6.3.1.1 Insulins
NovoRapid® (insulin aspart) FlexTouch® 100units/ml solution for injection 3ml pre-filled pens are being discontinued. Stock is anticipated to be exhausted by March 2025.
Please do not initiate new patients on NovoRapid® (insulin aspart) FlexTouch® 100units/ml solution for injection 3ml pre-filled pens.
The recommendation in Kent and Medway is that patients currently prescribed NovoRapid® FlexTouch® pens are pro-actively reviewed and switched to Trurapi®, where clinically suitable in line with NICE guidelines on an individual patient basis.
Please see here on the SPS Medicines Supply Tool for more information and actions."
("Click here" to link to the following: https://www.sps.nhs.uk/shortages/discontinuation-of-novorapid-insulin-aspart-flextouch100units-ml-solution-for-injection-3ml-pre-filled-pens/ )
Suliqua® All strengths of Suliqua® (insulin glargine + lixisenatide) are being discontinued in March 2025 (100units/ml /33micrograms/ml and 100units/ml /50micrograms/ml solution for injection pre-filled SoloStar pens). Please see here on the SPS Medicines Supply Tool for more information and actions."
Click here for link to SPS https://www.sps.nhs.uk/shortages/discontinuation-of-insulin-glargine-lixisenatide-suliqua/
The Levemir® (insulin detemir) range will be discontinued at the end of 2026. Further information will be communicated following the publication of National advice in a Medicines Supply Notification, providing guidance for prescribers on what alternatives will be available and recommended
*SUPPLY ISSUE: A Medicine Supply Notification (MSN) was issued on the 4th March 2024 on the shortage of Fiasp® (insulin aspart) FlexTouch® 100units/ml solution for injection 3ml pre-filled pens. The shortage started on 1st April 2024, and on 26th November 2024 the anticipated resupply date has been updated to 2nd January 2026.
Please see the SPS medicines supply tool (free subscription required) for further information, actions and advice on alternatives and the current anticipated re-supply date.
(Link for SPS: https://www.sps.nhs.uk/shortages/shortage-of-fiasp-flextouch-insulin-aspart-100units-ml-solution-for-injection-3ml-pre-filled-pens/ )
Please do not initiate new patients on Fiasp® (insulin aspart) FlexTouch® 100units/ml solution for injection 3ml pre-filled pens for the duration of the shortage.
*SUPPLY ISSUE: A Medicine Supply Notification (MSN) was issued on the 24th May 2023 on the shortage of Tresiba® (insulin degludec) FlexTouch® 100units/ml solution for injection 3ml pre-filled pens. This has since been deescalated from a tier 3 to a tier 2 in September 2024. The shortage started on 1st August 2023, and on 2nd December 2024 the anticipated resupply date has been updated to 2nd January 2026.
Please see the SPS medicines supply tool (free subscription required) for further information, actions and advice on alternatives and the current anticipated re-supply date. Link for SPS: https://www.sps.nhs.uk/shortages/shortage-of-tresiba-insulin-degludec-flextouch-100units-ml-solution-for-injection-3ml-pre-filled-pens/
Please do not initiate new patients on Tresiba® (insulin degludec) FlexTouch® 100units/ml solution for injection 3ml pre-filled pens for the duration of the shortage.
**A National Patient Safety Alert (NPSA) was issued on the 8th of December 2023 about the "Potential for inappropriate dosing of insulin when switching insulin degludec (Tresiba®) products". Please refer to the NPSA for further information on the identified safety issue, clinical information and actions required.**" Link for NPSA:https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103242
Note: Prescribing Insulins
- Always remember to prescribe the needles for SC injection.
- The type of insulin and administration device needed should always be specified alongside the insulin prescription. (e.g disposable pen or 3ml cartridge)
- Nurses should ensure that an individual sharps bin is given to patients who are self-managing.
For more information on the PRGC Recommendations please click the following links (pdf)
Insulin Degludec/ Liraglutide (IDegLira; Xultophy) for type 2 diabetes mellitus
• For Kent and Medway Guidance on Safe Insulin Prescribing
&
• Kent and Medway Guidance of Biosimilar Insulin Prescribing
Click Here
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 1 vial |
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
Insulin Aspart - (FIASP) Initiation and stabilisation should be in SECONDARY CARE ONLY and only for patients fitting in the specialist criteria:
- Pregnancy where tight control is needed
- Clinical diagnosis of gastroparesis
- Type 1 diabetics only requiring tighter control
NovoRapid® (insulin aspart) FlexTouch® 100units/ml solution for injection 3ml pre-filled pens are being discontinued. Stock is anticipated to be exhausted by March 2025.
Please do not initiate new patients on NovoRapid® (insulin aspart) FlexTouch® 100units/ml solution for injection 3ml pre-filled pens.
The recommendation in Kent and Medway is that patients currently prescribed NovoRapid® FlexTouch® pens are pro-actively reviewed and switched to Trurapi®, where clinically suitable in line with NICE guidelines on an individual patient basis.
Please see here on the SPS Medicines Supply Tool for more information and actions."
