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Generic Name:

insulin-glulisine, Injectable solution

Generic Name:

All Brands

  • Apidra
  • Apidra SoloStar
SECTION 1 of 5

Highlights for insulin-glulisine

Injectable solution
1

Glulisine is rapid-acting insulin used to treat high blood sugar (hyperglycemia) in people with type 1 or type 2 diabetes.

2

Your doctor will decide the correct dose for you. Dosage is based on your blood sugar levels, other health conditions you have, and your level of physical activity.

3

It’s important to eat regular meals when you take insulin. Never skip meals. What you eat, when you eat, exercise, and other medicines can impact how your insulin works.

4

If your dose of glulisine isn’t working well, your blood sugar will be high and your diabetes won’t improve. Contact your doctor if your blood sugar readings are high or if you have symptoms of high blood sugar.

5

Common side effects include low blood sugar (hypoglycemia) and injection site reactions.

IMPORTANT INFORMATION

Low blood sugar warning

You may have trouble paying attention or reacting quickly if you have low blood sugar. This can make it dangerous to drive, operate heavy machinery, or perform similar activities that require alertness. Ask your healthcare provider if it’s okay for you to drive if you often have low blood sugar, especially if it occurs without symptoms.

Heart failure

Taking diabetes pills called thiazolidinediones or "TZDs" with this drug may cause heart problems in some people. This can happen even if you’ve never had heart issues before. If you already have heart failure, your condition may get worse. Your doctor may monitor you closely while you’re taking TZDs with this drug. Tell your doctor if you have any new or worse symptoms of heart failure including:

  • shortness of breath
  • swelling of your ankles or feet
  • sudden weight gain

Kidney or liver problems

If your kidneys or liver aren’t working well, insulin may build up in your body and cause low blood sugar. Your doctor may start you at a lower dose of this drug and slowly increase your dose if necessary.

What is glulisine?

This drug is a prescription drug. It comes in these forms: injectable vials, injectable prefilled pen, infusion sets, and intravenous use. The vials and pens are self-injectable. This means that you will give yourself the injection of glulisine.

It’s also available in a generic version. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug may be used as part of a combination therapy. That means you may need to take it with other medications. It is generally given together with an intermediate- or long-acting insulin.

Why it's used

This drug is a rapid-acting insulin that’s used to decrease high blood sugar (hyperglycemia) in people with type 1 or type 2 diabetes.

How it works

This drug belongs to a class of medicines called insulin.

More Details

How it works

This drug belongs to a class of medicines called insulin. Insulin is a hormone that your body makes to help move sugar from your bloodstream into your body’s cells. Your cells use the sugar as fuel. If you have type 1 diabetes, your pancreas doesn’t make insulin. If you have type 2 diabetes, your body doesn’t make enough or it can't use insulin properly. Without enough insulin, the sugar stays in your bloodstream, causing high blood sugar. This drug replaces part of the insulin that your body needs.

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SECTION 2 of 5

insulin-glulisine Side Effects

Injectable solution

Most Common Side Effects

The most common side effects that occur with glulisine include:

  • low blood sugar (hypoglycemia). Symptoms may include:

    • hunger
    • dizziness
    • shakiness
    • lightheadedness
    • sweating
    • irritability
    • headache
    • fast heartbeat
    • confusion

    If you have a low blood sugar reaction, you’ll need to treat it:

    • For mild hypoglycemia (55–70 mg/dL), treatment is 15—20 grams of glucose (a type of sugar). You need to eat or drink one of the following:
      • 3–4 glucose tablets
      • a tube of glucose gel
      • ½ cup of juice or regular, non-diet soda
      • 1 cup of nonfat or 1% cow’s milk
      • 1 tablespoon of sugar, honey, or corn syrup
      • 8–10 pieces of hard candy, such as lifesavers
    • Test your blood sugar 15 minutes after you treat the low blood sugar reaction. If your blood sugar is still low, then repeat the above again.
    • Once your blood sugar is back in the normal range, eat a small snack if your next planned meal or snack is more than 1 hour later. 

    If you don’t treat low blood sugar, you can have a seizure, pass out, and possibly develop brain damage. Low blood sugar can even be fatal. If you pass out because of a low blood sugar reaction or cannot swallow, someone will have to give an injection of glucagon to treat the reaction. You may need to go to the emergency room.

  • injection site reaction, such as:

    • redness
    • swelling
    • itching
  • skin thickening or pits at the injection site (lipodystrophy). Change where you inject your insulin to prevent these skin changes from happening. Don’t inject insulin into this type of skin.

