Novolog, the brand name for insulin aspart, is a type of rapid-acting manufactured insulin that is used to prevent mealtime spikes in the blood sugar level among patients of diabetes mellitus. The medicine is generally used as part of a basal-bolus insulin therapy to keep the blood sugar levels within a healthy range.
For those who do not know, basal-bolus insulin therapy is a comprehensive treatment plan that involves using two types of insulin – long-acting (also called basal insulin) and fast/short/rapid-acting (also called bolus insulin) – to closely mimic the natural insulin release mechanism of the body.
The therapy helps maintain stable blood sugar levels during periods of fasting as well as at meal times and is used for patients of type 1 diabetes and people with type 2 diabetes who do not benefit from oral medications and basal insulin alone.
Who Can Use Novolog?
Novolog is suitable for adults with either type 1 or type 2 diabetes. However, it can only be used in children with type 1 diabetes who are at least 2 years of age.
How Quickly Novolog Functions?
Novolog works faster than many other fast-acting varieties of insulin, such as insulin lispro (sold under the brand name of Humalog) – it starts to work within 5 to 10 minutes after entering into your body. The effects of Novolog peak in about 1 hour and last for a total of 2 to 4 hours.
Novolog’s Mechanism of Action
The insulin aspart medication Novolog prevents blood sugar levels from increasing after consumption of food primarily by regulating the process of glucose metabolism.
It binds to the insulin receptors on both fat and muscle cells and facilitates the process of cellular glucose uptake as well as prevents or reduces glucose output from the liver.
In animal testing (on rabbit and mice), Novolog has shown the same glucose-lowering effects as natural human insulin. However, in humans, the effects are found to be more rapid and short-lasting than natural insulin due to the quick absorption rate of the manufactured insulin.
Available Forms and Strengths
Novolog is available in 100 units/ml (U-100) injection solution in the following forms:
- 10 ml vials
- 3 ml Novolog FlexPen
- 3 ml PenFill cartridges, to be used only with the 3 ml PenFill cartridge device
- 3 ml Novolog FelxTouch
Dosage and Administration
Just like most other types of insulin, there is no universal recommended dosage of Novolog. It has to be individualized according to each patient’s metabolic needs, the severity of the disease, other medicines or insulin the patient is using, and the required level of glycemic control. The dosage may also need to be adjusted during the treatment according to the patient’s response to the drug, any changes in the treatment plan that requires starting or stopping any other medicine, and any changes in diet and/or physical activity. Dosage adjustment for Novolog may also be required during acute illness and with any changes in hepatic and/or renal function.
How is Novolog Used?
Novolog can be taken subcutaneously via an injection, insulin pen and insulin pump. When administered via an injection, Novolog can be diluted (with Novolog diluting medium only) or mixed with other types of insulin. However, make sure to ask your doctor about the right way to do it.
Important: Novolog can only be mixed with NPH insulin formulations. When mixing these two types of insulin, make sure to first draw Novolog into the injection and then the NPH insulin and administer it immediately after mixing.
Important Administration Instructions for Novolog
While using Novolog, or any other type of insulin, is quite simple, here are some important instructions that you need to know and follow to avoid any issues or negative effects:
- Always inspect the insulin before using – it has to be colorless and clear. Do not use it if there is any coloration or particulate matter in your Novolog solution.
- When using Novolog through an injection, administer it subcutaneously in the upper arm, thighs, abdominal area, or buttocks, and make sure you eat something within 5 to 10 minutes. Novolog is a fast-acting insulin and will most likely cause hypoglycemia (low blood sugar) if you do not eat after administering it.
- While insulin injections can be administered in the same area, it is highly recommended to change the injection sites within that area. Regularly administering injections at the same site can lead to lipodystrophy; an adipose tissue disorder that causes selective loss of body fat.
- When using Novolog via an insulin pump, administer it into the subcutaneous tissues of the abdominal wall. Again, change the infusion sites to prevent lipodystrophy.
- Follow your doctor’s recommendations and directions when diluting Novolog for subcutaneous injections.
- Never dilute Novolog or mix it with any other insulin when administering it by continuous subcutaneous infusion via an insulin pump.
- Intravenous administration of Novolog should only be done under medical supervision because it requires close monitoring of blood sugar and potassium levels to make sure they don’t get too low.
- Do not change the prescribed dosage of Novolog on your own and consult your doctor if you feel you need dosage adjustment.
