6.1.1.1 Short-acting insulin |
GREEN Human Actrapid® |
GREEN Humulin S® |
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The insulin analogues have a faster onset and shorter duration of action than standard soluble insulin. |
They should be injected immediately before or, when necessary, shortly after a meal. |
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GREEN Humalog® (insulin lispro) |
GREEN NovoRapid®(insulin aspart) (prescribe by brand) |
GREEN Apidra® (insulin glulisine) 1st line |
GREEN Trurapi®(insulin aspart) 3rd line bolus insulin
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GREEN restricted* Fiasp®▼ (insulin aspart) * restricted use/(prescribe by brand) |
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* Insulin Aspart (Fiasp®▼) is recommended for the treatment of diabetes mellitus in adults who are suitable for NovoRapid® and their diabetes cannot be adequately managed with alternative formulary choices and at least one of the following |
applies: |
> Where the doctor believes a faster onset of action would be beneficial to the patient |
> Where a patient requires 'tight' control of blood sugar levels |
> Where a patient has rapid post meal increase in blood sugar levels |
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GREEN restricted** Lyumjev® [insulin Lispro - Suitable for initiation in primary care in line with restrictions] |
** Insulin Lispro (Lyumjev®) is recommended for the treatment of diabetes mellitus in adults who are suitable for |
Humalog and their diabetes cannot be adequately managed with alternative formulary choices and at least one of the |
following applies: |
> Where the prescriber believes a faster onset of action would be beneficial to the patient |
> Where a patient requires 'tight' control of blood sugar levels |
> Where a patient has rapid post-meal increase in blood sugar levels |
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6.1.1.2 Intermediate and long-acting insulin |
Intermediate |
GREEN Insulatard® |
GREEN Humulin I® |
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Long acting insulin |
Long-acting recombinant human insulin analogues should be used in accordance with NICE guidance. |
Biosimilars of insulin glargine 100 units/mL (Lantus®) are recommended for use in patients with type 1and type 2 diabetes |
mellitus. The prescribing of biosimilar preparations should be by brand name, followed by the concentration and |
recommended daily dose in units and a statement of the formulation. Treatment should normally be started with the least |
expensive drug. The initiation of biosimilar insulins should be in NEW patients or patients assessed to need a medication |
change, with close monitoring of their blood glucose to ensure good control is achieved. |
GREEN Abasaglar® (insulin glargine) |
GREEN Lantus® (insulin glargine) |
GREEN Levemir® (insulin detemir) |
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Toujeo is a High strength basal Insulin product it is Not bioequivalent to glargine or other insulins. Units are exclusive to |
the potency of Toujeo®. Dose adjustment is needed if switching patients to or from Toujeo® |
See Product information Sheet & Good Practice Guide |
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Insulin glargine 300 units/mL (Toujeo®) is recommended as an option in adults with type 2 diabetes mellitus (T2DM) only in |
accordance with the recommendations in NICE NG28 and in those who suffer from symptomatic nocturnal hypoglycaemia |
whilst being treated with a first-line long-acting insulin analogue. it is also recommended as an option in adults with type 1 |
diabetes mellitus in accordance with NICE NG17 and in those patients who experience an unacceptable frequency and/or |
severity of nocturnal hypoglycaemia on attempting to achieve better glycaemic control during treatment with first-line |
long-acting insulin analogues; or as a once daily insulin therapy for patients who require assistance with administering |
injections. |
AMBER Toujeo® SoloStar® DoubleStar® (insulin glargine) |
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Insulin Degludec (Tresiba®▼) |
Recommended as an alternative treatment option in patients over the age of 1 year experiencing poor glycaemic control or |
recurrent hypoglycaemic episodes with existing long-acting basal insulin. to be initiated by diabetes specialist only. |
AMBER Tresiba®▼ (insulin degludec) |
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Insulin degludec plus liraglutide (Xultophy®▼) |
The combination product insulin degludec plus liraglutide (Xultophy®▼) is not recommended to treat type 2 diabetes |
mellitus (T2DM) to improve glycaemic control in combination with oral glucose-lowering medicinal products when these |
alone, or combined with basal insulin, do not adequately provide glycaemic control. |
BLACK Xultophy®▼ |
Click here to access New Medicines Assessment for this product |
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Biphasic |
GREEN Humulin M3® |
GREEN Insuman Comb 25® |
GREEN Humalog Mix25®, Humalog Mix50® (insulin lispro) |
GREEN NovoMix 30® |
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Biphasic analogue insulins (e.g. Novomix, Humalog Mix) do not offer any advantage over conventional human biphasic |
insulins in terms of efficacy, long term outcomes or safety but cost considerably more. The above brands of insulin are |
recommended for new diabetics and are available in a variety of vial, species for established diabetics. The hospital |
pharmacy will keep stocks of other brands and Insulin is usually available in 3mL cartridges, 10mL vials, and 3mL |
disposable pens. Pens are available on prescription except disposable pens. Not all insulin cartridges fit all pens. | The National Patient Safety Agency issued an alert in June 2010 for the safer administration of insulin. | |
Click here to access the full documents online. |
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All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the | public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service. | Email: info.elmmb@nhs.net | Copyright© 2016 -2020 East Lancashire Medicines Management Board. | All rights reserved. Disclaimer/Terms and conditions | |
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