  • weight gain

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • severe hypoglycemia (less than 35–40 mg/dL). Symptoms may include:

    • mood changes, such as irritability, impatience, anger, stubbornness, or sadness
    • confusion, including delirium
    • lightheadedness or dizziness
    • sleepiness  
    • blurred or impaired vision
    • tingling or numbness in your lips or tongue
    • headaches
    • weakness or fatigue
    • lack of coordination
    • nightmares or crying out during sleep
    • seizures
    • unconsciousness

    If you don’t treat low blood sugar, you can have a seizure, pass out, and possibly develop brain damage. Low blood sugar can even be fatal. If you pass out because of a low blood sugar reaction or can’t swallow, someone will have to give an injection of glucagon to treat the reaction. You may need to go to the emergency room.

  • severe allergic reaction. Symptoms may include:

    • a rash all over your body
    • shortness of breath
    • trouble breathing or wheezing
    • fast pulse
    • sweating
    • feeling faint (due to low blood pressure)
  • heart failure and fluid retention. Taking certain diabetes pills called thiazolidinediones or "TZDs" with glulisine may cause new or worse heart problems in people with or without existing heart issues. Symptoms of heart failure may include:

    • shortness of breath
    • swelling of your ankles or feet
    • sudden weight gain
  • low blood potassium (hypokalemia). If left untreated, this can lead to breathing problems, irregular heartbeat, or death. Symptoms may include:

    • abnormal heartbeat or palpitations
    • weakness
    • extreme tiredness
    • cramping in your arm or leg muscles
    • tingling skin
    • nausea and vomiting
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug may cause drowsiness.

Mild side effects may disappear within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

insulin-glulisine May Interact with Other Medications

Injectable solution

Glulisine may interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions

Medications That Might Interact with This Drug

Drug combinations that decrease your blood sugar

Oral diabetes drugs:

  • pramlintide
  • glimepiride
  • pioglitazone
  • canagliflozin

Blood pressure drugs:

  • ACE inhibitors, such as enalapril, lisinopril, and captopril

Heart rate disorder drugs:

  • disopyramide

Drugs that treats high triglycerides:

  • fibrates, including:
    • fenofibrate
    • fenofibric acid
    • gemfibrozil

Drugs that treat depression:

  • fluoxetine
  • monoamine oxidase inhibitors (MAOIs)

Pain medication:

  • aspirin

Drug that slows digestion:

  • octreotide

Sulfonamide antibiotics:

  • sulfamethoxazole-trimethoprim
  • sulfasalazine
  • erythromycin/sulfisoxazole

Drug combinations that increase your blood sugar

Drugs for allergies or asthma:

  • albuterol
  • corticosteroids
  • epinephrine
  • terbutaline

Heart or cholesterol drugs:

  • diuretics
  • niacin

Endocrine disorder drugs:

  • donazol
  • glucagon
  • somatropin
  • thyroid hormones

Tuberculosis drug:

  • isoniazid

Oral birth control pills:

  • estrogens
  • progestogens

Drugs for HIV infection:

  • protease inhibitors, including:
    • ritonavir
    • indinavir
    • saquinavir

Antipsychotics:

  • newer antipsychotic drugs:
    • aripiprazole
    • risperidone
    • clozapine
  • phenothiazine antipsychotics:
    • chlorpromazine
    • thioridazine

Drug combinations that can increase or decrease your blood sugar levels

High blood pressure drugs:

  • beta blockers, such as propranolol, metoprolol, atenolol
  • clonidine

These drugs may also mask symptoms of low blood sugar.

Medicine to treat mood disorders:

  • lithium salts

HIV medication:

  • pentamidine

This drug can cause decrease in blood sugar then cause an increase in blood sugar later on.

Drug combinations that mask low blood sugar symptoms

Some medications for hypertension may mask symptoms of low blood sugar. These include:

  • reserpine
  • clonidine
  • beta blockers, such as propranolol, metoprolol, and atenolol

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
liver problems
People with liver problems

If you have liver problems, you may be more sensitive to glulisine and may need lower doses of insulin. 

kidney problems
People with kidney problems

If you have kidney problems, your body may not get rid of insulin as well as it should. You may need lower doses of insulin.

allergies
People with allergies

Don’t use this drug if you are allergic to insulin or any component of this drug.

low blood potassium
People with low blood potassium

This is also called hypokalemia. If you have low potassium in your blood, talk to your doctor. If it’s not treated, you may experience breathing problems, irregular heartbeat, or even death. Symptoms of low potassium level are:

  • abnormal heartbeat or palpitations
  • weakness
  • tiredness
  • cramping in arm or leg muscles
  • tingling
  • nausea or vomiting
heart problems
People with heart problems

If have heart failure or other heart problems, tell you doctor. Taking certain diabetes pills called thiazolidinediones (TZDs) with glulisine may make your heart failure worse.

pregnant woman
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

It isn’t known if this drug passes through breast milk. If it does, it could cause side effects in a breastfeeding child.

