Generic Name: Novolog Brand Name(s): Generics only. No brands available.

Uses

What is Novolog® (insulin aspart) used for?

Novolog® is a fast-acting insulin that starts to work about 15 minutes after injection, peaks in about 1 hour, and keeps working for 2 to 4 hours. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood.

Novolog® is used to improve blood sugar control in adults and children with diabetes mellitus. This medicine is sometimes used together with a long-acting or intermediate-acting insulin.

Novolog® is used to treat type 2 diabetes in adults. Novolog® is also used to treat type 1 diabetes in adults and children who are at least 2 years old.

How should I take Novolog® (insulin aspart)?

Use Novolog® exactly as it was prescribed for you. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Novolog® is injected under the skin, or into a vein through an IV. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of needles, IV tubing, and other items used.

Your care provider will show you the best places on your body to inject Novolog®. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

After using Novolog®, you should eat a meal within 5 to 10 minutes.

If you use an injection pen, use only the injection pen that comes with Novolog®. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe or infusion pump.

If you use this medicine with an insulin pump, do not mix or dilute Novolog® with any other insulin. Infusion pump tubing, catheters, and the needle location on your skin should be changed every 3 days. Change the medicine in the reservoir every 6 days.

Never share an injection pen, cartridge, or syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

Use a disposable needle or syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof “sharps” disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.

Novolog® is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor’s instructions very closely.

How do I store Novolog® (insulin aspart)?

Keep this medicine in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) Novolog®:

  • Refrigerate and use until expiration date.
  • Store at room temperature and use within 28 days.

Storing opened (in use) Novolog®:

  • Store the vial in a refrigerator or at room temperature and use within 28 days.
  • Store the cartridge or injection pen at room temperature (do not refrigerate) and use within 28 days. Do not store the injection pen with a needle attached.

Precautions & warnings

What should I know before using Novolog® (insulin aspart)?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of Novolog® or other medications.
  • You have any other illnesses, disorders, or medical conditions.

You should not use Novolog® if you are having an episode of hypoglycemia (low blood sugar).

Novolog® is not approved for use by anyone younger than 2 years old. This medicine should not be used to treat type 2 diabetes in a child of any age.

To make sure Novolog® is safe for you, tell your doctor if you have:

  • Liver or kidney disease
  • Low levels of potassium in your blood (hypokalemia)

Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while you are using insulin may increase your risk of serious heart problems.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using Novolog® during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Novolog®. Novolog® is pregnancy risk category B, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from Novolog® (insulin aspart)?

Get emergency medical help if you have signs of an allergic reaction to Novolog®: redness or swelling where an injection was given, itchy skin rash over the entire body, trouble breathing, fast heartbeats, feeling like you might pass out, or swelling in your tongue or throat.

Call your doctor at once if you have:

  • Fluid retention–weight gain, swelling in your hands or feet, feeling short of breath
  • Low potassium–leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling

Common side effects may include:

  • Low blood sugar
  • Itching, mild skin rash
  • Thickening or hollowing of the skin where you injected the medicine

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Novolog® (insulin aspart)?

Novolog® may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Novolog® (insulin aspart)?

Novolog® may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Novolog® (insulin aspart)?

Novolog® may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Novolog® (insulin aspart).

What is the dose of Novolog® (insulin aspart) for an adult?

Usual Adult Dose for Diabetes Type 1

Individualize dose based on metabolic needs and frequent monitoring of blood glucose

  • Total daily insulin requirements are generally between 0.5 to 1 unit/kg/day; 50% to 70% of total daily requirements are generally provided by prandial insulin with the remainder provided by intermediate-acting or long-acting basal insulin.
  • Use HbA1c values to guide therapy; consult current guidelines for optimal target ranges.

Multiple-daily injection (MDI):

  • Administer subcutaneously immediately before a meal (within 5 to 10 minutes) or soon after the start of a meal.
  • Match prandial insulin dose to carbohydrate intake, pre-meal blood glucose, and anticipated activity.
  • Use in combination with an intermediate-acting or long-acting basal insulin

Continuous Subcutaneous Infusion (Insulin Pump)

  • Initial programming should be based on the total daily insulin dose of previous MDI regimen; check with pump labeling to ensure the pump has been evaluated with this insulin
  • While there is significant interpatient variability, approximately 50% of the total dose is provided as meal-related boluses and the remainder as a basal infusion

Intravenous Administration

  • Dilute to a concentration of 0.05 to 1 unit/mL in normal saline in an infusion system using polypropylene infusion bags; closely monitor blood glucose and serum potassium during administration

Usual Adult Dose for Diabetes Type 2

Individualize dose based on metabolic needs and frequent monitoring of blood glucose

  • Use HbA1c values to guide therapy; consult current guidelines for optimal target ranges.

Prandial Insulin:

  • Administer subcutaneously immediately before a meal (within 5 to 10 minutes) or soon after the start of a meal
  • Use in combination with an intermediate-acting or long-acting basal insulin and/or with other anti-diabetic agents.

Continuous Subcutaneous Infusion (Insulin Pump)

  • Initial programming should be based on the total daily insulin dose of previous MDI regimen; check with pump labeling to ensure the pump has been evaluated with this insulin
  • While there is significant interpatient variability, approximately 50% of the total dose is provided as meal-related boluses and the remainder as a basal infusion

Intravenous Administration

  • Dilute to a concentration of 0.05 to 1 unit/mL in normal saline in an infusion system using polypropylene infusion bags; closely monitor blood glucose and serum potassium during administration

Usual Adult Dose for Diabetic Ketoacidosis

Successful treatment of hyperglycemic emergencies such as diabetic ketoacidosis (DKA) and hyperosmolar state (HHS) requires frequent monitoring of clinical and laboratory parameters while carefully correcting volume deficits, managing electrolytes, and normalizing blood glucose. Insulin therapy is used to slowly correct high glucose levels; consult current treatment protocols for specific guidance on fluid and electrolyte management.

