Insulin Aspart

What Is Insulin aspart?

Insulin aspart (NOVOLOG) is rapid acting human insulin analog indicated to improve glycemic control in adults and pediatric patients with diabetes mellitus.

What are the uses of this medicine?

• Insulin aspart is a rapid-acting, human insulin analog that is FDA approved for the treatment of type-1 and type-2 diabetes mellitus to improve glycemic control in adults and children.

How does this medicine work?

• Insulin aspart regulates the metabolism of glucose.
• It promotes the storage and inhibits the breakdown of glucose, fat, and amino acids.
• Insulin lowers blood glucose by increasing peripheral glucose uptake, particularly in the skeletal muscle and fat.
• Insulin aspart also inhibits gluconeogenesis (hepatic glucose production), lipolysis (breakdown of fat/lipids to fatty acids), and proteolysis (breakdown of proteins into amino acids).
• Maximum glucose lowering effects are seen within 1 to 2 hours and endure for 3 to 5 hours.
• Insulin aspart is equipotent to regular insulin with a faster onset and shorter duration of action.
• Thus insulin aspart is preferred for mealtime insulin coverage as it can be administered up to every 4 hours.

How is this medicine manufactured?

• Endogenous insulin is naturally produced by the pancreas.
• Insulin apart is manufactured through recombinant DNA technology using Saccharomyces cerevisiae expression system.

Who Should Not Use this medicine ?

This medicine cannot be used in following condition:

• During episodes of hypoglycemia
• In patients with hypersensitivity to NOVOLOG or one of its excipients,

Is this medicine FDA approved?

• Insulin aspart was approved for medical use in the United States in 2000.
• In 2018, it was the 65th most commonly prescribed medication in the United States, with more than 12 million prescriptions.

How should this medicine be used?

Subcutaneous injection

• Inject subcutaneously within 5-10 minutes before a meal into the abdominal area, thigh, buttocks or upper arm.
• Rotate injection sites within the same region from one injection to the next to reduce risk of lipodystrophy and localized cutaneous amyloidosis.
• Should generally be used in regimens with an intermediate- or long-acting insulin.

Continuous Subcutaneous Infusion (Insulin Pump)

• Administer by continuous subcutaneous infusion using an insulin pump in a region recommended in the instructions from the pump manufacturer.
• Rotate the injection sites within the same region from one injection to the next to reduce the risk of lipodystrophy and localized cutaneous amyloidosis.

Intravenous Administration

• Dilute NOVOLOG to concentrations from 0.05 unit/mL to 1 unit/mL insulin aspart in infusion systems using polypropylene infusion bags.
• NOVOLOG is stable in infusion fluids such as 0.9% Sodium Chloride Injection, USP.

What are the dosage forms and brand names of this medicine?

This medicine is available in fallowing dosage forms:

• 10 mL multiple-dose vial
• 3 mL single-patient-use PenFill® cartridges for the 3 mL PenFill cartridge device
• 3 mL single-patient-use NOVOLOG FlexPen®
• 3 mL single-patient-use NOVOLOG FlexTouch

This medicine is available in fallowing brand names:

• Fiasp®
• NovoLog®
• NovoLog® Mix 70/30

What side effects can this medication cause?

Common possible side effects of this medicine include:

• hypoglycemia
• allergic reactions
• local injection site reactions
• lipodystrophy
• rash
• pruritus

What special precautions should I follow?

• Never share a NOVOLOG FlexPen or a NOVOLOG FlexTouch, PenFill cartridge or PenFill cartridge device between patients, even if the needle is changed.
• Increase frequency of glucose monitoring with changes to: insulin dosage, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with renal or hepatic impairments and hypoglycemia unawareness.
• Instruct patients to check insulin labels before injection .
• Discontinue NOVOLOG, treat, and monitor, if hypersensitivity reactions are indicated
• Monitor potassium levels in patients at risk of hypokalemia and treat if indicated
• Observe for signs and symptoms of heart failure; consider dosage reduction or discontinuation if heart failure occurs
• Monitor glucose and administer NOVOLOG by subcutaneous injection if pump malfunction occurs

What to do in case of emergency/overdose?

• Excess insulin administration may cause hypoglycemia and hypokalemia.
• Mild episodes of hypoglycemia usually can be treated with oral glucose.
• Adjustments in drug dosage, meal patterns, or exercise may be needed.

• More severe episodes with coma, seizure, or neurologic impairment may be treated with intramuscular/subcutaneous glucagon or concentrated intravenous glucose.
• Sustained carbohydrate intake and observation may be necessary because hypoglycemia may recur after apparent clinical recovery.
• Hypokalemia must be corrected appropriately.

Can this medicine be used in pregnancy?

• With insulin aspart use during the second trimester of pregnancy have not reported any adverse maternal or fetal outcomes .
• There are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy.

Can this medicine be used in children?

• The safety and effectiveness of NOVOLOG to improve glycemic control have been established in pediatric patients.

What should I know about storage and disposal of this medication?

• Dispense in the original sealed carton with the enclosed Instructions for Use.
• Unused NOVOLOG should be stored in a refrigerator between 2°C and 8°C (36°F to 46°F).
• Do not freeze NOVOLOG and do not use NOVOLOG if it has been frozen.
• Do not expose NOVOLOG to excessive heat or light.
• NOVOLOG should not be drawn into a syringe and stored for later use.
• Always remove and discard the needle after each injection from the NOVOLOG FlexPen or NOVOLOG FlexTouch and store without a needle attached.
• Opened vials of insulin aspart solution (Fiasp, Novolog) can be stored for 28 days at room temperature or in the refrigerator.
• If your doctor tells you to dilute your insulin aspart (Novolog), the vial of diluted medication can be stored for up to 28 days in the refrigerator or at room temperature.
• Opened insulin aspart solution (Novolog) cartridges and pens may be stored at room temperature for up to 28 days; do not refrigerate them.
• Opened pens containing NovoLog Mix 70/30 may be stored at room temperature for up to 14 days; do not refrigerate them. Opened insulin aspart solution (Fiasp) pens can be stored at room temperature or in the refrigerator for up to 28 days.
• Discard any insulin aspart product that has been exposed to extreme heat or cold.

• Dailymed label info on Insulin Aspart
• FDA Insulin Aspart

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