 

 

4.         Clinical particulars

 

4.1       Therapeutic indications

 

Actrapid is indicated for Ttreatment of diabetes mellitus.

 

4.2       Posology and method of administration

 

Posology

 

The potency of human insulin is expressed in international units (iu).

 

Actrapid dosing is individual and determined in accordance with the needs of the patient. It can be used alone or in combination with intermediate-acting or long-acting insulin before a meal or a snack.

 

The individual insulin requirement is usually between 0.3 and 1.0 international unit/kg/day. The daily insulin requirement may be higher in patients with insulin resistance (e.g. during puberty or due to obesity) and lower in patients with residual, endogenous insulin production.

In patients with diabetes mellitus optimised glycaemic control delays the onset of late diabetic complications. Close blood glucose monitoring is therefore recommended. Adjustment of dose may be necessary if patients undertake increased physical activity, change their usual diet or during concomitant illness.

 

Special populations

 

Elderly (≥ 65 years old)

Actrapid can be used in elderly patients.

As with all insulin medicinal products, iIn elderly patients, glucose monitoring should be intensified and the insulin dose adjusted on an individual basis.

 

Renal and hepatic impairment

Renal or hepatic impairment may reduce the patient’s insulin requirements.

As with all insulin medicinal products, iIn patients with renal or hepatic impairment, glucose monitoring should be intensified and the human insulin dose adjusted on an individual basis.

 

Paediatric population

Actrapid can be used in children and adolescents.

 

Transfer from other insulin medicinal products

When transferring from other insulin medicinal products, adjustment of the Actrapid dose and the dose of the basal insulin may be necessary.

 

Close glucose monitoring is recommended during the transfer and in the initial weeks thereafter (see section 4.4).

 

Method of administration

 

Actrapid is a fast-acting human insulin and may be used in combination with intermediate or long-acting insulin medicinal products.

 

Actrapid is administered subcutaneously by injection in the abdominal wall, the thigh, the gluteal region or the deltoid region. Injection into a lifted skin fold minimises the risk of unintended intramuscular injection. The needle should be kept under the skin for at least 6 seconds to make sure the entire dose is injected. Injection sites should always be rotated within the same region in order to reduce the risk of lipodystrophy. As with all insulin medicinal products, sSubcutaneous injection into the abdominal wall ensures a faster absorption than other injection sites. As with all insulin medicinal products, tThe duration of action will vary according to the dose, injection site, blood flow, temperature and level of physical activity.

 

An injection should be followed within 30 minutes by a meal or snack containing carbohydrates.

 

Due to the risk of precipitation in pump catheters, Actrapid should not be used in insulin pumps for continuous subcutaneous insulin infusion.

 

Administration with a syringe

Actrapid vials are for use with insulin syringes with a corresponding unit scale. When two types of insulin are mixed always mix the insulin medicinal products in the same sequence.

 

Actrapid vial is accompanied by a package leaflet with detailed instructions for use to be followed.

 

Intravenous use

If necessary, Actrapid can be administered intravenously. whichThis should be carried out by healthcare professionals.

 

For intravenous use, infusion systems with Actrapid at concentrations from 0.05 international unit/ml to 1.0 international unit/ml human insulin in the infusion fluids 0.9% sodium chloride, 5% dextrose and 10% dextrose inclusive 40 mmol/l potassium chloride using polypropylene infusion bags, are stable at room temperature for 24 hours. Although stable over time, a certain amount of insulin will initially be adsorbed to the material of the infusion bag. Monitoring of blood glucose is necessary during the insulin infusion.

 

4.4          Special warnings and precautions for use

 

Before travelling between different time zones, the patient should seek the doctor’s advice since this may mean that the patient has to take the insulin and meals at different times.

