Echo NovoPen Quick Manual

NovoPen Echo®

Page 321 of 387

Quick guide

Important: Read the complete
user guide before you use your
pen for insulin delivery the first time

NovoPen Echo® remembers your last dose

Your pen has a dose memory that saves information about how much
insulin you last injected and the time passed since then.

The number in the dose memory display is the number of units last
injected.
The segments around the edge show how many full hours have passed
since your last injection. When a full hour has passed, one segment will be
shown. Another segment will appear when another full hour has passed.

The examples below show you how to read the dose memory.

More than 12 hours ago

(All 12 segments shown)

16.5 units injected

More than 1 hour ago, but less than 2
(One segment shown)

16.5 units injected

Less than 1 hour ago

Page 320 of 387

(No segments shown)

16.5 units injected

How to check your last dose

• Make sure the dose counter shows “0“ before you
start.

• Pull out the dose button.

• Push the dose button back in to check your last

dose.

Start-up display

First you see the start-up display. All display

elements are shown to confirm that it is working.

Next, the display shows the details of your last
dose. After 10 seconds, it turns off.

8-4251-31-001-X

NovoPen Echo®

User guide

Read this user guide carefully before you use your
NovoPen Echo® for insulin delivery the first time

Find a quick guide at the back of this manual

Rx only

For Single Patient Use Only

Contents

Overview of pen

parts ...............................Inside cover

Introduction...................Inside cover

Important notes...............................1

Prepare the pen for an injection

Insert an insulin cartridge ..................................2

Attach a new needle .........................................6

ALWAYS test the insulin flow before you inject..8

Select your dose..............................................10

Inject your dose .............................12

After your injection.......................14

How to use the dose memory

What is the dose memory?..............................16

How to read the dose memory ........................17

How to check your last dose ...........................18

Special display messages .................................19

How to replace a used insulin

cartridge.........................................20

How to check how much insulin

is left...............................................22

If you need more insulin than

what is left in the cartridge ..........24

How to care for your pen ..............26

Care................................................................26

Cleaning .........................................................26

Storage...........................................................27

Disposal ..........................................................27

Warranty.........................................28

For more
information go to
novopenecho.com

NovoPen Echo®
Pen

Pen cap

Dose memory

Number of hours since last
injection

Number of units
last injected

Disposable needle
(example)

Outer

needle

cap

Inner

needle

cap

Needle Paper

Insulin

scale

Insulin

window

tab

Cartridge

holder

Threaded end

(for needle

attachment)

Piston

rod head

Piston

rod

Dose

pointer

Dose

counter

Dose

button

LOT

number

Dose

memory

Insulin cartridge
(PenFill® cartridge 3 mL)

Colored

band

Piston

Introduction

Thank you for choosing NovoPen Echo®.
NovoPen Echo® is a re-usable insulin pen
with a dose memory function.

You should read this guide carefully
before you use your pen – even if you

have used NovoPen Echo® or similar Novo
Nordisk delivery systems before. It will tell you
all you need to know about your pen and
how to use it.

The NovoPen Echo® is a re-usable pen
injector designed for single patient use by
diabetics for the self-injection of a desired
dose of insulin. The pen injector uses PenFill®
3 mL cartridges of Novo Nordisk insulin and a
single use detachable and disposable pen
needle (supplied separately). The pen injector
allows the user to dial the desired dose from

0.5 to 30 units in 0.5 unit increments.

The pen has a dose memory that helps you
remember the number of units you last
injected and the time passed since that
injection.

The pen is durable, which means that you
can use it again and again. When you have
used all the insulin in a cartridge, you simply
replace it with a new one.

You can get the pen in red or blue. It is
recommended that you use a different
colored pen for each type of insulin you use.

About this user guide:

Throughout this guide, instructions on how
to use your pen are presented step by step.
Important information and additional
information are clearly marked by the
symbols you see below:

Important information

Pay special attention to these notes as
they are important for safe use of the
pen.

Additional information

Insert an insulin
cartridge

Attach a new
needle

1

• Pull off the pen cap.

