Novolog FlexPen alternatives

In this article:

• What can I take in place of NovoLog Flexpen?
• Top 5 Novolog alternatives
• Natural alternatives to NovoLog
• How to switch to a NovoLog alternative

In this article

• What can I take in place of NovoLog Flexpen?
• Top 5 Novolog alternatives
• Natural alternatives to NovoLog
• How to switch to a NovoLog alternative

NovoLog Flexpens are a multi-dose injectable device containing insulin aspart manufactured by Novo Nordisk. Insulin aspart is a rapid-acting insulin analog that is derived from a modification to regular insulin. NovoLog Flexpens are indicated for glycemic control in both Type 1 diabetes mellitus and Type 2 diabetes mellitus. It is estimated that over 34 million Americans have a form of diabetes, so the need for effective drug therapies is widespread. Type 1 diabetics are not able to produce insulin, and therefore insulin must be provided to the body in the form of injectable products. Type 2 diabetics may be able to produce insulin, but the body is not efficient in utilizing it. Insulin is an essential therapy in both Type 1 and Type 2 diabetes, as well as gestational diabetes and diabetic ketoacidosis.

Read more on diabetes here: Type 1 vs. Type 2 diabetes: Compare causes, symptoms & treatments

Dosing insulin to maintain adequate control of blood glucose levels is a delicate balance. For some, it may require multiple doses per day or more than one type of insulin. Type 2 diabetics are often dependent on more than one antidiabetic agent to control their blood sugar, including oral medications. Healthcare providers often have to make frequent adjustments and monitor blood sugar levels closely. Adjustments may be needed in the type of insulin used based on blood sugar control. Insurance coverage and formularies often play an important role in determining what insulin a patient can be compliant with long-term due to cost-related factors. Insulin therapy can be very expensive, and costs can sometimes dictate insulin choice for an individual. Fortunately, there are alternative insulin options that can be considered in order to achieve hypoglycemia control. 

What can I take in place of NovoLog Flexpen?

There are alternative options to NovoLog Flexpen (insulin aspart). Alternatives can include other types of rapid-acting insulins, or the use of different types of insulin, which may be short-acting or long-acting. While many consider the use of an insulin pen preferable to the use of a vial and syringe to inject insulin, insulin vials are still an option if needed. There is now an inhaled insulin available as well. Factors that should be considered when selecting an alternative should include dosing frequency, dosing compliance by the patient, cost, and insurance formulary coverage.

Today, there are more alternative insulin options available than ever before, thanks to the introduction of biosimilar insulin products and interchangeable biosimilar insulin products. Biosimilar insulins are very similar to the original insulin. The FDA considers them safe and effective options with differences only in the inactive ingredients of the formulation. If a product is considered an “interchangeable biosimilar” this means your pharmacist can make a direct substitution between those products. Biosimilar products that have not been proven with studies to be “interchangeable” require your prescriber’s permission to make a change. These products may provide a more cost-effective alternative for you in insulin therapy.

Check out this related article: How much is Novolog Flexpen without insurance?

The below list includes some alternative options to NovoLog Flexpens. It is not intended to be a complete list of alternatives. Only your healthcare provider or endocrinology specialist can determine what is appropriate to treat your diabetes effectively.

Other alternatives to Novolog FlexPen

• Humalog Mix KwikPen (insulin lispro/ insulin lispro protamine systemic)
• Humulin Mix Pen (insulin isophane/ insulin regular systemic)
• Basaglar (insulin glargine)
• Semglee (insulin glargine-yfgn)
• Tresiba (insulin degludec)
• Lyumjev (insulin lispro)
• Levemir (insulin detemir)
• Humulin R (insulin regular)
• Humulin N (insulin isophane)
• Novolin N (insulin isophane)

Top 5 Novolog alternatives

The following are some of the most common insulin alternatives to Novolog.

1. Rapid-acting insulins

Novolog is one example of a rapid-acting insulin. Rapid-acting insulins are utilized shortly before or after a meal to help control the increase in blood sugar caused by food consumption. Most start working within 10 to 15 minutes, reach their peak in 30 minutes, and last for two to four hours. These insulins are used in combination with a longer-acting insulin that is designed to provide more continuous glycemic control. Rapid-acting insulins are dosed based on body weight and carbohydrate intake. If dosed incorrectly, there is a risk of blood sugar going too low and developing hypoglycemia, so it is important to monitor blood sugar levels and food consumption. While NovoLog may work for many, there could be reasons to consider an alternative rapid-acting insulin. This may be due to insurance formulary tiers or product availability, among other factors. There is also an option for an inhaled rapid-acting insulin on the market now known as Afrezza. This may be an option for patients when insulin injections at mealtime are not feasible.

