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Novolog Mix 50-50

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NovoLog Mix 50/50

PATIENT INFORMATION

NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection)
(NO-vo-log-MIX-FIF-tee-FIF-tee)
(50% insulin aspart protamine suspension and 50% insulin aspart injection, [rDNA origin])

Important:

Know your insulin. Do not change the type of insulin you take unless told to do so by your healthcare provider. The amount of insulin you take as well as the best time for you to take your insulin may need to change if you take a different type of insulin.

Make sure you have the type and strength of insulin prescribed for you.

Read this Patient Information that comes with NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) before you start taking it and each time you get a refill. There may be new information since your last refill. This leaflet does not take the place of talking with your healthcare provider about your diabetes or your treatment. Make sure that you know how to manage your diabetes. Ask your healthcare provider if you have any questions about managing your diabetes.

What is NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) ?

NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) is both a rapid-acting and long-acting man-made insulin.

NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) comes in:

  • 3 mL PenFill® cartridges.
  • 3 mL NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen®Prefilled syringe.

Only use NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) if all of the medicine looks white and cloudy after you mix it (resuspension) (see “Patient Instructions for Use”). If your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) looks clear, do not use it and call Novo Nordisk at 1-800-727-6500.

Who should not take NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) ?

Do not use NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) if:

  • Your blood sugar is too low (hypoglycemia). After treating your low blood sugar, follow your healthcare provider's instructions on the use of NovoLog® Mix 50/50.
  • You are allergic to anything in NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) . See the end of this leaflet for a complete list of ingredients in NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) . Check with your healthcare provider if you are not sure.

Tell your healthcare provider:

  • about all of your medical conditions. Medical conditions can affect your insulin needs and your dose of NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) .
  • if you are pregnant or breast feeding. You and your healthcare provider should talk about the best way to manage your diabetes while you are pregnant or breastfeeding. NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) has not been studied in pregnant or nursing women.
  • about all of the medicines you take, including prescription and nonprescription medicines, vitamins and herbal supplements. Many medicines can affect your blood sugar levels and your insulin needs. Your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) dose may need to change if you take other medicines.
    Know the medicines you take. Keep a list of your medicines with you to show all your healthcare providers.

How should I take NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) ?

Read the instructions for use that come with your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) product. Talk to your healthcare provider if you have any questions. Your healthcare provider should show you how to inject NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) before you start taking it.

  • Take NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) exactly as prescribed. NovoLog® Mix 50/50 is injected right before a meal, up to three (3) times each day.
  • NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) starts acting fast, so inject it up to 15 minutes before you eat a meal. Do not inject NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) if you are not planning to eat within 15 minutes.
  • Inject NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) under the skin of your stomach area, upper arms, or upper legs. NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) may affect your blood sugar levels sooner if you inject it into the skin of your stomach area.
  • Change (rotate) sites with each dose. Although you can inject insulin in the same area, do not inject into the exact same spot for each injection.
  • Check your blood sugar levels. Ask your healthcare provider how often you should check your blood sugar levels for hypoglycemia (too low blood sugar) and hyperglycemia (too high blood sugar).
  • If you take too much NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) , your blood sugar may fall low (hypoglycemia). You can treat mild low blood sugar (hypoglycemia) by drinking or eating something sugary right away (fruit juice, sugar candies, or glucose tablets). It is important to treat low blood sugar (hypoglycemia) right away because it could get worse and you could pass out (become unconscious). If you pass out you will need help from another person or emergency medical services right away, and will need treatment with a glucagon injection or treatment at a hospital. See “What are the most common side effects of NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) ?” for more information on low blood sugar (hypoglycemia).
  • If you forget to take your dose of NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) , your blood sugar may go too high (hyperglycemia). High blood sugar (hyperglycemia) if not treated can lead to loss of consciousness (passing out), coma or even death. Symptoms of high blood sugar may include:

  • increased thirst
  • frequent urination
  • drowsiness
  • loss of appetite
  • fruity odor on the breath
  • high amounts of sugar and ketones in your urine
  • nausea, vomiting (throwing up), or abdominal pain
  • a hard time breathing

Follow your healthcare provider's ons for treating high blood sugar, and talk to your healthcare provider if high blood sugar is a problem for you.

Your insulin dosage may need to change because of:

  • illness
  • stress change
  • other medicines
  • change in food intake
  • in physical activity or
  • you take exercise
  • surgery

Follow your healthcare provider's instructions to make changes in your insulin dose.

