Apidra Special Precautions

Follow closely the instructions for dosage, monitoring (blood tests), diet and physical activity (physical work and exercise) as discussed with the physician.
If the patient has liver or kidney problems, inform the physician as a lower dose may be needed.
Before traveling consult the physician. The patient may need to talk about the availability of insulin in the country the patient is visiting; supplies of insulin, injection syringes; correct storage of insulin while traveling; timing of meals and insulin administration while traveling; 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 the patient feels unwell or becomes ill.
Illnesses and Injuries: In the following situations, the management of diabetes may require a lot of care: If the patient is ill or has a major injury, blood sugar level may increase (hyperglycemia); not eating enough, blood sugar level may become too low (hypoglycemia).
If the patient has type I diabetes (insulin-dependent diabetes mellitus), the patient should not stop insulin and continue to get enough carbohydrates.
If the patient stopped using Apidra, this could lead to severe hyperglycemia (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 Apidra without consulting the physician.
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 physician as soon as possible if the patient experiences signs of heart failure eg, unusual shortness of breath or rapid increase in weight, or localized swelling (edema).
Effects on the Ability to Drive or Operate Machinery: The patient's ability to concentrate or react may be reduced if he has hypoglycemia (low blood sugar levels) or hyperglycemia (high blood sugar levels). Keep this possible problem in mind in all situations where the patient might put himself and others at risk (eg, driving a car or operating machines). Contact the physician for advice on driving if there are frequent episodes of hypoglycemia and/or the 1st warning symptoms which help recognize hypoglycemia are reduced or absent.
Use in pregnancy: Ask the physician or pharmacist for advice before taking any medicine.
Inform the physician if the patient is planning to become pregnant, or if already pregnant. Insulin dosage may need to be changed during pregnancy and after giving birth. Careful control of diabetes and prevention of hypoglycemia are important for the health of the baby.
There are no adequate data on the use of Apidra in pregnant women.
Use in lactation: Consult a physician as breastfeeding women may require adjustments in insulin doses and diet.
Use in children: There is insufficient clinical information on the use of Apidra in children <6 years.