Humalog Mix 50/50: Adult Dosing

Dosage forms: SC

diabetes mellitus

individualize dosing SC qd-bid

Info: usual total insulin requirement 0.5-1 units/kg/day; give <15min before meals; onset <30min, lispro peak 30-90min, protamine peak 1-2h, duration 6-12h (rapid-onset/intermediate-acting insulin analog)

renal dosing

adjust dose amount

renal impairment: decr. dose, amount not defined; HD/CAPD: not defined

hepatic dosing

adjust dose amount

hepatic impairment: decr. dose, amount not defined

Humalog Mix 50/50: Peds Dosing

This information is currently unavailable or not applicable for this drug.

Humalog Mix 50/50: Contraindications/Cautions

• hypersens. to drug/class/compon.
• IV administration
• hypoglycemia
• caution if infection, illness, or stress
• caution if hypokalemia
• caution if impaired renal fxn
• caution if impaired liver fxn

Humalog Mix 50/50: Drug Interactions

Avoid/Use Alternative

• beta blockers, systemic

• repaglinide

Monitor/Modify Tx

• A2R blocker/HCTZ combos

• acarbose

• ACE inhibitor/HCTZ combos

• ACE inhibitors

• amitriptyline/perphenazine

• androgens

• antihist/decongest/DM combos

• antihist/decongestant combos

• antipsychotics, atypical

• baclofen

• beta blocker/thiazide combos

• budesonide

• contraceptives, oral combo

• contraceptives, other combo

• corticosteroids, systemic

• decongest/opiate combos

• decongestants

• diazoxide

• disopyramide

• diuretics, loop

• diuretics, potassium-sparing/HCTZ

• diuretics, thiazide

• enalapril/felodipine

• ethanol

• gatifloxacin

• growth hormone

• HRT, estrogen

• HRT, estrogen/progestin combo

• isoniazid

• isoniazid/pyrazinamide/rifampin

• isoniazid/rifampin

• lanreotide

• levofloxacin

• MAOIs, all

• mecasermin (recombinant)

• meperidine/promethazine

• metformin

• metformin/sulfonylurea combos

• miglitol

• nateglinide

• niacin

• niacin/lovastatin

• niacin/simvastatin

• nicotine

• octreotide

• ofloxacin

• pegvisomant

• pentamidine

• phenothiazines

• phenytoins

• promethazine/codeine

• protease inhibitors

• sitagliptin

• sitagliptin/metformin

• sotalol

• sulfonylureas

• sympathomimetics, all

• thiazolidinediones

• thyroid hormones

• vorinostat

Therapeutic Advantage

• pramlintide

Caution Advised

• bortezomib

Humalog Mix 50/50: Adverse Reactions

Serious Reactions

• hypoglycemia, severe
• hypokalemia
• hypersensitivity rxn, generalized
• anaphylaxis (rare)

Common Reactions

• hypoglycemia
• injection site rxn
• lipodystrophy at injection site
• pruritus
• rash
• weight gain

Humalog Mix 50/50: Safety Monitoring

Pregnancy: B

Lactation: Probably Safe

Monitoring Parameters: Cr at baseline

Noninterchangeable Forms: may need dose adjustment if change insulin strength, timing, type, source species, manufacturer, or manufacturing method

Humalog Mix 50/50: Pharmacology

Metabolism: liver, kidney, fat; CYP450: none

Excretion: see individual drugs (insulin lispro); for insulin lispro protamine: urine; Half-life: not reported; Info: onset, peak, duration vary among insulin products and routes

Class: Diabetes Mellitus

Mechanism Of Action
stimulates peripheral glucose uptake, inhibits hepatic glucose production, inhibits lipolysis and proteolysis, regulating glucose metabolism

Humalog Mix 50/50: Manufacturer/Pricing

Manufacturer: Eli Lilly and Co. DEA/FDA: Rx

Humalog Mix 50/50: Patient Education

• Generic Name: insulin lispro and insulin lispro protamine

• Pronounced: IN soo lin LISS pro and IN soo lin LISS pro PRO ta meen

• Brand Names: Humalog Mix 50/50 Pen, Humalog Mix 75/25, Humalog Mix 75/25 Pen

What is the most important information I should know about insulin lispro and insulin lispro protamine?

Insulin lispro is a fast-acting insulin that begins to work very quickly. Use this medication within 15 minutes before eating a meal.

Take care to keep your blood sugar from getting too low, causing hypoglycemia. Symptoms of low blood sugar may include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, or trouble concentrating. Carry a piece of non-dietetic hard candy or glucose tablets with you in case you have low blood sugar. Also be sure your family and close friends know how to help you in an emergency.

Also watch for signs of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. Check your blood sugar levels and ask your doctor how to adjust your insulin doses if needed.

Insulin lispro and insulin lispro protamine is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

What is insulin lispro and insulin lispro protamine?

Insulin is a hormone that is produced in the body. It works by lowering levels of glucose (sugar) in the blood. Insulin lispro is a fast-acting form of insulin. Insulin lispro protamine is an intermediate-acting form of insulin.

