Humalog 100 U/ml Kwik Pen Inj 3ml

Manufacturer LILLY Active Ingredient Insulin Lispro (U-100) Cartridges and Pens(IN soo lin LYE sproe) Pronunciation IN soo lin LYE sproe
It is used to lower blood sugar in patients with high blood sugar (diabetes).
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Drug Class
Antidiabetic agent
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Pharmacologic Class
Rapid-acting insulin analog
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Pregnancy Category
Category B
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FDA Approved
Jun 1996
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

Humalog is a fast-acting insulin that helps your body use sugar for energy. It starts working quickly, usually within 15-30 minutes, and is typically taken just before or after meals to help control your blood sugar after eating. It's used to treat diabetes.
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How to Use This Medicine

Proper Use of This Medication

To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is administered via injection into the fatty layer of the skin. If you will be self-administering the injection, your doctor or nurse will provide guidance on the proper technique.

Administration Guidelines

Take the medication within 15 minutes before or immediately after a meal.
Rotate the injection site each time to avoid tissue damage.
Avoid injecting into skin that is:
+ Thickened or has pits or lumps
+ Irritated, tender, bruised, red, scaly, hard, scarred, or has stretch marks
Do not use the medication if the solution is:
+ Cloudy
+ Leaking
+ Contains particles
+ Has changed color
Remove all pen needle covers before injecting a dose. If you are unsure about the type of pen needle or how to use it, consult your doctor.
Note that the device may produce a clicking sound when preparing the dose. However, do not rely on the clicks to determine the correct dose.
Remove the needle after each injection and do not store the device with the needle attached.
Do not transfer the medication from the pen to a syringe or mix it with other types of insulin.

Disposal and Storage

Dispose of used needles in a designated needle/sharp disposal box. Do not reuse needles or other items.
When the disposal box is full, follow local regulations for proper disposal.
Store unopened containers in the refrigerator. Do not freeze, and do not use if the medication has been frozen.

Missed Dose

If you miss a dose, follow the plan outlined by your doctor. If you are unsure, consult your doctor for guidance.
* It is essential to follow the diet and exercise plan recommended by your doctor. Be prepared for situations where you may not eat as much as usual or skip a meal, and know how to adjust your medication accordingly. If you have any questions or concerns, consult your doctor or pharmacist.
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Lifestyle & Tips

  • Always check your blood sugar levels as directed by your doctor.
  • Follow your prescribed diet and exercise plan.
  • Rotate injection sites to prevent skin problems (lipodystrophy).
  • Never share your insulin pen or needles with others.
  • Carry a source of fast-acting sugar (e.g., glucose tablets, juice) to treat low blood sugar.
  • Inform your healthcare provider about all medications, supplements, and herbal products you are taking.

Dosing & Administration

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Adult Dosing

Standard Dose: Highly individualized based on metabolic needs, blood glucose monitoring, and glycemic goals. Typically administered subcutaneously 5-15 minutes before a meal or immediately after a meal.

Condition-Specific Dosing:

Type 1 Diabetes: Often used as part of a basal-bolus regimen, with bolus doses adjusted for carbohydrate intake, pre-meal glucose, and activity.
Type 2 Diabetes: May be used alone or in combination with oral antidiabetic agents or basal insulin, with doses adjusted based on glycemic control.
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Pediatric Dosing

Neonatal: Not established (use with extreme caution and expert guidance)
Infant: Dosing individualized based on metabolic needs and blood glucose monitoring. Requires careful titration.
Child: Dosing individualized based on metabolic needs and blood glucose monitoring. Requires careful titration.
Adolescent: Dosing individualized based on metabolic needs and blood glucose monitoring. Requires careful titration.
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Dose Adjustments

Renal Impairment:

Mild: No specific dose adjustment typically required, but monitor glucose closely.
Moderate: Insulin requirements may be reduced; monitor glucose closely and adjust dose as needed.
Severe: Insulin requirements are often significantly reduced; monitor glucose closely and adjust dose as needed. Increased risk of hypoglycemia.
Dialysis: Insulin requirements are often significantly reduced; monitor glucose closely and adjust dose as needed. Increased risk of hypoglycemia.

