Insulin Aspart Side Effects

Medically reviewed by Philip Thornton, DipPharm. Last updated on Sep 9, 2024.

Applies to insulin aspart: solution.

Precautions

It is very important that your doctor check your progress at regular visits especially during the first few weeks you use this medicine. Blood tests may be needed to check for unwanted effects.

Never share insulin pens or cartridges with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles or pens can result in transmission of hepatitis viruses, HIV, or other bloodborne illnesses.

It is very important to follow carefully any instructions from your health care team about:

• Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
• Other medicines—Do not take other medicines during the time you are taking insulin aspart unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
• Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
• Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency: There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to:

• Wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
• Keep an extra supply of insulin aspart and syringes with needles or injection devices on hand in case high blood sugar occurs.
• Keep some kind of quick-acting sugar handy to treat low blood sugar.
• Have a glucagon kit and a syringe and needle available in case severe low blood sugar occurs. Check and replace any expired kits regularly.

Insulin aspart may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, swelling of the face, tongue, and throat, trouble breathing or swallowing, or chest pain after you get the injection.

Too much insulin aspart can cause hypoglycemia (low blood sugar). Low blood sugar can also occur if you use insulin aspart with another antidiabetic medicine, changes in insulin regimen (eg, insulin strength, type of insulin, injection site), delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting or have diarrhea. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

Symptoms of low blood sugar include anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, depression, difficulty in thinking, dizziness or lightheadedness, drowsiness, excessive hunger, fast heartbeat, headache, irritability or abnormal behavior, nervousness, nightmares, restless sleep, shakiness, slurred speech, and tingling in the hands, feet, lips, or tongue.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Get to a doctor or a hospital right away if the symptoms do not improve. Someone should call for emergency help immediately if severe symptoms such as convulsions (seizures) or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your household should also know how to use it.

This medicine may make you dizzy, drowsy, or less alert than you are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

You may have some skin redness, rash, itching, or swelling at the injection site. If this irritation is severe or does not go away, call your doctor. Do not inject insulin aspart into a skin area that is red, swollen, or itchy.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine or insulin, changes in insulin regimen, you overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

Symptoms of high blood sugar include blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination, ketones in the urine, loss of appetite, stomachache, nausea or vomiting, tiredness, trouble breathing (rapid and deep), unconsciousness, and unusual thirst.

If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

This medicine may cause low levels of potassium in your blood. Do not use medicines, supplements, or salt substitutes that contain potassium unless you have discussed this with your doctor.

Ketoacidosis (high ketones and acid in the blood) may occur while you are using this medicine. This can be life-threatening and requires immediate medical attention. Your doctor may give you insulin, fluid, and carbohydrate replacement to treat this condition. Tell your doctor right away if you have nausea, vomiting, trouble breathing, increased thirst or urination.

Using this medicine together with other diabetes medicine (eg, thiazolidinedione [TZD] medicine) may cause serious heart problem or edema (fluid retention). Check with your doctor immediately if you are rapidly gaining weight, having, chest pain or discomfort, extreme tiredness or weakness, trouble breathing, uneven heartbeat, or excessive swelling of the hands, wrist, ankles, or feet.

Serious side effects of insulin aspart

Along with its needed effects, insulin aspart may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking insulin aspart:

Other side effects of insulin aspart

Some side effects of insulin aspart may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to insulin aspart: injectable solution, subcutaneous solution.

General adverse events

Adverse reactions observed have included hypoglycemia, allergic reactions, local injection site reactions, lipodystrophy, rash, and pruritus.^[Ref]

Hypersensitivity

• Very rare (less than 0.01%): Anaphylaxis
• Common (1% to 10%): Allergic skin manifestations
• Frequency not reported: Allergic reactions^[Ref]

Hypersensitivity side effects have included both local and systemic reactions. Anaphylaxis has been reported. Local reactions have presented as erythema, local edema, and pruritus at the injection site. Most minor reactions to insulin at the injection site resolve in a few days to a few weeks.

Generalized allergy to insulin may present as a whole body rash, dyspnea, wheezing, hypotension, tachycardia, or diaphoresis. In clinical trials, allergic reactions were reported in 0.7% (10/1394) patients receiving insulin aspart.

Clinical trials with Fiasp(R) reported generalized hypersensitivity reactions at 0.2% (comparator 0.1%). Anaphylactic reactions were not reported. Allergic skin manifestations were reported at 1.5% (comparator 1.4%) and included eczema, rash, pruritic rash, urticaria, and dermatitis.^[Ref]

Metabolic

• Very common (10% or more): Hypoglycemia
• Frequency not reported: Weight gain^[Ref]

Weight gain has been reported with insulin therapy and has been attributed to the anabolic effects of insulin and the decrease in glucosuria.^[Ref]

Local

• Common (1% to 10%): Injection site reactions (including rash, redness, inflammation, pain, itching, and bruising)
• Frequency not reported: Lipodystrophy (including lipohypertrophy, lipoatrophy)
• Postmarketing reports: Localized cutaneous amyloidosis at injection site

Localized cutaneous amyloidosis at the injection site has been reported with resultant hyperglycemia with repeated insulin injections into that area; hypoglycemia has been reported with a sudden change to an unaffected injection site.

Cardiovascular

• Common (1% to 10%): Chest pain
• Uncommon (0.1% to 1%): Peripheral edema^[Ref]

Insulin may cause sodium retention and edema, especially as metabolic control is improving.^[Ref]

Dermatologic

• Common (1% to 10%): Skin disorder, eczema, dermatitis
• Uncommon (0.1% to 1%): Urticaria, rash
• Frequency not reported: Lipodystrophy including lipohypertrophy and lipoatrophy^[Ref]

Long-term use of insulin may cause lipodystrophy at the site of repeated injection. Lipodystrophy includes lipohypertrophy, a thickening of adipose tissue, and lipoatrophy, thinning of adipose tissue.^[Ref]

Immunologic

• Common (1% to 10%): Onychomycosis
• Frequency not reported: Anti-insulin antibody titers^[Ref]

The clinical significance of the development of these antibody titers is unknown.^[Ref]

Ocular

• Uncommon (0.1% to 1%): Refraction disorder, worsening of diabetic retinopathy^[Ref]

Rapid improvement in glucose control has been associated with a transitory, reversible ophthalmologic refraction disorder and worsening of diabetic retinopathy. However, long-term glycemic control decreases the risk of diabetic retinopathy.^[Ref]

Nervous system

• Very common (10% or more): Headache (up to 12%)
• Common (1% to 10%): Hyporeflexia, sensory disturbance
• Rare (less than 0.1%): Painful peripheral neuropathy^[Ref]

Rapid improvement in glucose control has been associated with a transitory, reversible acute painful peripheral neuropathy. However, long-term glycemic control decreases the risk.^[Ref]

Gastrointestinal

• Common (1% to 10%): Nausea, diarrhea, abdominal pain^[Ref]

Genitourinary

• Common (1% to 10%): Urinary tract infection^[Ref]

Musculoskeletal

• Common (1% to 10%): Back pain^[Ref]

Respiratory

• Very common (10% or more): Nasopharyngitis (23%)
• Common (1% to 10%): Upper respiratory infection^[Ref]

See also:

Frequently asked questions

• How and where should I inject insulin?
• Humalog vs Novolog (Novalog): What's the difference?
• What biosimilars have been approved in the United States?
• What is the difference between Fiasp and NovoLog?
• What are the ingredient drugs in Ryzodeg 70/30?

Further information

Insulin aspart side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer