North East and North Cumbria
ICS Formulary
 
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6 Endocrine system
06-01-01-02 Intermediate- and long-acting insulins

Note: preloaded pens should only be used where cartridges are not suitable.


Isophane Insulin Insulatard®
Formulary
  • 100units/ml suspension for injection 10ml vial

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Isophane Insulin Humulin® I
Formulary
  • Approved Humulin® I formulations include:
    • 10ml vials;
    • 5x3ml cartridges;
    • 5x3ml pens. 


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Insulin Glargine biosimilar Abasaglar®
Formulary
  • First choice long acting basal insulin in patients eligible for treatment in line with NICE and NTAG
  • Approved Abasaglar® formulations include:
    • 5x3ml cartridge
    • 5x3ml Kwikpen®.

Link  NG17: Type 1 diabetes in adults: diagnosis and management
Link  NTAG: Abasaglar® Insulin Glargine Biosimilar 100 units/ml for the treatment of type 1 or type 2 diabetes mellitus.

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Insulin degludec 100 units/mL Tresiba®
Formulary
  • 100 units/mL
  • Pre-filled pen and cartridges
  • Approved for use in patients with Type 1 diabetes with
    • Nocturnal/Severe Hypogycaemia (with or without hypoglycaemic unawareness) in patients who would otherwsie progress to insuling pump treatment as per NICE TA151); or
    • Recurrent DKA episodes despite good compliance and who would otherwise progress to insulin pump therapy
    • Paediatric patients who cannot tolerate glargine sting
    • Paediatric patients with poor control on the high HbA1c pathway
    • Patients or Parents/Carers with unpredictable lifestyles such as students or shift workers.

“**Note that there are two strengths of Tresiba® (insulin degludec). Caution should be exercised when prescribing and dispensing**


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Insulin degludec 200 units/mL Tresiba®
Formulary
  • 200 units/mL
  • Pre-filled pen
  • Approved for use in patients with Type 1 diabetes with
    • Nocturnal/Severe Hypogycaemia (with or without hypoglycaemic unawareness) in patients who would otherwise progress to insulin pump treatment as per NICE TA151; or
    • Recurrent DKA episodes despite good compliance and who would otherwise progress to insulin pump therapy
    • Paediatric patients who cannot tolerate glargine sting
    • Paediatric patients with poor control on the high HbA1c pathway
    • Patients or Parents/Carers with unpredictable lifestyles such as students or shift workers.

**Note that there are two strengths of Tresiba® (insulin degludec). Caution should be exercised when prescribing and dispensing**


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Insulin Detemir Levemir®
Formulary
  • Alternative choice long acting basal insulin.
  • Approved Levemir® formualtions include:
    • 5x3ml cartridges;
    • 5x3ml pens. 


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Insulin Glargine Lantus®
Formulary
  • Alternative choice long acting basal insulin. 
  • Approved Lantus® formulations include:
    • 10ml vials;
    • 5x3ml cartridges;
    • 5x3ml pens (Solostar® - in line with NICE). 

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Insulin Glargine  Toujeo®
Formulary
  • Alternative choice long acting basal insulin.
  • Approved Toujeo® formulations include:
    • 1.5mL pre-filled pen (Solostar): Dose range 1-80 units in 1 unit increments. 450 units in a pen
    • 3mL pre-filled pen (DoubleStar): Dose range 2-160 units in 2 unit increments. 900 units in a pen.

**CARE: HIGH STRENGTH INSULIN**

Approved for use in patients on insulin glargine who require:

  • High dose (60+ units per dose for Toujeo SoloStar and 80+ units per dose for DoubleStar
  • Large volume of insulin and local site reactions
  • Twice daily insulin

NOTE: Toujeo 300 units/ml is not bioequivalent to insulin glargine 100 units/ml and is not directly interchangeable


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