Apidra (Insulin Glulisine) – Subcutaneous

What Is Apidra?

Apidra (insulin glulisine) is a rapid-acting insulin that lowers blood sugar in adults and children with diabetes. It is a human insulin analog, meaning it is made in a lab and altered slightly to work faster than natural human insulin.

There are many types of insulin available. They generally are grouped by how quickly they work to lower blood sugar. Apidra is a rapid-acting insulin. It lowers blood sugar within 15 minutes and peaks one hour after injection. It continues working for about two to four hours.

Apidra is a prescription product, so you can’t purchase it over the counter (OTC). You’ll receive a prescription from your healthcare provider to fill the medication at your pharmacy. It is available for subcutaneous use, meaning it is injected under the skin.

Drug Facts

Generic Name: Insulin glulisine

Brand Name: Apidra 

Drug Availability: Prescription

Administration Route: Subcutaneous

Therapeutic Classification: Rapid-acting insulin

Available Generically: No

Controlled Substance: N/A

Active Ingredient: Insulin glulisine

Dosage Form: Solution

What Is Apidra Used For?

The Food and Drug Administration (FDA) approved Apidra to treat diabetes and diabetes-related high blood sugar levels. It is most commonly used in individuals with type 1 diabetes whose bodies do not produce enough insulin. It is sometimes also used in type 2 diabetes when lifestyle changes and oral medicines are not enough to control blood sugar.

Insulin is a hormone produced by the pancreas. It helps your body effectively use or store the glucose (sugar) that comes from carbohydrates in your diet. When there isn’t enough insulin in your body, glucose can’t enter your cells to be used for energy. As a result, glucose builds up in your blood.

Injecting insulin helps shift glucose from the blood into cells, lowering blood sugar levels. Keeping blood sugar levels within a normal range helps prevent complications of diabetes, such as kidney disease or nerve damage.

Since type 1 diabetes is usually a genetic condition, it is often diagnosed at a young age. Early symptoms of type 1 diabetes may include excessive hunger or thirst, frequent urination, fatigue, unintended weight loss, and blurred vision.

How to Take Apidra

Apidra is available as two different products: vials of 10 milliliters and prefilled SoloStar pens of 3 milliliters.

Vials will require you to draw up the insulin with a syringe. With prefilled pens, attach a needle and then twist the dial on the pen to load the amount of insulin you want to inject. Insulin syringes and the needles you attach to pens (called pen needles) come in various sizes, with different thicknesses and lengths to choose from.

Insulin is injected the same way between vials and pens. It is a subcutaneous injection with the following steps:

  1. Gather your supplies. You will need an alcohol pad and your insulin, either in a pen or vial, and a syringe.
  2. Wash your hands.
  3. Select the injection site (any area with some fat like your abdomen, thigh, or upper arm) and clean it using the alcohol pad.
  4. Draw up the correct dose in the prefilled pen or syringe.
  5. Take a large pinch of skin to pull the fatty tissue away from the muscle underneath it.
  6. Holding the pen or syringe like a dart, quickly insert the needle at a 90-degree angle to the skin.
  7. Slowly inject the medication.
  8. Release the pinch of skin, then withdraw the needle.
  9. If needed, you can apply a bandage or gauze, but this is not usually necessary with insulin injections.

Storing Apidra

Unopened vials and pens should be stored in the refrigerator (between 36 and 46 degrees Fahrenheit), ideally in their original box or carton to protect them from light. Never store insulin in the freezer or allow it to freeze. If this does happen, you will need to discard it. Unopened vials or pens not stored in the fridge must be used within 28 days.

Opened vials must be used within 28 days of opening, whether or not you refrigerate them. If you choose not to refrigerate the vial, make sure to keep it away from direct heat and light at a temperature below 77 degrees.

Opened pens should not be refrigerated, but keep them at temperatures below 77 degrees and away from direct heat and light. An opened pen is good for 28 days, starting when you remove it from the fridge. After 28 days, it must be discarded.

If you’re traveling by plane, you’ll want to keep Apidra in your carry-on luggage so that you aren’t separated from it in case your checked baggage goes missing. No need to worry about TSA liquid restrictions with insulin, as medications are exempt from this rule.

If traveling by car, do not leave your insulin in hot or cold temperatures for long periods, like overnight in the car.

If you need to transport extra unopened vials or pens while traveling, keep them in a cooler or an insulated bag with ice packs until they can be refrigerated again. It’s a good idea to check for locations of nearby pharmacies wherever you’ll be traveling, just in case you need to get more insulin.

How Long Does Apidra Take to Work?

Apidra is a rapid-acting insulin, meaning it starts to work to lower blood sugar within 15 minutes after you inject it. It will continue working for anywhere from two to four hours, with the peak of its action happening at the one-hour mark.

