Before using NovoRapid
Do not use NovoRapid
If you are allergic (hypersensitive) to insulin aspart or any of the other ingredients not use NovoRapid (see section 6. Additional information).
If you suspect hypoglycaemia (low blood sugar) (see section 4. Vazmozhninezhelani effects).
If the cartridge or the device containing the cartridge is dropped, damaged or crushed
If stored correctly or been frozen (see 5. How to store not use NovoRapid)
If insulin does not appear water clear and colorless.
Before using NovoRapid
Check the label to make sure it is the right type of insulin
Always check the cartridge, including the rubber plunger (stopper). Do not use if damaged or if there is a gap between the rubber plunger and the white label band. Return it to your dealer. Look at the instructions for use of the injection device for further instructions
Disinfect the rubber membrane with a medicinal swab with disinfectant
Always use a new needle for each injection to prevent contamination.
Take special care with NovoRapid
If you have problems with your kidneys or liver, or with your adrenal, pituitary or thyroid glands
For more than usual or if you want to change your usual diet, as this can affect blood sugar levels.
If you're sick /: carry on taking your insulin and consult your doctor
When traveling abroad: traveling over time zones may affect your insulin travel.
NovoRapid can be used in demos instead of soluble human insulin when a rapid onset of action may be beneficial. For example, when it is difficult to dose to the infant feeding. There is no clinical experience with NovoRapid in children under 2 years. So use NovoRapid in children below this age, if your doctor specifically told you. As with all insulin preparations in patients with elderly and patients with renal or hepatic impairment should intensify monitoring of glucose and insulin aspart dosage should be adjusted individually.
Taking other medicines
Some medicines affect the way glucose works in your body and can affect your insulin dose. The most common medicines which may affect your insulin treatment are listed below. Tell your doctor, nurse or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. In particular, you should tell your doctor if you use any drug that affects blood sugar levels, as described below.
If you take any of the below medicine your blood sugar may fall (hypoglycaemia):
 Other medicines for diabetes
 Monoamine oxidase (MAO) inhibitors (used to treat depression)
 Beta-blockers (used to treat high blood pressure)
 Angiotensin converting enzyme (ACE) inhibitors (used to treat certain heart conditions or high blood pressure)
 Salicylates (used to relieve pain and reduce fever) Anabolic steroids (such as testosterone)
Sulfonamides (used to treat infections).

If you take any of the below medicine your blood sugar level may rise (hyperglycaemia):
 Oral contraceptives (birth control pills)
 Thiazides (used to treat high blood pressure or excessive fluid retention)
 Glucocorticoids (such as "cortisone" used to treat inflammation)
 Thyroid hormones (used to treat thyroid gland disorders)
 Sympathomimetics (such as epinephrine [adrenaline], or salbutamol, terbutaline used to treat asthma)
 Growth hormone (medicine for stimulation of bone growth and body and pronounced effect on the metabolic processes of the body)
 Danazol (medicine acting on ovulation).
Octreotide and lanreotide (used for treatment of acromegaly) may increase or decrease blood sugar levels.
Beta-blockers (used to treat high blood pressure) may weaken or suppress entirely the first warning symptoms which help you to recognize a hypoglycaemia.
Application of NovoRapid with food and drink
If you consume alcohol, your need for insulin may change as your blood sugar may be increased or decreased. Careful monitoring.
Pregnancy and lactation
Ask your doctor or pharmacist before taking any medicine.
If you are pregnant, planning to become pregnant or breast-feeding: please contact your doctor for advice. NovoRapid can be used during pregnancy. You need to change your insulin dosage during pregnancy or after birth. Careful control of your diabetes, and prevention of hypoglycaemia especially important for the health of your baby.
Driving and operating machinery
If your blood sugar is low or high your concentration and ability to react might be affected and therefore also your ability to drive or operate machinery. Note that you can put yourself and others at risk. Discuss with your doctor whether you can drive:
If you often get hypoglycemia
If hardly recognize hipoglzhemiyata
NovoRapid has a faster onset of action, and therefore if hypoglycaemia occurs after the injection, you may feel it earlier than soluble human insulin.
