DISCLAIMER

The Diabetes Québec Toolbox is intended for Québec healthcare professionals only. By accessing this web application, you confirm that you are a healthcare professional. The information in the Toolbox is provided for general information purposes only and is not comprehensive. Under no circumstances can Diabetes Québec be held responsible for any error or omission or be prosecuted for any reason whatsoever.

Insulins

Chart Summary DQ (FR)

General info:

- Relative A1C lowering:

- Hypoglycemia: Yes

- Weight:

- Effect in cardiovascular outcome trial: Neutral

- Other therapeutic considerations: No dose ceiling, flexible regimens

- Cost: $ to $$$$


Insulins (Bolus)
Prandial

Aspart
Fiasp®
Onset of action: 4 min
Peak of action: 0.5 to 1.5 h
Duration of action: 3 to 5 h
Stability at room temperature: 28 days
Not covered / Private coverage
Product Monograph
Video demo. of the injection technic with the Flextouch Pen

Presentation

- Cartridge
- Vial
- Pre-filled insulin pen

Devices

- NovoPen® 4 and 5 (memory)
- NovoPen Echo® (0.5 un - memory)
- Fiasp® FlexTouch® (pre-filled)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Aspart
NovoRapid®
Onset of action: 9 to 20 min
Peak of action: 1 to 1.5 h
Duration of action: 3 to 5 h
Stability at room temperature: 28 days
Not covered - To be checked with private insurance
See Infolettre RAMQ
Product Monograph
Video demo. of the injection technic with the Flextouch Pen

Presentation

- Cartridge
- Vial

Devices

- NovoPen® 4 and 5 (memory)
- NovoPen Echo® (0.5 un - memory)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Aspart
Trurapi® (Biosimilar)
Onset of action: 9 to 20 min
Peak of action: 1 to 1.5 h
Duration of action: 3 to 5 h
Stability at room temperature: 28 days
Covered
Product Monograph
See Infolettre RAMQ
Information Brochure

Presentation

- Cartridge
- Pre-filled insulin pen

Devices

- JuniorSTARTM (0.5 un)
- ClikSTAR®
- Trurapi® SoloSTAR® (pre-filled)
- AllStarTM Pro
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Aspart
Kirsty® (Biosimilar)
Onset of action: 9 to 20 min
Peak of action: 1 to 1.5 h
Duration of action: 3 to 5 h
Stability at room temperature: 28 days
Covered
See Infolettre RAMQ
Product Monograph
Guide

Presentation

- Pre-filled insulin pen

Devices

-Pre-filled insulin pen only (looks like Sanofi's Solostar pre-filled pen)
*Warning. Both Kirsty and Semglee pens are the same color
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Glulisine
Apidra®
Onset of action: 10 to 15 min
Peak of action: 1 to 1.5 h
Duration of action: 3.5 to 5 h
Stability at room temperature: 28 days
Covered
Product Monograph

Presentation

- Cartridge
- Vial
- Pre-filled insulin pen

Devices

- JuniorSTARTM (0.5 un)
- ClikSTAR®
- Apidra® SoloSTAR® (pre-filled)
- AllStarTM Pro
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Lispro
Humalog® U100
Onset of action: 10 to 15 min
Peak of action: 1 to 2 h
Duration of action: 3 to 4.75 h
Stability at room temperature: 28 days
Private Insurance / Conditional coverage
See Infolettre RAMQ
Product Monograph

Presentation

- Cartridge
- Vial (3 ml and 10 ml)
- Pre-filled insulin pen

Devices

- HumaPen LUXURA® HD (0.5 un)
- HumaPen SAVVIOTM
- Humalog® KwikPen® (pre-filled)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Lispro
Admelog® (Biosimilar)
Onset of action: 10 to 15 min
Peak of action: 1 to 2 h
Duration of action: 3 to 4.75 h
Stability at room temperature: 28 days
Covered
Product Monograph
Information Brochure
Your guide to getting started

