What is NovoRapid (NovoLog) Penfill?
NovoRapid (NovoLog) Penfill, available from Novo Nordisk Canada, is an insulin pen injection cartridge that contains 300 units (3 mL) of insulin aspart.
It is used to treat patients with type 1 and type 2 diabetes mellitus who require insulin to manage their glucose levels and avoid hypoglycemia.
This rapid-acting insulin is typically prescribed by doctors as a meal time insulin to help reduce blood glucose levels after meals.
How does NovoRapid work?
NovoRapid insulin will begin to lower glucose levels 10-20 minutes after injection. It has a maximum effect between 1-3 hours and can have a lasting effect for up to 3-5 hours.
Since this preparation is short-acting, it is usually used in combination with intermediate-acting or long-acting insulin.
What are the ingredients in NovoRapid?
The active ingredient in NovoRapid is insulin aspart. Non-medical ingredients include: zinc chloride, metacresol, phenol, glycerol, sodium chloride, disodium phosphate dihydrate, sodium hydroxide, hydrochloric acid and water for injection.
How to use NovoRapid Penfill?
Your doctor will personalize our treatment and dose for your specific needs and lifestyle. Your doctor, nurse, diabetes educator or pharmacist will teach you how to inject your insulin.
Due to NovoRapid’s fast onset of action, it should be taken 5-10 minutes before meal times. When necessary it can be taken soon after a meal rather than before.
NovoRapid is to be injected under the skin (subcutaneously). The best places to inject yourself are the abdomen/waist (will work quicker), upper arm, front of thigh or buttocks.
Keep track of where you have injected yourself as it’s good practice to rotate injection site in order to avoid skin complications.
Check the medications label to ensure you are taking the right dose and concentration. Dosage refers to how many units of insulin you require and concentration is how many units are in each milliliter (mL). For example, the concentration may be 100 units/mL (U-100) does not mean 100 units at once.
If you have any questions about how to use the NovoRapid Penfill be sure to discuss with your doctor, pharmacist or diabetes educator.
WARNINGS & PRECAUTIONS
Always check the Penfill® cartridge, including the plunger. Don’t use it if any damage is seen or if there is a gap between the plunger and the white barcode label.
When taking insulin, it’s important for diabetes patients to monitor glucose levels regularly.
Never share this medication with others, even if they have the same symptoms as it can make them ill.
It is recommended to carry an extra insulin as a precaution if delivery device is lost or damaged.
Changes in dosage can lead to hyperglycemia or hypoglycemia. If adjustments are made to a patients dosage they should be made cautiously and under the guidance of medical supervision.
Do not be inject directly into a vein.
Always rotate injection sites. By repeating injections into the same site can lead to lipodystrophy or localized cutaneous amyloidosis.
NovoRapid insulin should appear clear and colorless. Do not use if substance appears cloudy, thick or contains particles.
Keep medication away from direct sunlight and heat. Dispose of medication if it is past the expiration date.
Keep medication away from children and pets.
Do not use this medication if you feel you are experiencing hypoglycemia.
Do not use if you are allergic to insulin aspart, metacresol or any ingredients in this medication.
Do not refill Penfill cartridge.
NovoRapid penfill cartridges are only to be used with Novo Nordisk Insulin Delivery Devices.
You should use two Novo Nordisk Insulin Delivery Devices if you are using two types of insulin (such as NovoRapid Penfill and another Penfill cartridge).
Due to the rapid onset of this insulin, you may experience hypoglycemia earlier after injection when compared to soluble human insulin.
Notify your doctor if you have any health conditions or issues such as:
- Having trouble with liver or kidneys; adrenal, pituitary or thyroid glands. Your doctor may adjust your insulin dosage depending on your individual needs.
- Drink alcohol (including beer or wine) as this may drastically affect blood glucose levels
- Have a fever, infection or have had a recent operation which may require more insulin than usual.
- Are vomiting or suffering from diarrhea.
- Exercising more than usual or looking to make dietary changes.
- If you are ill. Continue taking your insulin as usual.
