Indications and Limitations of Use

RYBELSUS^® (semaglutide) tablets 7 mg or 14 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.

Limitations of Use

• RYBELSUS^® is not recommended as a first-line therapy for patients who have inadequate glycemic control on diet and exercise because of the uncertain relevance of rodent C-cell tumor findings to humans
  
  
• RYBELSUS^® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis
  
  
• RYBELSUS^® is not indicated for use in patients with type 1 diabetes
  
  

Important Safety Information

Contraindications

• RYBELSUS^® is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), and in patients with a prior serious hypersensitivity reaction to semaglutide or to any of the excipients in RYBELSUS^®. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with RYBELSUS^®

Warnings and Precautions

• Risk of Thyroid C-Cell Tumors: Patients should be further evaluated if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging
  
  
• Pancreatitis: Has been reported in clinical trials. Observe patients carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting). If pancreatitis is suspected, discontinue RYBELSUS^® and initiate appropriate management; if confirmed, do not restart RYBELSUS^®
  
  
• Diabetic Retinopathy Complications: In a pooled analysis of glycemic control trials with RYBELSUS^®, patients reported diabetic retinopathy related adverse reactions during the trial (4.2% with RYBELSUS^® and 3.8% with comparator). In a 2-year trial with semaglutide injection involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with semaglutide injection (3.0%) compared to placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
  Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy
  
  
• Hypoglycemia: Patients receiving RYBELSUS^® in combination with an insulin secretagogue (e.g., sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. The risk of hypoglycemia may be lowered by a reduction in the dose of sulfonylurea (or other concomitantly administered insulin secretagogue) or insulin. Inform patients using these concomitant medications of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia
  
  
• Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists, including semaglutide. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Monitor renal function when initiating or escalating doses of RYBELSUS^® in patients reporting severe adverse gastrointestinal reactions
  
  
• Hypersensitivity: Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema) have been reported in patients treated with RYBELSUS^®. If hypersensitivity reactions occur, discontinue use of RYBELSUS^®, treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist

Adverse Reactions

• The most common adverse reactions, reported in ≥5% of patients treated with RYBELSUS^® are nausea, abdominal pain, diarrhea, decreased appetite, vomiting and constipation

Drug Interactions

• When initiating RYBELSUS^®, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia
  
  
• RYBELSUS^® delays gastric emptying and has the potential to impact the absorption of other oral medications. Closely follow RYBELSUS^® administration instructions when coadministering with other oral medications and consider increased monitoring for medications with a narrow therapeutic index, such as levothyroxine

Use in Specific Populations

• Pregnancy: Available data with RYBELSUS^® are not sufficient to determine a drug-associated ricks for major birth defects, miscarriage, or other adverse maternal or fetal outcomes. Based on animal reproduction studies, there may be risks to the fetus from exposure to RYBELSUS^®. Use only if the potential benefit justifies the potential risk to the fetus
  
  
• Lactation: There are no data on the presence of semaglutide in human milk, the effects on the breastfed infant, or the effects on milk production. Because of the unknown potential for serious adverse reactions in the breastfed infant due to the possible accumulation of salcaprozate sodium (SNAC), an absorption enhancer in RYBELSUS^®, from breastfeeding and because there are alternative formulations of semaglutide that can be used during lactation, advise patients that breastfeeding is not recommended during treatment with RYBELSUS^®
  
  
• Discontinue RYBELSUS^® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide
  
  
• Pediatric Use: Safety and efficacy of RYBELSUS^® have not been established in pediatric patients (younger than 18 years)

RYBELSUS^® is a registered trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US21RYB00211 June 2021

Indication and Limitations of Use

Ozempic^® (semaglutide) injection 0.5 mg or 1 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established CV disease.

• Ozempic^® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis.
  
  
• Ozempic^® is not indicated for use in patients with type 1 diabetes mellitus.

Contraindications

• Ozempic^® is contraindicated in patients with a personal or family history of MTC or in patients with MEN 2, and in patients with a prior hypersensitivity reaction to semaglutide or to any of the excipients in Ozempic^®. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with Ozempic^®.

Warnings and Precautions

• Risk of Thyroid C-Cell Tumors: Patients should be referred to an endocrinologist for further evaluation if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging.
  
  
• Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signsand symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Ozempic^® promptly, and if pancreatitis is confirmed, do not restart.
  
  
• Diabetic Retinopathy Complications: In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with Ozempic^® (3.0%) compared with placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
  
  Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. The effect of long-term glycemic control with semaglutide on diabetic retinopathy. The effect of long—term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy.
  
  
• Never Share an Ozempic^® Pen Between Patients: Ozempic^® pens must never be shared between patients, even if the needle is changed. Pen-sharing poses a risk for transmission of blood-borne pathogens.
  
  
• Hypoglycemia: Patients receiving Ozempic^® in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Inform patients using these concomitant medications of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia.
  
  
• Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Monitor renal function when initiating or escalating doses of Ozempic^® in patients reporting severe adverse gastrointestinal reactions.
  
  
• Hypersensitivity: Serious hypersensitivity reactions (eg, anaphylaxis, angioedema) have been reported in patients treated with Ozempic^®. If hypersensitivity reactions occur, discontinue use of Ozempic^®; treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist.

Adverse Reactions

• The most common adverse reactions, reported in ≥5% of patients treated with Ozempic^® are nausea, vomiting, diarrhea, abdominal pain, and constipation.

Drug Interactions

• When initiating Ozempic^®, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia.
  
  
• Ozempic^® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications, so caution should be exercised.

Use in Specific Populations

• There are limited data with semaglutide use in pregnant women to inform a drug- associated risk for adverse developmental outcomes. Discontinue Ozempic^® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide.

Ozempic^®, NovoCare^®, NovoFine Plus^®, NovoFine^®, and NovoTwist^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US21OZM00393 April 2021

Tresiba^® (insulin degludec injection) is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus.

Limitations of Use

Tresiba^® is not recommended for treating diabetic ketoacidosis.

Important Safety Information

Contraindications

•  Tresiba^® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba^® or one of its excipients

Warnings and Precautions

• Never Share a Tresiba^® FlexTouch^® Pen, Needle, or Syringe Between Patients, even if the needle is changed. Patients using Tresiba^® vials should never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens
  
  
• Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, or injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
  
  
• Hypoglycemia is the most common adverse reaction of insulin, including Tresiba^®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment
  
  
• Accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. To avoid medication errors, always instruct patients to check the insulin label before each injection
  
  
• Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including Tresiba^®
  
  
• As with all insulins, Tresiba^® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Closely monitor potassium levels in patients at risk of hypokalemia and treat if indicated
  
  
• Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Tresiba^®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered

Adverse Reactions

• Adverse reactions commonly associated with Tresiba^® are hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, and weight gain

Drug Interactions

• There are certain drugs that may cause clinically significant drug interactions with Tresiba^®.
  