 How to use NovoRapid
Dosage
Talk to your doctor and nurse about your insulin dose. Make sure you use NovoRapid Penfill, that your doctor and nurse have told you to follow their advice carefully. This leaflet is a general guide.
If your doctor has changed the type or brand of insulin to another, you may need to adjust your dose. Do not change your insulin unless your doctor tells you to.
Within 10 minutes of injection Eat a meal or snack containing carbohydrates to avoid hypoglycaemia. Where necessary, NovoRapid can be given immediately after a meal instead of before meals.
Route of administration
NovoRapid is injected under the skin (subcutaneously) or by continuous infusion pump system. NovoRapid can be given directly into a vein (intravenously) by medical personnel under strict medical supervision. Never inject your insulin directly into a vein or muscle (intramuscular).
Always vary the sites you inject within the same region to avoid lumps (see 4. Possible side effects). The best places for injection are: the front of your waist (abdomen); arms and front thighs. We regularly measure your blood sugar.
 Inject the insulin under the skin. Use the injection technique advised by your doctor or nurse and described in the manual for your device delivery
Keep the needle under your skin for at least 6 seconds to make sure that the full dose has been delivered
 After each injection be sure to remove and discard the needle and store NovoRapid without
needle attached. Otherwise, the liquid may leak out which can cause inaccurate dosing.
Do not refill the cartridge. NovoRapid Penfill cartridges are designed for use with insulin delivery devices Novoo Nordisk (Novo Nordisk) and NovoFine or NovoTwist.
If you are treated with NovoRapid Penfill and another insulin cartridge Penfil, you should use two delivery systems, one for each type of insulin.
When using an infusion pump system
NovoRapid should never be mixed with any other insulin when used in a pump. Follow the instructions and advice of your doctor regarding the use of NovoRapid in the pump. Before using NovoRapidpompena system must receive detailed instructions and information on how to take the illness, too high or too low blood sugar, or damage to the pump system. Before inserting the needle, use soap and water, your hands and the injection site to avoid infection at the site of infusion
When you fill a new tank, make sure there are no large air bubbles in either the syringe or the tubing
 Changing the infusion set (tubing and needle) must be done according to supplied
instructions in the product information supplied with the infusion set.
To have a positive effect on insulin insruziya and find time insulin pump malfunctions, it is advisable to measure your blood sugar regularly.
What to do in case of pump system failure
Always carry a spare insulin injection under the skin in case of pump system failure.
If you take more insulin than you need
If you take too much insulin, your blood sugar is too low (called hypoglycemia). This may also happen:
 If you eat too little or miss a meal
 For more than usual.
The warning signs of hypoglycemia may occur suddenly and can include: cold sweat, cool pale skin, headache, rapid heart beat, feeling of nausea, excessive hunger, temporary vision disturbances, drowsiness, unusual tiredness and weakness, nervousness or tremor; feeling anxiety, confusion, difficulty in concentrating. If you feel a hypo coming on: take a high sugar snack and then measure your blood sugar.
If your blood sugar is too low: eat glucose tablets or a high sugar snack (sweets, biscuits, fruit juice), then rest. In any case, always carry glucose tablets, sweets, biscuits or fruit juice. When symptoms of hypoglycaemia have disappeared or when blood glucose level is stabilized continue insulin treatment. Warn others of you people that have diabetes and what may be the consequences, including the risk of passing out due to hypoglycemia. Tell people to you people that if you pass out (become unconscious), they must turn you on your side and get medical help. You should not give anything to eat or drink. It could choke you.
Coming your mind can be accelerated by injection of the hormone glucagon by a trained person. If you are given glucagon coming soon your mind is you need to give glucose or a sugary snack. If you do not respond to glucagon treatment, you will have to go into hospital. Contact your doctor or an emergency ward after an injection of glucagon: you need to find the reason for your hypo to avoid getting more.

 If prolonged severe hypoglycaemia is not treated it can cause brain damage (temporary or permanent) and even death
 If you have hypoglycemia, leading to unconsciousness or recurrent hypoglycemia, consult your doctor. Amount or timing of insulin, food or exercise may need to be adjusted.
