Classes
DEA Class; Rx
Common Brand Names; Admelog, Humalog, Humalog Kwikpen, Humalog Junior KwikPen, Admelog Solostar, insulin lispro-aabc, Lyumjev
- Antidiabetics, Insulins;
- Antidiabetics, Rapid-Acting Insulins
Description
Rapid-acting insulin analog with a quicker onset/shorter duration of action than regular insulin
Used to improve glycemic control in adult and pediatric patients with diabetes; often given as prandial or snack boluses
Faster-acting insulin aspart (Lyumjev) has a different onset of action and timing of administration with respect to meals
Indications
Diabetes Mellitus Type I or II
Rapid-acting human insulin analogue indicated to improve glycemic control in patients with type 1 or 2 diabetes mellitus
Contraindications
During episodes of hypoglycemia
Hypersensitivity to drug or excipients
Adverse Effects
Admelog
Severe hypoglycemia, after 52 weeks (13.5%)
Nasopharyngitis, in combination with insulin glargine (13.1%)
Humalog (Type 1 Diabetes)
Flu syndrome (34.6%)
Pharyngitis (33.3%)
Rhinitis (29.6%)
Headache (24.7%)
Pain (19.8%)
Increased cough (17.3%)
Infection (13.6%)
Humalog (Type 2 Diabetes)
Headache (11.6%)
Pain (10.8%)
Infection (10.1%)
Admelog
Upper respiratory tract infection, in combination with insulin glargine (6%)
Severe hypoglycemia, after 26 weeks (2.4%)
Humalog, continuous SC insulin infusion
Infusion site reactions (2.6%)
Humalog (Type 1 Diabetes)
Accidental injury (8.6%)
Diarrhea (8.6%)
Myalgia (7.4%)
Abdominal pain (7.4%)
Asthenia (7.4%)
Bronchitis (7.4%)
Urinary tract infection (6.2%)
Dysmenorrhea (6.2%)
Surgical procedure (6.2%)
Fever (6.2%)
Nausea (6.2%)
Humalog (Type 2 Diabetes)
Rhinitis (8.1%)
Surgical procedure (7.4%)
Pharyngitis (6.6%)
Hypoglycemia
Pallor
Palpitation
Redness
Hunger
Nausea
Tachycardia
Lipodystrophy
Lipohypertrophy
Local allergic reaction
Hypokalemia
Hypoglycemia from medication errors
Localized cutaneous amyloidosis
Warnings
Never share a pen between patients even if the needle is changed
Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia; adjust dosage cautiously and closely monitor blood glucose
May cause a shift in potassium from extracellular to intracellular space, possibly leading to hypokalemia; caution when coadministered with potassium-lowering drugs or conditions that may decrease potassium
Do not transfer Humalog U-200 from the KwikPen to a syringe for administration; the markings on the insulin syringe will not measure the dose correctly and can result in overdosage and severe hypoglycemia
Insulin pump or insulin infusion set malfunction or insulin degradation can rapidly lead to hyperglycemia and ketoacidosis; promptly identify and correct the cause of hyperglycemia or ketosis is necessary; interim insulin lispro injections may be required; patients using continuous SC insulin infusion pump therapy must be trained to administer insulin by injection and have alternate insulin therapy available in case of pump failure
Thiazolidinediones are peroxisome proliferator-activated receptor (PPAR)-gamma agonists and can cause dose-related fluid retention, particularly when used in combination with insulin; fluid retention may lead to or exacerbate heart failure; monitor for signs and symptoms of heart failure, treat accordingly, and consider discontinuing thiazolidinediones
Severe, life-threatening, generalized allergy including anaphylaxis may occur; if hypersensitivity reactions occur, discontinue treatment; treat accordingly and monitor until resolution of signs and symptoms
Pregnancy and Lactation
Published studies with insulin lispro used during pregnancy have not reported an association between insulin lispro and induction of major birth defects, miscarriage, or adverse maternal or fetal outcomes
There are no data on presence of drug in human milk, effects on breastfed infant, or on milk production
Maximum Dosage
How supplied
Insulin Lispro
injectable solution
- 100 units/mL (Humalog; 10mL vial)
- 100 units/mL (Admelog; 10mL vial)
- 100 units/mL (Lyumjev; 10mL vial)
injectable pen
- 100 units/mL (Humalog KwikPen; Humalog Junior KwikPen 3mL pen or cartridge)
- 100 units/mL (Admelog SoloStar; 3 mL)
- 100 units/mL (Lyumjev KwikPen; Lyumjev Junior KwikPen; Lyumjev Tempo Pen; 3 mL)
- 200 units/mL (Humalog KwikPen; 3mL pen)
- 200 units/mL (Lyumjev KwikPen; 3mL pen)
- KwikPen dose increment: 1 unit; maximum dose/injection is 60 units
- Junior KwikPen dose increment: 0.5 unit; maximum dose/injection is 30 units