  
  • Drugs that may increase the risk of hypoglycemia: antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), sulfonamide antibiotics, GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT-2 inhibitors
    
    
  • Drugs that may decrease the blood glucose lowering effect: atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g., albuterol, epinephrine, terbutaline), and thyroid hormones
    
    
  • Drugs that may increase or decrease the blood glucose lowering effect: alcohol, beta-blockers, clonidine, lithium salts, and pentamidine
    
    
  • Drugs that may blunt the signs and symptoms of hypoglycemia: beta-blockers, clonidine, guanethidine, and reserpine

Cornerstones4Care^®, FlexTouch^®, Levemir^®, NovoFine^®, NovoLog^®, Tresiba^®, and Victoza^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US20TSM00425 March 2021

Indications and Limitations of Use

RYBELSUS^® (semaglutide) tablets 7 mg or 14 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.

Limitations of Use

• RYBELSUS^® is not recommended as a first-line therapy for patients who have inadequate glycemic control on diet and exercise because of the uncertain relevance of rodent C-cell tumor findings to humans
  
  
• RYBELSUS^® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis
  
  
• RYBELSUS^® is not indicated for use in patients with type 1 diabetes
  
  

Important Safety Information

Contraindications

• RYBELSUS^® is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), and in patients with a prior serious hypersensitivity reaction to semaglutide or to any of the excipients in RYBELSUS^®. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with RYBELSUS^®

Warnings and Precautions

• Risk of Thyroid C-Cell Tumors: Patients should be further evaluated if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging
  
  
• Pancreatitis: Has been reported in clinical trials. Observe patients carefully for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting). If pancreatitis is suspected, discontinue RYBELSUS^® and initiate appropriate management; if confirmed, do not restart RYBELSUS^®
  
  
• Diabetic Retinopathy Complications: In a pooled analysis of glycemic control trials with RYBELSUS^®, patients reported diabetic retinopathy related adverse reactions during the trial (4.2% with RYBELSUS^® and 3.8% with comparator). In a 2-year trial with semaglutide injection involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with semaglutide injection (3.0%) compared to placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
  Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy
  
  
• Hypoglycemia: Patients receiving RYBELSUS^® in combination with an insulin secretagogue (e.g., sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. The risk of hypoglycemia may be lowered by a reduction in the dose of sulfonylurea (or other concomitantly administered insulin secretagogue) or insulin. Inform patients using these concomitant medications of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia
  
  
• Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists, including semaglutide. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Monitor renal function when initiating or escalating doses of RYBELSUS^® in patients reporting severe adverse gastrointestinal reactions
  
  
• Hypersensitivity: Serious hypersensitivity reactions (e.g., anaphylaxis, angioedema) have been reported in patients treated with RYBELSUS^®. If hypersensitivity reactions occur, discontinue use of RYBELSUS^®, treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist

Adverse Reactions

• The most common adverse reactions, reported in ≥5% of patients treated with RYBELSUS^® are nausea, abdominal pain, diarrhea, decreased appetite, vomiting and constipation

Drug Interactions

• When initiating RYBELSUS^®, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia
  
  
• RYBELSUS^® delays gastric emptying and has the potential to impact the absorption of other oral medications. Closely follow RYBELSUS^® administration instructions when coadministering with other oral medications and consider increased monitoring for medications with a narrow therapeutic index, such as levothyroxine

Use in Specific Populations

• Pregnancy: Available data with RYBELSUS^® are not sufficient to determine a drug-associated ricks for major birth defects, miscarriage, or other adverse maternal or fetal outcomes. Based on animal reproduction studies, there may be risks to the fetus from exposure to RYBELSUS^®. Use only if the potential benefit justifies the potential risk to the fetus
  
  
• Lactation: There are no data on the presence of semaglutide in human milk, the effects on the breastfed infant, or the effects on milk production. Because of the unknown potential for serious adverse reactions in the breastfed infant due to the possible accumulation of salcaprozate sodium (SNAC), an absorption enhancer in RYBELSUS^®, from breastfeeding and because there are alternative formulations of semaglutide that can be used during lactation, advise patients that breastfeeding is not recommended during treatment with RYBELSUS^®
  
  
• Discontinue RYBELSUS^® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide
  
  
• Pediatric Use: Safety and efficacy of RYBELSUS^® have not been established in pediatric patients (younger than 18 years)

RYBELSUS^® is a registered trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US21RYB00211 June 2021

Indication and Limitations of Use

Ozempic^® (semaglutide) injection 0.5 mg or 1 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established CV disease.

• Ozempic^® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis.
  
  
• Ozempic^® is not indicated for use in patients with type 1 diabetes mellitus.

Contraindications

• Ozempic^® is contraindicated in patients with a personal or family history of MTC or in patients with MEN 2, and in patients with a prior hypersensitivity reaction to semaglutide or to any of the excipients in Ozempic^®. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with Ozempic^®.

Warnings and Precautions

• Risk of Thyroid C-Cell Tumors: Patients should be referred to an endocrinologist for further evaluation if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging.
  
  
• Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signsand symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Ozempic^® promptly, and if pancreatitis is confirmed, do not restart.
  
  
• Diabetic Retinopathy Complications: In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with Ozempic^® (3.0%) compared with placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
  
  Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. The effect of long-term glycemic control with semaglutide on diabetic retinopathy. The effect of long—term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy.
  
  
• Never Share an Ozempic^® Pen Between Patients: Ozempic^® pens must never be shared between patients, even if the needle is changed. Pen-sharing poses a risk for transmission of blood-borne pathogens.
  
  
• Hypoglycemia: Patients receiving Ozempic^® in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Inform patients using these concomitant medications of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia.
  
  
• Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Monitor renal function when initiating or escalating doses of Ozempic^® in patients reporting severe adverse gastrointestinal reactions.
  
  
• Hypersensitivity: Serious hypersensitivity reactions (eg, anaphylaxis, angioedema) have been reported in patients treated with Ozempic^®. If hypersensitivity reactions occur, discontinue use of Ozempic^®; treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist.

Adverse Reactions

• The most common adverse reactions, reported in ≥5% of patients treated with Ozempic^® are nausea, vomiting, diarrhea, abdominal pain, and constipation.

Drug Interactions

• When initiating Ozempic^®, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia.
  
  
• Ozempic^® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications, so caution should be exercised.

Use in Specific Populations

• There are limited data with semaglutide use in pregnant women to inform a drug- associated risk for adverse developmental outcomes. Discontinue Ozempic^® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide.

