FIASP FLEXTOUCH

Clinical safety rating: caution

Comprehensive clinical and safety monograph for FIASP FLEXTOUCH (FIASP FLEXTOUCH).

How it works

Insulin analog that binds to insulin receptors, lowering blood glucose by facilitating cellular uptake of glucose and inhibiting hepatic glucose production.

What the body does with it

Metabolism	Degraded by insulin protease or insulin-degrading enzymes; metabolism primarily in liver and kidneys.
Excretion	Renal: approximately 60% of administered insulin is excreted via the kidneys, with the remainder undergoing hepatic metabolism and biliary excretion.
Half-life	Terminal elimination half-life is approximately 1.3 hours (range 1-1.5 hours) in healthy subjects, corresponding to the rapid clearance of monomeric insulin aspart. This short half-life supports prandial dosing to cover meal-related glucose excursions.
Protein binding	Approximately 50-60% bound to plasma proteins, primarily albumin and alpha-globulins.
Volume of Distribution	Volume of distribution (Vd) is approximately 0.3-0.4 L/kg, reflecting distribution primarily into extracellular fluid and tissues.
Bioavailability	Subcutaneous injection: absolute bioavailability is approximately 85-90% (based on euglycemic clamp studies), due to complete absorption from the injection site facilitated by the formulation enhancers.
Onset of Action	Subcutaneous administration: onset of action occurs within 2.5 minutes (range 1-5 minutes), due to the formulation containing niacinamide and L-arginine to accelerate absorption.
Duration of Action	Subcutaneous administration: duration of action is 3-5 hours (mean approximately 4 hours). The shorter duration compared to regular human insulin reduces risk of late postprandial hypoglycemia.

Classification & Brands

Action Class	Insulin analogues- rapid acting
Brand Substitutes	Fiasp 100IU/ml Penfill, Fiasp 100IU/ml Solution for Injection

Dosing & administration

Subcutaneous injection at mealtime, 0.2-0.4 units/kg per dose, with total daily dose individualized; typically 50-70% of total daily insulin as bolus, remainder as basal.

Dosage form	SOLUTION
Renal impairment	No specific dose adjustment; monitor glucose closely due to reduced insulin clearance in severe renal impairment (eGFR <30 mL/min/1.73m²); may require lower doses.
Liver impairment	No specific dose adjustment; caution in severe hepatic impairment (Child-Pugh class C) due to risk of hypoglycemia; may require dose reduction.
Pediatric use	Children ≥1 year: 0.2-0.5 units/kg per dose administered subcutaneously at mealtime; total daily dose individualized based on glucose monitoring.
Geriatric use	Initiate at lower doses (e.g., 0.1-0.2 units/kg per meal) due to increased risk of hypoglycemia; titrate slowly based on glucose response.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for FIASP FLEXTOUCH (FIASP FLEXTOUCH).

Breastfeeding	Insulin aspart is excreted in breast milk in negligible amounts; M/P ratio not available. Considered compatible with breastfeeding; monitor infant for hypoglycemia if high maternal doses.
Teratogenic Risk	Insulin aspart (FIASP) does not cross the placenta in significant amounts; no known teratogenic risk. Poor glycemic control increases congenital malformation risk in first trimester and macrosomia, neonatal hypoglycemia in second/third trimester.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

Never share disposable prefilled pen between patients, even if needle changed, due to risk of transmission of blood-borne pathogens.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Hypersensitivity to insulin aspart or any excipients","During episodes of hypoglycemia"]

Clinical Precautions

Precautions

["Hypoglycemia","Hypokalemia","Fluid retention and heart failure with concomitant thiazolidinediones","Hypersensitivity reactions","Needle sharing risk","Accidental mix-ups between insulin products"]

Clinical Tips & Counseling

Drug interactions

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FIASP FLEXTOUCH

Clinical safety rating: caution

Comprehensive clinical and safety monograph for FIASP FLEXTOUCH (FIASP FLEXTOUCH).

How it works

Insulin analog that binds to insulin receptors, lowering blood glucose by facilitating cellular uptake of glucose and inhibiting hepatic glucose production.

What the body does with it

Metabolism	Degraded by insulin protease or insulin-degrading enzymes; metabolism primarily in liver and kidneys.
Excretion	Renal: approximately 60% of administered insulin is excreted via the kidneys, with the remainder undergoing hepatic metabolism and biliary excretion.
Half-life	Terminal elimination half-life is approximately 1.3 hours (range 1-1.5 hours) in healthy subjects, corresponding to the rapid clearance of monomeric insulin aspart. This short half-life supports prandial dosing to cover meal-related glucose excursions.
Protein binding	Approximately 50-60% bound to plasma proteins, primarily albumin and alpha-globulins.
Volume of Distribution	Volume of distribution (Vd) is approximately 0.3-0.4 L/kg, reflecting distribution primarily into extracellular fluid and tissues.
Bioavailability	Subcutaneous injection: absolute bioavailability is approximately 85-90% (based on euglycemic clamp studies), due to complete absorption from the injection site facilitated by the formulation enhancers.
Onset of Action	Subcutaneous administration: onset of action occurs within 2.5 minutes (range 1-5 minutes), due to the formulation containing niacinamide and L-arginine to accelerate absorption.
Duration of Action	Subcutaneous administration: duration of action is 3-5 hours (mean approximately 4 hours). The shorter duration compared to regular human insulin reduces risk of late postprandial hypoglycemia.

Classification & Brands

Action Class	Insulin analogues- rapid acting
Brand Substitutes	Fiasp 100IU/ml Penfill, Fiasp 100IU/ml Solution for Injection

Dosing & administration

Subcutaneous injection at mealtime, 0.2-0.4 units/kg per dose, with total daily dose individualized; typically 50-70% of total daily insulin as bolus, remainder as basal.

Dosage form	SOLUTION
Renal impairment	No specific dose adjustment; monitor glucose closely due to reduced insulin clearance in severe renal impairment (eGFR <30 mL/min/1.73m²); may require lower doses.
Liver impairment	No specific dose adjustment; caution in severe hepatic impairment (Child-Pugh class C) due to risk of hypoglycemia; may require dose reduction.
Pediatric use	Children ≥1 year: 0.2-0.5 units/kg per dose administered subcutaneously at mealtime; total daily dose individualized based on glucose monitoring.
Geriatric use	Initiate at lower doses (e.g., 0.1-0.2 units/kg per meal) due to increased risk of hypoglycemia; titrate slowly based on glucose response.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for FIASP FLEXTOUCH (FIASP FLEXTOUCH).

Breastfeeding	Insulin aspart is excreted in breast milk in negligible amounts; M/P ratio not available. Considered compatible with breastfeeding; monitor infant for hypoglycemia if high maternal doses.
Teratogenic Risk	Insulin aspart (FIASP) does not cross the placenta in significant amounts; no known teratogenic risk. Poor glycemic control increases congenital malformation risk in first trimester and macrosomia, neonatal hypoglycemia in second/third trimester.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

Never share disposable prefilled pen between patients, even if needle changed, due to risk of transmission of blood-borne pathogens.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Hypersensitivity to insulin aspart or any excipients","During episodes of hypoglycemia"]

Clinical Precautions

Precautions

["Hypoglycemia","Hypokalemia","Fluid retention and heart failure with concomitant thiazolidinediones","Hypersensitivity reactions","Needle sharing risk","Accidental mix-ups between insulin products"]

Clinical Tips & Counseling

Drug interactions

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