Examples of rapid-acting insulins: Humalog, Apidra, Fiasp, Lyumjev, Afrezza

Related: Humalog vs. Novolog: Differences, similarities, and which is better for you

2. Short-acting insulins

Short-acting insulin is often referred to as “regular” insulin. Insulin aspart, the active ingredient in NovoLog, is made from a modification of regular human insulin that renders it even faster acting than regular insulin, hence the designation of “rapid-acting” for Novolog. Short-acting or regular insulin must be taken 30 to 60 minutes before a meal, and it will take about 2 to 3 hours to hit peak concentration in the body. The effects last for anywhere from 3 to 6 hours. Some people are able to achieve adequate control on regular insulin alone without a longer-acting insulin since it lasts a bit longer. The appropriate insulin regimen for each person will be up to the healthcare provider. As with other insulins, short-acting insulins still carry a risk of low blood sugar levels, and blood glucose levels must be monitored regularly.

Examples of short-acting insulins: Humulin R (U-100), Novolin R, Novolin R ReliOn

3. Intermediate-acting insulin

Intermediate-acting insulin provides more steady blood sugar control for a longer period of time. For this reason, it can be used for overnight control and in combination with rapid or short-acting insulin. Intermediate insulins do not reach their peak concentration until 4 to 12 hours after the dose, and blood sugar control can last for 12 to 18 hours. 

Examples of intermediate-acting insulins: Humulin N (NPH), Novolin N (NPH), Novolin N ReliOn

4. Long-acting and ultra-long-acting insulins

Long-acting and ultra-long-acting insulins provide 24 hours or more of insulin coverage and make it possible to achieve good blood sugar control with minimal injections. Long-acting insulins start acting within 2 hours of dosing and last up to 24 hours. Ultra long-acting starts acting within 6 hours and can last for 24 to 36 hours. Neither long-acting nor ultra-long-acting insulins have a peak in concentration. This translates into a lower risk of hypoglycemia as compared to those with defined peaks, but the risk is still present. Blood sugar monitoring and diet awareness are essential regardless of the insulin regimen you are on.

Examples of long-acting insulins: Lantus, Basaglar, Levemir, Semglee, Humulin R U-500

Examples of ultra long-acting insulins: Toujeo, Tresiba

5. Pre-mixed insulins

Some individuals require a mix of different insulin types to achieve control of their blood sugar levels. While that can be done with two separate injections, there are some pre-formulated mixed products available which may decrease the number of injections for a person. These products combine a short and intermediate-acting formulation administered before meals to get the glycemic control for the meal intake in addition to baseline coverage. Onset, peak, and length of coverage vary between products, and blood sugars must be monitored regularly to reduce the risk of a hypoglycemic event.

Examples of pre-mixed insulins: Humulin 70/30, Novolin 70/30, NovoLog 70/30, Humulin 50/50, Humalog Mix 75/25, Humalog Mix 50/50

Natural alternatives to NovoLog

While there is no natural source for exogenous insulin replacement, there are natural and herbal remedies that may help combat your body’s natural insulin resistance and support better blood sugar control. There are products that are thought to have a natural ability to lower blood sugar levels to some extent, and these are categorized as hypoglycemic agents. Other products, known as carbohydrate absorption blockers, are thought to play a role in reducing the sugar your body takes up from food. Finally, there are some products that are believed to increase your body’s sensitivity to your natural insulin levels. Lifestyle modifications such as increased physical activity or acupuncture may also be associated with positive outcomes in blood glucose control. While there may be therapeutic value in these alternatives, your healthcare provider may have concerns about the safety and efficacy of natural products. Regulatory standards are different for natural products than they are for prescription products, so it is important to do your research to understand the quality of a product you would like to potentially use.

Examples of hypoglycemic natural products: Bitter melon, fenugreek

Examples of carbohydrate absorption inhibitors natural products: Aloe vera, flaxseed, prickly pear cactus, soy, turmeric

Examples of insulin sensitizer natural products: American ginseng, cinnamon, milk thistle

How to switch to a NovoLog alternative

Finding the right insulin regimen for you can be challenging. When considering insulin therapy with your doctor, it’s important to be honest about your ability to remain compliant, your lifestyle habits, your insurance coverage, and your access to medications. Insulins can be very expensive, especially if you have a high deductible, high copay structure, or a limited product formulary to choose from. Providing that information to your doctor will help you both choose a product that you can be the most successful with and be able to achieve glycemic control. If NovoLog is not the right fit for you or something changes and you feel a switch is necessary, reach out to your healthcare provider immediately. Do not skip insulin doses as there can be dangerous effects from uncontrolled high blood sugar.