• Twist off the cartridge
holder.

• The piston rod may stick

out of your pen. If so, push
it in until it stops.

2 3

• Take a new insulin cartridge
and check that:
– It contains the right insulin,

which looks as it should.

– It has no cracks or

damage.

• Slide the cartridge into the
cartridge holder with the

threaded end first.

• Twist the cartridge holder
back on.

• Take a new needle, and tear
off the paper tab.

• Push the needle straight
onto the pen. Turn until it is

on tight.

• Pull off the outer needle cap
and save it.

• Pull off the inner needle cap
and throw it away.

Do not share your pen and
needles. Use a new needle
for each injection.

ALWAYS test

the insulin flow

Select your dose

Inject your dose

4 5 6

ALWAYS test the flow
before you inject. Keep

testing until insulin squirts from
the needle tip. This makes sure
that any gap and air bubbles
are removed and that insulin is
getting through the needle.

• Select 2 units and press the
dose button until the dose
counter shows “0”.

• If no insulin appears or there
is a gap in the insulin window,
repeat the insulin flow test. The
insulin flow test is complete
when you see insulin squirt and
there is no longer a gap
between the piston rod head
and the piston.

• Pull out the dose button, if
it is not already out.

• Make sure the dose
counter shows “0“ before
you start.

• Turn the dose button to

select the dose you need.

You can turn forward or
backward.

Wait and

count slowly

• Insert the needle into your
skin and press the dose
button until the dose
counter shows “0”.

• Then wait and count
slowly to 6 before you
remove the needle from
your skin.

• Safely remove and
dispose of the needle.
Put the pen cap back on.

Do not store your pen with
a needle attached.

Important notes

1

• Do not use NovoPen Echo® without proper
training from your healthcare professional.

Make sure you are confident in making an
injection with the pen before you start your
treatment with it. Refresh the training at any
time by taking a look at the training video
online at novopenecho.com.

• If you are blind or have severe visual

problems, do not use NovoPen Echo®
without help. Get help from a person with

good eyesight who is trained to use NovoPen
Echo®.

• ALWAYS test the insulin flow before each
injection. Do not use the pen if insulin does
not squirt from the needle tip when you test
the insulin flow. If you do not test the insulin
flow, you may get too little or too much or no
insulin at all.

• If you drop your pen, check the insulin
cartridge for damages, for example cracks.
Replace the cartridge with a new one if
necessary.

• If you accidentally twist your pen apart
between injections, it is important to test the
flow of insulin before your next injection. You
may need to do it several times before insulin
appears at the needle tip.

• NovoPen Echo® is designed to be used

with PenFill® cartridge 3 mL and
NovoFine® or NovoTwist® disposable

needles up to a length of 8 mm.
Novo Nordisk is not responsible for harm
due to using NovoPen Echo® with products
other than these.

• Always check the name and color of the
cartridge to make sure that it contains the
type of insulin you need. This is especially
important if you take more than one type of
insulin.

• Always carry a spare pen, extra insulin of
the same type(s) you use, and new needles
with you in case of loss or damage.

• Never share your pen, insulin cartridges,
and needles with other people. They are for
your use ONLY.

• Always keep your pen, insulin cartridges,
and needles out of sight and reach of

others, especially children.

• Always keep your pen with you. Do not

leave it in a car or other place where it can
get too hot or too cold.

• Caregivers must be very careful when
handling used needles to reduce the risk
of needle sticks and cross-infection.

Insert an insulin cartridge

2

1

2

• Pull off the pen cap.

• Twist off the cartridge holder. Put it to one side for later
use.

3

• The piston rod may stick out of your pen. If so, push it
completely in until it stops.

Need help?
Call 1-800-727-6500

The piston rod and the piston rod head may be loose
and move on their own. This is natural and does not
affect the function of the pen.

3

4

4

• Take a new insulin cartridge. Hold the black cartridge holder
and let the cartridge slide in with the threaded end first as
illustrated. The color of your cartridge may differ from the
one shown in the illustration. It depends on the type of
insulin you use.

