Classes
DEA Class; Rx
Common Brand Names; NovoLog, NovoLog FlexPen, NovoPen Echo, NovoLog FlexTouch, Fiasp
- Antidiabetics, Insulins;
- Antidiabetics, Rapid-Acting Insulins
Description
Rapid-acting insulin analog; quicker onset/shorter duration of action than regular insulin
Used in adult and pediatric patients with type 1 and 2 diabetes mellitus; often used as prandial insulin
Faster-acting insulin aspart (Fiasp) has a different onset of action and timing of administration with respect to meals
Indications
Indicated for the treatment of type 1 diabetes mellitus, Improvement of glycemic control in adults and children with diabetes mellitus.
Contraindications
During episodes of hypoglycemia
Documented hypersensitivity
Adverse Effects
Nasopharyngitis, postmeal Fiasp with insulin detemir (23.9%)
Nasopharyngitis, mealtime Fiasp with insulin detemir (20.2%)
Fiasp with insulin glargine
Urinary tract infection (5.9%)
Severe hypoglycemia (3.2%)
Mealtime Fiasp with insulin detemir
Upper respiratory tract infection (9.1%)
Severe hypoglycemia (6.7%)
Diarrhea (5.4%)
Back pain (5.2%)
Nausea (4.9%)
Post meal Fiasp with insulin detemir
Severe hypoglycemia (8%)
Upper respiratory tract infection (7.4%)
Diarrhea (5%)
Back pain (4%)
Nausea (3.2%)
Novolog
Hypoglycemia
Lipodystrophy
Lipohypertrophy
Local allergic reaction
Hypokalemia
Paresthesia
Itching
Tremor
Hunger
Nausea
Urticaria
Redness
Diaphoresis
Hypothermia
Mental confusion
Fiasp with insulin aspart
Hyperglycemia (with repeated injections into areas of cutaneous amyloidosis)
Hypoglycemia (with sudden change to unaffected injection site)
Warnings
Decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, and hepatic impairment; monitor therapy closely
Increased insulin requirements: Fever, hyperthyroidism, trauma, infection, and surgery
Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia; these changes should be made cautiously and only under close medical supervision, and the frequency of blood glucose monitoring should be increased.
All insulin products can cause a shift in potassium from the extracellular to intracellular space, possibly leading to hypokalemia; untreated hypokalemia may cause respiratory paralysis, ventricular arrhythmia and death; monitor potassium levels in patients at risk for hypokalemia if indicated (eg, patients using potassium-lowering medications, patients taking medications sensitive to potassium concentrations)
Thiazolidinediones are peroxisome proliferator-activated receptor (PPAR)-gamma agonists and can cause dose-related fluid retention, particularly when used in combination with insulin; fluid retention may lead to or exacerbate heart failure; monitor for signs and symptoms of heart failure, treat accordingly, and consider discontinuing thiazolidinediones
Never share pen between patients even if needle is changed; patients using vials must never share needles or syringes with another person
To avoid accidental mix-ups between insulin products, instruct patients to always check insulin label before each injection
If hypersensitivity reactions occur, discontinue therapy; treat per standard of care and monitor until symptoms and signs resolve
Pregnancy and Lactation
Available information from published randomized controlled trials during second trimester of pregnancy have not reported association with insulin aspart and major birth defects or adverse maternal or fetal outcomes
There are no data on presence of insulin in human milk, effects on breastfed infant, or on milk production
Maximum Dosage
Specific maximum dosage information is not available. Individualize dosage based on careful monitoring of blood glucose and other clinical parameters in all patient populations.
How supplied
Insulin Aspart rDNA Origin
injectable solution
- 100 units/mL (NovoLog, Fiasp)
prefilled syringe
- 100units/mL (3mL NovoLog FlexPen, NovoLog FlexTouch, Fiasp FlexTouch)