Ozempic^®, NovoCare^®, NovoFine Plus^®, NovoFine^®, and NovoTwist^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US21OZM00393 April 2021

Indications and Usage

Saxenda^® (liraglutide) injection 3 mg is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in:

• Adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obese) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, or dyslipidemia)
  
  
• Pediatric patients aged 12 years and older with body weight above 60 kg (132 lbs) and initial BMI corresponding to 30 kg/m2 or greater for adults (obese) by international cut-offs

Limitations of Use

• Saxenda^® contains liraglutide and should not be coadministered with other liraglutide-containing products or with any other GLP-1 receptor agonist.
  
  
• The safety and effectiveness of Saxenda^® in pediatric patients with type 2 diabetes have not been established.
  
  
• The safety and effectiveness of Saxenda^® in combination with other products intended for weight loss, including prescription drugs, over-the-counter drugs, and herbal preparations, have not been established.
  
  

Contraindications

Saxenda^® is contraindicated in:

• Patients with a personal or family history of MTC or patients with MEN 2.
  
  
• Patients with a prior serious hypersensitivity reaction to liraglutide or to any of the excipients in Saxenda^®.
  
  
• Pregnancy.

Warnings and Precautions

• Risk of Thyroid C-cell Tumors: If serum calcitonin is measured and found to be elevated, the patient should be further evaluated. Patients with thyroid nodules noted on physical examination or neck imaging should also be further evaluated. 
  
  
• Acute Pancreatitis: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with liraglutide postmarketing. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Saxenda^® promptly and if pancreatitis is confirmed, do not restart.
  
  
• Acute Gallbladder Disease: Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in patients treated with Saxenda^® than with placebo even after accounting for the degree of weight loss. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated.
  
  
• Hypoglycemia: Adult patients with type 2 diabetes on an insulin secretagogue (eg, a sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia with use of Saxenda^®. The risk may be lowered by a reduction in the dose of insulin secretagogues or insulin. In pediatric patients without type 2 diabetes, hypoglycemia occurred. Inform all patients of the risk of hypoglycemia and educate them on the signs and symptoms.
  
  
• Heart Rate Increase: Mean increases in resting heart rate of 2 to 3 beats per minute (bpm) were observed in patients treated with Saxenda^®. Monitor heart rate at regular intervals and inform patients to report palpitations or feelings of a racing heartbeat while at rest during treatment with Saxenda^®. Discontinue Saxenda^® in patients who experience a sustained increase in resting heart rate.
  
  
• Renal Impairment: Acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis, have been reported, usually in association with nausea, vomiting, diarrhea, or dehydration. Use caution when initiating or escalating doses of Saxenda^® in patients with renal impairment.
  
  
• Hypersensitivity Reactions: Serious hypersensitivity reactions (eg, anaphylaxis and angioedema) have been reported in patients treated with liraglutide. If a hypersensitivity reaction occurs, patients should stop taking Saxenda^® and promptly seek medical advice.
  
  
• Suicidal Behavior and Ideation: In adult clinical trials, 9 (0.3%) of 3,384 patients treated with Saxenda^® and 2 (0.1%) of the 1,941 treated with placebo reported suicidal ideation; one of the Saxenda^® treated patients attempted suicide. In a pediatric trial, 1(0.8%) of the 125 Saxenda^® treated patients died by suicide. There was insufficient information to establish a causal relationship to Saxenda^®. Monitor patients for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Discontinue treatment if patients experience suicidal thoughts or behaviors. Avoid Saxenda^® in patients with a history of suicidal attempts or active suicidal ideation.

Adverse Reactions

• The most common adverse reactions, reported in ≥5% are nausea, diarrhea, constipation, vomiting, injection site reactions, headache, hypoglycemia, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, upper abdominal pain, pyrexia, and gastroenteritis.

Drug Interactions

• Saxenda^® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications. Monitor for potential consequences of delayed absorption of oral medications concomitantly administered with Saxenda^®.

Use in Specific Populations

• There are no data on the presence of liraglutide in human breast milk; liraglutide was present in the milk of lactating rats.
  
  
• Saxenda^® has not been studied in patients less than 12 years of age.
  
  
• Saxenda^® slows gastric emptying. Saxenda^® has not been studied in patients with preexisting gastroparesis.

NovoMedLink^™, Saxenda^®, SaxendaCare^®, and Victoza^® are registered trademarks of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

Noom is a registered trademark of Noom, Inc.

This website is intended for US Health Care Professionals.

© 2021 Novo Nordisk All rights reserved. US20SX00403 March 2021

Indications and Usage

Saxenda^® (liraglutide) injection 3 mg is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in:

• Adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obese) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, or dyslipidemia)
  
  
• Pediatric patients aged 12 years and older with body weight above 60 kg (132 lbs) and initial BMI corresponding to 30 kg/m2 or greater for adults (obese) by international cut-offs

Limitations of Use

• Saxenda^® contains liraglutide and should not be coadministered with other liraglutide-containing products or with any other GLP-1 receptor agonist.
  
  
• The safety and effectiveness of Saxenda^® in pediatric patients with type 2 diabetes have not been established.
  
  
• The safety and effectiveness of Saxenda^® in combination with other products intended for weight loss, including prescription drugs, over-the-counter drugs, and herbal preparations, have not been established.
  
  

Contraindications

Saxenda^® is contraindicated in:

• Patients with a personal or family history of MTC or patients with MEN 2.
  
  
• Patients with a prior serious hypersensitivity reaction to liraglutide or to any of the excipients in Saxenda^®.
  
  
• Pregnancy.

Warnings and Precautions

• Risk of Thyroid C-cell Tumors: If serum calcitonin is measured and found to be elevated, the patient should be further evaluated. Patients with thyroid nodules noted on physical examination or neck imaging should also be further evaluated. 
  
  
• Acute Pancreatitis: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with liraglutide postmarketing. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Saxenda^® promptly and if pancreatitis is confirmed, do not restart.
  
  
• Acute Gallbladder Disease: Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in patients treated with Saxenda^® than with placebo even after accounting for the degree of weight loss. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated.
  
  
• Hypoglycemia: Adult patients with type 2 diabetes on an insulin secretagogue (eg, a sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia with use of Saxenda^®. The risk may be lowered by a reduction in the dose of insulin secretagogues or insulin. In pediatric patients without type 2 diabetes, hypoglycemia occurred. Inform all patients of the risk of hypoglycemia and educate them on the signs and symptoms.
  
  
• Heart Rate Increase: Mean increases in resting heart rate of 2 to 3 beats per minute (bpm) were observed in patients treated with Saxenda^®. Monitor heart rate at regular intervals and inform patients to report palpitations or feelings of a racing heartbeat while at rest during treatment with Saxenda^®. Discontinue Saxenda^® in patients who experience a sustained increase in resting heart rate.
  
  
• Renal Impairment: Acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis, have been reported, usually in association with nausea, vomiting, diarrhea, or dehydration. Use caution when initiating or escalating doses of Saxenda^® in patients with renal impairment.
  
