- Approval Id
- 43268816ccb55c13
- Drug Name
- FIASP FLEXTOUCH 100U/ML
- Product Name
- FIASP FLEXTOUCH 100U/ML
- Approval Number
- SIN15994P
- Approval Date
- 2020-08-17
- Registrant
- NOVO NORDISK PHARMA (SINGAPORE) PTE LTD
- Licence Holder
- NOVO NORDISK PHARMA (SINGAPORE) PTE LTD
- Drug Type
- Therapeutic
- Forensic Classification
- Prescription Only
- Dosage Form
- INJECTION, SOLUTION
- Dosage
- **4.2 Posology and method of administration**
Posology
Fiasp® is a mealtime insulin for subcutaneous administration up to 2 minutes before the start of the meal, with the option to administer up to 20 minutes after starting the meal (see section 5.1 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
Dosing with Fiasp® is individual and determined in accordance with the needs of the patient. Fiasp® given by subcutaneous injection should be used in combination with intermediate-acting or long-acting insulin given at least once a day. In a basal-bolus treatment regimen approximately 50% of this requirement may be provided by Fiasp® and the remaining by intermediate-acting or long-acting insulin.
The individual total daily insulin requirement in adults, adolescents and children may vary and is usually between 0.5 and 1 unit/kg/day.
Blood glucose monitoring and insulin dose adjustment are recommended to achieve optimal glycaemic control.
Adjustment of dose may be necessary if patients undertake increased physical activity, change their usual diet or during concomitant illness. Blood glucose levels should be monitored adequately under these conditions.
The duration of action will vary according to the dose, injection site, blood flow, temperature and level of physical activity.
Patients on basal-bolus treatment who forget a mealtime dose are advised to monitor their blood glucose level to decide if an insulin dose is needed. Patients should resume their usual dosing schedule at the next meal.
The potency of insulin analogues, including Fiasp®, is expressed in units. One (1) unit of Fiasp® corresponds to 1 international unit of human insulin or 1 unit of other fast-acting insulin analogues.
The early onset of action must be considered when prescribing Fiasp® (see section 5.1 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
_Initiation_
_Patients with type 1 diabetes mellitus_
The recommended starting dose in insulin naïve patients with type 1 diabetes is approximately 50% of the total daily insulin dose and should be divided between the meals based on the size and composition of the meals. The remainder of the total daily insulin dose should be administered as intermediate-acting or long-acting insulin. As a general rule, 0.2 to 0.4 units of insulin per kilogram of body weight can be used to calculate the initial total daily insulin dose in insulin naïve patients with type 1 diabetes.
_Patients with type 2 diabetes mellitus_
The suggested initial dose is 4 units at one or more meals. The number of injections and subsequent titration will depend on the individual glycaemic target and the size and composition of the meals.
Dose adjustment may be considered daily based on self-measured plasma glucose (SMPG) on the previous day(s) according to Table 1.
- Pre-breakfast dose should be adjusted according to the pre-lunch SMPG the previous day
- Pre-lunch dose should be adjusted according to the pre-dinner SMPG the previous day
- Pre-dinner dose should be adjusted according to the bedtime SMPG the previous day
_Special populations_
_Elderly patients (≥ 65 years old)_
The safety and efficacy of Fiasp® have been established in elderly patients aged 65 to 75 years. Close glucose monitoring is recommended and the insulin dose should be adjusted on an individual basis (see sections 5.1 and 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). The therapeutic experience in patients ≥ 75 years of age is limited.
_Renal impairment_
Renal impairment may reduce the patient’s insulin requirements. In patients with renal impairment, glucose monitoring should be intensified and the dose adjusted on an individual basis (see section 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
_Hepatic impairment_
Hepatic impairment may reduce the patient’s insulin requirements. In patients with hepatic impairment, glucose monitoring should be intensified and the dose adjusted on an individual basis (see section 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
_Paediatric population_
Fiasp® can be used in adolescents and children from the age of 2 years (see section 5.1 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). There is no clinical experience with the use of Fiasp® in children below the age of 2 years.
Fiasp® is recommended to be administered prior to the meal (0–2 minutes), with the flexibility to administer up to 20 minutes after starting the meal in situations, when there is uncertainty about the meal intake.
_Transfer from other insulin medicinal products_
Close glucose monitoring is recommended during the transfer from other mealtime insulins and in the initial weeks thereafter. Converting from another mealtime insulin can be done on a unit-to-unit basis. Transferring a patient from another type, brand or manufacturer of insulin to Fiasp® must be done under strict medical supervision and may result in the need for a change in dose.
Doses and timing of concurrent intermediate-acting or long-acting insulin medicinal products or other concomitant antidiabetic treatment may need to be adjusted.
Method of administration
_Subcutaneous injection_
Fiasp® is recommended to be administered subcutaneously by injection in the abdominal wall or the upper arm (see section 5.2 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). Injection sites should always be rotated within the same region in order to reduce the risk of lipodystrophy and cutaneous amyloidosis (see sections 4.4 and 4.8 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_).
The pre-filled pen (FlexTouch®) is designed to be used with NovoTwist®, NovoFine® or NovoFine® Plus injection needles. The pre-filled pen (FlexTouch®) delivers 1–80 units in steps of 1 unit.
For instructions on administration, see ‘Instructions on how to use Fiasp® FlexTouch®’ at the end of this package leaflet – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_. The pre-filled pen is only suitable for subcutaneous injections. If administration by syringe, intravenous injection or infusion pump is necessary, a vial should be used.
- Route Of Administration
- SUBCUTANEOUS
- Indication Info
- **4.1 Therapeutic indications**
Treatment of diabetes mellitus in adults, adolescents and children aged 2 years and above.
- Contraindications
- **4.3 Contraindications**
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_.
- Atc Code
- A10AB05
- Atc Item Name
- insulin aspart
- Pharma Manufacturer Name
- NOVO NORDISK PHARMA (SINGAPORE) PTE LTD
- Company Detail Path
- /organization/877c4bac80747145/novo-nordisk-pharma-singapore-pte-ltd
