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

Insuman insulin shortage

Sanofi have announced there will be a temporary and short-term supply shortage of

  • Insuman® Basal pre-filled pens
  • Insuman® Basal cartridges
  • Insuman® Comb25 (pre-mixed insulin) pre-filled pens.
  • Insuman® Comb25 (pre-mixed insulin) cartridges

 

Vials of both products are unaffected. The NHSGGC Diabetes MCN has issued the following guidance for managing the shortage.

 

Summary of Recommendations

  • Patients on Insuman Basal® can be switched to Humulin 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)

 

Cartridges

Or

Solostar (prefilled disposable pen)

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 )

 

Cartridges

Or

Solostar (prefilled disposable pen)

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.

 

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 and prescribers can call Sanofi Medical Information on the Insuman Emergency Line on 0800 281 973 to discuss whether a vulnerable patient supply of Insuman Basal / Comb25 on an individual basis may be appropriate.

 

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 18/01/2016