Humalog® [Lyspro insulin]

Pharmacological properties

Humalog mix 25 is a dna recombinant analogue of human insulin, it is a mixture of 25% lispro insulin (a fast-acting drug to lower blood glucose) and a 75% suspension of lispro protamine insulin (a medium-acting drug to lower blood glucose).

Lispro insulin was equivalent to human insulin. It begins to act quickly, the peak of action occurs earlier, and the duration of the glucose-lowering effect is less than that of ordinary human insulin. The earlier onset of lispro insulin (15 minutes after administration) is directly related to its faster absorption. This allows the use of Lispro insulin closer to food intake (0–15 min) compared to regular insulin (30–45 min before meals).

The main action of insulin lispro is the regulation of glucose metabolism. In addition, all insulins have several anabolic and anti-catabolic effects on a significant number of body tissues. In muscles and other tissues (except the brain), insulin leads to the rapid intracellular transport of glucose and amino acids, stimulates anabolism and inhibits protein catabolism. In the liver, insulin supports the uptake and deposition of glucose in the form of glycogen, inhibits gluconeogenesis and provides the conversion of excess glucose into fats.

The onset of insulin lispro action is noted 15 minutes after sc administration. The rate of absorption and, accordingly, the onset of action depends on the injection site.

Indications

Diabetes mellitus (type i and ii).

Application

The dosage of lispro insulin in adult patients is determined individually. the rapid onset of action of the drug allows insulin to be administered closer to food intake (0–15 min) compared to insulin mixtures that contain regular insulin (30–40 min before meals).

Humalog Mix 25 is necessary to enter only s / c. The drug can not be prescribed iv. SC injected into the shoulder, thigh, buttocks or abdomen. You can not perform an injection in the same place for a month. It is forbidden to enter the product into a blood vessel. Patients need to be taught injection techniques.

Instructions for preparation and use. Before use, you must turn the Humaloga Mix cartridge between your palms 10 times. Holding the cartridge at one end, turn it 180 ° 10 times so that the glass ball completely passes the entire length of the cartridge each time it is turned over. Insulin should acquire uniform turbidity or milky color. If this does not happen, you should repeat the previous steps until the components are fully mixed. Insulin cartridges need to be checked frequently. Do not use the drug if the insulin substance (white substance) remains seemingly separated from the liquid after mixing. Do not use if the suspension contains lumps or if white particles adhere to the bottom or walls of the cartridge, making the glass opaque.

In order to charge the cartridge into the pen-injector, attach the needle and inject insulin, refer to the manufacturers instructions for the pen-injector for administering insulin.

Contraindications

Episodes of hypoglycemia, hypersensitivity to lispro insulin or to any of the components of the drug.

Side effects

Allergic reaction, reaction at the injection site, lipodystrophy, itching, rash, hypoglycemia. hypoglycemia is the most common side effect of insulin therapy in patients with diabetes. severe hypoglycemia can lead to loss of consciousness, and in some cases to death.

Local allergies in patients may manifest as redness, swelling, or itching at the injection site. These minor reactions usually disappear after a few days or weeks.In some cases, these reactions may not be associated with insulin, but with other factors, such as detergents that irritate the skin, or an inappropriate administration technique.

Systemic allergy appears very rarely, but is potentially a more serious side effect and is a generalized form of an allergic reaction to insulin, which can manifest itself in the form of a rash over the entire surface of the body, shortness of breath, wheezing, decreased blood pressure, increased heart rate and sweating. Severe cases of generalized allergies are life threatening.

special instructions

Humalog mix 25 differs from other insulin mixtures in that this mixture contains fast-acting insulin lispro. patients who use Humalog Mix 25 may need a dosage adjustment.

Hypoglycemia is the most common side effect of insulin preparations, including Humalog Mix 25. The early threatening symptoms of hypoglycemia may differ or be less pronounced in certain conditions, such as prolonged diabetes mellitus or during intensive treatment of diabetes mellitus.

Any changes in insulin treatment should be carried out with caution and only under medical supervision. Changes in the dosage of insulin, brand (manufacturer), type (e.g. Regular), variety (bovine, pork, pork, pig, human, analogue of human insulin) and / or production method may require a change in dosage.

During illness or emotional disturbance, insulin requirements may be elevated. In the presence of renal or hepatic insufficiency, the need for insulin can be reduced. Dosage adjustment may be necessary when changing the physical activity of patients or their usual diet.

Clinical studies regarding the use of Humalog Mix 25 during pregnancy have not been conducted. Patients with diabetes should inform their healthcare provider if they are pregnant or plan to become pregnant.

Patients who are breastfeeding may need a dose adjustment of insulin and / or diet. There is no evidence of clinically significant amounts of insulin lispro or a suspension of protamine lispro excreted in human milk. Many drugs, including human insulin, are excreted in breast milk.

Children

The safety and effectiveness of Humalog Mix 25 for patients under the age of 18 have not been studied.

When using insulin in the recommended therapeutic doses, no effects on the ability to drive a car or work with complex mechanisms were noted. The ability to concentrate and the rate of psychomotor reactions may decrease due to hypoglycemia.

Interactions

The need for insulin may increase when taking drugs with hyperglycemic activity, such as oral contraceptives, corticosteroids, or with thyroid hormone replacement therapy.

The need for insulin may decrease with the use of oral hypoglycemic agents, salicylates, sulfonamides and some antidepressants (MAO inhibitors), ACE inhibitors and angiotensin II receptor blockers.

Before using other medicines, in addition to Humalog Mix 25, you should consult your doctor.

Overdose

An overdose of insulin can cause hypoglycemia with concomitant symptoms, which may include apathy, confusion, palpitations, sweating, vomiting, and headache.

Hypoglycemia can develop due to an excess of insulin activity and the mismatch of food intake with energy or both. Mild episodes of hypoglycemia can usually be treated with oral glucose. There may be a need for dose adjustment, changes in nutrition and physical activity.More severe episodes with coma, seizures, or neurological damage are treated with i / m or s / c by the administration of glucagon or concentrated i / v glucose. Long-term carbohydrate intake and screening may be necessary, since hypoglycemia may recur after a clear clinical recovery.

Storage conditions

At a temperature of 2–8 ° c. Avoid freezing. during the use of cartridges, store at a temperature of up to 30 ° C for no more than 28 days, protect from exposure to heat and sunlight.