What Are the Side Effects of Apidra?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects associated with Apidra include the following:

  • Hypoglycemia (low blood sugar) is the most commonly observed adverse reaction in people using insulin. This is any blood sugar level below 70 milligrams per deciliter (mg/dL). Earlier symptoms of hypoglycemia include hunger, tiredness, headache, shakiness, and sweating. If this occurs, test your blood sugar. If it is low, consume 15 grams of fast-acting carbs like half a cup of fruit juice or sugary soda, or take a glucose tablet.
  • Nasopharyngitis, which causes symptoms that feel like allergies or a common cold, especially in the nose and throat.
  • Injection site reactions such as redness or bruising may occur when injecting your insulin. Be sure to rotate sites to minimize this risk.

Severe Side Effects

Hypoglycemia can become a severe side effect of Apidra if left untreated. Symptoms of severe hypoglycemia include confusion, slurred speech, blurred vision, and eventually seizures, fainting, and coma. Do not ignore early symptoms of hypoglycemia, like shaking, sweating, or headache, as this may lead to severe hypoglycemia and the need for medical attention.

Long-Term Side Effects

Long-term use of Apidra (and any insulin) can cause lipodystrophy at the site of repeated insulin injections or infusions. In lipodystrophy, the fatty tissue can either get thicker or thinner and may not be able to absorb insulin as well over time.

Be sure to rotate insulin injection sites within the same area to reduce this risk. Rotate between your abdomen and thighs, and rotate the specific spots on those sites where you inject.

Report Side Effects

Apidra may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Apidra Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form:
    • For type 1 diabetes mellitus:
      • Adults and children 4 years of age and older—Dose is based on your blood sugar and must be determined by your doctor.
      • Children younger than 4 years of age—Use and dose must be determined by your doctor.
    • For type 2 diabetes mellitus:
      • Adults—Dose is based on your blood sugar and must be determined by your doctor.
      • Children—Use and dose must be determined by your doctor.

Modifications

Sometimes, you may need to take precautions while taking or administering this medication.

Pregnancy

Apidra has not been studied in pregnancy. Talk with your healthcare provider about controlling your blood sugar while pregnant. They may prescribe insulin that is more commonly used in pregnant people, such as insulin aspart or lispro and, therefore, considered lower risk.

Breastfeeding

According to research, Apidra is likely to transfer into breast milk. However, there doesn’t seem to be any harm to breastfed infants. It is unknown how using insulin products like Apidra influences breast milk production. People with diabetes who are breastfeeding may also require insulin dose adjustments.

Children

Apidra is safe and effective for children age 4 to 17 with type 1 diabetes. It has not been studied in children younger than 4 with type 1 diabetes or in children with type 2 diabetes. Just as in adults, Apidra dosing should be tailored to each child based on individual needs and frequent monitoring of blood sugar levels.

Missed Dose

Ideally, you should take Apidra 15 minutes before or 20 minutes after starting a meal. It’s best to get into a routine of giving the dose at the same time relative to each meal so that it becomes a habit.

There is no set course of action to take if you forget to give your dose since it depends on how long ago the injection was meant to be given.

If you realize in the middle of a meal or even up to about two hours later that you forgot to give a dose, it is most likely fine to go ahead and take it. However, in that case, the insulin action will not align with your sugar levels as it typically would. This may cause high or low blood sugar.

Monitor your blood glucose levels more often than usual and contact your healthcare provider if you have questions or concerns.

Overdose: What Happens If I Take Too Much Apidra?

Because of the risk of hypoglycemia, it is important to take Apidra exactly as prescribed. Test your blood sugar if you experience symptoms of low blood sugar, such as sweating, fast heart rate, or shakiness. If it’s low, you can take 15–20 grams of fast-acting carbs such as a glucose tablet or 4 ounces (half a cup) of sugary soda or juice.

Check your blood sugar again 15 minutes later and repeat this process until your sugar reads at least 70 milligrams per deciliter.

Call 911 or go to the emergency department immediately if you experience symptoms of severe hypoglycemia like confusion, slurred speech, or blurred vision.

What Happens If I Overdose on Apidra?

If you think you or someone else may have overdosed on Apidra, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Apidra, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

Never share insulin pens with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles or pens can result in transmission of hepatitis viruses, HIV, or other bloodborne illnesses.

Your doctor will want to check your progress at regular visits, especially during the first few weeks you take this medicine. Blood and urine tests may be needed to check for unwanted effects.

It is very important to follow carefully any instructions from your health care team about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines during the time you are taking insulin glulisine unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to:

  • Wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
  • Keep an extra supply of insulin glulisine and syringes with needles or injection devices on hand in case high blood sugar occurs.
  • Keep some kind of quick-acting sugar handy to treat low blood sugar.
  • Have a glucagon kit and a syringe and needle available in case severe low blood sugar occurs. Check and replace any expired kits regularly.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, swelling of the face, tongue, and throat, trouble breathing, or chest pain after you receive the medicine.