Presentation

- Cartridge
- Vial
- Pre-filled insulin pen

Devices

- JuniorSTARTM (0.5 un)
- ClikSTAR®
- Admelog® SoloSTAR® (pre-filled)
- AllStarTM Pro
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Lispro
Humalog® U200
Onset of action: 10 to 15 min
Peak of action: 1 to 2 h
Duration of action: 3 to 4.75 h
Stability at room temperature: 28 days
Covered
Product Monograph

Presentation

- Pre-filled insulin pen

Device

- Humalog® KwikPen® 200 u/ml (pre-filled)
Caution: Do not transfer to a syringe. Severe overdose can result.
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Humulin R U500
EntuzityTM
Onset of action: 15 min
Peak of action: 4 to 8 h
Duration of action: 17 to 24 h
Stability at room temperature: 28 days
Covered
Product Monograph

Presentation

- Pre-filled insulin pen

Device

- KwikPenTM (Pre-filled) 3 ml = 1500 units of insulin with an increment of 5 and a maximum of 160 units per injection
Caution: Do not transfer to a syringe. Severe overdose can result.
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Insulin Regular
Humulin®R
Onset of action: 30 min
Peak of action: 2 to 3 h
Duration of action: 6.5 h
Stability at room temperature: 28 days
Covered
Product Monograph

Presentation

- Cartridge
- Vial
- Pre-filled insulin pen

Devices

- HumaPen LUXURA® HD (0.5 un)
- HumaPen SAVVIOTM
- Humulin® R KwikPen® (pre-filled)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Insulin Regular
Novolin®ge Toronto
Onset of action: 30 min
Peak of action: 2 to 3 h
Duration of action: 6.5 h
Stability at room temperature: 28 days
Covered
Product Monograph

Presentation

- Cartridge
- Vial

Devices

- NovoPen® 4 and 5 (memory)
- NovoPen Echo® (0.5 un - memory)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

BASAL INSULINS

NPH
Humulin®N
Onset of action: 1 to 3 h
Peak of action: 5 to 8 h
Duration of action: Up to 18 h
Stability at room temperature: 28 days
Covered
Product Monograph

Presentation

- Cartridge
- Vial
- Pre-filled insulin pen

Devices

- HumaPen LUXURA® HD (0.5 un)
- HumaPen SAVVIOTM
- Humulin® N KwikPen® (pre-filled)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

NPH
Novolin®ge NPH
Onset of action: 1 to 3 h
Peak of action: 5 to 8 h
Duration of action: Up to 18 h
Stability at room temperature: 28 days
Covered
Product Monograph

Presentation

- Cartridge
- Vial

Devices

- NovoPen® 4 and 5 (memory)
- NovoPen Echo® (0.5 un - memory)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Degludec U100 and U200
Tresiba®
Onset of action: 90 min
Peak of action: No significant peak
Duration of action: Up to 42 h
Stability at room temperature: 56 days
Covered
Product Monograph
Video demo. of the injection technic with the Flextouch Pen
Initiation,Titration and Technic Patient Handout
Complete Guide for Virtual Care

Presentation

- Cartridge
- Pre-filled insulin pen

Devices

- Tresiba FlextouchTM (pre-filled) 3 ml 100 U/ml and 200 U/ml with an increment of 2 and a maximum of 160 units per injection
Caution: Do not transfer to a syringe. Severe overdose can result.
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Detemir
Levemir®
Onset of action: 90 min
Peak of action: No significant peak
Duration of action: 16 to 24 h
Stability at room temperature: 42 days
Covered
Product Monograph
Video demo. of the injection technic with the Flextouch Pen
"Switch" and adjustment

Presentation

- Cartridge

Devices

- NovoPen® 4 and 5 (memory)
- NovoPen Echo® (0.5 un - memory)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Glargine U100
Lantus®
Onset of action: 90 min
Peak of action: No significant peak
Duration of action: Up to 24 h
Stability at room temperature: 28 days
Not Covered / Private coverage
See Infolettre RAMQ
Product Monograph
"Switch" and adjustment
SUPPLY CONSTRAINTS FOR LANTUS ®SOLOSTAR ®(Insulin glargine) AND LANTUS ® CARTRIDGES (Insulin glargine)

