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NovoLog (insulin aspart)
What is NovoLog (insulin aspart)?
NovoLog is a rapid-acting insulin injection prescribed to improve blood sugar levels in patients with diabetes mellitus. NovoLog is prescribed to be used 5-10 minutes before a meal. Novolog will start working within 15 minutes of the injection, lasting for 2-4 hours.
NovoLog belongs to the drug class, antidiabetics, insulin. Insulin medications work by mimicking human insulin, which helps control blood sugar levels. When insulin made by the body decreases, blood sugar levels will rise to high levels. Very high blood sugar levels can be dangerous and life-threatening.
What are the Indications for NovoLog?
NovoLog is prescribed as part of a treatment plan to manage blood sugar levels consisting of exercise, diet changes, and regular blood sugar testing. Any change in diet and activity can affect blood sugar levels.
NovoLog is not recommended if you have or have had a severe allergic reaction to NovoLog or any ingredients in NovoLog
How is NovoLog used?
NovoLog should be used as prescribed by your doctor by injecting the medication under your skin through a needle and syringe, infusion pump, or injection pen.
NovoLog that has not been opened may be stored at room temperature up to 86°F (30°C) for up to 28 days or in the refrigerator between 36° to 46°F (2° to 8°C) indefinitely. NovoLog should not be stored in the freezer.
Once you’ve opened NovoLog, it must be used within 28 days. After 28 days, any opened remaining medication must be thrown away even if there is still some medication left.
NovoLog vial that has been opened and is currently in use may be stored at room temperature or be refrigerated for up to 28 days. If using the vial with an insulin pump, the vial may be used and stored for up to 19 days.
NovoLog FlexPen that has been opened and is currently in use should be stored at room temperature between under 86°F or 30°C. NovoLog should be kept away from direct light and heat. Do not refrigerate NovoLog FlexPen.
Follow the patient information pamphlet that comes with your medication. NovoLog needs to be injected under the skin of your stomach, thigh, buttocks, or upper arm. NovoLog should never be injected into a vein or muscle.
NovoLog should be injected 5-10 minutes before a meal. Novolog should only be prepared when you are ready to use it.
- Before injecting NovoLog, prepare the insulin. Change the injection needle if it was not changed from the last injection. Do not reuse needles.
- Select your injection site and clean with an alcohol swab. The injection site should be rotated so as not to be in the exact same location as the last injection.
- Do not inject in areas with scars, stretch marks, bruises, or where the skin is tender, hard, or red.
- Do not use the medication if it appears to be broken, cloudy, has clumps or debris in it, or if it has expired.
- Inject the medication as directed in the patient information pamphlet or as directed by your doctor.
- After the injection, dispose of the needle in an FDA-cleared sharps disposal container immediately. Do not reuse or share needles with other people. You can create a sharps disposable container by using any heavy-duty plastic household container that you have that:
- Is leak-resistant
- Has a tight-fitting, puncture-proof lid so sharps such as needles cannot escape
- Has a label warning there are hazardous materials inside the container
NovoLog is a clear, colorless solution that is available in one strength, 100 units/mL (U-100), and various 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
The dose for each person will vary and can change depending on several factors; weight, current blood sugar level, activity levels, and how well you respond to insulin.
It’s important to understand that although NovoLog is FDA approved, it comes with side effects that may or may not affect you.
Before starting NovoLog, you should discuss possible side effects with your doctor or pharmacist.
Common Side Effects
Not all side effects require medical attention. As your body adjusts to NovoLog, side effects may go away.
Tell your doctor if you experience the following symptoms, and they become severe or do not go away on their own:
- Weight gain
- Reaction at the injection site (e.g. itching, thickening of the skin)
- Swelling of hands and feet
- Skin rash or redness
Serious Side Effects
Severe adverse reactions while taking NovoLog can occur. Seek emergency medical care or call 911 if you experience any of the following symptoms:
- Severe allergic reaction: severe rash or itching, swelling in the face, lips, tongue, or throat, rapid heartbeat, fainting or dizziness, or problems breathing or swallowing.
- Low blood sugar: headache, irritability, confusion, blurred vision, slurred speech, dizziness or light-headedness, shakiness, fast heartbeat, mood change, anxiety, or excessive hunger.
- Low potassium: constipation, fluttering in the chest or irregular heartbeats, leg cramps, increased thirst or need to urinate, muscle weakness or unusual tiredness, or tingling sensation.
- Heart problems: weight gain, shortness of breath even at rest, swelling of the legs and/or stomach, increased tiredness and weakness, nausea, abdominal pain, or persistent cough with blood-tinged mucous.
