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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 6 - Endocrine system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
06.01.01.02 Intermediate- and long-acting insulins
MHRA Drug Safety Update: Insulins (all types): risk of cutaneous amyloidosis at injection site (Sept 2020) NICE TA151: Insulin pumps NICE TA53: Diabetes (types 1 and 2) - long acting insulin analogues

Allstar Pro® reusable insulin pen

GREEN
Formulary

Compatible with Trurapi® , Lantus® cartridges

Pen life: 3 years

Entry reviewed: November 2025

BNF BNFc SPC
Reusable Insulin Pen Device Guide - BLMK ICB

HumaPen Savvio® reusable insulin pen

GREEN
Formulary

Compatible with Humalog® , Humulin I/M3/S® , Abasaglar® cartridges

Pen life: 6 years

Entry reviewed: November 2025

BNF BNFc SPC
Reusable Insulin Pen Device Guide - BLMK ICB

Insulin degludec
(100units/mL)

Amber SPA
Restricted Drug Restricted

Tresiba® (3mL cartridge, 3mL FlexTouch prefilled disposable injection device)

Restricted - initiation by Diabetes specialists only

 

Tresiba Flextouch pre-filled pens are being discontinued

No New Patients should be initiated.
Tresiba Penfill® cartridges are a suitable alternative. These can be used with the NovoPen 6® and NovoPen Echo Plus® devices.
Tresiba® FlexTouch® 100units/ml pens are calibrated to adjust the dose in 1 unit increments. If switching patients to the Penfill Cartridges be aware that :
• NovoPen 6® dials in 1 unit increments to a maximum 60units
• NovoPen Echo Plus® dials in 0.5unit increments to a maximum 30units

Last updated: Dec 2025

BNF BNFc SPC
APC Bulletin 5 (March 2023): Insulin degludec (Tresiba®) CAS Alert Dec 2023 Potential for inappropriate dosing of insulin when switching insulin degludec (Tresiba) products MHRA Drug Safety Update (April 2013) - Insulin degludec (Tresiba▼): available in additional higher strength

Insulin degludec
(200units/mL)

Amber SPA
Restricted Drug Restricted

Tresiba®  (FlexTouch prefilled disposable injection device)

High strength insulin degludec 200 units/ml is not recommended for routine use. It should be considered for patients with severe insulin resistance requiring large daily doses of insulin (≥3units/kg/day), where treatment is initiated by the Specialist Diabetes Service.

 

How to recycle pens using PenCycle®

BNF BNFc SPC
APC Bulletin 5 (March 2023): Insulin Degludec (Tresiba®) MHRA Drug Safety Update (April 2013) - Insulin degludec (Tresiba▼): available in additional higher strength

Insulin Detemir
(100units/mL)

GREEN
Formulary

Levemir® (3mL cartridge, 3mL FlexPen prefilled disposable injection device)

Levemir® (insulin detemir) is being discontinued; stock is anticipated to be exhausted by the end of 2026. No new patients should be initiated and no switches to alternative insulins at this time for existing patients. A national guidance on managing the discontinuation will be issued in coming months.

How to recycle pens using PenCycle®

Entry updated June 2025

BNF BNFc SPC

Insulin Glargine
(100units/mL)

GREEN
Formulary

Biosimilar brands:

Semglee® - Consider 1st line for new patients (cost-effective)

Abasaglar®

 

Originator brands:

Lantus® (10mL vial, 3mL cartridge)
Lantus® Solostar 3mL prefilled disposable injection device.

 

Entry reviewed: February 2024

BNF BNFc SPC

Insulin Glargine (Toujeo®)
(300units/mL )

Amber SPA
Restricted Drug Restricted

Initiation by Specialist Diabetes team

Toujeo 300 units/ml (1.5mL) SoloStar, Toujeo 300 units/ml (3mL) DoubleStar pre-filled pen.

N.B. the dose increment for Solostar is 1 unit and the dose increment for Doublestar is 2 units.

Insulin glargine 100 units/ml and Toujeo are not bioequivalent and are not directly interchangeable.

For initiation by the Specialist Diabetes Service only.

BNF BNFc SPC
APC Bulletin 6 (March 2023): Insulin glargine 300 units/ml (Toujeo®)

Isophane Insulin (HUMAN)
(100units/mL)

GREEN
Formulary

Insulatard® (10mL vial)
Humulin® I (10mL vial, 3mL cartridge)
Humulin® I-Pen prefilled disposable injection device.
Insuman Basal® (10mL vial, 3mL cartridge)
Insuman Basal® (pre-filled pen)

Insulatard® Penfill® is being discontinued by the manufacturer. No new initiations. Supplies anticipated to be exhausted by the end of June 2025 - patients will require switching.

Humulin I vials are due to be discontinued by April 2026 - switch to either Kwikpen or cartridge

How to recycle pens using PenCycle®

BNF BNFc SPC
Medicine Supply Notification: Various Insuman Insulin preparations discontinued Jan 2023

Junior Star® reusable insulin pen

GREEN
Formulary

Compatible with Trurapi® , Lantus® cartridges

Pen life: 2 years

Entry reviewed: November 2025

BNF BNFc SPC
Reusable Insulin Pen Device Guide - BLMK ICB

MyPen2® reusable insulin pen

GREEN
Formulary

Compatible with Hypurin® Porcine Isophane, Neutral and 30/70 Mix

Pen life: 3 years

Entry reviewed: November 2025

BNF BNFc SPC
Reusable Insulin Pen Device Guide - BLMK ICB

Novopen 6® and Novopen Echo Plus® reusable insulin pen

GREEN
Formulary

Re-usable pen to be used in conjunction with Tresiba cartridges during period of Tresiba flextouch shortage.

Smart reusable insulin pens with memory function, for use with 3ml Penfill cartridges. Compatible with Dexcom, FreeStyle LibreLink, Glooko and mySugr apps.

Compatible with NovoRapid®, NovoMix® 30, Fiasp® , Tresiba® Levemir** cartridges

** Levemir due to be discontinued - no new initiations

On average, batteries last for 4 -5 years from first use therefore most patients will not need a replacement pen earlier than 4 years after initial issue.

 

Novopen 6 user guide

 

Novopen Echo plus user guide 

 

Entry reviewed: November 2025

BNF BNFc SPC
Reusable Insulin Pen Device Guide - BLMK ICB
Non formulary items

Pork derived Insulins (Hypurin®)

 
Non Formulary

Hypurin® Porcine insulin is an animal-derived insulin (porcine, pork base) and Wockhardt are the only remaining manufacturer in the world.

Not to be initiated for any new patients.

 

Vial presentations of Hypurin Porcine Isophane, Hypurin Porcine Neutral and Hypurin Porcine 30/70 Mix are being discontinued with supplies anticipated to be exhausted by the end of September 2025, mid-February 2026, and end of July 2026, respectively - prescribe as cartridges if patient is on porcine insulin.

BNF BNFc SPC
06.01.01.02 Biphasic insulins
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.