  • Never mix NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) with other insulin products.
  • Never use NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) in an insulin pump.
  • Never inject NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) into a vein.

See the end of this patient information for instructions about preparing and giving the injection.

What are the most common side effects of NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) ?

  • Low blood sugar (hypoglycemia). Symptoms of low blood sugar may include:

  • sweating
  • dizziness or lightheadedness
  • shakiness
  • fast heart beat
  • tingling of lips or tongue
  • trouble concentrating or confusion
  • blurred vision
  • slurred speech
  • anxiety, irritability or mood changes
  • hunger headache

Alcohol, including beer and wine, may affect your blood sugar when you take NovoLog®Mix 50/50.

Your ability to concentrate or react may be reduced if you have hypoglycemia. Be careful when you drive a car or operate machinery. Ask your healthcare provider if you should drive if you have:

  • frequent hypoglycemia
  • reduced or absent warning signs of hypoglycemia

Severe low blood sugar can cause unconsciousness (passing out), seizures, and death. Know your symptoms of low blood sugar. Follow your healthcare provider's instructions for treating low blood sugar. Talk to your healthcare provider if low blood sugar is a problem for you.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other possible side effects include:

  • Serious allergic reaction (whole body allergic reaction). Get medical help right away if you develop a rash over your whole body, have trouble breathing, a fast heartbeat, or sweating.
  • Reactions at the injection site (local allergic reaction). You may get redness, swelling and itching at the injection site. If you keep having skin reactions or they are serious, you may need to stop taking NovoLog® Mix 50/50 and take a different insulin. Do not inject insulin into a skin area that is red, swollen, or itchy.
  • Skin thickens or pits at the injection site (lipodystrophy). Change (rotate) where you inject your insulin to help prevent these skin changes from happening. Do not inject insulin into this type of skin.
  • Swelling of your hands and feet.
  • Low potassium in your blood (hypokalemia).

These are not all of the possible side effects from NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) . Ask your healthcare provider or pharmacist for more information.

How should I store NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) ?

Unopened NovoLog Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) :

  • Keep all unopened NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) in the refrigerator between 36° to 46° F (2° to 8° C). Do not store in the freezer or next to the refrigerator cooling element. Do not freeze.
  • Keep unopened NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) in the carton to protect from light.

After the package has been opened:

  • Do not put NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) that you are using in the refrigerator. Keep at room temperature at or below 86°F (30°C) for up to 14 days.
  • Keep NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) away from direct heat or light.
  • Throw away used NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) after 14 days of use, even if there is insulin left in the cartridge or syringe.

General information about NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection)

Medicines are sometimes prescribed for conditions that are not mentioned in the patient leaflet. Do not use NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) for a condition for which it was not prescribed. Do not give NovoLog Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) to other people, even if they have the same symptoms you have. It may harm them.

This leaflet summarizes the most important information about NovoLog® Mix 50/50. If you would like more information about NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) or diabetes, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) which is written for healthcare professionals. For more information, call 1-800-727-6500 or visit www.novonordisk-us.com.

Helpful information for people with diabetes is published by the American Diabetes Association, 1660 Duke Street, Alexandria, VA 22314 and on www.diabetes.org.

What are the ingredients in NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) ?

  • insulin aspart
  • glycerol
  • phenol
  • metacresol
  • protamine sulfate
  • zinc
  • disodium hydrogen phosphate dihydrate
  • sodium chloride
  • hydrochloric acid and/or sodium
  • hydroxide may be added

Patient Instructions for Use

NovoLog®Mix 50/50 FlexPen®Prefilled syringe

How to use the NovoLog®Mix 50/50 FlexPen®Prefilled syringe

NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe is a disposable insulin delivery system. NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe is to be used with NovoFine® single use needles. People who are blind or have severe vision problems should only use the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe with the help of a sighted person who is trained to use the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe the right way.

Please read these instructions completely before using this device.

Figure 1: Diagram of a NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe

Diagram of a NovoLog® Mix 50/50 FlexPen® Prefilled syringe - Illustration

Figure 2: Diagram of a NovoFine® needle

Diagram of a NovoFine® needle  - Illustration

1. PREPARING THE NOVOLOG® MIX 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FLEXPEN® PREFILLED SYRINGE

Before you start to prepare your injection, check the label to make sure that you are taking the right type of insulin. NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) should look white and cloudy (after being mixed). This is especially important if you use 2 types of insulin.