Novolog is a rapid-acting insulin that starts working within 5 to 10 minutes. Therefore, make sure to have a meal quickly after administering it to prevent hypoglycemia (low blood sugar).
Storage Directions for Novolog
Just like with all other types of insulin, it is critical that Novolog should be stored the right way in order to maintain its effectiveness. Here are some important storage directions that you should follow:
- Store the unused Novolog insulin vials/injections/pens/cartridges in the refrigerator between 36 to 46 degrees Fahrenheit (2-8 degrees centigrade) to keep them in good condition until their expiry date. Even when unopened, Novolog can only be stored at room temperature, that too at below 86 degrees Fahrenheit (30 degrees centigrade), for 28 days.
- Opened Novolog vials can be stored either at room temperature, below 86 degrees Fahrenheit, or in the refrigerator. However, Novolog cartridges and pens should not be refrigerated, once they are opened; store them at room temperature below 86 degrees Fahrenheit and discard after 28 days.
- Do not store Novolog insulin for later use once it is drawn into a syringe – use it immediately or discard it.
- Store Novolog pens without needles. This ensures accurate dosing by eliminating the risk for leakage as well as helps prevent contamination and the resulting infections.
For Diluted Novolog
Diluted Novolog can be used for up to 28 days if stored at temperatures below 86 degrees Fahrenheit (30 degrees centigrade).
For Insulin Pump
Discard the Novolog insulin in the pump reservoir at least after every 6 days, or even earlier if it gets exposed to temperatures above 98.6 degrees Fahrenheit (37 degrees centigrade). Also, change the infusion set and set the insertion site every 3 days.
For Intravenous Infusion Fluids
Novolog infusion bags prepared for intravenous administration remain stable for 24 hours, at room temperature. They should not be used after that.
Possible Side Effects of Novolog
In addition to providing the desired effects i.e. preventing blood sugar spikes after a meal, Novolog may cause some adverse effects in some patients. Tell your doctor if you experience any negative effects with Novolog use. While some of them are not dangerous and may go away with time, others may need medical attention.
Common Side Effects of Novolog
The following side effects are comparatively more common among diabetic patients using Novolog:
- Hypoglycemia; low blood sugar – signs include excessive sweating or cold sweats, hunger, dizziness, shakiness, headache, nervousness, anxiety, moodiness, irritability.
- Mild skin rash
- Excessive hunger
- Weight gain
- Hollowing or thickening of the skin at the injection site(s)
- Blurred vision
- Restless sleep
- Difficulty in concentrating and/or thinking
- Slurred speech
- Tingling in hands and/or feet
Serious Side Effects of Novolog
While their occurrence is rare, get medical help immediately if you experience any of the following severe side effects with Novolog use:
- Low blood potassium level – symptoms include irregular heartbeat, fluttering in the chest, constipation, increased thirst, increased urination, muscle weakness, limp feeling, leg cramps, numbness or tingling in hands and/or feet.
- Heart issues – signs include rapid weight gain without any apparent reason, shortness of breath, swelling.
- An allergic reaction to Novolog – signs include skin rash with itchiness all over the body, increased heart rate, redness and/or swelling at the injection site, trouble breathing, swelling in the throat or tongue, feeling like you are about to faint.
- Difficulty in swallowing and/or breathing.
- Swelling of arms, hands, feet, lower legs, face, throat, and/or tongue.
- Accumulation or redistribution of body fat.
Prescription Assistance for Novolog
Novolog is only available as a branded drug; a generic version of insulin aspart isn’t yet available. Hence, it doesn’t come as a surprise that it is an expensive drug. The average price for a 10 ml supply of Novolog solution is over $300, which makes it unaffordable for a large number of patients.
However, the good news is that this fast-acting insulin is covered by most major health plans, including Medicaid and Medicare.
On the other hand, there are also assistance programs for those who do not have an insurance plan or are underinsured. As part of their Patient Affordability and Access Support Program, called Novocare, Novo Nordisk offers two key financial assistance options for those diabetic patients who do not have inadequate insurance coverage and cannot afford to buy the drug either.
With the Savings Card, eligible patients can get a month’s supply of this insulin for just $25, for up to 2 years.
You may also get this brand of insulin aspart free of cost if you qualify for the company’s Patient Assistance Program (PAP). Click here to check out the eligibility requirements and to know the application procedure.
Do not qualify for any of these support programs?
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