Insulin (Soluble / Actrapid)

The bundle re-fetched 2026-09-10 carries a DIFFERENT product: 'Actrapid 100 international units/ml, Solution for Injection in a vial' (eMC product 3849). That is exactly this page's drug and this page's first-named brand — soluble (regular / neutral) human insulin. §4.1 verbatim: 'Actrapid is indicated for treatment of diabetes mellitus.' §4.2 confirms the route and character: '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.' SCOPE OF WHAT IS PUBLISHED — READ THIS. The page declares route 'Subcutaneous or Intravenous' and sits in Endocrinology and Emergency Medicine. Only the SUBCUTANEOUS side is sourced. The single numeric figure in §4.2 is verbatim: 'The individual insulin requirement is usually between 0.3 and 1.0 international unit/kg/day.' That is a TOTAL DAILY REQUIREMENT and is stated as such in the dose field; it must never be read as a single injection dose. §4.2's only intravenous content is a stability/compatibility statement, NOT a dose: '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 with 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.' Those are millilitre CONCENTRATIONS of the infusion, not units/hour, and no rate is derivable from them. If the page is to carry them, a protocol source must be cited separately. NO MAXIMUM DOSE IS STATED. The SPC gives no ceiling for insulin, so maxDose is deliberately absent rather than invented. DOSE-ALTERING FACTORS (§4.2 and §4.4): adjustment may be necessary with increased physical activity, a change in usual diet, or during concomitant illness. Concomitant illness — especially infections and feverish conditions — usually INCREASES the insulin requirement; renal or hepatic impairment may REDUCE it; concomitant disease of the kidney, liver, adrenal, pituitary or thyroid can require dose change. Elderly (65 years and older): Actrapid can be used, with intensified glucose monitoring and individual dose adjustment. Transfer from another insulin: do so under strict medical supervision — changes in strength, brand, type, origin or method of manufacture may require a dose change, patients may need an increased number of daily injections, and the adjustment may occur with the first dose or over the first weeks or months. Warning symptoms of hypoglycaemia may change or become less pronounced after transfer. ADMINISTRATION DETAIL (§4.2): inject into a lifted skin fold to minimise unintended intramuscular injection; keep the needle under the skin for at least 6 seconds to ensure the entire dose is injected; subcutaneous injection into the abdominal wall gives faster absorption than other sites; duration of action varies with dose, injection site, blood flow, temperature and physical activity. 'Due to the risk of precipitation in pump catheters, Actrapid should not be used in insulin pumps for continuous subcutaneous insulin infusion.' Vials are for use with insulin syringes with a corresponding unit scale; when two types of insulin are mixed, always mix them in the same sequence. PAEDIATRIC: §4.2 states only 'Actrapid can be used in children and adolescents' and gives NO separate paediatric figure. paedDose is therefore null so that no weight calculation can run — the 0.3-1.0 international unit/kg/day figure is a per-DAY total and would be a large overdose if fed to a per-dose weight calculator. Verify any under-18 regimen against a children's formulary and local DKA policy. TRUNCATION: §4.1, §4.2, §4.3, §4.4 (which absorbs §4.5) and §4.6 were retrieved complete. Some sections of the product information we used were incomplete — check the full SPC.