As of June 2018, the colour of the Fiasp brand of insulin aspart pre-filled pens, vials and cartridges is changing from yellow to red and yellow.1,2 This change follows case reports of confusion between rapid-acting Fiasp and the Tresiba brand of long-acting insulin degludec. Patients have mistakenly administered insulin Fiasp (available as yellow pens) instead of Tresiba (available as light green pens) or vice versa, leading to an increased risk of hypoglycemic or hyperglycemic events.

Fiasp is used as a mealtime insulin that is administered up to 2 minutes before the start of the meal.3 Tresiba is a basal insulin that is administered once-daily at any time of the day.4

Fiasp products will now be manufactured with red and yellow packaging, to better differentiate between the two brands. Until the colour change of Fiasp products has been fully implemented, patients should be extra vigilant.2 The EMA and the market authorisation holder have recommended that prescribers and dispensers should check whether a patient prescribed Fiasp also uses Tresiba, and to remind patients of the risk of confusion between the products.1,2 Patients should be advised to carefully check the name of the insulin before each injection, and to take extra care if preparing injections in poor light. Patients should contact their diabetes nurse or doctor or their GP immediately if they do mix up injections.

Images of the old and new Fiasp products are available on the electronic Medicines Compendium (eMC) website.2

Comment: Healthcare professionals who prescribe or dispense insulin products need to be aware of the change in colour of the Fiasp products and should remind patients who use both Fiasp and Tresiba of the potential for confusion between the products.