  
• Hypersensitivity Reactions: Serious hypersensitivity reactions (eg, anaphylaxis and angioedema) have been reported in patients treated with liraglutide. If a hypersensitivity reaction occurs, patients should stop taking Saxenda^® and promptly seek medical advice.
  
  
• Suicidal Behavior and Ideation: In adult clinical trials, 9 (0.3%) of 3,384 patients treated with Saxenda^® and 2 (0.1%) of the 1,941 treated with placebo reported suicidal ideation; one of the Saxenda^® treated patients attempted suicide. In a pediatric trial, 1(0.8%) of the 125 Saxenda^® treated patients died by suicide. There was insufficient information to establish a causal relationship to Saxenda^®. Monitor patients for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Discontinue treatment if patients experience suicidal thoughts or behaviors. Avoid Saxenda^® in patients with a history of suicidal attempts or active suicidal ideation.

Adverse Reactions

• The most common adverse reactions, reported in ≥5% are nausea, diarrhea, constipation, vomiting, injection site reactions, headache, hypoglycemia, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, upper abdominal pain, pyrexia, and gastroenteritis.

Drug Interactions

• Saxenda^® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications. Monitor for potential consequences of delayed absorption of oral medications concomitantly administered with Saxenda^®.

Use in Specific Populations

• There are no data on the presence of liraglutide in human breast milk; liraglutide was present in the milk of lactating rats.
  
  
• Saxenda^® has not been studied in patients less than 12 years of age.
  
  
• Saxenda^® slows gastric emptying. Saxenda^® has not been studied in patients with preexisting gastroparesis.

NovoMedLink^™, Saxenda^®, SaxendaCare^®, and Victoza^® are registered trademarks of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

Noom is a registered trademark of Noom, Inc.

This website is intended for US Health Care Professionals.

© 2021 Novo Nordisk All rights reserved. US21OB00064 March 2021

Esperoct^® [antihemophilic factor (recombinant), glycopegylated-exei] is indicated for use in adults and children with hemophilia A for on-demand treatment and control of bleeding episodes, perioperative management of bleeding, and routine prophylaxis to reduce the frequency of bleeding episodes

• Esperoct^® is not indicated for the treatment of von Willebrand disease
  
  

Important Safety Information

Contraindications

• Do not use in patients who have known hypersensitivity to Esperoct® or its components, including hamster proteins

Warnings and Precautions

• Hypersensitivity reactions, including anaphylaxis, may occur. Should hypersensitivity reactions occur,discontinue Esperoct^® and administer appropriate treatment

• Development of neutralizing antibodies (inhibitors) has occurred. Perform an assay that measures Factor VIII inhibitor concentration if bleeding is not controlled with the recommended dose of Esperoct^® or if the expected plasma Factor VIII activity levels are not attained
  
  

Adverse Reactions

• The most frequently reported adverse reactions in clinical trials (>1%) were rash, redness, itching (pruritus), and injection site reactions

Esperoct^®, Novoeight^®, NovoSeven^®, Rebinyn^®, and Tretten^® are registered trademarks of Novo Nordisk Health Care AG. Novo Nordisk is a registered trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

©2021 Novo Nordisk All rights reserved. US21ESP00043 June 2021

Rebinyn^®, Coagulation Factor IX (Recombinant), GlycoPEGylated, is a recombinant DNA derived coagulation Factor IX concentrate indicated for use in adults and children with hemophilia B for on demand treatment and control of bleeding episodes and perioperative management of bleeding.

Limitations of Use: Rebinyn^® is not indicated for routine prophylaxis or for immune tolerance induction in patients with hemophilia B.

Important Safety Information

Contraindications

• Rebinyn® is contraindicated in patients with a known hypersensitivity to Rebinyn^® or its components, including hamster proteins.

Warnings and Precautions

• Hypersensitivity reactions, including anaphylaxis, may occur. Signs may include angioedema, chest tightness, difficulty breathing, wheezing, urticaria, and itching. Discontinue Rebinyn^® if allergic or anaphylactic-type reactions occur and initiate appropriate treatment.
  
  
• Development of neutralizing antibodies (inhibitors) to Factor IX may occur. Monitor patients for development of factor IX inhibitors if bleeding is not controlled with the recommended dose of Rebinyn^® or if expected Factor IX activity plasma levels are not attained. Factor IX activity assay results may vary with the type of activated partial thromboplastin time reagent used.
  
  
• The use of Factor IX-containing products has been associated with thrombotic complications. Monitor for thrombotic and consumptive coagulopathy when administering Rebinyn^® to patients with liver disease, post-operatively, to newborn infants, or to patients at risk of thrombosis or disseminated intravascular coagulation (DIC).
  
  
• Nephrotic syndrome has been reported following immune tolerance induction therapy with Factor IX products in hemophilia B patients with Factor IX inhibitors, often with a history of allergic reactions to Factor IX. The safety and efficacy of using Rebinyn^® for immune tolerance induction have not been established.

Adverse Reactions

• The most common adverse reactions reported in clinical trials (≥1%) were itching and injection site reactions. • Animals administered repeat doses of Rebinyn® showed accumulation of PEG in the choroid plexus. The potential clinical implications of these animal findings are unknown.

Esperoct^®, Novoeight^®, NovoSeven^®, Rebinyn^®, and Tretten^® are registered trademarks of Novo Nordisk Health Care AG. Novo Nordisk is a registered trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S. All other trademarks, registered or unregistered, are the property of their respective owners.

©2021 Novo Nordisk All rights reserved. US21REB00012 June 2021

NovoSeven^® RT (coagulation Factor VIIa, recombinant) is a coagulation factor indicated for:

• Treatment of bleeding episodes and perioperative management in adults and children with hemophilia A or B with inhibitors, congenital Factor VII (FVII) deficiency, and Glanzmann’s thrombasthenia with refractoriness to platelet transfusions, with or without antibodies to platelets
  
  
• Treatment of bleeding episodes and perioperative management in adults with acquired hemophilia
  
  

Important Safety Information

Warnings and Precautions

• Serious arterial and venous thrombotic events have been reported in clinical trials and postmarketing surveillance
  
  
• Patients with congenital hemophilia receiving concomitant treatment with aPCCs (activated prothrombin complex concentrates), older patients particularly with acquired hemophilia and receiving other hemostatic agents, and patients with a history of cardiac and vascular disease may have an increased risk of developing thrombotic events
  
  
• Hypersensitivity reactions, including anaphylaxis, can occur with NovoSeven^® RT. Patients with a known hypersensitivity to mouse, hamster, or bovine proteins may be at a higher risk of hypersensitivity reactions. Discontinue infusion and administer appropriate treatment when hypersensitivity reactions occur
  
  
• Factor VII deficient patients should be monitored for prothrombin time (PT) and factor VII coagulant activity (FVII:C). If FVII:C fails to reach the expected level, or PT is not corrected, or bleeding is not controlled after treatment with the recommended doses, antibody formation may be suspected and analysis for antibodies should be performed
  