 

Hyperglycaemia

 

Inadequate dosing or discontinuation of treatment, especially in type 1 diabetes, may lead to hyperglycaemia and diabetic ketoacidosis. Usually, the first symptoms of hyperglycaemia develop gradually over a period of hours or days. They include thirst, increased frequency of urination, nausea, vomiting, drowsiness, flushed dry skin, dry mouth, loss of appetite as well as acetone odour of breath. In type 1 diabetes, untreated hyperglycaemic events eventually lead to diabetic ketoacidosis, which is potentially lethal.

 

Hypoglycaemia

 

Omission of a meal or unplanned, strenuous physical exercise may lead to hypoglycaemia.

 

Hypoglycaemia may occur if the insulin dose is too high in relation to the insulin requirement. In case of hypoglycaemia or if hypoglycaemia is suspected, Actrapid must not be injected. After stabilisation of the patient’s blood glucose, adjustment of the dose should be considered (see sections 4.8 and 4.9).

 

Patients whose blood glucose control is greatly improved, e.g. by intensified insulin therapy, may experience a change in their usual warning symptoms of hypoglycaemia and should be advised accordingly. Usual warning symptoms may disappear in patients with longstanding diabetes.

 

Concomitant illness, especially infections and feverish conditions, usually increases the patient’s insulin requirement. Concomitant diseases in the kidney, liver or affecting the adrenal, pituitary or thyroid gland can require changes in the insulin dose.

 

When patients are transferred between different types of insulin medicinal products, the early warning symptoms of hypoglycaemia may change or become less pronounced than those experienced with their previous insulin.

 

Transfer from other insulin medicinal products

 

Transferring a patient to another type or brand of insulin should be done under strict medical supervision. Changes in strength, brand (manufacturer), type, origin (animal insulin, human insulin or human insulin analogue) and/or method of manufacture (recombinant DNA versus animal source insulin) may result in a need for a change in dose. Patients transferred to Actrapid from another type of insulin may require an increased number of daily injections or a change in dose from that used with their usual insulin medicinal products. If an adjustment is needed, it may occur with the first dose or during the first few weeks or months.

 

Injection site reactions

 

As with any insulin therapy, injection site reactions may occur and include pain, redness, hives, inflammation, bruising, swelling and itching. Continuous rotation of the injection site within a given area may help to reduces the risk of developing these reactions. Reactions usually resolve in a few days to a few weeks. On rare occasions, injection site reactions may require discontinuation of Actrapid.

 

 

4.8       Undesirable effects

 

a. Summary of the safety profile

 

The most frequently reported adverse reaction during treatment is hypoglycaemia. The frequencies of hypoglycaemia vary with patient population, dose regimens and level of glycaemic control, please see section cDescription of selected adverse reactions below.

 

At the beginning of the insulin treatment, refraction anomalies, oedema and injection site reactions (pain, redness, hives, inflammation, bruising, swelling and itching at the injection site) may occur. These reactions are usually of transitory nature. Fast improvement in blood glucose control may be associated with acute painful neuropathy, which is usually reversible. Intensification of insulin therapy with abrupt improvement in glycaemic control may be associated with temporary worsening of diabetic retinopathy, while long-term improved glycaemic control decreases the risk of progression of diabetic retinopathy.

 

b. Tabulated list of adverse reactions

 

The Aadverse reactions listed below are based on clinical trial data and classified according to MedDRA frequency and System Organ Class. Frequency categories are defined according to the following convention: Very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100); rare (≥ 1/10,000 to < 1/1,000); very rare (< 1/10,000); not known (cannot be estimated from the available data).

 

Immune system disorders

Uncommon – Urticaria, rash

 

Very rare – Anaphylactic reactions*

 

Metabolism and nutrition disorders

 

Very common – Hypoglycaemia*

 

Nervous system disorders

Uncommon – Peripheral neuropathy (painful neuropathy)

 

Eye disorders

 

 

Uncommon – Refraction disorders

 

Very rare – Diabetic retinopathy

 

Skin and subcutaneous tissue disorders

 

Uncommon – Lipodystrophy*

General disorders and administration site conditions

Uncommon – Injection site reactions, Oedema

 

Uncommon – Oedema

* see section cDescription of selected adverse reactions

 

c. Description of selected adverse reactions

 

Anaphylactic reactions:

The occurrence of generalised hypersensitivity reactions (including generalised skin rash, itching, sweating, gastrointestinal upset, angioneurotic oedema, difficulty in breathing, palpitation and reduction in blood pressure) is very rare but can potentially be life threatening.