The information above does not list all possible side effects. Contact your doctor or pharmacist if you experience any side effects not listed. You or your doctor may report side effects to the FDA by calling 1-800-FDA-1088.
Warnings & Precautions
Before using NovoLog, tell your doctor or pharmacist:
- If you are allergic to any medications such as insulin
- If you have or have had liver or kidney disease
- If you have or have had heart problems,
- If you have or have had low levels of potassium such as hypokalemia
- If you are pregnant or plan to become pregnant
- If you are breastfeeding
Heart Failure and Fluid Retention
Taking insulin such as NovoLog with thiazolidinediones (TZDs) can result in fluid retention leading to heart failure. Your doctor will monitor your symptoms and adjust your medications as needed.
Hyperglycemia or High Blood Sugar Due to Insulin Pump Failure
High blood sugar and ketoacidosis can result from insulin pump failure. You should be aware of the signs and symptoms of high blood pressure and be prepared with an alternative treatment plan such as self-injection.
Hypoglycemia or Low Blood Sugar
The risks of having low blood sugar levels increase:
- If there is a change in your diet and exercise
- If you consume alcohol
- If you take medications for diabetes such as NovoLog
- If you are over 65 years of age
- If you have liver or kidney problems
Symptoms include the inability to concentrate, irritability, shakiness, fast heartbeat, unusual weakness or tiredness, excessive hunger, and confusion.
Severe low blood sugar may become life-threatening, cause seizures, or result in death. Your doctor will create a treatment plan that includes monitoring your blood sugar level to determine if a change in treatment is necessary.
Taking insulin such as NovoLog can result in low potassium levels, especially if you are taking another medication that may also lower potassium levels. Low potassium levels can be dangerous, resulting in ventricular arrhythmia, respiratory paralysis, or death. Your doctor may monitor your potassium levels to determine if a change in treatment is necessary.
Take precautions such as carefully reviewing labels to ensure you use the correct insulin before making an injection. Using the wrong insulin and/or dose may lead to overdose and severe high blood pressure. There have been reports of accidental insulin mix-ups of patients using different insulins in the incorrect amount.
Pregnant or Plan to Become Pregnant
Having high blood sugar during pregnancy may cause complications during the pregnancy and delivery for both mother and baby. Complications include premature birth, low birth weight, and breathing problem. There is also an increased risk of miscarriage or stillborn. Your doctor will create a treatment plan to monitor your blood sugar levels.
Sharing of Cartridges, Needles, Pens, and Vials
Cartridges, needles, pens, and vials should never be reused or shared with anyone else. Doing so creates risks of dangerous diseases spread through blood transmission.
Interactions & Contraindications
Before using NovoLog, tell your doctor or pharmacist if you take any medications, herbal supplements, or vitamins.
Increased Risk of Low Blood Sugar
Taking NovoLog with the following types of medications may increase your risk of low blood sugar. Your doctor will monitor your treatment plan and make changes as necessary.
- Angiotensin II receptor blocking agents
- Somatostatin analogs (e.g., Sandostatin and Mycapssa)
- Antidiabetic agents (e.g. metformin, glyburide, and glipizide)
- Sulfonamide antibiotics
- Monoamine oxidase inhibitors (e.g., Azilect and Marplan)
- ACE inhibitors (e.g., Benazepril and Lisinopril)
Taking NovoLog with the following types of medications may weaken the signs and symptoms of low blood sugar. Check your blood sugar regularly and contact your doctor with any concerns.
- Beta-blockers (e.g., Atenolol and Metoprolol)
Effectiveness of Blood Sugar Lowering Ability
Taking NovoLog with the following types of medications may decrease the effectiveness of NovoLog to lower blood sugar. Your doctor will monitor your treatment plan and make changes as necessary.
- Corticosteroids (e.g., betamethasone, prednisone, and prednisolone).
- Estrogens (e.g., Estradiol and Imvexxy)
- Oral contraceptives
- Phenothiazines (e.g., prochlorperazine and promethazine)
- Sympathomimetic agents (e.g., albuterol inhalers and EpiPen)
- Somatropin (e.g., Humatrope and Omnitrope)
- Atypical antipsychotics (e.g., risperidone and aripiprazole)
- Protease inhibitors (e.g., Reyataz and Norvir)
- Thyroid hormones (e.g., Synthroid)
Taking NovoLog with the following medications can either decrease or increase the effectiveness of NovoLog to lower blood sugar levels. Your doctor will monitor your treatment plan and make changes as necessary.
- Beta-blockers (e.g., Atenolol, Metoprolol, Nadolol, and Propranolol)
- Lithium salts