Check the name and color of the cartridge to make
sure that it contains the type of insulin you need. This is
especially important if you take more than one type of
insulin.

Check that the cartridge is not damaged, for
example by cracks. See how to do this in the PenFill®

cartridge 3 mL leaflet that comes with the PenFill®
cartridge 3 mL package.

Check that the insulin looks the way it should. The

PenFill® cartridge 3 mL leaflet will tell you how your type
of insulin should look.

NovoPen Echo® is designed to be used with PenFill®
cartridge 3 mL and NovoFine® or NovoTwist®

disposable needles up to a length of 8 mm.

5

• Twist the cartridge holder back on, as illustrated, until you

hear or feel a click.

5

Attach a new needle

6

1

2

• Take a new needle, and tear off the paper tab.

• Push the needle straight onto the pen. Turn until it is on

tight.

• Pull off the outer needle cap and save it. You will need it
after the injection, to safely remove the needle from the
pen.

Always use a new needle for each injection. This
reduces the risk of blocked needles, contamination,
infection, and inaccurate dosing.

Never use a bent or damaged needle.

Do not attach a new needle to your pen until you are

ready for your next injection.

7

• Pull off the inner needle cap and throw it away.

A drop of insulin may appear at the needle tip. This is
normal, but you must still test the insulin flow.

Need help?
Call 1-800-727-6500

NovoPen Echo® is designed to be used with PenFill®
cartridge 3 mL and NovoFine® or NovoTwist® disposable
needles up to a length of 8 mm.

3

ALWAYS test the insulin flow before you inject

8

1

ALWAYS test the flow before you inject.

Keep testing until insulin squirts from the needle tip. This
makes sure that any gap and air bubbles are removed and
that insulin is getting through the needle.

• Pull out the dose button, if it is not already out.

Dose
button
out

2

2 units
selected

• Turn the dose button to select 2 units.

Always test the flow every time you inject. Keep

testing until insulin squirts from the needle tip. This
makes sure that any gap and air bubbles are removed
and that insulin is getting through the needle.

9

• Press the dose button until the dose counter shows “0”.
The “0” must line up with the dose pointer.

• Check that insulin squirts from the needle tip.

• Check the insulin window to see that there is no gap
between the black piston rod head and the orange piston,

see illustration 3A.

If no insulin appears or if there is a gap in the insulin
window, see illustration 3B, repeat the insulin flow test until
insulin squirts from the needle tip. If no insulin appears after
several attempts, change the needle and test the insulin
flow again.

The insulin flow test is complete when you see insulin squirt
from the needle tip and when there is no longer a gap
between the piston rod head and the piston.

Do not try to inject if no insulin appears. You may
not receive any insulin, even though the dose counter
may move. This could lead to hyperglycemia.

If insulin does not appear after testing the flow
repeatedly, do not use the pen and call Novo Nordisk at

1-800-727-6500.

3

3B3A

Select your dose

10

1

2

2.5 units
selected

12 units
selected

• Pull out the dose button, if it is not already out.

• Make sure the dose counter shows “0“ before you
start. The “0“ must line up with the dose pointer.

• Turn the dose button to select the dose you need.

You can turn the dose button forward or backward.

The dose button changes the number of units. Only the
dose counter and the dose pointer will show how many
units you select per dose.
You can select up to 30 units per dose.

Half units are shown as lines between the figures.

Always look through the insulin window to make sure

that the insulin in your pen looks the way it should.

The PenFill® cartridge 3 mL leaflet will tell you how your
type of insulin should look.

Always use the dose counter and the dose pointer
to see how many units you select.

Do not use the insulin scale on the cartridge holder. It
only shows approximately how much insulin is left in
your pen.
Do not count the pen clicks.

If you need more than 30 units, you may choose to use
another Novo Nordisk insulin delivery device with a
higher maximum dose.

The dose button should turn easily. Do not force it to
turn.

