NovoRapid and Admelog: Key Differences
NovoRapid (insulin aspart) and Admelog (insulin lispro) are clinically interchangeable rapid-acting insulin analogs with nearly identical pharmacokinetic profiles, efficacy, and safety—you can switch between them without dose adjustment or concern for different clinical outcomes. 1, 2, 3
Pharmacokinetic Properties
Both insulins share essentially the same time-action characteristics:
- Onset of action: 0.25-0.5 hours (10-20 minutes) 3
- Peak action: 1-3 hours 3
- Duration: 3-5 hours 3
- Both should be administered 0-15 minutes before meals for optimal postprandial glucose control 1
Clinical Efficacy
Multiple head-to-head randomized controlled trials demonstrate no clinically meaningful differences:
- HbA1c reduction: Both produce similar decreases in glycated hemoglobin when used in basal-bolus regimens 4, 5
- Postprandial glucose control: Both provide superior postprandial control compared to regular human insulin, with no significant difference between them 3, 6, 4
- Glycemic variability: No significant differences in 24-hour mean amplitude of glycemic excursions (MAGE), mean blood glucose (MBG), or standard deviation of blood glucose 5
- Insulin dosing requirements: Total daily insulin doses are comparable between the two analogs 4, 7
Safety Profile
The safety profiles are essentially identical:
- Hypoglycemia rates: Similar incidence of overall, nocturnal, and severe hypoglycemic events in both type 1 and type 2 diabetes 4, 7
- Treatment-emergent adverse events: Comparable rates of adverse events and serious adverse events 4
- Weight changes: No significant differences in weight gain or loss 4, 7
- Both demonstrate lower rates of nocturnal and severe hypoglycemia compared to regular human insulin 3, 6
Clinical Interchangeability
The American Diabetes Association explicitly groups insulin lispro (Admelog), insulin aspart (NovoRapid), and insulin glulisine together as interchangeable options for prandial coverage. 2
- You can switch from one to the other using the same dose without titration 2, 4
- Both work equally well in continuous subcutaneous insulin infusion (CSII) pumps 7
- Both are appropriate for use in type 1 and type 2 diabetes 6, 4, 7
Cost Considerations
The primary practical difference is pricing:
- NovoRapid (insulin aspart): Approximately $224 per prefilled pen (U-100) or $174 per vial 2
- Admelog (insulin lispro): Pricing varies but is generally comparable to other rapid-acting analogs 2
Choose based on insurance formulary coverage and out-of-pocket cost rather than clinical differences, as both are therapeutically equivalent. 2, 4
When Regular Human Insulin Might Be Considered
If cost is prohibitive for either analog:
- Regular human insulin costs approximately $46 per 10mL vial versus $78-84 for rapid-acting analogs 2
- However, regular insulin requires administration 30 minutes before meals and has longer duration of action, increasing delayed hypoglycemia risk 2
- Regular insulin provides inferior postprandial glucose control compared to both NovoRapid and Admelog 3, 6