Humalog SC Injection

Humalog SC Injection 100 unit/ml

Humalog SC Injection 100 unit/ml is a fast-acting insulin analog used to control high blood sugar in patients with diabetes mellitus. It helps to lower blood sugar levels by enabling glucose to enter the cells of the body and be used for energy.

Introduction

Insulin lispro is a human insulin analogue produced by recombinant DNA technology. It is composed of a peptide sequence of A21-B30-A20. It is an 'insulin secretagogue' which accelerates the release of endogenous insulin from beta cells of the pancreas. It may also have a role in preventing diabetes and improving glycaemic control in existing diabetes patients.

Uses for

To control high blood sugar levels in type 1 and type 2 diabetes mellitus (DM).
To reduce glucose levels in diabetic ketoacidosis (buildup of ketones in the blood due to lack of insulin) and hyperosmolar hyperglycemic state (HHS, high level of sugar in the blood due to inadequate production of insulin).
To reduce the risk of major cardiovascular events such as stroke, heart attack, and death from cardiovascular disease in adults with type 2 diabetes who are having difficulty controlling their blood sugar levels with other medications.

Mechanism of action

Insulin lispro binds to insulin receptors on the surface of cells, activating the enzyme adenyl cyclase and phosphoinositide 2-kinase, which increases intracellular levels of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). These peptides promote insulin secretion from pancreatic beta cells, which then passes into the bloodstream and helps to regulate blood glucose levels.

How long does it take to work?

Insulin lispro starts to work within minutes of injection and can last up to 8 hours. It typically starts to reduce elevated blood glucose levels with 30 minutes of administration.

Absorption

Insulin lispro is rapidly absorbed after subcutaneous injection, reaching peak levels within 30-90 minutes depending on the site of injection. After absorption, insulin lispro is distributed throughout the body, reaching its target tissues to promote the transport of glucose into the cells.

Route of elimination

Insulin lispro is broken down by the body and eliminated through the kidneys. A small amount is also excreted by the gut.

Dosage

Adult: SC Dosing regimen should be individualised and adjusted based on patient's glycaemic response. Usual range is 0.5-1 unit/kg/day.

Type 1 diabetes mellitus: Approximately one third of the total daily insulin requirements SC; rapid-acting or short-acting, premeal insulin should be used to satisfy the remainder of the daily insulin requirements

Usual daily maintenance range: 0.5-1 unit/kg/day in divided doses; nonobese may require 0.4-0.6 unit/kg/day; obese may require 0.8-1.2 units/kg/day

Type 2 diabetes mellitus: If inadequately controlled with oral medication: 10 units/day SC (or 0.1 -0.2 unit/kg/day) of intermediate- or long-acting insulin given at bedtime generally recommended; as an alternative, rapid-acting formulations, such as insulin lispro, given before meals have also been used; dose must be adjusted carefully.

The dose of insulin lispro depends on the individual's blood glucose level, age, sex, and other conditions such as kidney or liver disease. It is usually given as a single subcutaneous injection and can be repeated once every 8 hours if necessary.

Administration

Insulin lispro is usually administered by subcutaneous injection. It can be injected into the abdomen, thigh, or upper arm. If an insulin pen is used, vary the injection site to avoid tissue damage.

Side Effect

Insulin lispro usually causes few side effects with low risk of severe hypoglycemia (low blood sugar). However, some people may experience mild side effects such as nausea, headache, blurred vision, or skin rash. If any of these side effects occur, contact your doctor.

Toxicity

Insulin lispro is not toxic. However, taking too much may cause low blood sugar (hypoglycemia), which can lead to severe health problems. Signs of hypoglycemia include confusion, feeling shaky, dizziness, sweating, and difficulty concentrating.

Precautions

Insulin lispro should not be given to people with a known hypersensitivity or allergy to any of its ingredients.
Before taking insulin lispro, tell your doctor if you are pregnant or breastfeeding.
Insulin lispro can cause low blood sugar, which can lead to serious health problems if not treated promptly. Monitor your blood sugar levels regularly and take the necessary steps to manage sudden drops in blood sugar levels.
Tell your doctor if you have any other medical conditions, are taking any other medications, and/or if you are drinking alcohol.

Interactions

Insulin lispro should not be taken with certain medications, including certain antibiotics, anti-fungals, and medications for HIV/AIDS. In addition, certain medications such as birth control pills, steroids, and over-the-counter medications may interact with insulin lispro and should not be taken at the same time.

Disease interaction

Insulin lispro may enhance the effects of some medications used in the treatment of diabetes such as sulfonylureas and thiazolidinediones. High doses of insulin lispro may also increase the risk of hypoglycemia (low blood sugar).

Drug interaction

Drugs that may interact with insulin lispro include certain beta blockers, non-steroidal anti-inflammatory drugs (NSAIDs), and antipsychotics. Drugs that may decrease blood sugar levels such as ACE inhibitors, angiotensin II receptor blockers, and diuretics should be used with caution.

Food interactions

Insulin lispro should be taken with food, as this helps to reduce the risk of hypoglycemia. Eating a meal high in carbohydrates and/or fat before taking insulin lispro may also help to reduce the risk of this side effect.

Pregnancy Use

Insulin lispro is not recommended during pregnancy, as it has not been studied in pregnant women. Women who are planning to become pregnant should discuss this with their doctor before taking insulin lispro.

Lactation Use

Insulin lispro is not recommended for use while breastfeeding, as it is unknown if it passes into breast milk. Women who are breastfeeding should discuss this with their doctor before taking insulin lispro.

Acute Overdose

An acute overdose of insulin lispro may cause hypotension, coma, and even death. Prompt medical attention and monitoring of blood sugar levels is necessary in case of an overdose.

Contraindication

Insulin lispro is not recommended for use in individuals with hypersensitivity or allergy to its ingredients. It is also not recommended for use in individuals with active malignancy, and those with diabetic ketoacidosis or diabetic coma.

Use Direction

To use insulin lispro, inject the prescribed dose into the skin, preferably the abdomen, following the instructions of your doctor or nurse. Do not inject into a muscle. Change the injection sites to avoid tissue damage.

Storage Condition

Insulin lispro should be stored in its original packaging at room temperature (between 15-30°C). It should be protected from light, moisture, and excessive heat. It should not be frozen or refrigerated.

Volume of Distribution

Insulin lispro is rapidly distributed throughout the body and reaches its target tissues to promote glucose absorption into the cells. In most cases, the drug is completely Babsorbed within 30-90 minutes of injection.

Half Life

The half-life of insulin lispro is 5-8 hours, although it may be shorter depending on the dose and route of administration.

Clearance

Insulin lispro is rapidly cleared from the body and eliminated by the kidneys. A small amount is also excreted by the gut.

Dosage Information

Usual starting dose is 0.2-0.3 Units/kg/day, given in divided doses. Dosage may be increased according to patient’s needs and as guided by glucose levels.
If taken orally, dosage of 4-10 Units two to four times a day is suggested.
Injectable insulin lispro is to be injected subcutaneously and is available in 100 units/mL or 200 units/mL formulations. Usual dose is 0.3-1 Unit/kg/day, divided into two to four doses.
For diabetes ketoacidosis, usual dose is 0.1 unit/ kg/hour, with 2-4 times daily insulin injections.

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