Hepatic Impairment:

Mild: No specific dose adjustment typically required, but monitor glucose closely.
Moderate: Insulin requirements may be reduced; monitor glucose closely and adjust dose as needed. Increased risk of hypoglycemia.
Severe: Insulin requirements are often significantly reduced; monitor glucose closely and adjust dose as needed. Increased risk of hypoglycemia.

Pharmacology

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Mechanism of Action

Insulin lispro is a rapid-acting insulin analog that lowers blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin inhibits lipolysis and proteolysis, and enhances protein synthesis.
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Pharmacokinetics

Absorption:

Bioavailability: Not applicable (subcutaneous injection)
Tmax: 0.5-1.5 hours (subcutaneous)
FoodEffect: Administered before or immediately after meals to cover postprandial glucose excursions.

Distribution:

Vd: ~0.26 L/kg
ProteinBinding: <10%
CnssPenetration: Limited

Elimination:

HalfLife: ~1 hour (functional half-life is longer due to absorption kinetics)
Clearance: Not available
ExcretionRoute: Primarily renal
Unchanged: Not available
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Pharmacodynamics

OnsetOfAction: 15-30 minutes
PeakEffect: 0.5-2.5 hours
DurationOfAction: 3-5 hours
Confidence: Medium

Safety & Warnings

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Side Effects

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following signs or symptoms, contact your doctor or seek medical attention immediately:

Allergic reaction symptoms, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Note: In rare cases, allergic reactions can be fatal.
Signs of low potassium levels, including:
+ Muscle pain or weakness
+ Muscle cramps
+ Abnormal heartbeat
Signs of infection, such as:
+ Fever
+ Chills
+ Severe sore throat
+ Ear or sinus pain
+ Cough
+ Increased or changed sputum production
+ Painful urination
+ Mouth sores
+ Wounds that won't heal
Injection site reactions, including:
+ Thick skin
+ Pits or lumps
Swelling in the arms or legs
Low blood sugar symptoms, which may include:
+ Dizziness or fainting
+ Blurred vision
+ Mood changes
+ Slurred speech
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Rapid heartbeat
+ Confusion
+ Hunger
+ Sweating
+ Seizures
If you experience any of these low blood sugar symptoms, contact your doctor right away and follow their instructions for managing the condition, which may include taking glucose tablets, liquid glucose, or consuming certain fruit juices.

Other Possible Side Effects

Like all medications, this drug can cause side effects. Many people may not experience any side effects or may only have mild ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention if they bother you or persist:

Weight gain
Flu-like symptoms
Nose or throat irritation
Common cold symptoms
Headache
Cough
Upset stomach
Stomach pain or diarrhea
Feeling tired or weak
* Irritation at the injection site

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
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Seek Immediate Medical Attention If You Experience:

  • Symptoms of low blood sugar (hypoglycemia): sweating, shakiness, dizziness, confusion, hunger, irritability, blurred vision, rapid heartbeat. Treat immediately with fast-acting sugar.
  • Symptoms of high blood sugar (hyperglycemia): increased thirst, frequent urination, increased hunger, fatigue, blurred vision. Contact your doctor if persistent.
  • Signs of allergic reaction: rash, itching, swelling of face/tongue/throat, severe dizziness, trouble breathing. Seek immediate medical attention.
  • Injection site reactions: redness, swelling, itching, pain, or changes in skin texture (lipodystrophy) at the injection site.
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Before Using This Medicine

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have low blood sugar (hypoglycemia), as this may affect your treatment plan.

This is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to discuss all of your:

Prescription and over-the-counter (OTC) medications
Natural products
Vitamins
Health problems

with your doctor and pharmacist. They will help you determine whether it is safe to take this medication in combination with your other medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
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Precautions & Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

This drug may cause low blood sugar, which can lead to seizures, loss of consciousness, permanent brain damage, and even death if not treated promptly. Consult your doctor to discuss the risks and prevention strategies. Additionally, this medication may cause low blood potassium levels, which can result in abnormal heart rhythms, severe breathing difficulties, and potentially death if left untreated. It is crucial to discuss this risk with your doctor.

