$172.00
Manufacturer: Ukraine
Ailar (insulin glargine) solution is a medical insulin that has been modified to act for a longer period of time. It is used to help manage both type I and type II diabetes.
Description
Pharmacodynamics.
Insulin glargine is developed as an analogue of human insulin, which has low solubility in a neutral environment. it is completely soluble in the drug due to the acidic environment of the injection solution (pH 4). after introduction into the subcutaneous tissue, the acidic solution is neutralized, which leads to the formation of microprecipitates, from which a small amount of insulin glargine is constantly released. this provides a smooth (no peaks) and predictable auc profile, as well as a longer duration of drug action.
Insulin glargine is metabolized to two active metabolites – M1 and M2 (see Pharmacokinetics).
Binding to the insulin receptor: the results of in vitro studies indicate that the affinity of insulin glargine and its metabolites M1 and M2 to the human insulin receptor is similar to that of human insulin.
Binding to the insulin-like growth factor (IGF)-1 receptor: the affinity of insulin glargine for the IGF-1 receptor is about 5-8 times higher than that of human insulin (but about 70-80 times lower than the affinity of IGF-1 for this receptor ), while metabolites M1 and M2 bind to the IGF-1 receptor with an affinity that is slightly lower than that of human insulin.
The total therapeutic concentration of insulin (insulin glargine and its metabolites), determined in patients with type I diabetes, was significantly lower than that which would be necessary for half-maximal binding to the IGF-1 receptor and for subsequent activation of the mitogen-proliferative mechanism , which is triggered by the IGF-1 receptor. Endogenous IGF-1 in physiological concentrations can activate the mitogen-proliferative mechanism; however, the therapeutic concentrations of insulin used in insulin therapy, including insulin glargine therapy, are well below the pharmacological concentrations required to activate the IGF-1-mediated mechanism.
The most important effect of insulin, including insulin glargine, is the regulation of glucose metabolism. Insulin and its analogues reduce the level of glucose in the blood by stimulating its consumption by peripheral tissues, in particular by skeletal muscles and adipose tissue, as well as by inhibiting the formation of glucose in the liver. Insulin suppresses lipolysis in adipocytes, proteolysis, while increasing protein synthesis.
The equivalence of the same doses of insulin glargine and human insulin after intravenous administration of these drugs has been proven. As with any insulin, physical activity and other factors can affect how insulin glargine works over time.
Studies using the method of fixing the euglycemic state, conducted with the participation of healthy volunteers and patients with type I diabetes, demonstrated that, unlike neutral protamine Hagedorn (NPH) – human insulin, the onset of action of insulin glargine after subcutaneous administration occurs later. the drug acts smoothly, without causing the appearance of C max glucose in the blood, and the duration of its action is prolonged.
The long duration of the effect of injected subcutaneous insulin glargine is directly related to slower absorption, which allows you to use the drug once a day. The time course of action of insulin and its analogues, such as insulin glargine, can have significant individual variability.
After intravenous administration of insulin glargine and human insulin, symptoms of hypoglycemia or counterregulation of the hormonal response were similar in healthy volunteers and patients with type I diabetes.
Indication
Treatment of diabetes in adults, adolescents and children aged 2 years and older.
Instructions
Dosage. Aylarov contains insulin glargine – an analog of long-acting insulin. the drug is administered once a day at any time of the day, but each time at the same time. The syringe-pen allows you to inject doses of insulin in increments of 1 unit.
The dosage regimen of Aylarov (dose and time of administration) should be selected individually. Aylarov can also be used simultaneously with oral antidiabetic drugs for patients with type II diabetes. The potency of this medicinal product is expressed in units. These units are used exclusively for Aylarov drug and differ from MO or units in which the strength of action of other insulin analogues is expressed.
Children and teenagers. It is used in children from the age of 2 years.
Elderly patients (over 65 years old). In the elderly, age-related progressive deterioration of kidney function can cause a constant decrease in the need for insulin.
Kidney failure. In patients with renal insufficiency, the need for insulin may be reduced due to impaired insulin metabolism.