When your pen contains less than 30 units, the dose
counter stops at the number of units left. If you need
more insulin than what is left in the cartridge,
see pages 24-25.

11

Inject your dose

12

1

2

Wait and

count slowly

ALWAYS test the flow before you inject.

• Check the color of the cartridge to make sure that it

contains the type of insulin you need.

• Insert the needle into your skin as your healthcare

professional has shown you.

• Make sure you can see the dose counter.

• Press the dose button until the dose counter shows “0”.

The “0” must line up with the dose pointer.
You may then hear or feel a click.

• Keep the needle in your skin after the dose counter has

returned to 0 and count slowly to 6.

If the needle is removed earlier, you may see a squirt of
insulin coming from the needle tip. If so, the full dose will
not be delivered, and you should increase the frequency of
checking your blood sugar levels.

13

• Remove the needle from your skin.

Always inject by pressing the dose button. Do not
turn it. If you turn the dose button, you will not inject

insulin.

Always watch the dose counter to know how many
units you inject. Do not count the pen clicks. The dose

counter will show the exact number of units.

If the dose button stops before the dose counter
shows ”0”, the needle may be blocked. Turn the dose
counter back to “0“ and replace the needle with a new
one. Test the insulin flow and inject your full dose.

You may see a drop of insulin at the needle tip after
injecting. This is normal and does not affect your dose.

3

After your injection

14

1

2

3

• Lead the needle tip into the outer needle cap on a flat

surface without touching the needle.

• Do not touch the outer needle cap before it covers the

needle.

• Once the needle is covered, carefully push the outer

needle cap completely on.

• Hold the black cartridge holder and unscrew the needle.

Dispose of it carefully as your healthcare professional has
instructed you.

Never try to put the inner needle cap back on the
needle.

You may stick yourself with the needle.

15

• Put the pen cap on your pen after each use to protect the
insulin from light.

• Store your pen carefully. The pen should be out of sight
and reach of others, especially children, see page 27 on

how to store the pen.

Always hold the black cartridge holder when you
unscrew the needle. Otherwise you may twist your pen

apart. If this happens, twist the pen together again,
replace the needle and test the insulin flow before your
next injection.

Always remove and dispose of the needle from
your pen.

This reduces the risk of blocked needles, contamination,
infection, and inaccurate dosing. Do not store your pen
with a needle attached.

Put the needle and any empty or used insulin cartridge
still containing insulin in a sharps container, or some type
of hard plastic or metal container with a screw top such
as a detergent bottle or empty coffee can.
When the container is full, seal and throw it away as
described by your healthcare professional and local or
state authorities. Do not throw away used needles in
household trash or recycling bins.

4

What is the dose memory?

16

Your pen has a dose memory that saves information about
how much insulin you last injected and the time passed
since then.

The number in the dose memory display is the number of
units last injected.

1h

2h

3h

Tick

marks

The segments around the edge show how many full hours
have passed since your last injection. When a full hour has
passed, one segment will be shown. Another segment will
appear when another full hour has passed.
The four tick marks are always visible when the display is
activated.

The example on the left shows 5.5 units injected more than
3 hours ago, but less than 4.

Note that the dose memory only saves information
about the last injection or insulin flow test. If for
example, you test the insulin flow with 2 units and then inject
15 units, the dose memory only saves information about the
15 units injected and the time passed since then.

Number of units

last injected

The dose memory does not tell you how much
insulin you need for your next injection. If in doubt

about how much insulin you need to inject, check your
blood sugar level.

How to read the dose memory

The examples below show you how to read the dose memory.

More than 12 hours ago

(All 12 segments shown)

16.5 units injected

More than 1 hour ago, but less than 2
(One segment shown)

16.5 units injected

Less than 1 hour ago

(No segments shown)

16.5 units injected

17

How to check your last dose

18

1

2

Start-up
display

• Make sure the dose counter shows “0” before you start.
The “0” must line up with the dose pointer.

• Pull out the dose button.

• Push the dose button back in to check your last dose.

First you see the start-up display. All display elements

are shown to confirm that it is working.