You and your doctor may need to decide if you’ll take this drug or breastfeed. If you take this drug while breastfeeding, your doses may need to be adjusted.

seniors
For seniors

This drug should only be used with caution in seniors. Your liver, kidney, and heart function may be decreased. If your organs don’t work well enough to remove the drug, it could build up in your body. This can increase your risk of side effects, such as low blood sugar.

children
For children

Type 1 diabetes: This drug shouldn’t be used in children younger than 4 years old with type 1 diabetes. It has been found to be safe and effective in children ages 4–17 years who have type 1 diabetes.

Type 2 diabetes: This drug hasn’t been studied in children with type 2 diabetes.

Keep this drug and all additional equipment needed for injections out of the reach of children.

call the doctor
When to call the doctor

Tell your doctor know if you’re sick, under a lot of stress, or if you have changed your eating or exercise habits. Each of these can affect how much glulisine you need, and your doctor may need to adjust your dose.

Contact your doctor if you have any symptoms of high blood sugar. These include:

  • more frequent urination
  • extreme thirst
  • extreme hunger, even though you’re eating
  • extreme fatigue
  • blurred vision
  • cuts or bruises that are slow to heal
  • tingling, pain, or numbness in your hands or feet
allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms may include:

  • a rash all over your body
  • shortness of breath
  • trouble breathing or wheezing
  • fast pulse
  • sweating
  • feeling faint (due to low blood pressure)

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

SECTION 4 of 5

How to Take insulin-glulisine (Dosage)

Injectable solution

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Type 1 and Type 2 Diabetes
Form: Injectable solution
Strength: 10 mL vials: 100 units/mL
Form: Injectable prefilled pen
Strength: 3 mL prefilled pen: 100 units/mL
Adult Dosage (ages 18-64 years)

Your doctor will determine the correct dose of glulisine for you. The total daily dose is usually between 0.5 to 1 unit per kilogram of weight per day.

Child Dosage (ages 4-17 years)
  • type 1 diabetes: Your doctor will determine the correct dose for your child.
  • type 2 diabetes: A safe and effective dose for children with type 2 diabetes hasn’t been established.
Child Dosage (ages 0-3 years)

This drug shouldn’t be used in children younger than 4 years old.

Senior Dosage (ages 65 years and older)

Glulisine should be used with caution in seniors. Your liver, kidney, and heart function may be decreased. If your organs don’t work well enough to remove the drug, it could build up in your body. Your doctor may start you at a lower dose and then make small adjustments if necessary.

Special Considerations

Liver problems: If you have liver problems, you may be more sensitive to glulisine and may need lower doses of insulin. Your doctor may start you at a lower dose and then slowly increase your dose if necessary.

Kidney problems: If you have kidney problems, your body may not get rid of insulin as well as it should. Your doctor may start you at a lower dose and then slowly increase your dose if necessary.

Warnings

It’s very important to measure each dose carefully. Only use the exact amount of glulisine your doctor prescribed. Small errors in the amount of insulin measured and injected may have a large effect on your blood sugar levels.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don't take it as prescribed.

If you don't take it at all

If you don’t take this drug at all, you may still experience high blood sugar levels and its symptoms. Over time, high blood sugar can harm your eyes, kidneys, nerves, or heart. This may lead to heart attack, stroke, blindness, kidney failure, and limb amputations.

If you don't take it on schedule

If you don’t inject your glulisine on schedule, your blood sugar levels may not be well controlled. If your injections are given too close together, you may experience low blood sugar (hypoglycemia). If your injections are given too far apart, you may experience high blood sugar (hyperglycemia).

If you take too much

If you take too much of this drug, you may get dangerously low blood sugar. Symptoms include:

  • shakiness
  • nervousness or anxiety
  • sweating, chills, and clamminess
  • irritability or impatience
  • confusion, including delirium
  • rapid or fast heartbeat
  • lightheadedness or dizziness
  • hunger
  • nausea
  • sleepiness
  • blurred or impaired vision
  • tingling or numbness in your lips or tongue
  • headaches
  • weakness or fatigue
  • anger, stubbornness, or sadness
  • lack of coordination
  • nightmares or crying out during sleep
  • seizures
  • unconsciousness

What to do if you miss a dose

You should inject this drug up to 15 minutes before eating a meal. If you forget to take a dose, you can inject your dose shortly after your meal. If a long time has passed since you’ve eaten your meal, call your doctor for instructions on what to do.

