Insulin Aspart

Insulin, Rapid-acting insulin analog, Mealtime (bolus) insulin

Insulin aspart

NovoLog, Fiasp (ultra-rapid), Trurapi

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Titration strategies

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Summary

Classes

Insulin, Rapid-acting insulin analog, Mealtime (bolus) insulin

Pharmacy

Starting dose

SC 4-6 units (or 1 unit per 10-15 g carbs) at meals; titrate to postprandial glucose

Preparations

100 U/mL (NovoLog, Fiasp) vials, pens, cartridges

US FDA Max

Titrated to glucose; no fixed maximum

Pharmacology

Routes

Subcutaneous, IV, insulin pumps

Onset

SC: 5-15 minutes (Fiasp 2.5 minutes earlier on average)

Duration

3-5 hours

Half-life

~80 minutes SC

Bioavailability

~100% from subcutaneous depot

Pregnancy

Insulin is the preferred glucose-lowering therapy in pregnancy; aspart is widely used.^{[citation needed]}

Legal status

Rx-only in US

Purported mechanism

Insulin aspart is a recombinant human insulin analog with B28-Pro replaced by aspartate; the substitution reduces hexamer stability, so injected insulin dissociates to monomer rapidly and absorbs in time for a meal-timed dose.▲0▼ Binds the same insulin receptor as endogenous insulin with comparable mitogenic-to-metabolic ratio. Fiasp formulation adds niacinamide and L-arginine to accelerate the initial absorption phase further, allowing dosing at meal start (or up to 20 minutes after).