Apidra Special Precautions

Apidra in a pre-filled pen is only suitable for injecting just under the skin (see Dosage & Administration). Speak to the doctor if insulin needs to be injected by another method.
Talk to the doctor, pharmacist or nurse before using Apidra.
Follow closely the instructions for dose, monitoring (blood tests), diet and physical activity (physical work and exercise) as discussed with the doctor.
Special patient groups: If the patient has liver or kidney problems, speak to the doctor as a lower dose may be needed.
There is insufficient clinical information on the use of Apidra in children younger than the age of 6 years.
Skin changes at the injection site: The injection site should be rotated to prevent skin changes such as lumps under the skin. The insulin may not work very well if injected into a lumpy area (see How to use Apidra). Contact the doctor if currently injecting into a lumpy area before start injecting in a different area. The doctor may advise the patient to check the blood sugar more closely, and to adjust the insulin or other antidiabetic medications dose.
Travel: Before travelling consult the doctor. The patient may need to talk about: The availability of the insulin in the country being visited; supplies of insulin, needles, etc; correct storage of the insulin while travelling; timing of meals and insulin administration while travelling; the possible effects of changing to different time zones; possible new health risks in the countries to be visited; what to do in emergency situations when feeling unwell or becoming ill.
Illnesses and injuries: In the following situations, the management of the diabetes may require extra care: If the patient is ill or has a major injury then the blood sugar level may increase (hyperglycaemia).
If the patient is not eating enough, the blood sugar level may become too low (hypoglycaemia).
In most cases, a doctor will be needed. Make sure to contact a doctor early.
If the patient has type 1 diabetes (insulin dependent diabetes mellitus), do not stop the insulin and continue to get enough carbohydrates. Always tell people who are caring or treating the patient that insulin is required.
Some patients with long-standing type 2 diabetes mellitus and heart disease or previous stroke who were treated with pioglitazone and insulin experienced the development of heart failure. Inform the doctor as soon as possible if the patient experiences signs of heart failure such as unusual shortness of breath or rapid increase in weight or localised swelling (oedema).
Important information about some of the ingredients of Apidra: This medicine contains less than 1 mmol (23 mg) sodium per dose, i.e. it is essentially 'sodium-free'.
Apidra contains metacresol: Apidra contains metacresol, which may cause allergic reactions.
Driving and using machines: The ability to concentrate or react may be reduced if: The patient has hypoglycaemia (low blood sugar levels); the patient has hyperglycaemia (high blood sugar levels).
Keep this possible problem in mind in all situations where the patient and others might be put at risk (such as driving a car or using machines).
Contact the doctor for advice on driving if: The patient has frequent episodes of hypoglycaemia; the first warning symptoms which help the patient to recognise hypoglycaemia are reduced or absent.