Presentation

- Cartridge
- Vial
- Pre-filled insulin pen

Devices

- JuniorSTARTM (0.5 un)
- ClikSTAR®
- Lantus® SoloSTAR® (pre-filled)
- AllStarTM Pro
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Glargine U100
Basaglar® (Biosimilar)
Onset of action: 90 min
Peak of action: No significant peak
Duration of action: Up to 24 h
Stability at room temperature: 28 days
Covered
Product Monograph
How to use the KwikPen®
Patient Teaching Guide
"Switch" and adjustment

Presentation

- Cartridge

Devices

- Basaglar® KwikPen® (pre-filled)
- HumaPen SAVVIOTM
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Glargine U100
Semglee® (Biosimilar)
Onset of action: 90 min
Peak of action: No significant peak
Duration of action: Up to 24 h
Stability at room temperature: 28 days
Covered
Product Monograph
Guide

Presentation

- Pre-filled insulin pen

Devices

-Pre-filled insulin pen only (looks like Sanofi's Solostar pre-filled pen)
*Warning. Both Kirsty and Semglee pens are the same color
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Glargine U300
Toujeo®
Onset of action: 90 min
Peak of action: No significant peak
Duration of action: > 30 h
Stability at room temperature: 42 days
Covered
Product Monograph
SoloSTAR® - Instructional Video®
DoubleSTAR® - Instructional Video®
"Switch" and adjustment

Device

- Toujeo® 300 u/ml SoloSTAR® (pre-filled) 1.5 ml = 450 units
- Toujeo® 300 u/ml DoubleSTAR® (pre-filled) 3 ml = 900 units with an increment of 2 and a maximum of 160 units per injection
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)
Caution: Do not transfer to a syringe. Severe overdose can result.

FIXED-RATIO COMBINATIONS

Glargine U100 (100 units/ml) / Lixisenatide (33 mcg/ml)
SoliquaTM
Maximum recommended daily dose is 60 units:
Glargine U100 60 units / Lixisenatide 20 mcg
Non Covered / Private coverage
Product Monograph
How to Inject (video)
How to Inject
Therapy Initiation and Titration

Device

- Stylo SoloSTAR® (pre-filled) 3 ml
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Degludec (100 units/ml) / Liraglutide (3.6 mg/ml)
Xultophy®
Maximum recommended daily dose is 50 units:
Degludec 50 units / Liraglutide 1.8 mg
Not Covered / Private coverage
Product Monograph
Therapy Initiation and Titration

Device

- Stylo Flextouch® (pre-filled) 3 ml
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

PREMIXED INSULINS
Medications - Injectable medications s/c

A single vial or cartridge contains a fixed ratio of insulin (% of rapid-acting or short-acting insulin to % of intermediate-acting insulin).

Humulin® 30/70
Humulin® 30/70
Covered
Product Monograph

Presentation

- Cartridge
- Vial

Devices

- HumaPen LUXURA® HD (0.5 un)
- HumaPen SAVVIOTM
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Novolin®ge
30/70

Novolin® ge
30/70

Covered
Product Monograph

Presentation

- Cartridge
- Vial

Devices

- NovoPen® 4 and 5 (memory)
- NovoPen Echo® (0.5 un - memory)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Biphasic Insulin Aspart
NovoMix® 30
Code EN22
Product Monograph

Presentation

- Cartridge

Devices

- NovoPen® 4 and 5 (memory)
- NovoPen Echo® (0.5 un - memory)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)

Lispro Insulin
Lispro Protamine

Humalog® Mix25® and Mix50®
Mix25®
Code EN22
Mix50TM
Not Covered / Private coverage
Product Monograph

Presentation

- Cartridge
- Pre-filled insulin pen

Devices

- HumaPen LUXURA® HD (0.5 un)
- HumaPen KwikPen® Junior® (0.5 un)
- HumaPen SAVVIOTM
- Humalog® Mix25® KwikPen® (pre-filled)
- Humalog® Mix50® KwikPen® (pre-filled)
- 4, 5 and 6 mm pen needles are suitable for all people living with diabetes regardless of BMI. (Ref. Fit Canada)