Insulin Aspart

NovoLog FlexPens

NovoLog FlexPen is a rapid-acting insulin approved by the FDA for managing blood sugar levels in adults and children with diabetes mellitus. It is available in a convenient prefilled pen form and is typically used before meals to control blood sugar spikes. The dosage of this medication may vary based on individual needs and is adjusted based on blood sugar monitoring. Patients must practice care while taking NovoLog FlexPen due to its potential side effects like hypoglycemia and skin reactions at the injection site. It is essential to follow safety guidelines, including proper storage and not sharing pens, to ensure effective and safe use of NovoLog FlexPen.

Product Overview

NovoLog FlexPen contains aspart, a rapid-acting insulin used to control blood sugar levels in adults and children with diabetes mellitus. This medication is essential for patients with type 1 or type 2 diabetes, as it aids in managing blood sugar levels effectively, which is crucial for preventing complications associated with the condition. Insulin aspart mimics the body’s natural insulin, helping glucose enter cells for energy and maintaining balanced blood sugar levels.

The NovoLog FlexPen is available in a strength of 100 units/mL and comes in prefilled syringes for easy administration. It is typically injected subcutaneously before meals, with dosages adjusted based on individual needs and blood sugar monitoring. The FlexPen is suitable for adults and children with diabetes and offers a convenient and precise way to administer insulin aspart, which starts working quickly to manage post-meal blood sugar spikes.

Common side effects of NovoLog FlexPen include hypoglycemia, increased weight, and reactions at the injection site. Patients are advised to follow their healthcare provider’s instructions for use, monitor for signs of low blood sugar, and store the pen properly. It’s important to have a missed dose plan and be aware of the signs of an overdose. The NovoLog FlexPen is FDA-approved, ensuring its safety and efficacy for managing diabetes when used as directed.

Uses of NovoLog FlexPens

• Helpful in controlling blood sugar levels in adults and children with diabetes mellitus.

How to Use NovoLog FlexPens?

Dosage

Form 1: Injectable Solution

Strengths: 100 units/mL (Available as NovoLog and Fiasp)

Form 2: Prefilled Syringe

Strengths: 100 units/mL (Available in 3mL as NovoLog FlexPen, Fiasp FlexTouch, NovoLog FlexTouch)

Recommended Dosage for Different Patients

For Type 1 Diabetes Patients:

• For improving blood sugar levels in adults and children with type 1 diabetes, the recommended dose is between 0.2 and 0.6 units/kg per day, divided into multiple doses. To mitigate the chances of low blood sugar (hypoglycemia), starting doses are often between 0.2 to 0.4 units/kg per day.
• The daily insulin requirement varies, typically between 0.5 to 1 unit/kg daily. Non-obese individuals may need 0.4 to 0.6 units/kg per day, while obese individuals may need 0.6 to 1.2 units/kg per day.

For Type 2 Diabetes Patients:

• For those with type 2 diabetes not well-controlled by diet, exercise, weight reduction, or oral medications, the recommended starting dose is 10 units per day subcutaneously (under the skin) or 0.1 to 0.2 units/kg per day. This can be given in the evening or divided every 12 hours using an intermediate (e.g., NPH) or long-acting insulin at bedtime. Alternatively, regular or rapid-acting insulin (like aspart insulin) can be taken before meals.

Dosing Considerations:

• In a meal-related insulin injection regimen, 50-75% of the total insulin needed may come from intermediate-acting or long-acting insulin. The rest is given as rapid-acting insulin, like insulin aspart, before or during meals.
• Insulin aspart has a quick start and short duration of action, so some patients might need more basal insulin and total insulin to prevent high blood sugar before meals compared to regular human insulin.
• Dosage must be tailored to each individual, and monitoring blood and urine sugar levels is crucial for all patients on insulin therapy.
• Insulin needs may change during stress, illness, exercise, meal patterns, or when taking other medications.

Fiasp Specific:

• If you’re changing from another mealtime insulin to Fiasp, the change can be made on a one-for-one basis.

Dosage Modifications:

• Patients with liver or kidney problems may have a potentially higher risk of low blood sugar (hypoglycemia) and may need more frequent dosage adjustments and blood sugar monitoring.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they will customize your dosage accordingly.]

How to Take It?

Using the NovoLog FlexPen involves several steps to ensure insulin’s safe and effective administration. Here’s a simplified guide:

Prepare the Pen:

• If your FlexPen is refrigerated, take it out 1-2 hours prior to using the medication to allow it to reach room temperature.
• Check the label for the correct insulin type and expiration date.
• Remove the pen cap and inspect the insulin. It should be clear and free of particles.