 

Hypoglycaemia:

The most frequently reported adverse reaction is hypoglycaemia. It may occur if the insulin dose is too high in relation to the insulin requirement. Severe hypoglycaemia may lead to unconsciousness and/or convulsions and may result in temporary or permanent impairment of brain function or even death. The symptoms of hypoglycaemia usually occur suddenly. They may include cold sweats, cool pale skin, fatigue, nervousness or tremor, anxiousness, unusual tiredness or weakness, confusion, difficulty in concentratingon, drowsiness, excessive hunger, vision changes, headache, nausea and palpitation.

 

In clinical trials, the frequency of hypoglycaemia varied with patient population, dose regimens and level of glycaemic control.

 

Lipodystrophy:

Lipodystrophy (including lipohypertrophy, lipoatrophy) may occur at the injection site. Continuous rotation of the injection site within the particular injection area may help to reduces the risk of developing these reactions.

 

d. Paediatric population

 

Based on post-marketing sources and clinical trials, the frequency, type and severity of adverse reactions observed in the paediatric population do not indicate any differences to the broader experience in the general population.

 

e. Other special populations

 

Based on post-marketing sources and clinical trials, the frequency, type and severity of adverse reactions observed in elderly patients and in patients with renal or hepatic impairment do not indicate any differences to the broader experience in the general population.

 

f. Reporting of suspected adverse reactions

 

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via Appendix V

 

United Kingdom

Yellow Card Scheme

Website: www.mhra.gov.uk/yellowcard

 

Ireland

HPRA Pharmacovigilance

Earlsfort Terrace

IRL - Dublin 2

Tel: +353 1 6764971

Fax: +353 1 6762517

Website: www.hpra.ie

e-mail: medsafety@hpra.ie

 

Malta

ADR Reporting

The Medicines Authority

Post-Licensing Directorate

203 Level 3, Rue D'Argens

GŻR-1368 Gżira

Website: www.medicinesauthority.gov.mt

e-mail: postlicensing.medicinesauthority@gov.mt

 

 

6.2       Incompatibilities

 

Insulin medicinal products should only be added to compounds with which it is known to be compatible. Medicinal products added to the insulin solution may cause degradation of the insulin, e.g. if the medicinal products contain thiols or sulfphites.

 

6.3       Shelf life

 

Before opening: 30 months.

 

During use or when carried as a spare: The product canmust be stored for a maximum of 6 weeks. Store below 25°C.

 

 

 

8.         MARKETING AUTHORISATION NUMBERS

 

EU/1/02/230/003

EU/1/02/230/004

EU/1/02/230/017

10.       DATE OF REVISION OF THE TEXT

11/201206/2014

Updated on 7 March 2013 PIL

Reasons for updating

  • Change to warnings or special precautions for use
  • Change of contraindications
  • Change to instructions about missed dose
  • Change to instructions about overdose
  • Change to storage instructions
  • Change to side-effects
  • Change to drug interactions
  • Change to information about pregnancy or lactation
  • Change to information about driving or using machinery
  • Change to how the medicine works
  • Change to date of revision
  • Correction of spelling/typing errors

Updated on 18 January 2013 SmPC

Reasons for updating

  • Change to section 1 - Name of medicinal product
  • Change to section 2 - Qualitative and quantitative composition
  • Change to section 3 - Pharmaceutical form
  • Change to section 4 - Clinical particulars
  • Change to section 5 - Pharmacological properties
  • Change to section 6 - Pharmaceutical particulars
  • Change to section 10 - Date of revision of the text
  • Change to improve clarity and readability

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

Lipodystrophy: The purpose is to update the wording on lipodystrophy to make the information more legible for healthcare professionals. The following sections have been updated: SmPC section 4.2 (Method of administration), SmPC section 4.8 (Undesirable effects).

