NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Insulin Insuman Shortage

There is a supply shortage of all Insuman® Basal and Insuman® Comb25 products

 

High Risk Patients

For some high risk patients (aged under 18 year or 70 years and over, pregnancy, allergies to other insulins etc), it may not be appropriate to change. Sanofi have restricted stocks for these patients so prescribers should call Medical Information on the Insuman Emergency Line on 0800 281 973 to discuss a vulnerable patient supply of Insuman Basal / Comb25 on an individual basis.

 

The NHSGGC Diabetes MCN issued the following guidance in January 2016 for managing the shortage which is still valid.

 

 Summary of Recommendations

  • Patients on Insuman Basal® can be switched to Humulin I® KwikPen®at the same dose.
  • Patients on Insuman Comb 25® can be switched to Humulin M3®KwikPen® at the same doses. The onset of action is similar with these two products, but there is slightly more quick acting insulin in M3 than in Comb25 ie 30% compared with 25%.

 

Insuman Product Alternative Insulin Recommended Dose Monitoring and Follow up
Basal  (isophane human 100units/ml) Humulin I  (isophane human 100units/ml) KwikPen Same dose as Insuman Basal Advise patient to monitor blood glucose levels (2-4 times a day for a week) and seek advice if not controlled
Comb 25 (isophane human 75 units/ml & soluble human 25 units/ml ) Humulin M3
(isophane human 70 units/ml & soluble human 30 units/ml) KwikPen

Same dose as current Insuman Comb 25 dose.


Please note there is slightly more quick acting insulin in M3 than in Comb25 ie 30% vs 25%. 

Advise patient to monitor blood glucose levels (2-4 times a day for a week) and seek advice if not controlled

 

  • If it becomes necessary to change the prescribed insulin, the advice to switch patients to KwikPen disposable injection devices is an interim measure to avoid confusion with different pen devices and cartridges.
  • A dose for dose switch is recommended for all preparations.
  • If patients have any issues with their device or there are any problems with their blood sugar control they should contact their diabetes care provider.
  • All patients must receive appropriate advice on the use of the new product and additional monitoring and follow up arrangements.

 

Additional Support

Patients may need support with using the new device, though the pen devices are similar. Where prescribers do not feel competent to undertake this, further advice is available from the Diabetes team that the patient is currently under

 

Communication

Please ensure that any change in insulin brand/device is communicated to the patient, carer and healthcare professionals involved in the care of the patient.

 

Community pharmacists dispensing Humulin I & Humulin M3 KwikPens are asked to confirm patients are expecting the change in insulin, they have been advised how to use the KwikPen and are aware of the requirement for monitoring blood glucose.

 

 

Published 2nd December 2016