Novolog dosage, forms, and strengths

Novolog is a rapid-acting insulin used to control high blood sugar levels in people with diabetes mellitus (Type 1 diabetes, Type 2 diabetes, or gestational diabetes). Insulin aspart, the active ingredient in Novolog, is a human insulin analog that has a similar chemical structure to regular insulin but it starts working faster and lasts for a shorter duration. 

Because of its rapid onset and short duration of action, insulin aspart can be administered shortly before every meal as needed. Rapid-acting insulins like Novolog are called prandial insulins, that is, they are taken to control blood sugar spikes associated with meals. Like other prandial insulins, Novolog is usually taken with a basal insulin that provides glycemic control throughout the day. A Novolog combination insulin is available called Novolog 70/30, which contains 70% rapid-acting insulin aspart combined with 30% intermediate-acting insulin aspart protamine. 

Novolog is injected beneath the skin (subcutaneous) five to ten minutes before a meal using a standard insulin syringe, reusable PenFill injector, NovoLog FlexPen, or NovoLog FlexTouch injector. Novolog can also be used with an insulin infusion pump.  

RELATED: Learn more about NovoLog | Get NovoLog discounts

Novolog forms and strengths

Most people who use Novolog give themselves subcutaneous injections through a standard syringe with needle or a NovoLog insulin pen injector. Others inject Novolog through their subcutaneous insulin pump and will need to refill the pump reservoir regularly.

• Multidose vial: 10 mL at 100 units/mL

• PenFill cartridge: 3 mL at 100 units/mL

• FlexPen injection pen: 3 mL at 100 units/mL

• FlexTouch injection pen: 3 mL at 100 units/m

ReliOn Novolog is sold at Walmart in two dose formats: multidose vials and FlexPens. Walmart started producing their own Novolog as a lower-cost alternative to Novolog produced by Novo Nordisk. It is chemically identical to Novolog produced by Novo Nordisk.

Novolog dosage for adults

Novolog is prescribed as a prandial (“mealtime”) insulin to help control blood sugar levels following a meal. Some doctors may prescribe Novolog off-label to treat diabetic ketoacidosis, a potentially serious complication of diabetes in which the body is unable to produce enough insulin. For most patients with diabetes mellitus, Novolog is just one part of an insulin regimen. People with diabetes may also be on a long-acting insulin (basal insulin) that helps keep fasting blood sugar levels normal throughout the day. 

Doses will vary depending on individual needs, blood sugar levels, blood sugar goals, age, route of administration, physical activities, meal patterns, and overall health. In general, adults with Type 1 diabetes require 0.5 to 1 unit of insulin per kilogram of body weight per day. Approximately half of the daily insulin dose is usually given with prandial insulin, such as NovoLog. People with Type 2 diabetes may not need insulin or have lower daily insulin requirements-. People taking insulin may also be prescribed daily oral antidiabetic medications, such as metformin.

Source: Epocrates

Novolog dosage for children

NovoLog is FDA-approved to treat children as young as two years of age with Type 1 diabetes. As with adults, children may take NovoLog to control high blood sugar levels following a meal. Children taking Novolog may also need to take an intermediate- or long-acting insulin to regulate fasting blood sugar throughout the day.

Doses will vary. In general, children with Type 1 diabetes require 0.7 to 1 unit of insulin per kilogram of body weight per day. Adolescents with Type 1 diabetes require more insulin, usually 1 to 2 units/kg/day. 

Source: Epocrates

Novolog dosage restrictions

People with kidney problems (renal impairment) or liver problems (hepatic impairment) may be prescribed lower doses of insulin than usual. People with kidney or liver problems may be at a high risk of hypoglycemia (low blood sugar levels) and may need to be monitored with regular dosage adjustments.

People with a hypersensitivity to insulin aspart or any of the inactive ingredients in Novolog should not take Novolog. People experiencing hypoglycemia should not take Novolog. 

Novolog dosage for pets

Dogs and cats with uncomplicated diabetes mellitus are commonly treated with daily insulin shots. Veterinarians also prescribe insulin as an add-on treatment for diabetic ketoacidosis in animals. Vetsulin (porcine zinc insulin) and ProZinc (protamine zinc recombinant human insulin) are insulins FDA-approved for use in dogs and cats. However, insulins used for humans are also prescribed for animals. HumulinN (isophane insulin) and Humalog (insulin lispro), as well as Levemir (insulin detemir) are commonly used to control blood sugar in animals. 

Depending on the condition being treated, insulin injections can be given subcutaneously, intramuscularly, or intravenously. Most injections are given by a veterinary professional in a clinical setting. Dosages will be based on weight and therapeutic goals.

How to take Novolog

Novolog is administered as a subcutaneous injection two to four times a day before meals. It can either be self-administered or given by a caretaker. People with a subcutaneous insulin pump using Novolog or a Novolog mix should discard the remaining insulin and refill the pump reservoir every seven days. 

There are four different methods to inject insulin at home:

• The Novolog multiple-dose vial contains 1000 units of insulin in 10 mL of solution. The exact number of units needed will need to be drawn up with a syringe and injected with a needle. Both the syringe and needle should be disposed of in a sharps container after each injection. Use a new insulin syringe with each injection. 

• The Novolog PenFill cartridge contains 300 units of insulin in 3 mL of solution. It is designed to be inserted into the reusable PenFill pen injector. The NovoFine, NovoFine Plus, or NovoTwist needle will need to be attached to the PenFill injector each time a dose is given. The needle should then be removed and disposed of in a sharps container after each injection. 

