NovoMix 30 FlexPen 100 IU/ml | Biphasic Insulin Aspart Premixed Pen

NovoMix 30 FlexPen – Biphasic Insulin Aspart 30 by Novo Nordisk

What is NovoMix 30 FlexPen?

NovoMix 30 FlexPen is a premixed biphasic insulin analogue combining 30% soluble insulin aspart (rapid-acting, post-meal control) and 70% insulin aspart protamine crystals (intermediate-acting, basal control) in a single twice-daily injection. Manufactured by Novo Nordisk A/S (Denmark), it covers both prandial and basal insulin needs — eliminating separate short-acting and basal insulin pens. The FlexPen device allows 1-unit increments up to 60 IU. Must be resuspended before each injection as it is a suspension. Widely used in Bangladesh for Type 2 diabetes for its combination convenience.

Generic Name & Composition

Each ml: 30 IU soluble insulin aspart (rapid, onset 10–20 min, peak 1–3 hrs) + 70 IU insulin aspart protamine crystals (intermediate, duration 18–24 hrs). Insulin aspart's B28 substitution (proline → aspartate) provides faster absorption than regular insulin. The protamine fraction acts as an intermediate component mimicking basal secretion.

Indications

• Type 2 diabetes — twice-daily premixed analogue regimen
• Type 1 diabetes — when premixed analogue is clinically appropriate
• Transitioning from oral antidiabetics to insulin
• Patients with fixed meal schedules preferring a single injection

How It Works — Mechanism of Action

Soluble aspart (30%): Rapidly absorbed (onset 10–20 min, peak 1–4 hrs) — post-meal glucose control. Protamine aspart (70%): Slowly dissolves over 18–24 hrs — prolonged basal coverage. Both activate insulin receptors: GLUT-4 glucose uptake, hepatic output suppression, glycogen synthesis.

Dosage & Administration

Regimen: Twice daily before breakfast and dinner. Starting dose (Type 2): 6 IU twice daily; titrate by 2 IU every 3 days. FlexPen: Roll 10×, invert 10× until milky suspension is uniform. Dial dose, inject subcutaneously. Do not shake — causes foaming and inaccurate dosing.

Side Effects

Very common: Hypoglycaemia — if meal is delayed or dose is too high.

Common: Injection site reactions, lipohypertrophy, weight gain.

Uncommon: Lipoatrophy, peripheral oedema, visual changes at initiation.

Rare: Anaphylaxis, severe allergic reactions.

Drug Interactions

Increase hypoglycaemia: Oral antidiabetics, GLP-1 agonists, SGLT-2 inhibitors, ACE inhibitors, MAO inhibitors, salicylates, alcohol.

Reduce effect: Corticosteroids, glucagon, thyroid hormones, thiazides, sympathomimetics, oral contraceptives.

Caution: Beta-blockers mask hypoglycaemia symptoms.

Contraindications

• Hypersensitivity to insulin aspart, protamine, or any excipient
• Active hypoglycaemia; subcutaneous use only

Pregnancy & Lactation

Pregnancy: Insulin aspart may be used; specialist supervision required. Lactation: Not expected at clinically significant concentrations in breast milk.

Precautions & Warnings

• Always resuspend before use: Roll 10×, invert 10×. Uneven suspension causes inaccurate dosing.
• Inject within 15 minutes before meal due to rapid aspart onset.
• Do not freeze. Protect from light.

Overdose

Hypoglycaemia. Mild: oral glucose. Severe: IV dextrose or IM glucagon. Monitor every 2–4 hours until stable.

Storage Instructions

• Unopened: 2–8°C. Do not freeze.
• In-use pen: Below 30°C. Do not refrigerate.
• Discard 28 days after first use.

Frequently Asked Questions (FAQs)

Q1: Why does NovoMix 30 need to be rolled and inverted before use?
NovoMix 30 is a suspension — protamine crystals settle at the bottom. Rolling and inverting 10 times each resuspends them uniformly. Without this, you inject an incorrect 30/70 ratio leading to unpredictable glucose control.

Q2: How is NovoMix 30 different from Mixtard 30?
Both are biphasic 30/70 premixed insulins, but NovoMix 30 uses insulin aspart (analogue, onset 10–20 min) while Mixtard 30 uses regular human insulin (onset 30–60 min). NovoMix 30 allows injection closer to meals and generally provides better post-meal control.

Q3: Can I inject NovoMix 30 at any time of day?
NovoMix 30 must be injected within 15 minutes before meals (typically breakfast and dinner). Unlike basal insulins, it cannot be taken at any time — the rapid component acts immediately.

Q4: Who manufactures NovoMix 30?
Novo Nordisk A/S (Denmark). NovoMix 30 is part of Novo Nordisk's insulin aspart (NovoRapid) product family.

⚕ Medical Disclaimer: For educational purposes only. NovoMix 30 is Rx-only. Consult your diabetologist before changing insulin therapy. DiabetesStore.com.bd is a licensed online pharmacy.