Section 4.2

Injection sites should always be rotated within an anatomic the same region in order to avoid reduce the risk of lipodystrophy.

 

Section 4.8

Skin and subcutaneous tissue disorders

Uncommon - Lipodystrophy

Lipodystrophy may occur at the injection site as a consequence of failure to rotate injection sites within an area.

Lipodystrophy:

Lipodystrophy (including lipohypertrophy, lipoatrophy) may occur at the injection site. Continuous rotation of the injection site within the particular injection area may help to reduce the risk of developing these reactions.

 

 

Concomitant illness: New information has been added about ‘concomitant illness’ in SmPC section 4.4 (Special warnings and precautions for use).

Section 4.4

Concomitant illness, especially infections and feverish conditions, usually increases the patient’s insulin requirement. Concomitant diseases in the kidney, liver or affecting the adrenal, pituitary or thyroid gland can require changes in the insulin dose.

 

Hypoglycaemia: Hypoglycaemia has been removed from section 4.3 (Contraindications) to section 4.4 (Special warnings and precautions for use) as it is considered inadvisable to state hypoglycaemia as a contraindication due to the risk of patients believing that they should not administer insulin if they at some point have experienced an event of hypoglycaemia.

Section 4.4

Hypoglycaemia

Omission of a meal or unplanned, strenuous physical exercise may lead to hypoglycaemia.

Hypoglycaemia may occur if the insulin dose is too high in relation to the insulin requirement. In case of hypoglycaemia or if hypoglycaemia is suspected <Insulatard/Actrapid> must not be injected. After stabilisation of patient’s blood glucose adjustment of the dose should be considered (see sections 4.8 and 4.9).

 

Alcohol: ‘alcohol’ is removed from section 4.5.

Section 4.5

The following substances may reduce the patient’s insulin requirement:

Oral antidiabetic medicinal products, hypoglycaemic agents (OHA), monoamine oxidase inhibitors (MAOI), non-selective beta-blockersing agents, angiotensin converting enzyme (ACE) inhibitors, salicylates,  alcohol, anabolic steroids and sulphonamides.

 

Elderly and children: Sections 4.2, 4.6 and 4.8 have been updated to reflect legislation on the elderly and children, and the EU SmPC guideline.

The remainder of the changes to the other changes are due to readability and harmonisation with the current QRD (SmPC) template.

Updated on 13 September 2012 PIL

Reasons for updating

  • Addition of manufacturer

Updated on 22 September 2011 PIL

Reasons for updating

  • Change to warnings or special precautions for use
  • Change to date of revision

Updated on 2 March 2011 SmPC

Reasons for updating

  • Change to section 4.4 - Special warnings and precautions for use
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

In section 4.4 Special warnings and precautions for use - addition of the following paragraph:-

Combination of Actrapid with pioglitazone

 

Cases of cardiac failure have been reported when pioglitazone was used in combination with insulin, especially in patients with risk factors for development of cardiac heart failure. This should be kept in mind if treatment with the combination of pioglitazone and Actrapid is considered. If the combination is used, patients should be observed for signs and symptoms of heart failure, weight gain and oedema. Pioglitazone should be discontinued if any deterioration in cardiac symptoms occurs.

Revision of text date
02/2011

Updated on 9 February 2010 PIL

Reasons for updating

  • Improved electronic presentation

Updated on 27 January 2010 PIL

Reasons for updating

  • New PIL for medicines.ie

Updated on 6 February 2008 SmPC

Reasons for updating

  • Change to section 4.4 - Special warnings and precautions for use
  • Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
  • Change to section 4.8 - Undesirable effects
  • Change to section 5.2 - Pharmacokinetic properties
  • Change to section 6.2 - Incompatibilities
  • Change to section 6.3 - Shelf life
  • Change to section 6.4 - Special precautions for storage
  • Change to section 6.5 - Nature and contents of container
  • Change to section 6.6 - Special precautions for disposal and other handling
  • Change to section 9 - Date of renewal of authorisation
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Free text change information supplied by the pharmaceutical company

4.4 Special warnings and precautions for use

 Inclusion of standard text concerning injection site reactions has been added:

 “As with any insulin therapy, injection site reactions may occur and include pain, itching, hives, swelling and inflammation. Continuous rotation of the injection site within a given area may help to reduce or prevent these reactions. Reactions usually resolve in a few days to a few weeks. On rare occasions, injection site reactions may require discontinuation of Actrapid”.