  • Pull off the pen cap.
  • Wipe the rubber stopper with an alcohol swab.

Hold the NovoLog® Mix 50/50 FlexPen® Prefilled syringe in a horizontal (flat) position between your palms - Illustration

  • Before using a new NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe for the first time, do the following to mix (resuspend) the insulin:
    • Hold the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe in a horizontal (flat) position between your palms (see diagram A above). Roll the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe between your palms 10 times.
    • Then, turn the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe up and down. Move the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe between position 1 and 2 so that the glass ball moves from one end of the insulin cartridge to the other (see diagram B above). Do this at least 10 times. Repeat the rolling and turning steps until all of the insulin looks white and cloudy. Mixing (resuspension) is easier when the insulin is at room temperature.
    • After mixing, continue to do the following steps right away. If there is a delay, the insulin will need to be mixed again.

Remove the protective tab from the disposable needle and screw the needle tightly onto the NovoLog® Mix 50/50 FlexPen® Prefilled syringe - Illustration

  • Remove the protective tab from the disposable needle and screw the needle tightly onto the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe (see diagram C above). Do not place a disposable needle on your NovoLog® Mix 50/50 FlexPen® Prefilled syringe until you are ready to take your injection.

Pull off the outer and inner needle caps - Illustration

  • Pull off the outer and inner needle caps (see diagram D above). Do not throw away the big outer needle cap.
  • Giving the airshot before each injection:
  • Small amounts of air may collect in the needle and insulin cartridge during normal use. To avoid injecting air and to make sure you take the right dose of insulin, do the following:
    • Dial 2 units by turning the dose selector so that the arrow lines up with the “2” in the dosage indicator window (see diagram E below).
    • Hold the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe with the needle pointing up. Tap the insulin cartridge gently with your finger a few times (see diagram F below). A small air bubble may remain but it will not be injected. The NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe prevents the insulin cartridge from being completely emptied.

Dial 2 units by turning the dose selector - Illustration

  • Keep the needle pointing up and press the push button (on the end of the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe) all the way in (see diagram G below). You should see a drop of insulin at the needle tip. If you don't see a drop of insulin, repeat the procedure (dial 2 units, tap the insulin cartridge and press the push button) until insulin appears. You may need to do this up to 6 times. If you don't see a drop of insulin after 6 times, do not use the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe and contact Novo Nordisk at 1-800-727-6500.

Keep the needle pointing up and press the push button - Illustration

2. SETTING THE DOSE

Setting the dose - Illustration

  • Check and make sure that the dose selector is set at zero (0) (see diagram H above).
  • Dial the number of units you need to inject by turning the dose selector so the arrow lines up with your dose.
  • The dose can be corrected by turning the dose selector in either direction. When dialing back, be careful not to press the push button. Pressing the button will cause the insulin to come out. You cannot set a dose larger than the number of units left in the cartridge. You will hear a click for every single unit dialed. Do not set the dose by counting the number of clicks you hear.

3. GIVING THE INJECTION

Do the injection exactly as shown to you by your healthcare provider.

Pinch a fold of skin between 2 fingers, then push the needle into the pinched up skin - Illustration

  • Wipe the injection site with an alcohol swab and let the area dry.
  • Pinch a fold of skin between 2 fingers, then push the needle into the pinched up skin (see diagram I above).
  • Give the dose by pressing the push button all the way in (see diagram J below). Be careful to only press the push button when injecting.

Give the dose by pressing the push button all the way in - Illustration

  • Keep the needle in the skin for at least 6 seconds, and keep the push button pressed all the way in until the needle has been pulled out from the skin. This will make sure that the full dose has been given. If blood appears after you take the needle out of your skin, press the injection site lightly with a finger. Do not rub the area.

After the injection

  • Remove the needle from the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe after each injection. This helps to prevent contamination, infection, and leakage of insulin, and will help to make sure you inject the right dose of insulin. Put the needle in a sharps container, or some type of hard plastic or metal container that can be sealed such as a detergent bottle or coffee can. These containers should be sealed and thrown away safely. Ask your healthcare provider how to throw away a used sharps container. There may be local or state laws about how to throw away used needles and syringe.
  • Put the pen cap back on the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe.

Healthcare providers, relatives, and other caregivers should follow general precautions for removing and disposing of needles to lessen the possible chance of needle stick injury.