  
• Laboratory coagulation parameters (PT/INR, aP'I'I', FVII:C) have shown no direct correlation to achieving hemostasis

Adverse Reactions

• The most common and serious adverse reactions in clinical trials are thrombotic events. Thrombotic adverse reactions following the administration of NovoSeven^® RT in clinical trials occurred in 4% of patients with acquired hemophilia and 0.2% of bleeding episodes in patients with congenital hemophilia

Drug Interactions

• Thrombosis may occur if NovoSeven^® RT is administered concomitantly with Coagulation Factor XIII

Esperoct^®, Novoeight^®, NovoSeven^®, Rebinyn^®, and Tretten^® are registered trademarks of Novo Nordisk Health Care AG. Novo Nordisk is a registered trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

©2021 Novo Nordisk All rights reserved. US21NSVN00051 June 2021

Novoeight^® (antihemophilic factor, recombinant) is indicated for use in adults and children with hemophilia A for on-demand treatment and control of bleeding episodes, perioperative management, and routine prophylaxis to reduce the frequency of bleeding episodes.

• Novoeight^® is not indicated for the treatment of von Willebrand disease
  
  

Important Safety Information

Contraindications

• Do not use in patients who have had life-threatening hypersensitivity reactions, including anaphylaxis, to Novoeight^® or its components, including hamster proteins

Warnings and Precautions

• Anaphylaxis and severe hypersensitivity reactions are possible. Patients may develop hypersensitivity to hamster proteins, which are present in trace amounts in the product. Should symptoms occur, discontinue Novoeight^® and administer appropriate treatment
  
  
• Development of activity-neutralizing antibodies (inhibitors) may occur. Previously untreated patients (PUPs) are at greatest risk for inhibitor development with allfactor VIII products. Inhibitors have been reported following administration of Novoeight^® in PUPs. If expected plasma factor VIII activity levels are not attained, or if bleeding is not controlled with an appropriate dose, perform testing for factor VIII inhibitors

Adverse Reactions

• The most frequently reported adverse reactions (>1%) were inhibitors in Previously Untreated Patients (PUPs), injection site reactions, and pyrexia.

Esperoct^®, Novoeight^®, NovoSeven^®, Rebinyn^®, and Tretten^® are registered trademarks of Novo Nordisk Health Care AG. Novo Nordisk is a registered trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

©2021 Novo Nordisk All rights reserved. US21NEGT00005 June 2021

Tretten^® (Coagulation Factor XIII A-Subunit [Recombinant]) is indicated for routine prophylaxis of bleeding in patients with congenital Factor XIII A-subunit deficiency.

Tretten^® is not for use in patients with congenital Factor XIII B-subunit deficiency.

Important Safety Information

Tretten^® is contraindicated in patients with hypersensitivity to the active substance or to any of the excipients.

Tretten^® may cause allergic reactions. If signs or symptoms of anaphylaxis or hypersensitivity reactions (including urticaria, rash, tightness of the chest, wheezing, hypotension) occur, discontinue immediately and institute appropriate treatment.

Thromboembolic complications may occur. Monitor patients with conditions that predispose to thrombosis for signs and symptoms of thrombosis after administration of Tretten^®.

Inhibitory antibodies may occur with Tretten^®. Patients with inhibitory antibodies may manifest as an inadequate response to treatment. If expected plasma FXIII activity levels are not attained, or if breakthrough bleeding occurs while receiving prophylaxis, perform an assay that measures FXIII inhibitory antibody concentrations.

The most common adverse reactions reported in clinical trials (≥1%) were headache, pain in the extremities, pain at injection site, and increase in fibrin D dimer levels.

Thrombosis may occur if Tretten^® is administered concomitantly with Factor VIIa.

There are no adequate and well-controlled studies using TRETTEN in pregnant women to determine whether there is a drug-associated risk. Animal reproduction studies have not been conducted with TRETTEN.

Esperoct^®, Novoeight^®, NovoSeven^®, Rebinyn^®, and Tretten^® are registered trademarks of Novo Nordisk Health Care AG. Novo Nordisk is a registered trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

©2021 Novo Nordisk All rights reserved. US21TTN00002 June 2021

Important Safety Information

Contraindications

• Fiasp^® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to Fiasp^® or one of its excipients.

Warnings and Precautions

• Never share a Fiasp^® FlexTouch^® Pen, PenFill^® cartridge or PenFill^® cartridge device between patients, even if the needle is changed. Patients using Fiasp^® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.
  
  
• Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
  
  
• Hypoglycemia is the most common adverse reaction of insulin, including Fiasp^®, and may be life-threatening. Increase glucose monitoring with changes to: insulin dosage, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with renal impairment or hepatic impairment or hypoglycemia unawareness.
  
  
• To avoid medication errors and accidental mix-ups between Fiasp^® and other insulin products, instruct patients to always check the insulin label before injection.
  
  
• As with all insulins, Fiasp^® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated.
  
  
• Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including Fiasp^®.
  
  
• Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Fiasp^®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered.
  
  
• Pump or infusion set malfunctions can lead to a rapid onset of hyperglycemia and ketoacidosis. Prompt identification and correction of the cause of hyperglycemia or ketosis is necessary. Interim therapy with subcutaneous injection of Fiasp^® may be required. Patients using continuous subcutaneous insulin infusion pump therapy must be trained to administer insulin by injection and have alternate insulin therapy available in case of pump failure.

Adverse Reactions

• Adverse reactions observed with Fiasp^® include hypoglycemia, allergic reactions, hypersensitivity, injection site reactions, lipodystrophy, and weight gain.

Use in Specific Populations

• Pediatric patients with type 1 diabetes treated with mealtime and postmeal Fiasp^® reported a higher rate of blood glucose confirmed hypoglycemic episodes compared to patients treated with NovoLog^® (insulin aspart injection); the imbalance was greater during the nocturnal period. Monitor blood glucose levels closely in pediatric patients.
  
  
• Like all insulins, Fiasp^® requirements may be reduced in patients with renal impairment or hepatic impairment. These patients may require more frequent blood glucose monitoring and dose adjustments.

Novolog^® Indications and Important Safety Information

Indications and Usage

Contraindications

• NovoLog^® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog^® or one of its excipients

Warnings and Precautions

• Never Share a NovoLog^® FlexPen, NovoLog^® FlexTouch^®, PenFill^® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog^® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.
• Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, or injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
• Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is recommended for all patients with diabetes and is particularly important for patients using external pump infusion therapy.
• To avoid medication errors and accidental mix-ups between NovoLog^® and other insulin products, instruct patients to always check the insulin label before injection.
• Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including NovoLog^®.
• As with all insulins, NovoLog^® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated.
• Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including NovoLog^®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered.
• Malfunction of the insulin pump or insulin infusion set or insulin degradation can rapidly lead to
  hyperglycemia and ketoacidosis. Patients using insulin infusion pump therapy must be trained to
  administer insulin by injection and have alternate insulin therapy available in case of pump failure.

