Adult: Dosage is individualised based on route of administration, patient’s diet, physical activity or concomitant illness. Insulin naive patient with type 1 diabetes mellitus: Initially, approx 50% of the total daily dose (TDD) of insulin divided between each daily meal, with the remainder given as long- or intermediate-acting insulin (basal insulin). TDD is the total units/kg/day of all insulin formulations combined. As a general rule, the initial TDD can be calculated using a dose of approx 0.4-0.5 unit/kg (or a more conservative dose of 0.2-0.4 unit/kg). Usual TDD maintenance: 0.4-1 unit/kg daily in divided doses. Dosage adjustments may be necessary with changes in physical activity, meal patterns, renal or hepatic functions or concomitant illness. Patient with type 2 diabetes mellitus: Initially, 4 units daily; number of injections and subsequent titration is based on individual glycaemic target. Insulin aspart may be given via continuous subcutaneous insulin infusion (CSII), covering both bolus and basal insulin doses. Additionally, doses may be given via IV administration when necessary using appropriate preparations for IV use. Refer to specific product guidelines. Child: ≥2 years Same as adult dose. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.
Renal Impairment
Dosage adjustment may be needed.
Hepatic Impairment
Dosage adjustment may be needed.
Administration
Should be taken with food. Administer immediately before meals or soon after meals.
Reconstitution
IV: Reconstitute with compatible diluents (e.g. 0.9% NaCl, 5% dextrose) to a concentration of 0.5-1 unit/mL.
Contraindications
Hypersensitivity. Episodes of hypoglycaemia.
Special Precautions
Patient with concomitant illness (e.g. infections or feverish conditions), adrenal, pituitary, or thyroid gland diseases. Renal and hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Hypoglycaemia. Cardiac disorders: Chest pain. Gastrointestinal disorders: Nausea, vomiting, abdominal pain, diarrhoea. General disorders and administration site conditions: Lipodystrophy, inj site reactions, fever. Immune system disorders: Insulin antibody formation. Musculoskeletal and connective tissue disorders: Back pain. Nervous system disorders: Headache, hyporeflexia, sensory disturbance. Renal and urinary disorders: UTI. Respiratory, thoracic and mediastinal disorders: Nasopharyngitis, rhinitis, sinusitis, viral respiratory tract infection. Skin and subcutaneous tissue disorders: Rash, eczema, pruritus, urticaria, dermatitis, onychomycosis. Potentially Fatal: Severe hypoglycaemia and hypokalaemia. Hypersensitivity reactions (e.g. anaphylaxis).
This drug may impair the ability to concentrate and react due to hypoglycaemia, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor serum glucose, HBA1c, serum electrolytes, renal and hepatic function, and weight at regular intervals during therapy. Assess for signs of hypoglycaemia and hypokalaemia.
Overdosage
Symptoms: Mild to severe hypoglycaemia, hypokalaemia. Management: For mild hypoglycaemic cases, administer oral glucose or products that contain sugar. For severe hypoglycaemic cases wherein the patient is unconscious, give IM/SC glucagon (0.5-1 mg); if the patient does not respond within 10-15 minutes, administer IV glucose. To prevent relapse after regaining consciousness, maintain carbohydrate intake.
Drug Interactions
Increased risk of fluid retention and heart failure with thiazolidinediones (e.g. pioglitazone). Increased risk of hypoglycaemia with oral antidiabetics, MAOIs, ACE inhibitors, salicylates, anabolic steroids, sulfonamide antibiotics, and GLP-1 receptor agonists. Decreased hypoglycaemic effect with oral contraceptives, thiazide diuretics, glucocorticoids, thyroid hormones, sympathomimetics, growth hormone and danazol. β-blockers may mask the symptoms of hypoglycaemia. Increased or decreased hypoglycaemic effect with octreotide or lanreotide.
Food Interaction
Alcohol may either potentiate or diminish the hypoglycaemic effect of insulin aspart.
Action
Description: Insulin aspart, a rapid-acting analogue of human insulin, lowers blood glucose levels by stimulating peripheral glucose uptake and inhibiting hepatic glucose metabolism. Onset: Approx 0.2-0.3 hours (SC). Duration: 3-7 hours, depending on product used (SC). Pharmacokinetics: Distribution: Plasma protein binding: <10%. Excretion: Via urine. Elimination half-life: 57 or 81 minutes, depending on product used (SC); 10 minutes (IV).
Chemical Structure
Insulin Aspart Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 118984445, Insulin aspart. https://pubchem.ncbi.nlm.nih.gov/compound/Insulin-aspart. Accessed Dec. 21, 2020.
Storage
Unopened vial/cartridge/pen: Store between 2-8°C. Do not freeze. Protect from heat and sunlight. Punctured (in use) vial/cartridge/pen: Store below 30°C. Protect from heat and sunlight. Storage recommendations may vary among countries or individual products. Refer to specific product guidelines.
A10AB05 - insulin aspart ; Belongs to the class of fast-acting insulins and analogues. Used in the treatment of diabetes.
References
Anon. Insulin Aspart. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 06/08/2020.Anon. Insulin Aspart. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 06/08/2020.Buckingham R (ed). Insulin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/08/2020.Joint Formulary Committee. Insulin Aspart. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 06/08/2020.Novolog Injection, Solution (Novo Nordisk). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 06/08/2020.NovoRapid FlexPen (Novo Nordisk). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my/. Accessed 06/08/2020.
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