Never try to catch up by doubling the dose you should inject. This could cause your blood sugar to become dangerously low (hypoglycemia).

How can I tell if the drug is working?

Your blood sugar readings may be lower and your symptoms of high blood sugar may decrease. You may need to check your blood sugar levels to make sure the drug is working for you.

This drug is used for long-term treatment.

Important considerations for taking this drug

It’s important to take this medication with food

For subcutaneous injections, inject glulisine 15 minutes before a meal or within 20 minutes after starting a meal.

Storage depends on the form you’re taking

Unused/unopened vial or pen:

  • Store all unopened vials and pens in the original box it came with. Store them in the refrigerator in temperatures from 36–46°F (2.2–7.8°C). These must be used within 28 days.
  • Protect this drug from light and don’t freeze it. Don’t use frozen medication, even after it’s been thawed.

In-use/open vial or pen:

  • Store vials in the refrigerator or at room temperature below 77°F (25°C) for up to 28 days. Don’t use it after 28 days. Keep it away from light or direct heat.
  • Don’t refrigerate pens. Store them at room temperature below 77°F (25°C) for up to 28 days. Don’t use it after 28 days. Keep it away from light or direct heat.

Infusion sets:

  • Infusion sets (reservoirs, tubing, and catheters) and the medication in the reservoir must be thrown away after 48 hours of use, or after being exposed to temperatures over 98.6°F (37°C).

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription-labeled box with you when traveling.
  • This medication needs to be refrigerated. You may need to use an insulated bag with a cold pack to maintain the temperature when traveling.
  • Don’t keep your medication in your luggage or in a car where the temperature could get hot or cold.
  • Needles and syringes need to be used to take this medicine. Check for special rules about traveling with medicine, needles, and syringes.

Self-management

You or your caregiver should receive training on the right way to do the injection. Don’t try to inject glulisine until you’ve been shown the right way to do it by your healthcare provider.

Subcutaneous injection

  • To avoid medication errors between glulisine and other insulins, always check the insulin label before each injection.
  • This drug is clear and colorless insulin. Before each injection, check the vial or pen to make sure there are no floating particles in the solution and that it has not changed color. Don’t use this drug if it’s cloudy, colored, or has particles in it.
  • Check your blood sugar level before each use.
  • This drug should be given within 15 minutes before a meal or within 20 minutes after starting a meal. Don’t inject this drug if you aren’t going to eat within 15 minutes.
  • Don’t mix this drug with insulins other than NPH insulin (Humulin N, Novolin N). If you’re mixing this drug with NPH, draw up glulisine into the syringe first. Inject the mixture right away.
  • Inject this drug into the skin of your upper arm, thigh, or stomach area.
  • Don’t inject this drug into a vein or into a muscle.
  • Change injection sites within the area you choose with each dose. Don’t inject into the exact same spot for each injection.

Continuous subcutaneous infusion

If you’re using this drug with an external pump infusion, your healthcare provider will train you on how to use it correctly.

Syringes and needles are used to inject this medicine. Don’t throw out individual needles into trashcans or recycling bins, and never flush them down the toilet. Ask your pharmacist for a needle clipper and a safe container for throwing away used needles and syringes.

Your community may have a program for throwing away needles and syringes. If you’re putting the container in the trash, label it “Do not recycle.”

When taking this drug, you may also need:

  • needles
  • syringes
  • needle clipper and a safe needle disposal container
  • alcohol swabs
  • lancing device and lancets (a pricking device used to obtain drops of blood for testing your blood sugar)
  • blood glucose test strips
  • blood glucose monitoring machine

Clinical monitoring

Your doctor may monitor you with certain blood tests before and during treatment to make sure it’s safe for you to take. Your doctor may check your:

  • blood sugar level
  • blood potassium level
  • liver function
  • kidney function

Your doctor may also do other tests to check for complications of diabetes, such as eye, foot, and blood pressure tests.

Hidden costs

Besides the medicine, you will need to purchase the following:

  • sterile alcohol wipes
  • lancing device and lancets (a pricking device used to obtain drops of blood for testing your blood sugar)
  • syringes and needles
  • blood glucose test strips
  • blood glucose monitoring machine
  • needle container for safe disposal of lancets, needles, and syringes

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for this drug.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

SECTION 5 of 5

How Much Does insulin-glulisine Cost?

Injectable solution

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on May 26, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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