Do not administer by IV or IM. Do not use in insulin infusion pumps. Do not draw from the cartridge of the pre-filled pen into a syringe. Always rotate inj sites w/in the same region to reduce risk of lipodystrophy & cutaneous amyloidosis. Blood glucose monitoring is recommended after change in the inj site from an affected area (inj site w/ lipodystrophy, cutaneous amyloidosis) to an unaffected area, & dose adjustment of antidiabetic medications may be considered. Risk of hypoglycaemia w/ excessive insulin dose, omitted meal, or unplanned, strenuous physical exercise. Change in usual warning symptoms of hypoglycaemia in patients w/ greatly improved blood glucose control (eg, by intensified insulin therapy); disappearance of usual warning symptoms in patients w/ longstanding diabetes. Dose adjustment may be necessary if patients undertake increased physical activity, change their usual diet, or during concomitant illness (especially infections & fever; concomitant diseases in the kidney, liver or affecting the adrenal, pituitary or thyroid gland). Prolonged effect of Tresiba may delay recovery from hypoglycaemia. Risk of hyperglycaemia & diabetic ketoacidosis w/ inadequate dosing or treatment discontinuation. Close glucose monitoring is recommended when transferring from other insulin medicinal products & in the following wk. Reports of cardiac failure when used in combination w/ thiazolidinediones, especially in patients w/ risk factors for development of cardiac heart failure. Intensification of insulin therapy w/ abrupt improvement in glycaemic control may be associated w/ temporary worsening of diabetic retinopathy. Insulin Ab formation. May impair ability to drive or use machine. Pregnancy & lactation. Intensify glucose monitoring & adjust insulin dose on an individual basis in patients w/ renal or hepatic impairment, & the elderly.
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