DIABETES ADVISORY NOTICE - APIDRA INSULIN SUPPLY PROBLEM
1) Due to a problem with supplies of Apidra - currently expected to last well into next year - clinicians may have to seek alternative treatment for patients. (There is no problem with production or supplies of Apidra 10ml vials for use with needle and syringe).
2) Apidra is a rapid acting analogue insulin which for practical clinical purposes can be considered equivalent to either Humalog or Novorapid.
3) For all of these insulins there are reusable and disposable pen options and the simplest strategy would be to offer a like-for-like substitution as and when continued Apidra supplies become problematic.
4) For patients using Apidra 3ml cartridges (in reusable pens) the appropriate substitution is to use equal doses of
a) Humalog cartridges in a Humapen Luxura
b) Novorapid cartridges in a Novopen 4
5) For patients using Apidra in disposable units (SoloStar or Optiset) the appropriate substitution is to use equal doses of
c) Novorapid in a Flexpen (or new FlexTouch)
d) Humalog in a KwikPen
6) While no particular problems are anticipated, as with any change in insulin, patients should be reminded to be alert to the risk of hypoglycaemia.
7) There are apparently no problems with the quality or safety of any Apidra insulin already in circulation. On resumption of supplies, patients can make a (more!) informed choice of which preparation/device they prefer to use.
8) There are modest current product cost differentials with the cost of 5 cartridges / prefilled devices at present: a and b) £28.31, c £30.60 (Flexpen) / £32.13 (FlexTouch) and d) £29.46 (KwikPen).
9) Further advice in individual cases is, as always, available via the specialist diabetes service.
Dr Ken McHardy
15 Nov 2011
Please remember that due to a 'product rationalisation' procedure, Sanofi Aventis, who also produce Lantus, are already scheduled to withdraw Optipen, Optiset and Opticlix devices by the end of 2011. SoloStar (disposable) and ClikStar (reusable) devices will be the company's available alternatives; Autopen24 (Owen Mumford), already a popular choice of reusable device for those using 3ml Lantus cartridges, will still be available.