- Are travelling abroad. Travelling to a new time zone may affect your insulin needs and schedule. Consult your doctor if you are planning on travelling and to find out if they carry NovoRapid in the destination country. If possible bring enough NovoRapid for your trip.
- Are pregnant, breast feeding or planning a pregnancy. Consult with your doctor for guidance.
- Drive or use heavy machinery. Pay attention for signs of hypoglycemia as it can affect your ability to concentrate, cause blurred vision or lose consciousness. Do not drive you feel a hypoglycemia reaction coming on. Speak to your doctor about whether you should drive or operate machinery.
- Are taking Thiazolidinediones which is a class of oral antidiabetic drugs together with your insulin. This may increase heart failure and oedema. Let your doctor know if you are experiencing localized swelling (oedema), signs of shortness of breath or heart failure.
Let your doctor know about any prescription medications you are taking, over-the-counter medicines, vitamins, minerals, supplements and alternative medicines.
Medications that can affect insulin
Below are common medications which can affect your insulin treatment and/or glucose levels:
Notify your doctor, pharmacist or diabetes educator if you are taking any of the listed medications.
The following drugs may cause your blood sugar to drop (hypoglycemia):
- Other diabetes medications
- Monoamine oxidase inhibitors (MAOI)
- Angiotensin converting enzyme (ACE) inhibitors
- Anabolic steroids
The following drugs may cause your blood sugar to rise (hyperglycemia)
- Oral contraceptives (ie birth control pills)
- Thyroid hormones
- Growth hormone
- Octreotide and lanreotide
Like any medication, NovoRapid can cause side effects however these are not experienced by everyone and rare.
The most common side effect patients experience with this insulin is low blood sugar (hypoglycemia).
If reactions to hypoglycemia are not treated they can result in the loss of consciousness, coma or even death.
If you lose consciousness, you may require a glucagon injection by someone who knows how to use it. Once you regain consciousness, you should consume a sugary snack or glucose tablet.
If you do not respond to the glucagon treatment, you will need to be treated at a hospital.
Inform the hospital and your doctor so they can find the reason for your hypoglycemia and provide treatment to avoid from happening again.
Patients my also experience hyperglycemia which happens if blood glucose levels are too high.
This can can happen if:
- you forget to take your insulin
- you repeatedly take less insulin than required
- you eat more than usual
- you exercise more than usual
The warning signs are usually gradual. They may include:
- increased thirst
- increased urination
- loss of appetite
- flushed dry skin
- feeling ill (nausea or vomiting)
- fruity (acetone) smelling breath
- dry mouth
Hypokalemia (low potassium) is a possible risk when taking insulin. You may be at increased risk if you have diarrhea which lowers potassium or taking certain drugs that lower potassium.
Less common side effects (1-10 users in 1000)
This may include hives or rashes may occur. Seek medical advice if:
- if allergic reactions are present
- you suddenly feel ill, start vomiting or feeling ill, have rapid heartbeat, feel dizziness, difficulty breathing
When you begin using insulin it may affect your vision. This disturbance is usually temporary.
Changes at injection site (lipodystrophy)
If you inject yourself repeatedly at the same location on the body, the fatty tissue under the skin may become thickened or shrink. This is why it’s suggested to rotate injections sites in order to reduce these unwanted skin changes. If you notice skin thickening or pitting at the injection site, notify your doctor. This can be a serious concern and can affect the absorption of insulin.
When you start taking insulin, you may experience swelling caused by water retention in the ankles and joints. This is usually temporary.
Diabetic Retinopathy (eye background changes)
If you experience diabetic retinopathy and your blood sugar levels improve quickly, the retinopathy may worsen. Speak to your doctor if you experience this.
Rare Side Effects (less than 1 user in 10,000)
Painful Neuropathy (nerve related pain)
If your blood glucose levels recover very quickly this may result in nerve related pain. This is also known as acute painful neuropathy and is usually transient.
If you experience any side effects, whether listed or not listed above, inform your doctor, pharmacist or diabetes educator.
Speak to your doctor or pharmacist if you have any questions regarding this medication.