• The Novolog FlexTouch injection pen contains 300 units of insulin in 3 mL of solution. It is a prefilled, single-patient-use pen designed for multiple doses. The NovoFine, NovoFine Plus, or NovoTwist needle will need to be attached to the FlexTouch pen each time an injection is given and then removed and disposed of in a sharps container when finished. 

• The Novolog Flexpen contains 300 units of insulin in 3 mL of solution. It is a prefilled, single-patient-use pen designed for multiple doses. The NovoFine, NovoFine Plus, or NovoTwist needle will need to be attached to the FlexPen each time a dose is given and then removed and disposed of in a sharps container after each injection. 

Injecting insulin involves a series of steps involving preparation, dosing, attaching needles, administering the injection, removing needles, and disposing of the needles, cartridges, syringes, or pen injectors as necessary. Consult with a healthcare provider on the proper method of injecting Novolog insulin.

Make sure to follow a few general instructions:

• Take this medicine as directed by a healthcare provider. Follow the dosing schedule given by the prescriber.

• A healthcare provider may recommend gradually increasing (titrating) the dose at home based on blood sugar levels. The titration instructions will be simple and step-wise. Follow these instructions carefully. Do not increase doses by more than those specified in the instructions.

• Each Novolog prescription is packaged with a patient information guide. It contains valuable medical advice and information about adverse effects. Please read this medication guide before using the insulin.

• A healthcare provider will demonstrate areas on the body where injections can be made. These areas include the stomach area, buttocks, thighs, and upper arms.

• To avoid injection site reactions or skin problems, such as loss of fat (lipodystrophy) or skin lumps (cutaneous amyloidosis), choose a different injection area for every injection. If using an insulin infusion pump, periodically change the infusion set and injection site per the pump’s instructions.

• Do not make injections into skin that is pitted, thick, lumpy, scaly, hard, tender, bruised, or scarred.

• Always inspect the vial or pen injector to make sure that it contains the appropriate type of insulin at the right concentration.

• Always inspect the insulin solution and the injector. Do not use the injector or the insulin if there is damage to the vial, syringe, or pen injector. The insulin should look clear and colorless. Do not use the insulin if it is discolored or has particles floating in it.

• Store unopened vials or pen injectors in a refrigerator (36°F to 46°F) protected from light up until their expiration date. Do not freeze. Unused vials or pen injectors will need to be disposed of beyond the expiration date.

• Used vials and pen injectors can be stored at room temperature (up to 86°F) away from heat and light up until the medicine’s expiration date. Used vials can be returned to the refrigerator for storage, but pen injectors or cartridges should not be put back into the refrigerator.  

• Always store the PenFill reusable injector, FlexPen, and FlexTouch pen without any needle attached. Only attach the needle when administering an injection.

Novolog dosage FAQs

How long does it take Novolog to work?

Insulin aspart begins stabilizing blood glucose levels more rapidly than regular insulin. It starts working within 5 to 15 minutes. Maximum glucose-lowering effects are reached in about one hour and last for three to five hours after the injection.

How do I stop taking Novolog?

Discontinuing any prescribed insulin product without the advice of a doctor may lead to a dangerous rise in blood sugar (hyperglycemia). Make sure an alternative fast-acting or regular insulin product has been substituted before stopping NovoLog.

People may switch to other insulins if they experience allergic reactions or serious side effects. Some adverse reactions, such as weight gain, might be unpleasant enough to consider switching to a different insulin. There are, fortunately, other rapid-acting insulins that can be taken before meals to control post-meal blood sugar spikes.

Can you overdose on Novolog?

Taking too much NovoLog can cause low blood sugar (hypoglycemia) and low potassium (hypokalemia). Unfortunately, mild hypoglycemia is a common occurrence among insulin users but is easily treated with oral glucose. Large amounts of insulin, however, can cause life-threatening hypoglycemia. If a glucagon kit is available, then immediately administer a glucagon injection. Otherwise, seek emergency medical treatment. 

What interacts with Novolog?

All insulin products have potential drug interactions. The most hazardous drug interactions involve a family of antidiabetic drugs called thiazolidinediones (TZDs) which, when combined with insulin, raise the risk of swelling (edema) and heart failure. Oral antidiabetics combined with insulin carry a risk of low blood sugar levels ( hypoglycemia). There is also a risk of hypoglycemia when insulin is combined with certain blood pressure medications, some antibiotics, and certain antidepressants. Some drugs, such as beta-blockers and reserpine, can mask episodes of hypoglycemia, requiring appropriate blood glucose monitoring.

Come drugs raise blood sugar, canceling out the benefits of insulin. These drugs include atypical antipsychotics, female hormone therapies, corticosteroids, and birth control pills. 

Is it safe to take Novolog during pregnancy?

Pregnant women are often prescribed NovoLog to help control gestational diabetes. In all clinical trials, insulin aspart has not been associated with birth defects or other significant problems. 

Women who are breastfeeding should get medical advice on the safest insulin products to take. There are no studies describing the presence of insulin aspart in human breast milk or the effects of insulin aspart in a nursing infant. 

Related resources for Novolog dosages:

• Insulin aspart rDNA origin drug summary, Prescriber’s Digital Reference

• Insulin therapy in dogs and cats, DVM360

• Novolog, Epocrates

• Novolog prescribing information, U.S. National Library of Medicine

• Plumb’s Veterinary Drug Handbook, 7th edition