Short answer: The Fiasp label gives each dose under the skin at the start of a meal or within 20 minutes after starting the meal, usually alongside an intermediate or long-acting insulin. The dose is set for each person. Switching from another mealtime insulin can start unit for unit. After a forgotten mealtime dose, the label says to check blood sugar to decide if a dose is needed.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Fiasp is approved for: Fiasp is a rapid-acting mealtime insulin approved to improve blood sugar control in adults and children with diabetes (section 1).
Source
FIASP (insulin aspart) injection, for subcutaneous or intravenous use, prescribing information and Patient Information. Novo Nordisk. DailyMed, version published July 25, 2023. DailyMed setid 834e7efc-393f-4c55-9125-628562a8a5cf
Fiasp is injected under the skin of the abdomen, upper arm or thigh at the start of a meal or within 20 minutes after starting a meal, rotating sites within the same region. By injection it is generally used with an intermediate or long-acting insulin. It is not mixed with any other insulin (sections 2.1 and 2.2).
It can also be given by insulin pump, following the pump's instructions, or into a vein under medical supervision with glucose and potassium monitoring. It is U-100 (100 units/mL) in a 10 mL vial, a 3 mL FlexTouch pen that dials in 1-unit steps, 3 mL PenFill cartridges and 1.6 mL PumpCart cartridges (sections 2.2 and 3).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Situation | What the label says |
|---|---|
| When to inject | At the start of a meal or within 20 minutes after starting a meal |
| Dose | Individualized by route, metabolic needs, glucose monitoring and glucose goal |
| Switching from another mealtime insulin | The initial change can be unit for unit |
| Forgot a mealtime dose (basal-bolus) | Check blood glucose to decide if a dose is needed; resume the usual schedule at the next meal |
| Pump reservoir | Change Fiasp at least every 6 days, or per the pump manual if shorter |
| PumpCart cartridge | Replace at least every 4 days, or per the pump manual if shorter |
| IV infusion | Diluted to 0.5 to 1 unit/mL; stable 24 hours at room temperature |
| Presentation | Unopened, room temp up to 86 F | Unopened, refrigerated 36-46 F | In use, room temp | In use, refrigerated |
|---|---|---|---|---|
| 10 mL multiple-dose vial | 28 days | Until expiration date | 28 days (up to 86 F) | 28 days |
| 3 mL FlexTouch pen | 28 days | Until expiration date | 28 days (up to 86 F) | 28 days |
| 3 mL PenFill cartridges | 28 days | Until expiration date | 28 days (up to 86 F) | Do not refrigerate |
| 1.6 mL PumpCart cartridges | 18 days | Until expiration date | 4 days (up to 98.6 F) | Do not refrigerate |
In-use vial: total 28 days, including 6 days in a pump reservoir. PumpCart: at most 18 days at room temperature, including 4 days in the pump.
Dose changes may be needed with a switch from another insulin, changes in activity, other medicines, meal content or timing, kidney or liver function, or during acute illness. Glucose is checked more often during any change.
Pump users are trained to inject insulin and keep backup insulin in case of pump failure. Fiasp in a pump reservoir is not exposed to temperatures above 98.6 F (37 C).
Fiasp should look clear and colorless and is not used if it has particles or color. The label advises caution with the FlexTouch pen for people with poor vision who rely on its clicks.
Fiasp is never frozen and is not used if it has been. It is not drawn into a syringe and stored for later. A new needle is used for each injection, and the pen is stored without a needle.
Section 2.2 says people on basal-bolus treatment who forget a mealtime dose monitor their blood glucose to decide if an insulin dose is needed, and resume their usual schedule at the next meal. The Patient Information says: "If you miss a dose of FIASP, monitor your blood sugar levels to decide if an insulin dose is needed. Continue with your regular dosing schedule at the next meal."
More on this: missed a dose of Fiasp.
Converting from another mealtime insulin to Fiasp, the initial change can be done unit for unit. Glucose is monitored closely when converting insulins in a pump, as pump settings may need adjusting.
Any change of insulin strength, maker, type, site or method is made under close medical supervision with more frequent glucose checks.
In Dose Track you set up Fiasp as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.