Next, the display shows the details of your last dose.

After 10 seconds, it turns off.

Do not turn the dose button when you check your last
dose. Turning and then pushing it will overwrite the
details of your last dose. If you turn the dose button by
accident, simply turn it back to “0” before you push it in.
This will not overwrite the details of your last dose.

Special display messages

Message Cause Action

19

The dose memory
has not registered
your last injection.

The dose memory is
not activated, or
the battery is dead.

The battery is
running low.

Normally, the dose memory will start working again
after your next injection. If not, contact Novo Nordisk
at 1-800-727-6500 to get a new pen. You can still use
the pen for insulin delivery without using the dose
memory.

Pull out the dose button then push it back in to
activate the dose memory. If the display stays blank,
the battery is dead. Contact Novo Nordisk at
1-800-727-6500 to get a new pen. You can still use
your pen for insulin delivery until you get a new one.

See page 28 for warranty information.

The battery will last four to five years. When it is
running low and the dose memory display has shown
“End” for a while, it will turn blank and stop working.
For your safety the battery is non-replaceable. Contact
Novo Nordisk at 1-800-727-6500 to get a new pen.
You can still use your pen for insulin delivery until you
get a new one. See page 28 for warranty information.

How to replace a used insulin cartridge

20

1

2

• Remove and dispose of the needle from your pen if the
needle is still on, see pages 14-15.

• Twist off the cartridge holder.

When you twist off the cartridge holder, the piston rod
sticks out of your pen. It may move back or forth on its
own. Push it back in as instructed on page 3.

21

• Tilt the black cartridge holder and let the cartridge slide
out. Dispose of it as your healthcare professional has

instructed you.

• Insert a new cartridge, push the piston rod back in, and
twist the cartridge holder back on.

3

How to check how much insulin is left

22

1

Dose counter

stopped:

23 units left

The dose counter will show exactly how much insulin is left in
the cartridge, when there is less than 30 units left.

• Turn the dose button until it stops.

• Check the dose counter:
– If it shows “30”: 30 units or more are left in the

cartridge.

– If it shows less than “30”: It is showing the number of

units left in the cartridge.

• Turn the dose button back until the dose counter shows
“0”.

23

• Use the insulin scale to see approximately how much
insulin is left in the insulin cartridge.

If you need more insulin than what is left in the
cartridge, take your full dose from a new cartridge,

see page 24.

2

Insulin scale
shows
approx. how
much insulin
is left

If you need more insulin than what is left in the cartridge

24

1

2

3

If you need more insulin than what is left in the cartridge,

take your full dose from a new cartridge.

• Remove the needle. Twist off the cartridge holder and
dispose of the used cartridge.

• Insert a new cartridge, see pages 2-5.

• Attach a new needle and test the insulin flow,

see pages 6-9.

• Select and inject your full dose with the new cartridge,

see pages 12-15.

Only if trained or advised by your healthcare professional, you may split your dose
between two cartridges.

If you become distracted, make a miscalculation or forget to test the flow, you may get a
single under- or overdose which may lead to too high or too low blood sugar levels.

If you feel unwell after splitting the dose, check your blood sugar and/or contact your
healthcare professional.

If you do split your dose:

1

Test the insulin flow.

Find out exactly how much insulin is left and make a note of it. Turn the dose button

2

until it stops. The dose counter then shows you the number of units left in the
cartridge.

3

Inject all the insulin left in the cartridge.

4

Work out how many more units you need to complete your dose.

5

Remove the used needle and cartridge.

Insert and prepare a new cartridge for injection.

6

Attach a new needle and test the insulin flow.

7

Select and inject the rest of your dose with the new cartridge.

8

If you split your dose into two injections, the dose memory will only save information
about the second injection.

25

How to care for your pen

26

Care

• Only use your NovoPen Echo® as
described in this guide.

• Do not drop your pen or knock it against
hard surfaces. If you drop it or suspect a
problem, check the insulin cartridge for
damages, for example cracks. Replace the
cartridge with a new one if necessary.

