novolog vs. humalog

[nantomsuethom]

How much of a diff. is there in Novolog and Humalog?

Thomas has been using Humalog in his pump. The doctor gave us some free Novolog. My husband seems to think if we change to the Novolog Thomas will have to make changes in his basals.

Also, I changed his site yesterday but not his cartridge (thought he had at least 2 days left). Can I put novolog in his cartridge with humalog in the tubing?

I will probably just change out the whole site. I just thought maybe someone would have some input on the 2.

Nancy

[David]

Novolog and Humalog are supposed to be equivalent, but some find a difference in their action. Novolog has a slightly longer tail of action for most of us. You may need to make adjustments to counter this but that's not for sure. Some (like me for example) find that Novolog takes longer to start working, for others the opposite is true.
Don't mix Novolog and Humalog in reservoirs or tubing.
David

[HeatherP]

Don't quote me on this, but it seems to me I read recently that Humalog isn't FDA approved to use in pumps. Not that the gov is the most up-to-date consultant to health care.

My understanding is that Novolog is Lilly's biggest competitor's answer to Humalog and so the two should be approx. equivalent.

[Shalyndria]

You're right Heather, Humalog isn't FDA approved for the pump. Approval is more of a formality though, and as far as I'm aware Lilly isn't making any plans to have the FDA's blessing any time soon.

Nancy, I've heard a lot of people say that after switching from Humalog to Novolog (Novorapid) they saw a significant decrease in insulin requirements, and also found Novolog to peak and hit a little harder than Humalog. Of course this isn't the same for everyone and YMMV. You might find that you have to tweak his basals or CHO ratios after switching, in which case you may want to have him monitor his BG's a little more frequently. I think if you do a search of the forums you'll find some good personal experiences from members regarding switching analogue insulins.

Switching reservoirs as well as infusion sets when switching insulin is a good idea. Like David said, don't mix the two.

Good luck and let us know how it turns out :)
Shy

[nantomsuethom]

Thomas' endo gave us 2 vials of Novolog. She read a study that said sites will last longer with Novolog. Of course the study was done by the co. that makes it.

OK-

We used the 2 vials of Novolog and are back to Humalog.

For the month and a half Thomas had Novolg in his pump his sites lasted the whole 3+ days unless the cath. got kinked. He didn't need to make any changes in his basasl (well we did but that was after wearing a sensor for 3 days and that was between the 2 insulins).

He had Humalog in his pump for 2 days and the site went bad. The first day his bg were good. The 2nd day his bgs started creeping up- 160-190- for no reason. Last night before I went to bed I checked his bg and it was 364!! No ketones, so we changed his site. He is back down to 150 when he woke up this morning.

We have 6 vials of Humalog left. It will be interesting to see if this keeps up. Unfortunately we will have to fight the insurance co. for Novolog- they only cover Humalog.

[David]

Humalog was approved for use in some pumps in June. This approval applies to only specific pumps and sets: MiniMed Models 506, 507, and 508 using MiniMed Polyfin infusion sets and Disetronic's H-TRONplus V100 (with plastic 3.15 mL reservoir), and the D-TRON and D-TRONplus insulin pumps (with Humalog 3 mL cartridges) using Disetronic Rapid infusion sets.

http://www.fda.gov/cder/rdmt/ESCY04AP.htm
http://www.fda.gov/cder/foi/appletter/2004/20563se3-024ltr.pdf

Humalog is not (yet) approved for use with any other pump or set. Point out this fact to your insurance company if you prefer Novolog. While doctors are allowed to prescribe approved meds for unapproved uses, if your doc prescribes the only approved med available for its approved use, your insurance should comply if you push the issue. (assuming you're not using one of the above pumps and sets). Don't wait if you're planning to appeal, since this partial approval will likely be extended to all pumps/sets sooner or later and you'll have less chance to win after full FDA approval.
David

[nantomsuethom]

David,

Thomas has an Animas 1200 and is using the new inset infusion sets. So as for now we shouldn't have a problem getting the insurance co. to cover (hopefully not). We have Aetna and they seem to be pretty good. We will see.

Thanks for the info. I am going to call his CDE in the morning.

Nancy