Short answer: Both are rapid-acting mealtime insulins for adults and children with diabetes.12 NovoLog (insulin aspart) is injected 5 to 10 minutes before a meal. Apidra (insulin glulisine) is injected within 15 minutes before a meal or within 20 minutes after starting one. The only direct comparison in either label is a small 12-week Apidra pump study against insulin aspart. Neither has a boxed warning.
| NovoLog | Apidra | |
|---|---|---|
| Insulin | Insulin aspart 100 units/mL1 | Insulin glulisine 100 units/mL2 |
| When injected | Within 5 to 10 minutes before a meal1 | Within 15 minutes before a meal or within 20 minutes after starting a meal2 |
| Forms | Vial, FlexPen, FlexTouch and PenFill cartridges1 | Vial and SoloStar pen2 |
| How fast (label studies) | Median time to peak level 40 to 50 minutes1 | Median time to peak level 60 minutes in type 1 diabetes2 |
| Pump study, 12 weeks (Apidra label) | Insulin aspart: catheter occlusions 0.15 a month; site reactions 13.3%2 | Catheter occlusions 0.08 a month; site reactions 10.3%2 |
| Pump reservoir | Change at least every 7 days1 | Change at least every 48 hours2 |
| Comparator in main label trials | Regular human insulin1 | Insulin lispro and regular human insulin2 |
| Mixing in a syringe | With NPH insulin only1 | With NPH insulin only2 |
| Missed dose | No instruction in the label1 | No instruction in the label2 |
In a 12-week study of 59 adults with type 1 diabetes on an insulin pump, mean HbA1c rose from 6.8% to 7.0% on Apidra and from 7.1% to 7.2% on insulin aspart. Catheter occlusions were 0.08 a month vs 0.15, and infusion site reactions 10.3% (3 of 29) vs 13.3% (4 of 30).2 The label says "insulin aspart" and does not name NovoLog. It is the only trial in either label that compares the two.
The NovoLog label reports severe lows in 17% of adults with type 1 diabetes over 24 weeks on injections, and warns that comparing its rates with other products may be misleading. The Apidra label reports 4.8% to 8.4% in its adult type 1 trials and 16.2% in children.12 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Which, if either, fits is for your prescriber. More detail: NovoLog side effects, Apidra side effects, the NovoLog and Apidra dosing schedules, the NovoLog missed-dose page, how to store NovoLog and Humalog vs NovoLog: what is different between the two mealtime insulins?.