• Keep your pen away from direct sunlight,
and do not expose it to dust, dirt, or liquid.

• Do not expose your pen (without an
insulin cartridge inserted) to temperatures
below -13°F or above +113°F. With an
insulin cartridge inserted, please see the
storage instructions in the PenFill® cartridge
3 mL leaflet that comes with the PenFill®
cartridge 3 mL package.

• Do not try to repair your pen or pull it
apart.

• The battery lasts for four to five years. For your
safety it is non-replaceable. When the battery
is dead, contact your supplier to get a new
pen. You can still use your pen for insulin
delivery without using the dose memory.

Cleaning

• Only clean your pen with mild detergent
on a moistened cloth.

• Do not wash, soak, or lubricate your
pen, and do not use products containing
bleaching agents, such as chlorine, iodine,
or alcohol to clean your pen. This may
damage it.

• If there is insulin on the outside of your pen,
clean it before it dries up with mild
detergent on a moistened cloth.

27

Storage

• Store your pen at room temperature –
with or without an insulin cartridge in the
cartridge holder.

• Do not store your pen with a needle

attached.

• Do not freeze your pen with an insulin
cartridge inserted or store it in a refrigerator
or next to a cooling element.

• Store the insulin cartridges as instructed
in the PenFill® cartridge 3 mL leaflet. There
you will also find information about expiry
date. The expiration date printed on the
cartridge is for unused cartridges under
refrigeration. Never use the cartridge after
the expiration date on the cartridge or its
box.

• Store your pen in its case when possible.

Disposal

• Do not throw the pen out with your
household waste.

• Dispose of your pen as instructed by

your healthcare professional,
pharmacist or local authorities. Consider

the environment when you dispose of your
pen. It contains a lithium battery, electronic
parts, and recyclable materials. Also make
sure to remove the insulin cartridge and
needle before you dispose of the pen.

Warranty

28

NovoPen Echo® comes with a 3-year
guarantee, which also includes the dose
memory.

If you find that your NovoPen Echo® is faulty,
Novo Nordisk will replace it. Return it to your
supplier for inspection within three years of
receiving it. Enclose the receipt you were
given when you received your NovoPen
Echo®.

The manufacturer cannot be held responsible
for any problems with your NovoPen Echo® if
the instructions have not been followed.

If you need your pen’s LOT number, you will
find it on the dose button as shown in the

diagram on the inside cover.

NovoPen Echo®, PenFill® cartridge 3 mL,
NovoFine® and NovoTwist® are registered
trademarks owned by Novo Nordisk A/S,
Denmark.

If you think your pen is not working the right
way, contact Novo Nordisk at
1-800-727-6500.

This warranty will be invalid and Novo Nordisk
Inc. cannot be held responsible in the case of
defects or damages arising from:

– The use of NovoPen Echo® with products

other than PenFill® cartridge 3 mL and
NovoFine® and NovoTwist® disposable
needles.

– The use of NovoPen Echo® not in

accordance with the instructions in this user
guide.

– Physical damage to NovoPen Echo® caused

by neglect, misuse, unauthorized repair,
accident, or other breakage.

For assistance or further information, write to:
Novo Nordisk Inc.
800 Scudders Mill Road
Plainsboro, New Jersey 08536
USA
www.novonordisk-us.com
Or call: 1-800-727-6500

For assistance or further information, write to:
Novo Nordisk Inc.
800 Scudders Mill Road
Plainsboro, New Jersey 08536
USA
Or call: 1-800-727-6500

NovoPen Echo® is covered under US Patent
Nos. 6,248,090; 6,277,098; 6,663,602; 7,241,278
and other patents pending.

Novo Nordisk®, NovoPen®, NovoPen Echo®,
NovoFine®, NovoTwist®, and PenFill® cartridge 3 mL
are registered trademarks of Novo Nordisk A/S.

© 2013 Novo Nordisk
www.novonordisk-us.com
Novo Nordisk A/S
2880 Bagsværd, Denmark

8-4251-31-001-X