Too much insulin glulisine can cause hypoglycemia (low blood sugar). Low blood sugar also can occur if you use insulin glulisine with another antidiabetic medicine, changes in insulin regimen (eg, insulin strength, type of insulin, injection site), delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting or have diarrhea. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

Symptoms of low blood sugar include: anxiety, behavior changes similar to being drunk, blurred vision, cold sweats, confusion, depression, difficulty in thinking, dizziness or lightheadedness, drowsiness, excessive hunger, fast heartbeat, headache, irritability or abnormal behavior, nervousness, nightmares, restless sleep, shakiness, slurred speech, and tingling in the hands, feet, lips, or tongue.

If symptoms of low blood sugar occur, eat glucose tablets or gel to relieve the symptoms. Also, check your blood for low blood sugar. Get to a doctor or a hospital right away if the symptoms do not improve. Someone should call for emergency help immediately if severe symptoms such as convulsions (seizures) or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your household also should know how to use it.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, changes in insulin regimen, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

Symptoms of high blood sugar include: blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination, ketones in the urine, loss of appetite, stomachache, nausea, or vomiting, tiredness, troubled breathing (rapid and deep), unconsciousness, and unusual thirst.

If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

This medicine may make you dizzy or drowsy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may cause low levels of potassium in your blood. Do not use medicines, supplements, or salt substitutes that contain potassium unless you have discussed this with your doctor.

Using this medicine together with other diabetes medicine (eg, pioglitazone, rosiglitazone, Actos®, Actoplus Met®, Avandia®) may cause serious heart problems or edema (fluid retention). Check with your doctor immediately if you are rapidly gaining weight, having chest pain or discomfort, extreme tiredness or weakness, trouble breathing, uneven heartbeat, or excessive swelling of the hands, wrist, ankles, or feet.

What Are Reasons I Shouldn't Take Apidra?

Apidra is not or may not be the best option if you:

  • Have advanced liver or kidney disease: These conditions may make you more likely to experience hypoglycemia.
  • Become pregnant: Tell your healthcare provider if you are pregnant or plan to become pregnant so they can determine whether Apidra is the best option for you.

What Other Medications Interact With Apidra?

When starting any new medication, always make sure that your healthcare providers (including your pharmacist) are aware of your full medication list so that they can identify any potential interactions and make adjustments if necessary.

The following drugs have the ability to lower your blood sugar or hide symptoms of low blood sugar, so you’ll want to look out for signs of hypoglycemia:

The following drugs may reduce how well Apidra works, causing a risk of increased blood sugar:

Your healthcare provider may increase your dose of Apidra if you take any of these medications for a long period.

What Medications Are Similar?

Other rapid-acting insulins that begin working in 15 minutes and last for two to four hours include Admelog and Humalog (insulin lispro), and Fiasp and NovoLog (insulin aspart).

Short-acting insulins that begin to work within 30 minutes and last for three to six hours include Humulin R and Novolin R (insulin human regular).

These are not other drugs recommended to take with Apidra. Discuss any questions or concerns about these medications with a pharmacist or healthcare provider.

Frequently Asked Questions

  • What is Apidra used for?

    Apidra is used to treat diabetes by controlling high blood sugar levels. It comes in vials or prefilled pens. Apidra is a rapid-acting insulin, most often taken before each meal.

  • How does Apidra work?

    Insulin works by helping the cells in your body take in glucose (sugar) from the blood, lowering blood glucose levels.

  • What are the side effects of Apidra?

    The most important side effect to be aware of when using Apidra is hypoglycemia (low blood sugar). Watch for symptoms such as shakiness, sweating, or fast heart rate.

  • How long does it take for Apidra to work?

    Apidra begins working within 15 minutes of injecting it, and lasts for two to four hours.

How Can I Stay Healthy While Taking Apidra?

Getting diagnosed with diabetes can be overwhelming. However, know that it is a common condition and there are many available resources to help you learn how to manage and cope with it. Lifestyle changes, like a healthy diet and physical activity, will make a big difference in controlling your blood sugar. Blood sugar control is essential to prevent diabetes-related complications.

While there is no cure for type 1 diabetes, new research is ongoing, and numerous devices and technologies have made it easier to manage the condition. For example, continuous glucose monitoring devices allow you to track your blood sugar levels without having to do a finger stick each time.

Communicating with your healthcare providers is important for gaining a better understanding of how to manage your diabetes. A certified diabetes care and education specialist can help you improve self-management by providing diabetes education, treatment management, and support. You can also find support groups to connect with other people with diabetes. All this and more can empower you to take control of your diabetes and improve your overall quality of life with the condition.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Apidra label.

  2. DiMeglio LA, Evans-Molina C, Oram RA. Type 1 diabetes. Lancet. 2018;391(10138):2449-2462. doi:10.1016/S0140-6736(18)31320-5

  3. Centers for Disease Control and Prevention. How to treat lower blood sugar (hypoglycemia).

  4. Erratum: Blum AK. Insulin use in pregnancy: an update. Diabetes Spectrum. 2016;29:92-97 (DOI:10.2337/diaspect.29.2.92). doi:10.2337/diaspect.29.3.191

By Sara Hoffman, PharmD
Sara is a clinical pharmacist that believes everyone should understand their medications, and aims to achieve this through her writing.