Adverse Reactions

• Adverse reactions observed with NovoLog^® include hypoglycemia, allergic reactions, local injection site reactions, lipodystrophy, rash, and pruritus.

Use in Specific Populations

• NovoLog^® has not been studied in children with type 2 diabetes or in children with type 1 diabetes who are younger than 2 years of age.
• Like all insulins, NovoLog^® requirements may be reduced in patients with renal impairment or hepatic impairment. These patients may require more frequent blood glucose monitoring and dose adjustments.

Cornerstones4Care^®, Fiasp^®, FlexPen^®, FlexTouch^®, NovoLog^®, and PenFill^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners

© 2021 Novo Nordisk All rights reserved. US21FSP00003 March 2021

Please scroll for Tresiba^® ISI and Fiasp^® ISI

Tresiba^® (insulin degludec injection) is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus.

Limitations of Use

Tresiba^® is not recommended for treating diabetic ketoacidosis.

Important Safety Information

Contraindications

• Tresiba^® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba^® or one of its excipients

Warnings and Precautions

• Never Share a Tresiba^® FlexTouch^® Pen, Needle, or Syringe Between Patients, even if the needle is changed. Patients using Tresiba^® vials should never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens
  
  
• Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, or injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
  
  
• Hypoglycemia is the most common adverse reaction of insulin, including Tresiba^®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment
  
  
• Accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. To avoid medication errors, always instruct patients to check the insulin label before each injection
  
  
• Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including Tresiba^®
  
  
• As with all insulins, Tresiba^® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Closely monitor potassium levels in patients at risk of hypokalemia and treat if indicated
  
  
• Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Tresiba^®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered

Adverse Reactions

• Adverse reactions commonly associated with Tresiba^® are hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, and weight gain

Drug Interactions

• There are certain drugs that may cause clinically significant drug interactions with Tresiba^®.
  
  
  • Drugs that may increase the risk of hypoglycemia: antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), sulfonamide antibiotics, GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT-2 inhibitors
    
    
  • Drugs that may decrease the blood glucose lowering effect: atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g., albuterol, epinephrine, terbutaline), and thyroid hormones
    
    
  • Drugs that may increase or decrease the blood glucose lowering effect: alcohol, beta-blockers, clonidine, lithium salts, and pentamidine
    
    
  • Drugs that may blunt the signs and symptoms of hypoglycemia: beta-blockers, clonidine, guanethidine, and reserpine

Fiasp^® Indications and Important Safety Information

Fiasp^® (insulin aspart injection) 100 U/mL is a rapid-acting insulin analog indicated to improve glycemic control in adult and pediatric patients with diabetes mellitus.

Important Safety Information

Contraindications

• Fiasp^® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to Fiasp^® or one of its excipients.

Warnings and Precautions

• Never share a Fiasp^® FlexTouch^® Pen, PenFill^® cartridge or PenFill^® cartridge device between patients, even if the needle is changed. Patients using Fiasp^® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.
  
  
• Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
  
  
• Hypoglycemia is the most common adverse reaction of insulin, including Fiasp^®, and may be life-threatening. Increase glucose monitoring with changes to: insulin dosage, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with renal impairment or hepatic impairment or hypoglycemia unawareness.
  
  
• To avoid medication errors and accidental mix-ups between Fiasp^® and other insulin products, instruct patients to always check the insulin label before injection.
  
  
• As with all insulins, Fiasp^® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated.
  
  
• Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including Fiasp^®.
  
  
• Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Fiasp^®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered.
  
  
• Pump or infusion set malfunctions can lead to a rapid onset of hyperglycemia and ketoacidosis. Prompt identification and correction of the cause of hyperglycemia or ketosis is necessary. Interim therapy with subcutaneous injection of Fiasp^® may be required. Patients using continuous subcutaneous insulin infusion pump therapy must be trained to administer insulin by injection and have alternate insulin therapy available in case of pump failure.

Adverse Reactions

• Adverse reactions observed with Fiasp^® include hypoglycemia, allergic reactions, hypersensitivity, injection site reactions, lipodystrophy, and weight gain.

Use in Specific Populations

• Pediatric patients with type 1 diabetes treated with mealtime and postmeal Fiasp^® reported a higher rate of blood glucose confirmed hypoglycemic episodes compared to patients treated with NovoLog^® (insulin aspart injection); the imbalance was greater during the nocturnal period. Monitor blood glucose levels closely in pediatric patients.
  
  
• Like all insulins, Fiasp^® requirements may be reduced in patients with renal impairment or hepatic impairment. These patients may require more frequent blood glucose monitoring and dose adjustments.

Cornerstones4Care^®, Fiasp^®, FlexPen^®, FlexTouch^®, NovoLog^®, and PenFill^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners

© 2021 Novo Nordisk All rights reserved. US20TSM00425 March 2021

Indication and Limitations of Use

Ozempic^® (semaglutide) injection 0.5 mg or 1 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established CV disease.

• Ozempic^® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis.
  
  
• Ozempic^® is not indicated for use in patients with type 1 diabetes mellitus.

Contraindications

• Ozempic^® is contraindicated in patients with a personal or family history of MTC or in patients with MEN 2, and in patients with a prior hypersensitivity reaction to semaglutide or to any of the excipients in Ozempic^®. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with Ozempic^®.

Warnings and Precautions

• Risk of Thyroid C-Cell Tumors: Patients should be referred to an endocrinologist for further evaluation if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging.
  
  
• Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signsand symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Ozempic^® promptly, and if pancreatitis is confirmed, do not restart.
  
  
• Diabetic Retinopathy Complications: In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with Ozempic^® (3.0%) compared with placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
  
  Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. The effect of long-term glycemic control with semaglutide on diabetic retinopathy. The effect of long—term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy.
  
  
• Never Share an Ozempic^® Pen Between Patients: Ozempic^® pens must never be shared between patients, even if the needle is changed. Pen-sharing poses a risk for transmission of blood-borne pathogens.
  
  
• Hypoglycemia: Patients receiving Ozempic^® in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Inform patients using these concomitant medications of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia.
  
  
• Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Monitor renal function when initiating or escalating doses of Ozempic^® in patients reporting severe adverse gastrointestinal reactions.
  
  
• Hypersensitivity: Serious hypersensitivity reactions (eg, anaphylaxis, angioedema) have been reported in patients treated with Ozempic^®. If hypersensitivity reactions occur, discontinue use of Ozempic^®; treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist.

Adverse Reactions

• The most common adverse reactions, reported in ≥5% of patients treated with Ozempic^® are nausea, vomiting, diarrhea, abdominal pain, and constipation.

