Humalog® [Insulin lispro]
Eli lilly
8 Items
2019-09-19
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Clinical Pharmacology
Humalog Mix is a hypoglycemic drug, a combination of insulin analogues of fast and medium duration of action. Humalog® Mix 25 is a DNA-recombinant analogue of human insulin and is a ready-made mixture consisting of a solution of insulin lispro (a fast-acting analogue of human insulin) and a suspension of insulin lispro-protamine (an analog of human insulin of average duration). The main effect of insulin lispro is the regulation of glucose metabolism. In addition, it has anabolic and anti-catabolic effects on various tissues of the body.
In muscle tissue, there is an increase in glycogen, fatty acids, glycerol, increased protein synthesis and increased amino acid intake, but there is a decrease in glycogenolysis, gluconeogenesis, ketogenesis, lipolysis, protein catabolism and release of amino acids.
Insulin lispro has been shown to be equimolar to human insulin, but its action develops faster and continues for a shorter time. The onset of action of the drug is approximately 15 minutes, which allows you to enter it immediately before a meal (for 0-15 minutes before a meal), compared with normal human insulin.
After s / c injections of Humaloga Mix 25, a rapid onset of action and an early achievement of the peak of insulin lispro activity are observed. The action profile of insulin lisprotamine is similar to the action profile of regular insulin isophane with a duration of action of approximately 15 hours.
Indications
Diabetes mellitus requiring insulin therapy.
Composition
1 ml of suspension contains: insulin lispro 100 IU is a mixture of: insulin lispro solution 25% insulin lizpro-protamine suspension 75%
Excipients: sodium phosphate dibasic, glycerol (glycerin), liquid phenol, metacresol, protamine sulfate, zinc oxide, water d / i, hydrochloric acid (solution 10%) and / or sodium hydroxide (solution 10%) (to adjust the pH).
Insulin lispro is marketed under different brands and generic names, and comes in different dosage forms:
| Brand name | Manufacturer | Country | Dosage form |
|---|---|---|---|
| Humalog Mix 25 | Eli lilly | USA | cartridge |
| cartridge |
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Dosage and Administration
The doctor determines the dose individually, depending on the level of glucose in the blood. The mode of administration of insulin is individual.
The drug should be administered SC.
IV the introduction of the drug Humalog® Mix 25 is contraindicated.
The temperature of the drug should be at room temperature. P / C should be entered in the shoulder, thigh, buttocks or abdomen. Injection sites should be alternated in such a way that the same place should not be used more than once a month.
When s / c the introduction of the drug Humalog® must be careful to avoid contact with the drug in a blood vessel.
After the injection should not massage the injection site.
When installing the cartridge in the device for insulin administration and attaching the needle, before the introduction of insulin, you should strictly follow the instructions of the manufacturer of the device for insulin administration.
Adverse reactions
Side effect associated with the main action of the drug: hypoglycemia is most common. Severe hypoglycemia can lead to loss of consciousness and, in exceptional cases, death.
Allergic reactions: local allergic reactions are possible - redness, swelling or itching at the injection site (usually disappear within a few days or weeks; in some cases, these reactions may be caused by causes not related to insulin, such as skin irritation with an antiseptic or improper injection); systemic allergic reactions (occur less frequently, but are more serious) - generalized itching, difficulty breathing, shortness of breath, decreased blood pressure, tachycardia, increased sweating. Severe cases of systemic allergic reactions can be life threatening.
In rare cases of severe allergy to Humalog Mix 25, immediate treatment is required. It may be necessary to change insulin, or desensitization.
Local reactions: with prolonged use - may develop lipodystrophy at the injection site.
Contraindications
Hypoglycemia; hypersensitivity to the drug.
Drug interactions
Hypoglycemic action of the drug Humalog Mix 25 decreases while the appointment with the following preparations: oral contraceptives, corticosteroids, thyroid hormone drugs, danazol, beta2-agonists (including ritodrine, salbutamol, terbutaline), thiazide diuretics, preparations lithium, chlorprothixene, diazoxide, isoniazid, nicotinic acid, phenothiazine derivatives.
Hypoglycemic effect of the drug Humalog Mix 25 is enhanced by beta-blockers, ethanol and ethanol-containing products, anabolic steroids, fenfluramine, guanethidine, tetracyclines, oral hypoglycemic drugs, salicylates (for example, acetylsalicylic acid), sulfanilamides, inhibitors, maras, inhibitors, inhibitors, maras, malic drugs, salicylates (for example, acetylsalicylic acid), sulfanilamides, inhibitors, maras, inhibitors, inhibitors, inhibitors, antioxidants, salicylates (for example, acetylsalicylic acid), sulfanilamides, inhibitors, maras, salicylates (eg, acetylsalicylic acid), sulfanilamides, inhibitors, maras, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, inhibitors, antioxidants, antioxidants, antioxidants, salicylates (eg, acetylsalicylic acid), sulfanilamides, inhibitors. Octreotide, angiotensin II receptor antagonists.
Beta-blockers, clonidine, reserpine may mask the manifestation of symptoms of hypoglycemia.
The interaction of Humalog Mix 25 with other insulin preparations has not been studied.
Special instructions
The transfer of a patient to another type or drug of insulin with a different trade name must take place under strict medical supervision. Changes in activity, brand (manufacturer), type (for example, Regular, NPH), species (animal, human, human insulin analogue) and / or production method (DNA-recombinant insulin or insulin of animal origin) may necessitate dose adjustment .
