PracticeUpdate Diabetes June 2019

* Compared with NovoRapid ® (insulin aspart) 1,2 A faster insulin response at mealtime * For adult patients with diabetes, Fiasp ® is:

2X faster into the bloodstream vs. NovoRapid ®1,3† Faster † Earlier onset of appearance in the bloodstream vs. NovoRapid ® [4.1 min vs. 8.9 min; P < 0.001] after administration in patients with type 1 diabetes. 1,3

Flexible

A faster formulation of NovoRapid ®1 – the world’s most prescribed rapid-acting insulin 4‡ Familiar

Dose within 2 minutes before or 20 minutes after the start of a meal 1

20

2

‡ IMS MIDAS (MAT December 2018 volume). 4

PBS Information: Fiasp ® is listed on the PBS for the treatment of diabetes mellitus.

Please review Product Information before prescribing. The Product Information can be accessed at www.novonordisk.com.au

Fiasp ® (insulin aspart (rys)). Indication: Treatment of diabetes mellitus in adults. Contraindications: Hypersensitivity to insulin aspart or excipients. Precautions: Fiasp ® has a distinct time action profile (see ’Pharmacology’ in full PI). If hypoglycaemia occurs, it may occur earlier after an injection/infusion when compared to other mealtime insulins. Where blood glucose is greatly improved, e.g. by intensified insulin therapy, patients may experience a change in usual warning symptoms of hypoglycaemia, and should be advised accordingly.The impact of the fast onset of action should be considered in patients with delayed gastric emptying. Inadequate dosing or discontinuation of treatment may lead to hyperglycaemia and diabetic ketoacidosis. Instruct patients to always check the insulin label before each injection to avoid accidental mix-ups between Fiasp and other insulin products. Fiasp must not be diluted or mixed with any other products except infusion fluids as described in method of administration. Pregnancy Category: A. Can be used in pregnancy (see ‘Clinical Trials’ in full PI). Paediatric use: The efficacy and safety of Fiasp in children and adolescents below 18 years of age have not been established. Use in the elderly: Close glucose monitoring is recommended and the insulin dose should be adjusted on an individual basis (see ’Pharmacology’ and ’Clinical Trials’ in full PI). Interactions: Oral hypoglycaemic agents, octreotide, lanreotide, monoamine oxidase inhibitors, non-selective, beta-adrenergic blocking agents, angiotensin converting enzyme (ACE) inhibitors, salicylates, alcohol, anabolic steroids, sulphonamides, oral contraceptives, thiazides, glucocorticoids, thyroid hormones, sympathomimetics, growth hormone, danazol. Adverse Effects: Hypoglycaemia. Dosage and Administration: Dosage as determined by physician. Fiasp is an ultrafast acting insulin. Fiasp should be administered 0-2 minutes before a meal, or up to 20 minutes after the start of a meal. The pharmacokinetic profiles of Fiasp and NovoRapid ® are distinct during the first hour following administration which is of particular importance for a mealtime insulin.The earlier onset of action of Fiasp and the subsequent increased glucose lowering effect compared with NovoRapid must be considered when prescribing Fiasp. Converting from another mealtime insulin can be done on a unit-to-unit basis but must be done under medical supervision. Patients transferring from other insulins will require training. Fiasp can be used subcutaneously, intravenously or via continuous subcutaneous insulin infusion (CSII). (March 2019) References: 1. Fiasp ® Product Information. 2. NovoRapid ® Product Information. 3. Heise T, et al. Clin Pharmacokinet. 2017; 56: 551-9. 4. Internal calculations based on IQVIA IMS database. IQVIA MIDAS (Dec 2018). Abbreviation: MAT, moving annual total. Novo Nordisk Pharmaceuticals Pty. Ltd. Level 3, 21 Solent Circuit, Baulkham Hills NSW 2153 Australia. Telephone: +61 2 8858 3600 | E-mail: aunrccc@novonordisk.com Internet: www.novonordisk.com.au ®Registered trademark of Novo Nordisk A/S. AU19FSP00013. Date of Preparation: May 2019.