Drug Interactions

• When initiating Ozempic^®, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia.
  
  
• Ozempic^® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications, so caution should be exercised.

Use in Specific Populations

• There are limited data with semaglutide use in pregnant women to inform a drug- associated risk for adverse developmental outcomes. Discontinue Ozempic^® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide.

Ozempic^®, NovoCare^®, NovoFine Plus^®, NovoFine^®, and NovoTwist^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US21OZM00393 April 2021

Indication and Limitations of Use

Ozempic^® (semaglutide) injection 0.5 mg or 1 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established CV disease.

• Ozempic^® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis.
  
  
• Ozempic^® is not indicated for use in patients with type 1 diabetes mellitus.

Contraindications

• Ozempic^® is contraindicated in patients with a personal or family history of MTC or in patients with MEN 2, and in patients with a prior hypersensitivity reaction to semaglutide or to any of the excipients in Ozempic^®. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with Ozempic^®.

Warnings and Precautions

• Risk of Thyroid C-Cell Tumors: Patients should be referred to an endocrinologist for further evaluation if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging.
  
  
• Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signsand symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Ozempic^® promptly, and if pancreatitis is confirmed, do not restart.
  
  
• Diabetic Retinopathy Complications: In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with Ozempic^® (3.0%) compared with placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
  
  Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. The effect of long-term glycemic control with semaglutide on diabetic retinopathy. The effect of long—term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy.
  
  
• Never Share an Ozempic^® Pen Between Patients: Ozempic^® pens must never be shared between patients, even if the needle is changed. Pen-sharing poses a risk for transmission of blood-borne pathogens.
  
  
• Hypoglycemia: Patients receiving Ozempic^® in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Inform patients using these concomitant medications of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia.
  
  
• Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Monitor renal function when initiating or escalating doses of Ozempic^® in patients reporting severe adverse gastrointestinal reactions.
  
  
• Hypersensitivity: Serious hypersensitivity reactions (eg, anaphylaxis, angioedema) have been reported in patients treated with Ozempic^®. If hypersensitivity reactions occur, discontinue use of Ozempic^®; treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist.

Adverse Reactions

• The most common adverse reactions, reported in ≥5% of patients treated with Ozempic^® are nausea, vomiting, diarrhea, abdominal pain, and constipation.

Drug Interactions

• When initiating Ozempic^®, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia.
  
  
• Ozempic^® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications, so caution should be exercised.

Use in Specific Populations

• There are limited data with semaglutide use in pregnant women to inform a drug- associated risk for adverse developmental outcomes. Discontinue Ozempic^® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide.

Ozempic^®, NovoCare^®, NovoFine Plus^®, NovoFine^®, and NovoTwist^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US21OZM00393 April 2021

Indication and Limitations of Use

Ozempic^® (semaglutide) injection 0.5 mg or 1 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus and to reduce the risk of major adverse cardiovascular (CV) events (CV death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established CV disease.

• Ozempic^® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis.
  
  
• Ozempic^® is not indicated for use in patients with type 1 diabetes mellitus.

Contraindications

• Ozempic^® is contraindicated in patients with a personal or family history of MTC or in patients with MEN 2, and in patients with a prior hypersensitivity reaction to semaglutide or to any of the excipients in Ozempic^®. Serious hypersensitivity reactions including anaphylaxis and angioedema have been reported with Ozempic^®.

Warnings and Precautions

• Risk of Thyroid C-Cell Tumors: Patients should be referred to an endocrinologist for further evaluation if serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging.
  
  
• Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signsand symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Ozempic^® promptly, and if pancreatitis is confirmed, do not restart.
  
  
• Diabetic Retinopathy Complications: In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with Ozempic^® (3.0%) compared with placebo (1.8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline than among patients without a known history of diabetic retinopathy.
  
  Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. The effect of long-term glycemic control with semaglutide on diabetic retinopathy. The effect of long—term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy.
  
  
• Never Share an Ozempic^® Pen Between Patients: Ozempic^® pens must never be shared between patients, even if the needle is changed. Pen-sharing poses a risk for transmission of blood-borne pathogens.
  
  
• Hypoglycemia: Patients receiving Ozempic^® in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. Inform patients using these concomitant medications of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia.
  
  
• Acute Kidney Injury: There have been postmarketing reports of acute kidney injury and worsening of chronic renal failure, which may sometimes require hemodialysis, in patients treated with GLP-1 receptor agonists. Some of these events have been reported in patients without known underlying renal disease. A majority of the reported events occurred in patients who had experienced nausea, vomiting, diarrhea, or dehydration. Monitor renal function when initiating or escalating doses of Ozempic^® in patients reporting severe adverse gastrointestinal reactions.
  
  
• Hypersensitivity: Serious hypersensitivity reactions (eg, anaphylaxis, angioedema) have been reported in patients treated with Ozempic^®. If hypersensitivity reactions occur, discontinue use of Ozempic^®; treat promptly per standard of care, and monitor until signs and symptoms resolve. Use caution in a patient with a history of angioedema or anaphylaxis with another GLP-1 receptor agonist.

Adverse Reactions

• The most common adverse reactions, reported in ≥5% of patients treated with Ozempic^® are nausea, vomiting, diarrhea, abdominal pain, and constipation.

Drug Interactions

• When initiating Ozempic^®, consider reducing the dose of concomitantly administered insulin secretagogue (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia.
  
  
• Ozempic^® causes a delay of gastric emptying and has the potential to impact the absorption of concomitantly administered oral medications, so caution should be exercised.

Use in Specific Populations

• There are limited data with semaglutide use in pregnant women to inform a drug- associated risk for adverse developmental outcomes. Discontinue Ozempic^® in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide.

Ozempic^®, NovoCare^®, NovoFine Plus^®, NovoFine^®, and NovoTwist^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US21OZM00393 April 2021

Important Safety Information

Contraindications

• Fiasp^® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to Fiasp^® or one of its excipients.

Warnings and Precautions

• Never share a Fiasp^® FlexTouch^® Pen, PenFill^® cartridge or PenFill^® cartridge device between patients, even if the needle is changed. Patients using Fiasp^® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.
  
  
• Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
  
  
• Hypoglycemia is the most common adverse reaction of insulin, including Fiasp^®, and may be life-threatening. Increase glucose monitoring with changes to: insulin dosage, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with renal impairment or hepatic impairment or hypoglycemia unawareness.
  
  
• To avoid medication errors and accidental mix-ups between Fiasp^® and other insulin products, instruct patients to always check the insulin label before injection.
  
  
• As with all insulins, Fiasp^® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated.
  
  
• Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including Fiasp^®.
  
  
• Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Fiasp^®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered.
  