4.5  Interaction with other medicinal products and other forms of interaction

 Anabolic steroids and sulphonamides have been added to the list of substances which my reduce insulin requirements. Oral contraceptives have been added to the list of substances which may increase insulin requirements. These changes are to ensure consistency with the corresponding section in the SPCs for analogue insulins.

4.8 Undesirable effects

The following information has been inserted

… “including isolated reports. Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness”.

5.2  Pharmacokinetic properties

Addition of heading:

Children and adolescents:

 6.1 List of excipients

“for pH adjustment” has been added for sodium hydroxide

 6.2 Incompatibilities

Addition of standard statement that insulin should only be added to compounds with which it is known to be compatible

This information has been added: “Insulin products should only be added to compounds with which it is known to be compatible”.

This information has been deleted “Upon mixing Actrapid with infusion fluids an unpredictable amount of insulin will be adsorbed to the infusion material. Monitoring of the patient's blood glucose during infusion is therefore recommended”.

6.3 Shelf life

“when stored between 2˚C-8˚C” has been added to the shelf life of 30 months.

“when used or stored at room temperature (below 25˚C)” has been added to the shelf life of 6 weeks.

“After first opening” has been deleted.

 “when used or stored at room temperature (below 25˚C)” has been added to the shelf life of 6 weeks.

6.4 Special precautions for storage

There have been a number of editorial changes to these sections, generally to standardise the statements. There have been no changes to the actual shelf life or storage conditions.

“Before use” has been added in front of: “Store in a refrigerator (2°C - 8°C)”.

This sentence has been added “Do not store them in or too near the freezer section or cooling element”.

6.5 Nature and contents of container

Size of container has been specified as “10ml”.

6.6 Special precautions for disposal and other handling

These sentences have been added:

“For intravenous use, infusion systems with Actrapid at concentrations 0.05 IU/ml – 1.0 IU/ml insulin human in he following infusion fluids: 0.9% sodium chloride, 5% dextrose and 10% dextrose inclusive 40 mmol/l potassium chloride, using polypropylene infusion bags, are stable at room temperature for 24 hours. Although stable over time, a certain amount of insulin will initially be absorbed to the material of the infusion bag. Monitoring of blood glucose is necessary during the infusion”.

Any unused product or waste material should be disposed of in accordance with local requirements”.

9.    Date of first authorisation/renewal of the authorisation

Date of last renewal: 18 October 2007

10.  Date of revision of the text
 
09/2007

 

Updated on 10 January 2006 SmPC

Reasons for updating

  • Change to joint SPC covering all presentations

Legal category: Product subject to medical prescription which may be renewed (B)

Updated on 2 November 2004 SmPC

Reasons for updating

  • Change to section 4.2 - Posology and method of administration
  • Change to section 4.4 - Special warnings and precautions for use
  • Change to section 4.8 - Undesirable effects
  • Change to section 4.9 - Overdose
  • Change to section 5.1 - Pharmacodynamic properties
  • Change to section 6.4 - Special precautions for storage
  • Change to section 10 - Date of revision of the text

Legal category: Product subject to medical prescription which may be renewed (B)

Updated on 22 August 2003 SmPC

Reasons for updating

  • Correction of spelling/typing errors

Legal category: Product subject to medical prescription which may be renewed (B)

Updated on 30 June 2003 SmPC

Reasons for updating

  • New SPC for medicines.ie

Legal category: Product subject to medical prescription which may be renewed (B)