Liver failure. In patients with liver failure, the need for insulin may decrease due to a decrease in the ability to gluconeogenesis and a slowdown in insulin metabolism.
Switching from other insulins to Aylarov. When switching from the regimens of treatment with insulins of medium duration of action or long-term effect to the regimen of treatment with Aylarov drug, it may be necessary to change the dose of basal insulin, as well as to correct the accompanying antidiabetic therapy (dosage and administration time of regular (regular) insulin or short-acting insulin analogs are additionally used or doses of oral antidiabetic drugs).
Transfer from double administration of NPH-insulin to Aylarov drug. In order to reduce the risk of developing hypoglycemia at night or in the early morning hours, patients who change the regimen of basal insulin from double administration of NPH insulin to single administration of Aylarov should reduce the dose of basal insulin by 20-30% during the first weeks of treatment.
During this period, the dose reduction should be, at least partially, compensated by an increase in the dose of insulin, the introduction of which is associated with food intake. After this period, the dosage regimen should be adjusted individually.
As with the use of other insulin analogs, in patients who receive insulin in high doses due to the presence of antibodies to human insulin, when switching to Aylarov, an improvement in the body’s response to insulin administration may be observed.
When switching to another drug and during the first weeks after that, it is recommended to carefully monitor metabolic indicators.
Improvement of metabolic control and associated increase in sensitivity to insulin may require additional correction of the dosage regimen. Dose correction may also be necessary, for example, when the patient’s body weight changes or his lifestyle changes, the time of day when insulin is administered changes, or when other factors occur that increase the tendency to develop hypo- or hyperglycemia (see. Features of use 🙂 .
Method of introduction. Aylarov should be administered subcutaneously.
Aylarov cannot be administered intravenously. The long-term effect of the Aylarov drug is due to its introduction into the subcutaneous adipose tissue. IV administration of the usual subcutaneous dose can lead to severe hypoglycemia.
There is no clinically significant difference in insulin or plasma glucose levels following abdominal, deltoid, or thigh administration of insulin glargine. With each subsequent injection, the injection site should be changed each time within the body area recommended for insulin administration.
Aylarov cannot be mixed with any other insulin or diluted. When mixing or diluting, the action profile of the drug may change over time. In addition, mixing with other insulins can lead to the formation of a precipitate.
Syringe pen for insulin. Administering the Aylarov drug in cartridges requires the use of a suitable dosing device – a syringe pen. It is recommended to use devices: VitalPen (Copernicus Sp. Z oo, Poland), i-PEN (INSUPen) (Biocon Limited, India) or similar.
Syringe pens should be used in accordance with the recommendations of the manufacturer of the injection device.
The manufacturer’s instructions for using the syringe pen should be strictly followed when filling the cartridge, attaching the needle and injecting insulin.
If the insulin pen is damaged or does not work properly (due to mechanical defects), it should be discarded and replaced with a new pen.
In case of a malfunction of the syringe pen, the solution from the cartridge can be drawn into a syringe (suitable for insulin injection and designed for 100 units / ml) and make an injection.
Cartridge. Before inserting the cartridge into the syringe pen, it must be kept for 1-2 hours at room temperature. Check the cartridge before using it. It can be used only when the liquid in it is transparent, colorless, without visible solid particles and has the consistency of water. Since Aylarov is a solution, it does not need to be resuspended before use.
Before injection, you need to remove all air bubbles from the cartridge. Empty cartridges are not allowed to be refilled.
Before each injection, you should check the label on the insulin to avoid mistakenly injecting other insulins instead of insulin glargine (see Features of use).
Bottle. Check the bottle before using it. It can be used only when the liquid in it is transparent, colorless, without visible solid particles and has the consistency of water.
Since Aylarov is a solution, it does not need to be resuspended before use.
Children. The drug should be used in children older than 2 years only under close medical supervision.
Contraindication
Hypersensitivity to the active substance or to any of the auxiliary substances included in the composition of the drug.
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