  
• Pump or infusion set malfunctions can lead to a rapid onset of hyperglycemia and ketoacidosis. Prompt identification and correction of the cause of hyperglycemia or ketosis is necessary. Interim therapy with subcutaneous injection of Fiasp^® may be required. Patients using continuous subcutaneous insulin infusion pump therapy must be trained to administer insulin by injection and have alternate insulin therapy available in case of pump failure.

Adverse Reactions

• Adverse reactions observed with Fiasp^® include hypoglycemia, allergic reactions, hypersensitivity, injection site reactions, lipodystrophy, and weight gain.

Use in Specific Populations

• Pediatric patients with type 1 diabetes treated with mealtime and postmeal Fiasp^® reported a higher rate of blood glucose confirmed hypoglycemic episodes compared to patients treated with NovoLog^® (insulin aspart injection); the imbalance was greater during the nocturnal period. Monitor blood glucose levels closely in pediatric patients.
  
  
• Like all insulins, Fiasp^® requirements may be reduced in patients with renal impairment or hepatic impairment. These patients may require more frequent blood glucose monitoring and dose adjustments.

Novolog^® Indications and Important Safety Information

Indications and Usage

Contraindications

• NovoLog^® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog^® or one of its excipients

Warnings and Precautions

• Never Share a NovoLog^® FlexPen, NovoLog^® FlexTouch^®, PenFill^® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog^® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens.
• Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, or injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
• Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is recommended for all patients with diabetes and is particularly important for patients using external pump infusion therapy.
• To avoid medication errors and accidental mix-ups between NovoLog^® and other insulin products, instruct patients to always check the insulin label before injection.
• Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with insulin products, including NovoLog^®.
• As with all insulins, NovoLog^® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia and treat if indicated.
• Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including NovoLog^®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered.
• Malfunction of the insulin pump or insulin infusion set or insulin degradation can rapidly lead to
  hyperglycemia and ketoacidosis. Patients using insulin infusion pump therapy must be trained to
  administer insulin by injection and have alternate insulin therapy available in case of pump failure.

Adverse Reactions

• Adverse reactions observed with NovoLog^® include hypoglycemia, allergic reactions, local injection site reactions, lipodystrophy, rash, and pruritus.

Use in Specific Populations

• NovoLog^® has not been studied in children with type 2 diabetes or in children with type 1 diabetes who are younger than 2 years of age.
• Like all insulins, NovoLog^® requirements may be reduced in patients with renal impairment or hepatic impairment. These patients may require more frequent blood glucose monitoring and dose adjustments.

Cornerstones4Care^®, Fiasp^®, FlexPen^®, FlexTouch^®, NovoLog^®, and PenFill^® are registered trademarks and NovoMedLink^™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners

© 2021 Novo Nordisk All rights reserved. US21FSP00003 March 2021

Norditropin^® is a prescription medicine that contains human growth hormone and is used to treat:

•  children who are not growing because of low or no growth hormone
  
  
• children who are short (in stature) and who have Noonan syndrome, Turnersyndrome, or were born small (small for gestational age-SGA) and have not caught-up in growth by age 2 to 4 years
  
  
• children who have Idiopathic Short Stature (ISS)
  
  
• children who are not growing who have Prader-Willi syndrome (PWS)
  
  
• adults who do not make enough growth hormone

Important Safety Information

Do not use Norditropin^® if:

• you have a critical illness caused by certain types of heart or stomach surgery, trauma or breathing (respiratory) problems
  
  
• you are a child with Prader-Willi syndrome who is severely obese or has breathing problems including sleep apnea
  
  
• you have cancer or other tumors
  
  
• you are allergic to somatropin or any of the ingredients in Norditropin^®
  
  
• your healthcare provider tells you that you have certain types of eye problems caused by diabetes (diabetic retinopathy)
  
  
• you are a child with closed bone growth plates (epiphyses)

Before taking Norditropin^®, tell your healthcare provider about all of your medical conditions, including if you:

• have had heart or stomach surgery, trauma or serious breathing (respiratory problems)
  
  
• have had a history of problems breathing while you sleep (sleep apnea)
  
  
• have or have had cancer or any tumor
  
  
• have diabetes
  
  
• are pregnant or breastfeeding, or plan to become pregnant or breastfeed

Tell your healthcare provider about all the medicines you take, including prescription andover-the-counter medicines, vitamins, and herbal supplements. Norditropin^® may affect how other medicines work, and other medicines may affect how Norditropin^® works.

How should I use Norditropin^®?

• Use Norditropin^® exactly as your health care provider tells you to
  
  
• Do not share your Norditropin^® pens and needles with another person even if the needle has been changed. You may give another person an infection or get an infection from them.

What are the possible side effects of Norditropin^®?

Norditropin^® may cause serious side effects, including:

• high risk of death in people who have critical illnesses because of heart or stomach surgery, trauma or serious breathing (respiratory) problems
  
  
• high risk of sudden death in children with Prader-Willi syndrome who are severely obese or have breathing problems including sleep apnea
  
  
• increased risk of growth of cancer or a tumor that is already present and increased risk of the return of cancer or a tumor in people who were treated with radiation to the brain or head as children and who developed low growth hormone problems. Contact the healthcare provider if you or your child start to have headaches, or have changes in behavior, changes in vision, or changes in moles, birthmarks, or the color of your skin
  
  
• new or worsening high blood sugar (hyperglycemia) or diabetes
  
  
• increase in pressure in the skull (intracranial hypertension). If you or your child has headaches, eye problems, nausea or vomiting, contact the healthcare provider
  
  
• serious allergic reactions. Get medical help right away if you or your child has the following symptoms: swelling of your face, lips, mouth or tongue, trouble breathing, wheezing, severe itching, skin rashes, redness or swelling, dizziness or fainting, fast heartbeat or pounding in your chest, or sweating
  
  
• your body holding too much fluid (fluid retention) such as swelling in the hands and feet, pain in your joints or muscles or nerve problems that cause pain, burning, or tingling in the hands, arms, legs and feet. Tell your healthcare provider if you have any of these signs or symptoms of fluid retention.
  
  
• decrease in a hormone called cortisol. Tell your or your child’s healthcare provider if you or your child has darkening of the skin, severe fatigue, dizziness, weakness or weight loss
  
  
• decrease in thyroid hormone levels
  
  
• hip and knee pain or a limp in children (slipped capital femoral epiphysis)
  
  
• worsening of pre-existing curvature of the spine (scoliosis)
  
  
• severe and constant abdominal pain can be a sign of pancreatitis. Tell your or your child’s healthcare provider if you or your child has any new abdominal pain.
  
  
• loss of fat and tissue weakness in the area of skin you inject
  
  
• increase in phosphorus, alkaline phosphatase, and parathyroid hormone levels in your blood

The most common side effects of Norditropin^® include:

• injection site reactions and rashes, and headaches

FlexPro^® and Norditropin^® are registered trademarks of Novo Nordisk Health Care AG.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

© 2021 Novo Nordisk All rights reserved. US21NORD00091 June 2021