Short answer: Both are rapid-acting mealtime insulins for adults and children with diabetes.12 Lyumjev (insulin lispro-aabc) is injected at the start of a meal or within 20 minutes after starting it; NovoLog (insulin aspart) within 5 to 10 minutes before a meal. Lyumjev's trials used Humalog as the comparator and NovoLog's used regular human insulin, so neither label compares the two.
| Lyumjev | NovoLog | |
|---|---|---|
| Insulin | Insulin lispro-aabc; contains treprostinil and sodium citrate1 | Insulin aspart2 |
| When injected | At the start of a meal or within 20 minutes after starting a meal1 | Within 5 to 10 minutes before a meal2 |
| Strengths | U-100 and U-2001 | U-1002 |
| Time to peak level | 57 minutes; first seen in the blood about 1 minute after a dose1 | Median 40 to 50 minutes, vs 80 to 120 for regular human insulin2 |
| Switching from another mealtime insulin | Unit for unit1 | A different dose may be needed2 |
| Mixing in a syringe | Not mixed with other insulins1 | With NPH insulin only2 |
| Insulin pump reservoir | U-100 only; change at least every 9 days1 | Change at least every 7 days2 |
| Opened pen | 28 days, not refrigerated1 | 28 days, not refrigerated2 |
| Missed dose | Check glucose to decide if a dose is needed; resume at the next meal1 | No rule in the label2 |
| Boxed warning | None1 | None2 |
The Lyumjev label lists side effects at 5% or more and at the same rate or higher than on Humalog, its comparator. Severe low blood sugar was 5.5% on mealtime Lyumjev in adults with type 1 diabetes and 0.9% in type 2.1 NovoLog's trials compared it with regular human insulin, both with NPH: severe low blood sugar was 17% of adults with type 1 diabetes over 24 weeks and 10% with type 2. The NovoLog label says comparing these rates with other products may be misleading.2 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Lyumjev comes in a U-200 KwikPen as well as U-100; the U-200 form is never drawn into a syringe, used in a pump or given into a vein. Its inactive ingredients treprostinil and sodium citrate have been linked to site reactions with other products; on a pump, 37.7% of adults had infusion site reactions.1 NovoLog is U-100 only, can be diluted with its own diluting medium, and can be mixed with NPH by syringe.2 Both share the insulin warnings: low blood sugar, low potassium, never sharing pens, and fluid retention with TZDs such as pioglitazone.12
Which, if either, fits is for your prescriber. More detail: Lyumjev side effects, NovoLog side effects, the Lyumjev and NovoLog dosing schedules, the Lyumjev and NovoLog missed-dose pages, the insulin lispro and insulin aspart guides, and Lyumjev vs Humalog: what changes with the newer insulin lispro?.