Until you understand how this medication affects you, avoid driving and other activities that require your full attention. Certain diabetes medications, such as pioglitazone or rosiglitazone, may increase the risk of heart failure or worsen existing heart failure, especially when combined with insulin. If you are taking one of these medications, consult your doctor to discuss the potential risks.

Ensure you have the correct insulin product and understand how to measure and prepare your dose, as insulin products are available in various containers, including vials, cartridges, and pens. If you have any questions or concerns, contact your doctor or pharmacist.

Stressful situations, such as fever, infection, injury, or surgery, may make it more challenging to control your blood sugar levels. Changes in physical activity, exercise, or diet can also impact your blood sugar levels.

Wear a medical alert identification to ensure prompt treatment in case of an emergency. Avoid driving if you have experienced low blood sugar, as it increases the risk of accidents. Monitor your blood sugar levels as instructed by your doctor and undergo regular blood tests as recommended.

Consult your doctor before consuming alcohol or using products containing alcohol. Do not share your insulin product, including pens, cartridge devices, needles, or syringes, with others, even if the needle has been changed, as this can transmit infections.

If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects. Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding, as you will need to discuss the benefits and risks of this medication for both you and your baby.
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Overdose Information

Overdose Symptoms:

  • Severe hypoglycemia (very low blood sugar)
  • Confusion
  • Seizures
  • Loss of consciousness
  • Coma

What to Do:

For mild to moderate hypoglycemia, consume fast-acting carbohydrates (e.g., glucose tablets, fruit juice, candy). For severe hypoglycemia, administer glucagon injection (if available and trained) and/or seek immediate medical attention. Call 911 or your local emergency number. Inform healthcare providers about insulin overdose. Call 1-800-222-1222 (Poison Control).

Drug Interactions

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Major Interactions

  • Beta-blockers (may mask symptoms of hypoglycemia)
  • Thiazolidinediones (TZDs) - e.g., pioglitazone, rosiglitazone (increased risk of fluid retention and heart failure when used with insulin)
  • Corticosteroids (may increase blood glucose, requiring higher insulin doses)
  • Diuretics (e.g., thiazides, loop diuretics) (may increase blood glucose, requiring higher insulin doses)
  • Sympathomimetics (e.g., epinephrine, albuterol) (may increase blood glucose)
  • Danazol (may increase blood glucose)
  • Growth hormone (may increase blood glucose)
  • Protease inhibitors (may increase blood glucose)
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Moderate Interactions

  • Alcohol (may potentiate or reduce hypoglycemic effect)
  • Salicylates (e.g., aspirin) (may enhance hypoglycemic effect)
  • Sulfonamide antibiotics (may enhance hypoglycemic effect)
  • MAO inhibitors (may enhance hypoglycemic effect)
  • ACE inhibitors (may enhance hypoglycemic effect)
  • Angiotensin II receptor blockers (ARBs) (may enhance hypoglycemic effect)
  • Octreotide/Lanreotide (may increase or decrease insulin requirements)
  • Lithium (may increase or decrease insulin requirements)

Monitoring

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Baseline Monitoring

HbA1c

Rationale: To establish baseline glycemic control and set treatment goals.

Timing: Prior to initiation

Fasting Plasma Glucose (FPG)

Rationale: To establish baseline glycemic control.

Timing: Prior to initiation

Renal function (SCr, eGFR)

Rationale: To assess kidney function, as insulin requirements may decrease in renal impairment.

Timing: Prior to initiation

Hepatic function (ALT, AST)

Rationale: To assess liver function, as insulin requirements may decrease in hepatic impairment.