4. FUTURE INJECTIONS

It is important that you use a new needle for each injection. Follow the directions in steps 1, 2, and 3 above.

Before you inject, there must be at least 12 units of insulin left in the cartridge to make sure the remaining insulin is evenly mixed. If there are less than 12 units left, use a new NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe.

The numbers on the insulin cartridge can be used to estimate the amount of insulin left in the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe. Do not use these numbers to measure the insulin dose. You cannot set a dose more than the number of units remaining in the cartridge.

Mix (resuspend) the insulin before each injection:

  • Turn the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe up and down between position 1 and 2 so that the glass ball moves from one end of the insulin cartridge to the other (see diagram B above). Do this at least 10 times. Repeat the procedure until all of the insulin looks white and cloudy.
  • Continue to follow the directions as described in steps 1, 2, and 3 above. If there is a delay in any step, the insulin will need to be mixed (resuspended) again.

5. FUNCTION CHECK

NovoLog®  (50% insulin aspart protamine suspension and 50% insulin aspart injection, [rDNA origin])  Diagram K Illustration

If your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe is not working the right way, follow this procedure:

  • Screw on a new NovoFine® needle.
  • Do an airshot as described in step 1.
  • Put the big outer needle cap onto the needle. Do not put on the inner needle cap.
  • Turn the dose selector so that the arrow lines up with the 20 units in the dose indicator window.
  • Hold the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe so the needle is pointing down.
  • Press the push button all the way in.

The insulin should fill the lower part of the big outer needle cap (see diagram K above). If the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe has released too much or too little insulin, do the function check again. If it happens again, do not use your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe and contact Novo Nordisk at 1-800-727-6500.

6.IMPORTANT NOTES

  • If you need to do more than 6 airshots before the first use of each NovoLog® Mix 50/50 FlexPen® Prefilled syringe to get a drop of insulin at the needle tip, do not use the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe. Contact Novo Nordisk at 1-800-727-6500.
  • Remember to perform an airshot before each injection. See diagrams E and F.
  • Do not drop the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe.
  • Keep the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe with you. Do not leave it in a car or other place where it can get too hot or too cold.
  • NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe should be used with NovoFine® disposable needles.
  • Do not put a disposable needle on the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe until you are ready to use it. Remove the needle right after use. Do not recap the needle.
  • Throw away used needles safely, so other people will not be harmed. Talk to your healthcare provider about how to safely throw away your used needles.
  • Throw away the used NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe without the needle attached.
  • Always carry an extra NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe with you in case the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe is damaged or lost.
  • Keep your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe out of the reach of children. Use NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) FlexPen® Prefilled syringe as directed to treat your diabetes. Do not share it with anyone else even if he or she also has diabetes.

Patient Instructions for Use
NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge

Before using the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge

  1. Talk with your healthcare provider to find out where to inject NovoLog® Mix 50/50 (injection sites) and how to give an injection with your insulin delivery device.
  2. Read the instruction manual that comes with your insulin delivery device for complete instructions on how to use the PenFill® cartridge with the device.

How to use the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge

1. Check your insulin. Just before using your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge, check to make sure that you have the right type of insulin. This is especially important if you use different types of insulin.

2. Carefully look at the cartridge and the insulin inside it. The insulin should be white and cloudy (after being mixed). The tamper-resistant foil should be in place before the first use. If the foil has been broken or removed before your first use of the cartridge, or if the insulin is clear, do not use it. Call Novo Nordisk at 1-800-727-6500.

3. Gather your supplies for injecting NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) . You will need your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) PenFill® cartridge, your insulin delivery device, NovoFine® single use needles and an alcohol swab. Be sure to use an insulin delivery device that is made to work with NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) PenFill® cartridges. These insulin delivery devices can be used with a NovoPen® 3 PenMate® if you would like to hide the needle from view during injection.

4. Wash your hands well with soap and water.

5. Clean your injection site with an alcohol swab and let the injection site dry before you inject.

6.Before inserting a 3 mL cartridge into your insulin delivery device for the first time, roll the cartridge between your palms 10 times. These steps should be done with the 3 mL PenFill® cartridge in a horizontal(flat) position (see Diagram 1 below). Then turn the PenFill® cartridge up and down between positions a and b (see Diagram 2 below) so the glass ball moves from one end of the cartridge to the other. Do this at least 10 times. Repeat the rolling and turning steps until the insulin looks white and cloudy. Mixing is easier when the insulin is at room temperature.