Attach the Needle:

• Wipe the pen tip with an alcohol pad.
• Remove the seal from the cap of the needle and attach the needle to the pen tip by twisting or pushing, depending on the needle type.

Perform a Safety Test:

• Select a 2-unit dose and press the button to ensure insulin comes from the needle. Repeat if necessary, changing the needle if insulin does not come out after three tries.

Select the Dose:

• Turn the dose counter to the number of units you need. Do not push the button while setting your dose.

Inject the Insulin:

• Clean the injection site first. You can use an alcohol swab for cleaning purposes and let it dry.
• Insert the needle thoroughly and gently into the skin while pressing the button to deliver the dose.
• Hold the button and count slowly to 10 before removing the needle.

After Injection:

• Do not rub the injection site.
• Put the outer needle cap back on and use it to remove the needle from the pen.
• Dispose of the used needle safely in a sharps disposal container.

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does NovoLog FlexPen Work?

NovoLog FlexPen is an instantly-acting insulin injection. It is prescribed to effectively control blood sugar levels in people who have diabetes mellitus. It functions by mimicking the action of natural insulin (a hormone secreted by the pancreas that helps regulate blood sugar levels.) NovoLog FlexPen starts working quickly after injection, usually within 15 minutes, peaks in approx 1 to 3 hours, and stays for 3 to 5 hours. This rapid action helps manage blood sugar spikes after meals, ensuring that glucose is efficiently absorbed by the body’s cells for energy.

Important Safety Information

Side Effects

Common side effects may include:

• Low blood sugar (hypoglycemia)
• Weight gain
• Low potassium levels
• Swelling in your hands and feet
• Skin reactions at the injection site
• Thickened or hollowed skin at the injection site

Adverse/Serious side effects may include:

• Anxiety
• Confusion
• Drowsiness
• Bladder pain
• Headache
• Depression
• Blurred vision
• Cold sweats
• Nightmares
• Seizures
• Fast heartbeat
• Shakiness
• Slurred speech
• Restless sleep
• Difficulty with thinking
• Bloody or cloudy urine
• Excessive hunger
• Frequent urge to urinate
• Irritability or abnormal behavior
• Lower back or side pain
• Dizziness or lightheadedness
• Behavior changes similar to being drunk
• Tingling sensation in the hands, feet, lips, or tongue

[Note: Remember, this list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings

• Hypoglycemia Risk: NovoLog is a fast-acting insulin that can cause low blood sugar (hypoglycemia). It’s crucial to eat a meal within 5 to 10 minutes after using it to avoid hypoglycemia.
• Sharing Devices: Do not share your injection pen, cartridge, or syringe with others, even with a new needle, to avoid the risk of transmitting infections.
• Allergy: Do not use NovoLog FlexPen if you are allergic to insulin aspart or any of the inactive ingredients in the product.
• Heart Problems and Potassium Levels: Call your doctor immediately if you notice symptoms of heart issues, such as swelling, rapid weight gain, or feeling shortness of breath, or you notice any of the low potassium symptoms, like muscle weakness, leg cramps, constipation, irregular heartbeats, increased thirst or urination, numbness or tingling, or a limp feeling.
• Pregnancy and Breastfeeding: If you are pregnant or planning to conceive or are breastfeeding, follow your doctor’s instructions about using insulin. Managing diabetes is crucial during pregnancy, as having high blood sugar may result in complications in both the mother and the baby.

Precautions

• Check the Insulin: Before using, check the insulin visually for particles or discoloration. If either is present, do not use the insulin.
• Injection Site: Clean the injection site with rubbing alcohol before each dose. Keep switching the injection sites to lessen the risk of skin changes such as pits, lumps, or thickened skin.
• Timing of Injection: Inject NovoLog FlexPen under the skin as your doctor directs, usually 5 to 10 minutes before meals. Do not inject into a vein or muscle as it may cause very low blood sugar (hypoglycemia).
• Do Not Use if Hypoglycemic: Do not use NovoLog FlexPen if you cannot eat right after the injection or have low blood sugar.
• Storage: The insulin container you use can be kept at room temperature.
• Hypokalemia: Use caution in patients predisposed to low potassium levels (hypokalemia).
• Renal or Hepatic Impairment: NovoLog requirements may decrease in renal or hepatic impairment patients.
• Allergy: Do not use NovoLog if you are allergic to insulin aspart or any of its ingredients.
• Age Limit: NovoLog FlexPen is not approved for anyone younger than 2 years old.
• Other Medications: Inform your doctor if you also take pioglitazone or rosiglitazone, mainly if contained in combinations with glimepiride or metformin. It has been reported that certain oral diabetes medicines may increase your risk of severe heart problems if you take them while taking insulin medications.

