Apidra causing Tandem occlusions?


#1

I have used Apidra for my insulin for over 12 years in my Medtronic pumps. Being on Medicare, now, I am switching to the Dexcom G5 CGM, and a Tandem t:slim X2 pump. Today I got a call from a Tandem rep, who said I should not be using Apidra with Tandem, since it has shown to cause occlusions in their pump/infusion sets. Has anyone else heard that Apidra should not be used with Tandem?


#2

Heard that - Yes.
Tried it personally - No.


#3

I don’t think a Tandem rep could advise use of any insulin other than Humalog and Novolog. Those are the only two insulins certified with the Tandem pump.


#4

I was unable to reliably use Apidra in my pump. The first two days were usually fine, but after that I experienced occlusions. If you’re someone who needs or is willing to change out cartridges every two days, it would probably work fine.


#5

Is there any news whether FIASP has been OK’d for pump use, specifically for a Tandem pump?


#6

Fiasp hasn’t been approved by the FDA for pump use (any pump). My guess is Novo is trying to get approval based on the clinical trials they completed last year. After (if) Novo gets approval I hope the pump manufacturers will certify it with their pumps. In the mean time you can use it off label. That’s what I’m doing with my X2. Some people (myself included) have had a few issues using it with X2. For others it works without trouble.


#7

I was told they (Novo Nordisk) are in front of the FDA for pumps and Pediatrics.

I think the study for Fiasp was on Medtronic equipment so it will be interesting if Fiasp is approved for all pumps or if the FDA approval for Fiasp in pumps (I assume it will be approved with only question being when) will be specific for Medtronic equipment.

Our Pediatric Endocrinologist was quite excited about us trying Fiasp in the X2 pump and she was 100% on board with writing an off-label prescription. She thought we would have trouble with the insurance company but Novolog is the preferred insulin under our plan and it seems that Fiasp is only about a 5% premium cost over Novolog (obviously same manufacturer of Novo Nordisk due to Fiasp BEING Novolog with two extra ingredients) and the pharmacy filled the script against the insurance with not even a question or issue.

So far so good. About 10 months now on Fiasp via X2.

BTW - Tandem is fully aware that people are running Fiasp through the X2 pumps. However due to FDA regulations, Tandem is legally prevented from anything that could be considered marketing, endorsing, suggesting or similar statements. But they absolutely know.


#8

I think that’s right. The clinical trial was done in collaboration with Medtronics, specifically on the 670G.

Tandem has several employees with T1 that are using Fiasp. Ironically it’s not on Tandem insurance’s formulary!