Turn the PenFill® cartridge up and down between positions a and b - Illustration

7. Insert the PenFill® cartridge into the insulin delivery device. Wipe the front rubber stopper of the 3 mL PenFill® cartridge with an alcohol swab, then screw on a new needle (see Diagram 3 below).

Wipe the front rubber stopper of the 3 mL PenFill® cartridge with an alcohol swab, then screw on a new needle - Illustration

For NovoFine® needles, remove the big outer needle cap and the inner needle cap (see Diagram 4 above). Always use a new needle for each injection to prevent infection.

Giving the airshot before each injection:

To prevent the injection of air and make sure insulin is delivered; you must do an air shot before each injection. Hold the device with the needle pointing up and gently tap the PenFill® cartridge holder with your finger a few times to raise any air bubbles to the top of the cartridge (see Diagram 5 below). Do the airshot as described in the device instruction manual.

Giving the airshot before each injection - Illustration

Giving the injection

8. Dial the number of units you need to inject on the device (see Diagram 6 below). Inject right away as you were shown by your healthcare provider. If there is a delay between mixing of the insulin and the injection, the insulin will need to be mixed again.

Dial the number of units you need to inject on the device - Illustration

9. Pinch a fold of skin between 2 fingers, then push the needle into the pinched up skin (see Diagram 7 below). Inject the dose by pressing the push button all the way in. Keep the needle in the skin for at least 6 seconds, and keep the push button pressed all the way in until the needle has been pulled out from the skin. This will make sure that the full dose has been given. If blood appears after you take the needle out of your skin, press the injection site lightly with a finger. Do not rub the area.

Pinch a fold of skin between 2 fingers, then push the needle into the pinched up skin - Illustration

After the injection

10. Remove the needle from the insulin delivery device after each injection. Keep the 3 mL PenFill® cartridge in the insulin delivery device. The needle should not be attached to the insulin delivery device during storage. This will prevent infection or leakage of insulin, and will help ensure that you receive the right dose of NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) .

11. Put the used needle in a sharps container, or some type of hard plastic or metal container that can be sealed, such as a detergent bottle or coffee can. Ask your healthcare provider how to seal and throw away these containers safely. There may be local or state laws about how to throw away used needles and syringes.

12. Put the pen cap back on the insulin delivery device.

After the first use of the 3 mL PenFill® cartridge

  1. If the 3 mL PenFill® cartridge is already in the insulin delivery device, turn it upside down between positions a and b (see Diagram 2 above), so that the glass ball moves from one end of the 3 mL PenFill® cartridge to the other. Do this until all of the insulin looks white and cloudy.
  2. Before you inject, there must be at least 12 units of insulin left in the cartridge to make sure the remaining insulin is evenly mixed. If there are less than 12 units left, use a new 3 mL PenFill® cartridge.
  3. An airshot should be done before each injection. Do the airshot as described in the device instruction manual.
  4. Do not remove the 3 mL cartridge from the insulin delivery device.
  5. Put the pen cap back on the insulin delivery device.

IMPORTANT NOTES

  • Do not use if you need to do more than 6 airshots before the first use of each NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge to get a drop of insulin at the needle tip. Contact Novo Nordisk at 1-800-727-6500.
  • Remember to do an airshot before each injection. See the device instruction manual.
  • Do not drop the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge and insulin delivery device.
  • Keep the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge and insulin delivery device with you. Do not leave it in a car or other places where it can get too hot or too cold.
  • NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridges are designed for use with NovoFine® disposable needles.
  • Do not put a disposable needle on the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge and insulin delivery device until you are ready to use it. Remove the needle right after use. Do not recap the needle.
  • Throw away used needles safely, so other people will not be harmed. Talk to your healthcare provider about how to safely throw away your used needles.
  • Throw away the used NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridges without the needle attached.
  • Always carry an extra NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge with you in case the NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge is damaged or lost. Always keep the NovoLog® Mix 50/50 cartridge in the outer carton when you are not using it in order to protect it from light.
  • Keep your NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridge out of the reach of children. Use NovoLog® Mix 50/50 (50% insulin aspart protamine suspension and 50% insulin aspart injection) cartridges as directed to treat your diabetes. Do not share it with anyone else even if he or she also has diabetes.

Last reviewed on RxList: 9/30/2008
This monograph has been modified to include the generic and brand name in many instances.

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