Timing: Prior to initiation

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Routine Monitoring

Self-Monitoring Blood Glucose (SMBG)

Frequency: Multiple times daily (pre-meal, 1-2 hours post-meal, bedtime, overnight as needed)

Target: Individualized, typically 80-130 mg/dL pre-meal, <180 mg/dL post-meal

Action Threshold: Hypoglycemia (<70 mg/dL), Hyperglycemia (>180-250 mg/dL depending on target)

HbA1c

Frequency: Every 3-6 months (or more frequently if glycemic control is unstable)

Target: <7% for most adults (individualized)

Action Threshold: >7% (consider dose adjustment or therapy change)

Weight

Frequency: Regularly (e.g., monthly or at each visit)

Target: Maintain healthy weight

Action Threshold: Significant unexplained weight gain or loss

Injection sites

Frequency: At each injection

Target: Rotate sites

Action Threshold: Lipodystrophy, redness, swelling, pain

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Symptom Monitoring

  • Symptoms of hypoglycemia (e.g., sweating, tremor, dizziness, confusion, hunger, irritability, blurred vision, palpitations)
  • Symptoms of hyperglycemia (e.g., polyuria, polydipsia, polyphagia, fatigue, blurred vision)
  • Signs of allergic reaction (e.g., rash, itching, swelling, difficulty breathing)
  • Signs of injection site reactions (e.g., redness, swelling, itching, pain, lipodystrophy)

Special Patient Groups

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Pregnancy

Insulin is the preferred treatment for glycemic control in pregnant women with pre-existing diabetes or gestational diabetes. Insulin lispro is generally considered safe and effective during pregnancy. Close monitoring of blood glucose is essential.

Trimester-Specific Risks:

First Trimester: Poor glycemic control in early pregnancy increases risk of congenital malformations. Insulin lispro helps achieve tight control.
Second Trimester: Insulin requirements typically increase during the second and third trimesters.
Third Trimester: Insulin requirements continue to increase. Close monitoring to prevent hypoglycemia and hyperglycemia.
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Lactation

Insulin lispro is considered compatible with breastfeeding. Insulin is a normal component of breast milk and is not expected to harm the breastfed infant. Maternal insulin requirements may change during lactation.

Infant Risk: Low risk to infant.
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Pediatric Use

Insulin lispro is approved for use in pediatric patients with diabetes. Dosing must be carefully individualized based on age, weight, and metabolic needs. Close monitoring for hypoglycemia is crucial.

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Geriatric Use

Elderly patients may be at increased risk of hypoglycemia due to impaired renal/hepatic function, reduced counter-regulatory responses, and polypharmacy. Start with lower doses and titrate carefully. Monitor glucose frequently.

Clinical Information

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Clinical Pearls

  • Humalog is a rapid-acting insulin; ensure patients eat a meal or snack within 5-15 minutes of injection to prevent hypoglycemia.
  • Always verify the correct insulin type (rapid, short, intermediate, long-acting) and concentration (U-100, U-200, U-500) before administration.
  • Educate patients on proper injection technique, site rotation, and storage (refrigerated for unopened, room temperature for opened/in-use).
  • Stress the importance of carrying a fast-acting carbohydrate source for hypoglycemia.
  • Patients should be aware that insulin requirements can change with illness, stress, changes in diet, or exercise.
  • Humalog KwikPens are for single-patient use only and should never be shared, even if the needle is changed.
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Alternative Therapies

  • Other rapid-acting insulins (e.g., insulin aspart, insulin glulisine, ultra-rapid insulin lispro [Lyumjev], ultra-rapid insulin aspart [Fiasp])
  • Short-acting insulins (e.g., Regular insulin)
  • Intermediate-acting insulins (e.g., NPH insulin)
  • Long-acting insulins (e.g., insulin glargine, insulin detemir, insulin degludec)
  • Oral antidiabetic agents (e.g., metformin, sulfonylureas, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists) for Type 2 Diabetes.
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Cost & Coverage

Average Cost: $100 - $250 per 5 KwikPens (3ml each)
Generic Available: Yes
Insurance Coverage: Tier 2 or Tier 3 (preferred or non-preferred brand)
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General Drug Facts

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.