NovoLog FlexPens Contraindications

• During Hypoglycemia: Do not use it if you are experiencing an episode of low blood sugar (hypoglycemia).
• Hypersensitivity: Do not use it if you have a known hypersensitivity to NovoLog or any of its excipients.

Missed Dose

• If you miss a dose of NovoLog FlexPen before eating, you can take your dose during the meal.
• If you’ve finished your meal, check your blood sugar level to determine whether you need to take insulin at that time. 
• Since NovoLog is to be taken prior to having meals, as of now, you may not be on a timed dosing schedule. 
• Avoid using extra insulin to make up for a missed dose. 
• Always have insulin on hand and get your prescribed pen refilled before you run out of medicine entirely.

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

An overdose of NovoLog FlexPen can result in life-threatening hypoglycemia. Signs that you may have overdosed on this medication include:

• Drowsiness
• Blurred vision
• Confusion
• Trouble speaking
• Muscle weakness
• Seizures (convulsions)
• Clumsy or jerky movements
• Loss of consciousness
• Numbness or tingling in your mouth

[Note: If you consumed more than the recommended dose, get medical help right away or call the Poison Help line at 1-800-222-1222.]

Storage

• Store unused NovoLog FlexPens in the refrigerator between 36°F to 46°F.
• Do not freeze them; keep them away from direct heat and light.

• Once in use, you can keep the FlexPen at an average temperature below 86°F (30°C).
• Use within 28 days.
• Store the pen with the cap on to protect it from light.
• Do not store the NovoLog pen with the needle attached to it.
• Keep it in a cool, dry place, away from children and pets.

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

NovoLog FlexPens Interactions

• Beta-Blockers: (like propranolol, metoprolol) – May mask symptoms of hypoglycemia.
• Thiazolidinediones: (like pioglitazone, rosiglitazone) – May increase the risk of heart failure when used with insulin.
• Angiotensin-Converting Enzyme (ACE) Inhibitors: (like lisinopril, enalapril) – May enhance the blood-glucose-lowering effect of insulin.
• Diuretics: (like furosemide, hydrochlorothiazide) – May affect blood glucose levels.
• Corticosteroids: (like prednisone) – May decrease the effectiveness of insulin.
• Alcohol: It may unpredictably enhance or weaken the blood-glucose-lowering effect of insulin.
• Monoamine Oxidase Inhibitors (MAOIs): (like phenelzine, tranylcypromine) – May enhance the hypoglycemic effect of insulin.
• Sulfonylureas: (like glipizide, glyburide) – Used together with insulin may increase the risk of hypoglycemia.
• Salicylates: (like aspirin) – May increase the blood-glucose-lowering effect of insulin.

[Note: This isn’t a complete list, and there could be other drugs that interact with NovoLog FlexPen. Make sure to tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

NovoLog FlexPens Alternatives

• Humalog (insulin lispro)
• Fiasp (insulin aspart)
• Apidra (insulin glulisine)
• Admelog (insulin lispro)
• Insulin Regular (human regular insulin)
• Insulin NPH (human isophane insulin)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

How long does the effect of NovoLog (insulin aspart) last?

The ability of NovoLog (insulin aspart) to lower blood sugar typically lasts between 2 to 4 hours after a dose. For this reason, it’s usually necessary to take the medication multiple times a day, generally with each meal.

Do I need a dosage calculator for NovoLog?

The necessity of using a dosage calculator for NovoLog depends on your type of diabetes. For individuals with type 1 diabetes, a dosage calculator is often required before meals to determine the appropriate dose based on pre-meal blood sugar levels and carbohydrate intake. Your healthcare professional will teach you the right way to calculate your dosage. However, for those with type 2 diabetes, a dosage calculator is usually not needed, as your doctor will prescribe a specific dosage tailored to your needs.

What precautions should I take while using NovoLog FlexPen?

• Be cautious of low blood sugar levels. Avoid using any heavy machinery until you understand how NovoLog FlexPen impacts you.
• To prevent medication errors, always verify the label on the insulin before each injection.
• Limit your alcohol consumption and avoid medications containing alcohol, as they can cause low blood sugar and disrupt your diabetes management.

How long can I use NovoLog (insulin aspart) after opening?

NovoLog (insulin aspart) remains typically effective for 28 days after opening. It’s advisable to note the expiration date, 28 days from the first use of a vial or pen. Do not use NovoLog (insulin aspart) beyond this date, even if medication remains in use. If you have further questions about the shelf life of this medication after opening, consult your healthcare provider or pharmacist.

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