Apidra Insulin Shortage in Pakistan: NovoRapid and Humalog Alternatives, How to Switch Safely

Short answer: Apidra (insulin glulisine), a rapid-acting insulin, is out of stock in Pakistan, and the federal health ministry says it will stay short until international supply returns. The ministry says two insulins of the same type, NovoRapid (insulin aspart) and Humalog (insulin lispro), are available nationwide. Do not switch on your own: ask your doctor for the new dose first.

The shortage was raised in the National Assembly on Friday 23 October 2026. The Parliamentary Secretary for Health told members that supplies from the German manufacturer fell sharply in October while it upgrades its products, as reported. Three days earlier, the ministry's spokesperson had said only one insulin brand was unavailable. We could not open either statement on an official website, so the details below are as reported. What follows is what has changed, which insulins the ministry names as alternatives, and the safe way to make a switch.

Apidra is unavailable, and the ministry expects a long gap

Insulin glulisine, sold as Apidra by Sanofi, is unavailable in Pakistan because of international supply problems, the health ministry's spokesperson said on 20 October, as reported. On 23 October the Parliamentary Secretary told the National Assembly that supplies had fallen from 3,500 kits to 1,000.

He said there was no shortage until June and stocks lasted until September. Supplies from Germany were then disrupted in October. He warned that they could fall further during the manufacturer's upgrade, which he described as lasting about a year, as reported. He also said the shortage is being felt across Asia, Australia and Europe, not only in Pakistan.

The ministry has asked distributors to arrange supplies, but the Parliamentary Secretary admitted that this would be difficult while production is halted. So if you use Apidra, plan for months, not weeks.

The ministry names NovoRapid and Humalog as alternatives

The health ministry says insulin aspart (NovoRapid, by Novo Nordisk) and insulin lispro (Humalog, by Eli Lilly) are readily available across Pakistan, as reported. Both are rapid-acting insulin analogues, the same class as Apidra, and are usually taken with meals.

The ministry also said all other main types of insulin remain available, including long-acting, premixed and human insulins. That matters because the shortage covers one rapid-acting brand only. Your long-acting or basal insulin, if you use one, is not affected by this.

In the Assembly, MNA Syeda Amna Batool said the alternatives cost at least 20 per cent more, and many patients cannot easily see a doctor to switch, as reported. We could not check current prices because the drug regulator's website did not load for us. You can check the official price of any medicine with the steps in how to check a medicine's price on DRAP's index.

How to switch from Apidra safely

See your doctor before your last Apidra pen runs out, and get the new insulin and dose in writing. The ministry's spokesperson said any change needs careful dose adjustment and closer monitoring of blood sugar, as reported. Never stop insulin because your brand is missing.

1. Count how many days of Apidra you have left, and book your doctor or diabetes clinic before it runs out.
2. Ask the doctor to write the new insulin name, the dose for each meal and any change to timing.
3. Ask the pharmacist which pen or cartridge and which needles go with the new insulin, because each brand has its own.
4. Check your blood sugar more often than usual in the first days after the switch, and write the readings down.
5. Take the readings to your next visit so the dose can be adjusted.

Keep a fast-acting sugar, such as glucose tablets or juice, with you while the dose settles. Shaking, sweating, sudden hunger and confusion are signs of low blood sugar. If they happen, take sugar at once and tell your doctor. This is the general advice that comes with any insulin change. It does not replace your doctor's instructions for your own dose.

Where to get help if you cannot see a specialist

Any government hospital's medicine or diabetes clinic can prescribe a replacement insulin, so you do not need a private specialist. In Punjab, free diabetes care and insulin are offered at government NCD clinics. In other provinces, ask at the district headquarters hospital.

The Punjab route, including the CM insulin card, is explained in how to get free diabetes care in Punjab. If a pharmacy charges above the printed price for NovoRapid or Humalog, keep the receipt and report it to the Drug Regulatory Authority of Pakistan or your provincial drug inspector. Buy insulin only from a licensed pharmacy that keeps it in a fridge, because insulin left in the heat can stop working.

If you are managing someone else's diabetes, such as a child with type 1 diabetes, make the doctor visit a priority this week. Children's doses are small, so even a small conversion error matters more.

Common questions about the Apidra shortage

Is there an insulin shortage in Pakistan?

One brand, Apidra (insulin glulisine), is unavailable. The health ministry says other insulins, including NovoRapid and Humalog, are available nationwide.

What can I use instead of Apidra?

The ministry names insulin aspart (NovoRapid) and insulin lispro (Humalog), which are in the same rapid-acting class. Your doctor must set the dose.

Can I switch to NovoRapid at the same dose?

Do not assume so. The ministry says any switch needs careful dose adjustment and monitoring. Ask your doctor for the new dose in writing.

When will Apidra be back in Pakistan?

No date has been given. The Parliamentary Secretary said supply depends on the manufacturer, whose upgrade could take about a year, as reported.

Are the alternatives more expensive?

An MNA told the Assembly they cost at least 20 per cent more, as reported. We could not check official prices on 24 October.

Is long-acting insulin also short?

No. The ministry said all other main insulin types, including long-acting and premixed, remain available.

How we verified this

What we checked, where we read it, and what we could not confirm.

Last checked 24 October 2026. The supply figures and the National Assembly statements of 23 October, and the ministry spokesperson's statement of 20 October naming the alternatives, come from press reports. We could not find either statement on the Ministry of National Health Services website or the National Assembly website on 24 October, and the drug regulator's website returned an error. The steps for switching follow the ministry's advice to consult a doctor and are general guidance, not a dosing instruction. Prices for the alternatives were not verified.