If you forget to inject insulas
If you forget to take your insulin, your blood sugar may get too high (this is called hyperglycaemia). This may also happen:
 If you repeatedly take less insulin than you need
 If you get an infection or fever
If you eat more than usual
 In less than usual.
The warning signs appear gradually. These include frequent urination, thirst, loss of appetite, or vomiting stinker; feeling drowsy or tired; flushed with> skin dryness in the mouth and breath smell fruity (acetone). If you experience any of these signs: test your blood sugar, test your urine for ketones ow you, then seek medical poms These may be signs of a very serious condition called diabetic ketoacidosis. If left untreated, it can lead to my diabetic coma and eventually death.
If you stop taking your insulin
This could lead to severe hyperglycaemia (very CEPA blood sugar) and ketoacidosis (accumulation of fatty acids in the blood because the body is breaking down fat vmests sugar). Do not stop taking your insulin without talking to your doctor who will advise you what to do.
If you have any further questions on the use of this product, ask your doctor or pharmacist.
 Possible side effects
Like all medicines, NovoRapid can cause side effects, although not everybody gets them. Side effects may occur with certain frequencies, which are defined as follows:
 Very common: affects more than 1 in 10 patients
 Common: affects 1 to 10 users in 100
 Uncommon: affects 1 to 10 users in 1,000
 Rare: affects 1 to 10 users in 10,000
 Very rare: affects less than 1 in 10,000 patients
 Not known: frequency can not be estimated from available data.
Uncommon side effects
Signs of allergy. Reactions (pain, redness, hives, inflammation, swelling and itching) at the injection site (local allergic reactions). They usually disappear after a few weeks of taking your insulin. If they do not disappear, consult your
doctor.
Seek immediate medical attention:
If signs of allergy spread to other parts of your body, or
If you suddenly feel unwell and you start sweating, you feel that you are sick (vomiting), have trouble breathing, have a rapid heart beat, feeling dizzy.
Vision problems. When you first start your insulin treatment, it may disturb your vision, but the offense is usually temporary. Changes at the injection site (lipodystrophy). In inject yourself too often at the same site, fatty tissue under the skin at this site may shrink (lipoatrophy) or thicken (lipohypertrophy). Changing the site with each injection may help to prevent such skin changes. If you notice your skin pitting or thickening at the injection site, tell your doctor or nurse because these reactions can become more severe, or they may change the absorption of your insulin if you inject in such a place. Swelling. When you start taking insulin, water retention may cause swelling around your ankles and other joints. Normally this soon disappears. Diabetic retinopathy. If you have diabetic retinopathy and your blood glucose levels improve very fast, the retinopathy may get worse. Talk to your doctor about this.
Common side effects
Low blood sugar (hypoglycemia).
Rare side effects
Neuropathy. If your blood glucose levels improve very fast, it is possible to get connected with nerve pain - this is called acute painful neuropathy and is usually transient.
Very rare side effects
Severe allergic reaction to NovoRapid or any of its ingredients (called a systemic allergic reaction). See also warning in 2. Before using NovoRapid
If any of the side effects gets serious, or you notice other effects not listed in this leaflet, tell your doctor, nurse or pharmacist Medicine.
 How to store NovoRapid
Keep out of reach of children.
Do not use NovoRapid after the expiry date stated on the label and carton cartridge after "EXP." Date of expiry date refers to the last day of that month.
NovoRapid Penfill, not being used should be stored in a refrigerator at 2 ° C - 8 ° C, away from the cooling element. Do not freeze.
NovoRapid Penfill, which is used or carried as a spare, it should be stored in the refrigerator. You can carry it with you and keep it at room temperature (below 30 ° C) to 4 weeks.
Always keep the cartridge in the outer carton when not in use to protect it from light.
NovoRapid must be protected from excessive heat and light.
Medicines should not be disposed of via household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
 Additional Information
What NovoRapid
- The active substance is insulin aspart. Each ml contains 100 U of insulin aspart. Each cartridge contains 300 U of insulin aspart in 3 ml solution for injection
- The other ingredients are: glycerol, phenol, metacresol, zinc chloride, disodium phosphate dihydrate, sodium chloride, hydrochloric acid, sodium hydroxide and water for injections