Insulin lispro and insulin lispro protamine is used to treat type 1 (insulin-dependent) diabetes in adults. It is usually given together with another long-acting insulin.

Insulin lispro and insulin lispro protamine may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before using insulin lispro and insulin lispro protamine?

Do not use this medication if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar).

Before using insulin lispro and insulin lispro protamine, tell your doctor if you have liver or kidney disease.

Tell your doctor about all other medications you use, including any oral (by mouth) diabetes medications.

Insulin lispro and insulin lispro protamine is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Your doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether insulin lispro and insulin lispro protamine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use insulin lispro and insulin lispro protamine?

Use this medication exactly as it was prescribed for you. Do not use it in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label.

Insulin lispro and insulin lispro protamine is given as an injection (shot) under your skin. Your doctor, nurse, or pharmacist will give you specific instructions on how and where to inject this medicine. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

Insulin lispro is a fast-acting insulin that begins to work very quickly. Use this medication within 15 minutes before eating a meal.

Insulin lispro and insulin lispro protamine should be thin, clear, and colorless. Do not use the medication if it has changed colors or has any particles in it. Call your doctor for a new prescription.

Choose a different place in your injection skin area each time you use this medication. Do not inject into the same place two times in a row.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Some insulin needles can be used more than once, depending on needle brand and type. But a reused needle must be properly cleaned, recapped, and inspected for bending or breakage. Reusing needles also increases your risk of infection. Ask your doctor or pharmacist whether you are able to reuse your insulin needles.

Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, or skip meals. These things can affect your glucose levels and your insulin dose needs may also change.

Ask your doctor how to adjust your insulin lispro and insulin lispro protamine dose if needed. Do not change your dose without first talking to your doctor.

Carry an ID card or wear a medical alert bracelet stating that you have diabetes, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are diabetic.

Storing unopened vials or injection pens: Keep in the carton and store in a refrigerator, protected from light. Throw away any insulin not used before the expiration date on the medicine label.

Unopened vials may also be stored at room temperature for up to 28 days, away from heat and bright light. Throw away any insulin not used within 28 days.

Unopened injection pens may also be stored at room temperature for up to 10 days, away from heat and bright light. Throw away any insulin not used within 10 days.

Storing after your first use: You may keep "in-use" vials in the refrigerator, protected from light. Use within 28 days.

Do not refrigerate an in-use injection pen. Keep it at room temperature and use within 10 days.

Do not freeze insulin lispro and insulin lispro protamine, and throw away the medication if it has become frozen.

What happens if I miss a dose?

Since insulin lispro and insulin lispro protamine is used before meals, you may not be on a timed dosing schedule. Whenever you use insulin lispro and insulin lispro protamine, be sure to eat a meal within 15 minutes. Do not use extra insulin lispro and insulin lispro protamine to make up a missed dose.

It is important to keep insulin lispro and insulin lispro protamine on hand at all times. Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An insulin overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include confusion, extreme weakness, blurred vision, sweating, fruit-like breath odor, tremors, stomach pain, confusion, seizure (convulsions), or coma.

What should I avoid while using insulin lispro and insulin lispro protamine?

Do not change the brand of insulin lispro and insulin lispro protamine or syringe you are using without first talking to your doctor or pharmacist.

Avoid drinking alcohol. Your blood sugar may become dangerously low if you drink alcohol while using insulin lispro and insulin lispro protamine.

Do not expose insulin lispro and insulin lispro protamine to high heat.

What are the possible side effects of insulin lispro and insulin lispro protamine?

Get emergency medical help if you have any of these signs of insulin allergy: itching skin rash over the entire body, wheezing, trouble breathing, fast heart rate, sweating, or feeling like you might pass out.

Hypoglycemia, or low blood sugar, is the most common side effect of insulin lispro and insulin lispro protamine. Symptoms of low blood sugar may include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, trouble concentrating, confusion, or seizure (convulsions). Watch for signs of low blood sugar. Carry a piece of non-dietetic hard candy or glucose tablets with you in case you have low blood sugar.

Hyperglycemia, or high blood sugar, may also occur. Symptoms of hyperglycemia include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, dry mouth.

Insulin lispro and insulin lispro protamine can also cause hypokalemia (low potassium levels in the blood). Call your doctor at once if you have symptoms such as dry mouth, increased thirst, increased urination, uneven heartbeats, muscle pain or weakness, leg pain or discomfort, or confusion.

Tell your doctor if you have itching, swelling, redness, or thickening of the skin where you inject insulin lispro and insulin lispro protamine.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect insulin lispro and insulin lispro protamine?

Using certain medicines can make it harder for you to tell when you have low blood sugar. Tell your doctor if you use any of the following:

• clonidine (Catapres);
• reserpine;
• guanethidine (Ismelin); or
• beta-blockers such as albuterol (Proventil, Ventolin), atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), timolol (Blocadren), and others.

There are many other medicines that can increase or decrease the effects of insulin lispro and insulin lispro protamine on lowering your blood sugar. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

Your pharmacist can provide more information about insulin lispro and insulin lispro protamine.

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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Humalog Mix 50/50: Pill Pictures

This information is currently unavailable or not applicable for this drug.