For some patients, switching from animal insulin to human insulin may require dose adjustment. This may occur already at the first injection of a human insulin preparation or gradually over several weeks or months after the transfer.
Symptoms are precursors of hypoglycemia in the presence of human insulin in some patients may be less pronounced or different from those observed in them in the presence of insulin of animal origin. With the normalization of blood glucose levels, for example, as a result of intensive insulin therapy, all or some of the symptoms, precursors of hypoglycemia, may disappear, about which patients should be informed. Symptoms, precursors of hypoglycemia may change or be less pronounced with long-term diabetes mellitus, diabetic neuropathy, or treatment with drugs such as beta-blockers.
The use of inadequate doses or discontinuation of treatment, especially in patients with insulin-dependent diabetes mellitus, can lead to hyperglycemia and diabetic ketoacidosis (conditions that are potentially life-threatening to the patient).
The need for insulin may be reduced in case of insufficiency of adrenal, pituitary or thyroid function, or in renal or hepatic failure. In some diseases or in emotional overstrain, the need for insulin may increase. Insulin dosage adjustment may also be required with increasing physical exertion or with a change in the normal diet.
Overdosage
Symptoms: hypoglycemia, accompanied by the following symptoms - lethargy, increased sweating, tachycardia, headache, vomiting, confusion. Under certain conditions, for example, with long duration or with intensive control of diabetes mellitus, the symptoms of precursors of hypoglycemia may change.
Treatment: light states of hypoglycemia are usually stopped by ingestion of glucose or other sugar, or products containing sugar. You may need a dose adjustment of insulin, diet, or physical activity. Correction of moderately severe hypoglycemia can be performed using IM or SC injection of glucagon with subsequent ingestion of carbohydrates. Severe conditions of hypoglycemia, accompanied by coma, convulsions or neurological disorders, stop i / m or s / c with glucagon injection or iv administration with a solution of dextrose (glucose) concentrated solution. After the recovery of consciousness, the patient must be given food rich in carbohydrates in order to avoid the recurrence of hypoglycemia. May require further carbohydrate intake and patient monitoring, as possible recurrence of hypoglycemia.
- Counterregulatory Hormone Responses and Symptoms During Hypoglycaemia Induced by Porcine, Human Regular Insulin, and Lys(B28), Pro(B29) Human Insulin Analogue (Insulin Lispro) in Healthy Male Volunteers
- Use of the short-acting insulin analogue lispro in intensive treatment of Type 1 diabetes mellitus: importance of appropriate replacement of basal insulin and time-interval injection-meal
- Reducing snacks when switching from conventional soluble to lispro insulin treatment: effects on glycaemic control and hypoglycaemia
- Intramuscular versus subcutaneous injection of soluble and lispro insulin: comparison of metabolic effects in healthy subjects
- Resolution of lipohypertrophy following change of short-acting insulin to insulin lispro (Humalog®)
- Severe hypoglycaemia in patients with type 1 diabetes and impaired awareness of hypoglycaemia: a comparative study of insulin lispro and regular human insulin
- Pramlintide reduces postprandial glucose excursions when added to insulin lispro in subjects with type 2 diabetes: a dose-timing study
- A parallel pore and surface diffusion model for predicting the adsorption and elution profiles of lispro insulin and two impurities in gradient-elution reversed phase chromatography
- Mealtime Pramlintide Administration Reduces Early Postprandial Glucose Excursions When Added to Regular Insulin or Insulin Lispro in Patients With Diabetes: A Dose-Timing Study
- Insulin lispro, an alternative in insulin hypersensitivity
- Advantage of insulin lispro in suspected insulin allergy
- Insulin lispro versus regular insulin in children with type 1 diabetes on twice daily insulin
- Treatment with insulin lispro changes the insulin profile but does not affect the plasma concentrations of IGF-I and IGFBP-1 in type 1 diabetes
- Effects of insulin lispro and chronic vitamin C therapy on postprandial lipaemia, oxidative stress and endothelial function in patients with type 2 diabetes mellitus
- Factors associated with nocturnal hypoglycaemia among patients with type 2 diabetes new to insulin therapy: experience with insulin lispro
- Impact of insulin lispro on HbA1c values in insulin pump users
- Does insulin lispro preserve the physiological defences to hypoglycaemia during intensive insulin therapy with a conventional basal bolus regimen?
- Comparison of additional metformin or NPH insulin to mealtime insulin lispro therapy with mealtime human insulin therapy in secondary OAD failure
- Insulin lispro (Lys(B28), Pro(B29)) in the treatment of diabetes during the fasting month of Ramadan
- The use of lispro for high sugar content snacks between meals in intensive insulin regimens
- A randomized, controlled trial comparing insulin lispro with human soluble insulin in patients with Type 1 diabetes on intensified insulin therapy
- Intramuscular injection of insulin lispro or soluble human insulin: pharmacokinetics and glucodynamics in Type 2 diabetes
- Post-prandial insulin lispro vs. human regular insulin in prepubertal children with Type 1 diabetes mellitus
- Basal-bolus insulin therapy in Type 1 diabetes: comparative study of pre-meal administration of a fixed mixture of insulin lispro (50%) and neutral protamine lispro (50%) with human soluble insulin
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