("Click here" to link to the following: https://www.sps.nhs.uk/shortages/discontinuation-of-novorapid-insulin-aspart-flextouch100units-ml-solution-for-injection-3ml-pre-filled-pens/ )
| Pack |
|---|
| 1 vial |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 1 vial |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 5 cartridge |
New patients should be started on Trurapi. Where clinically suitable in line with NICE guidelines on an individual patient basis, patients can be switched from originator product to Trurapi as a shared decision with a patient, with close glucose monitoring where this decision is made.
| Pack |
|---|
| 1 vial |
New patients should be started on Trurapi. Where clinically suitable in line with NICE guidelines on an individual patient basis, patients can be switched from originator product to Trurapi as a shared decision with a patient, with close glucose monitoring where this decision is made.
| Pack |
|---|
| 5 cartridge |
New patients should be started on Trurapi. Where clinically suitable in line with NICE guidelines on an individual patient basis, patients can be switched from originator product to Trurapi as a shared decision with a patient, with close glucose monitoring where this decision is made.
| Pack |
|---|
| 5 pre-filled disposable injection |
This is only for initiation by diabetes specialist consultants, diabetes specialist nurses and GPs with specialist interest in diabetes. Criteria for use are specified in the PRGC document PR 2017-04 Insulin degludec for type 1 diabetes in adults and PRGC document PR 2019-06: Insulin degludec for adults with type 2 diabetes mellitus.
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 3 pre-filled disposable injection |
The Levemir® (insulin detemir) range will be discontinued at the end of 2026. Further information will be communicated following the publication of National advice in a Medicines Supply Notification, providing guidance for prescribers on what alternatives will be available and recommended
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 1 vial |
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
| Pack |
|---|
| 3 pre-filled disposable injection |
| Pack |
|---|
| 3 pre-filled disposable injection |
• Warning where there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
New patients should be started on Admelog. Where clinically suitable in line with NICE guidelines on an individual patient basis, patients can be switched from originator product to Admelog as a shared decision with a patient, with close glucose monitoring where this decision is made.
| Pack |
|---|
| 1 vial |
New patients should be started on Admelog. Where clinically suitable in line with NICE guidelines on an individual patient basis, patients can be switched from originator product to Admelog as a shared decision with a patient, with close glucose monitoring where this decision is made.
| Pack |
|---|
| 5 cartridge |
New patients should be started on Admelog. Where clinically suitable in line with NICE guidelines on an individual patient basis, patients can be switched from originator product to Admelog as a shared decision with a patient, with close glucose monitoring where this decision is made.
| Pack |
|---|
| 5 pre-filled disposable injection |
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
| Pack |
|---|
| 1 vial |
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
| Pack |
|---|
| 5 pre-filled disposable injection |
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
| Pack |
|---|
| 5 pre-filled disposable injection |
Lyumjev® is the second line option for the treatment of diabetes mellitus in patients who are suitable for Humalog® and their diabetes cannot be adequately managed with Humalog choices and at least one of the following applies:
o Where the prescriber believes a faster onset of action would be beneficial to the patient
o Where a patient requires ‘tight’ control of blood sugar levels
o Where a patient has rapid post-meal increase in blood sugar levels”
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
| Pack |
|---|
| 1 vial |
Lyumjev® is the second line option for the treatment of diabetes mellitus in patients who are suitable for Humalog® and their diabetes cannot be adequately managed with Humalog choices and at least one of the following applies:
o Where the prescriber believes a faster onset of action would be beneficial to the patient
o Where a patient requires ‘tight’ control of blood sugar levels
o Where a patient has rapid post-meal increase in blood sugar levels”
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
| Pack |
|---|
| 5 cartridge |
Lyumjev® is the second line option for the treatment of diabetes mellitus in patients who are suitable for Humalog® and their diabetes cannot be adequately managed with Humalog choices and at least one of the following applies:
o Where the prescriber believes a faster onset of action would be beneficial to the patient
o Where a patient requires ‘tight’ control of blood sugar levels
o Where a patient has rapid post-meal increase in blood sugar levels”
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
| Pack |
|---|
| 5 pre-filled disposable injection |
Lyumjev® is the second line option for the treatment of diabetes mellitus in patients who are suitable for Humalog® and their diabetes cannot be adequately managed with Humalog choices and at least one of the following applies:
o Where the prescriber believes a faster onset of action would be beneficial to the patient
o Where a patient requires ‘tight’ control of blood sugar levels
o Where a patient has rapid post-meal increase in blood sugar levels”
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance
| Pack |
|---|
| 5 pre-filled disposable injection |
This device allows half unit doses titration of insulin which will be useful to optimise glucose control.
Lyumjev® is the second line option for the treatment of diabetes mellitus in patients who are suitable for Humalog® and their diabetes cannot be adequately managed with Humalog choices and at least one of the following applies:
o Where the prescriber believes a faster onset of action would be beneficial to the patient
o Where a patient requires ‘tight’ control of blood sugar levels
o Where a patient has rapid post-meal increase in blood sugar levels”
• Warning there are 2 strengths available- to avoid errors ensure the brand, strength and device is clear and in line with MHRA guidance’’
| Pack |
|---|
| 5 pre-filled disposable injection |
Insulatard® (isophane insulin, human) Penfill® 100units/ml suspension for injection 3ml cartridges are being discontinued. Stock is anticipated to be exhausted by June 2025.
Please do not initiate new patients on Insulatard® (isophane insulin, human) Penfill® 100units/ml suspension for injection 3ml cartridges.
Please see here on the SPS Medicines Supply Tool for more information and actions
| Pack |
|---|
| 1 vial |
Insulatard® (isophane insulin, human) Penfill® 100units/ml suspension for injection 3ml cartridges are being discontinued. Stock is anticipated to be exhausted by June 2025.
Please do not initiate new patients on Insulatard® (isophane insulin, human) Penfill® 100units/ml suspension for injection 3ml cartridges.
Please see here on the SPS Medicines Supply Tool for more information and actions
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 1 vial |
| Pack |
|---|
| 5 cartridge |
| Pack |
|---|
| 5 pre-filled disposable injection |
- First Line Choice
- On Formulary
- Specialist Initiation Only
- Hospital Only
- KMPT Initiation Only