Intravenous:

  • IV insulin infusion is generally started 1 to 2 hours after initiating fluid replacement therapy
  • Dose: 0.14 unit/kg/hour IV; alternatively, a bolus of 0.1 unit/kg followed by an infusion of 0.1 unit/kg/hr has been used
  • If blood glucose has not fallen by 10% in first hour, give bolus of 0.14 units/kg while continuing insulin infusion.

DKA: When blood glucose concentration reaches 200 mg/dL, decrease the insulin infusion to 0.02 to 0.05 unit/kg/hr; dextrose should be added to the IV fluids to maintain a blood glucose between 150 and 200 mg/dL until resolution of DKA (serum bicarbonate level 15 mEq/L or greater, venous pH greater than 7.3, and a calculated anion gap in the normal range)

HHS: When blood glucose concentration reaches 300 mg/dL or less, decrease the insulin infusion to 0.02 to 0.05 unit/kg/hr; dextrose should be added to the IV fluids to maintain blood glucose between 250 and 300 mg/dL until resolution of HHS.

Subcutaneous:

Rapid acting insulin analogs (lispro, aspart, and glulisine) have been used in studies for the treatment of uncomplicated mild to moderate DKA. The following regimens have been used:

  • Initial dose of 0.2 unit/kg followed by 0.1 unit/kg every hour subcutaneously until blood glucose decreased below 250 mg/dL, then 0.05 unit/kg every hour until DKA resolved
  • Initial dose of 0.3 units/kg followed by 0.2 unit/kg every 2 hours until blood glucose decreased below 250 mg/dL, then 0.1 unit/kg every 2 hours until DKA resolved

Usual Adult Dose for Nonketotic Hyperosmolar Syndrome

Successful treatment of hyperglycemic emergencies such as diabetic ketoacidosis (DKA) and hyperosmolar state (HHS) requires frequent monitoring of clinical and laboratory parameters while carefully correcting volume deficits, managing electrolytes, and normalizing blood glucose. Insulin therapy is used to slowly correct high glucose levels; consult current treatment protocols for specific guidance on fluid and electrolyte management.

Intravenous:

  • IV insulin infusion is generally started 1 to 2 hours after initiating fluid replacement therapy
  • Dose: 0.14 unit/kg/hour IV; alternatively, a bolus of 0.1 unit/kg followed by an infusion of 0.1 unit/kg/hr has been used
  • If blood glucose has not fallen by 10% in first hour, give bolus of 0.14 units/kg while continuing insulin infusion.

DKA: When blood glucose concentration reaches 200 mg/dL, decrease the insulin infusion to 0.02 to 0.05 unit/kg/hr; dextrose should be added to the IV fluids to maintain a blood glucose between 150 and 200 mg/dL until resolution of DKA (serum bicarbonate level 15 mEq/L or greater, venous pH greater than 7.3, and a calculated anion gap in the normal range)

HHS: When blood glucose concentration reaches 300 mg/dL or less, decrease the insulin infusion to 0.02 to 0.05 unit/kg/hr; dextrose should be added to the IV fluids to maintain blood glucose between 250 and 300 mg/dL until resolution of HHS.

Subcutaneous:

Rapid acting insulin analogs (lispro, aspart, and glulisine) have been used in studies for the treatment of uncomplicated mild to moderate DKA. The following regimens have been used:

  • Initial dose of 0.2 unit/kg followed by 0.1 unit/kg every hour subcutaneously until blood glucose decreased below 250 mg/dL, then 0.05 unit/kg every hour until DKA resolved
  • Initial dose of 0.3 units/kg followed by 0.2 unit/kg every 2 hours until blood glucose decreased below 250 mg/dL, then 0.1 unit/kg every 2 hours until DKA resolved

What is the dose of Novolog® (insulin aspart) for a child?

Usual Pediatric Dose for Diabetes Type 1

2 years and older: Individualize dose based on metabolic needs and frequent monitoring of blood glucose.

Use HbA1c values to guide therapy; consult current guidelines for optimal target ranges.

Multiple-daily injection (MDI):

  • Administer subcutaneously immediately before a meal (within 5 to 10 minutes) or soon after the start of a meal
  • Match prandial insulin dose to carbohydrate intake, pre-meal blood glucose, and anticipated activity
  • Use in combination with an intermediate-acting or long-acting basal insulin

Continuous Subcutaneous Infusion (Insulin Pump)

  • Initial programming should be based on the total daily insulin dose of previous MDI regimen; check with pump labeling to ensure the pump has been evaluated with this insulin.
  • While there is significant interpatient variability, approximately 50% of the total dose is provided as meal-related boluses and the remainder as a basal infusion.

Intravenous Administration

  • Dilute to a concentration of 0.05 to 1 unit/mL in normal saline in an infusion system using polypropylene infusion bags; closely monitor blood glucose and serum potassium during administration.

How is Novolog® (insulin aspart) available?

Novolog® is available in the following dosage forms and strengths:

  • Injection

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Novolog®, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: September 7, 2017 | Last Modified: September 7, 2017

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