Humalog Mix 75/25 Kwikpen Inj 3ml
Overview
What is this medicine?
How to Use This Medicine
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 tissue of the skin in the upper arm, thigh, buttocks, or stomach area. If you will be self-administering the injection, your doctor or nurse will instruct you on the proper technique.
Preparation and Administration
Before use, this medication must be mixed according to the instructions provided by your doctor. Use the medication immediately after mixing. It is recommended to take the medication within 15 minutes before a meal. Rotate the injection site each time to avoid damaging the skin.
Important Administration Guidelines
Do not inject the medication into skin that is thickened, has pits or lumps, or is irritated, tender, bruised, red, scaly, hard, scarred, or has stretch marks. The medication should appear cloudy and milky when ready to use. Do not use the medication if the solution is clear or contains lumps. Additionally, do not use the medication if the powder is stuck to the sides of the container, the solution is leaking, or the solution contains particles or has changed color.
Using the Pen Needle
Remove all pen needle covers before injecting a dose. If you are unsure about the type of pen needle you have or how to use it, consult your doctor. After each injection, remove the needle and do not store the device with the needle attached. You may hear a clicking sound when preparing the dose, but do not use the clicks to determine the dose. Never transfer the medication from the pen to a syringe.
Disposing of Needles and Supplies
Dispose of used needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow local regulations for disposal. If you have any questions, consult your doctor or pharmacist.
Diet and Exercise
Follow the diet and exercise plan recommended by your doctor. Be aware of what to do if you do not eat as much as normal or if you skip a meal.
Important Warnings
Do not mix this insulin with other types of insulin in the same syringe. This medication is not suitable for use in an insulin pump. If you have any questions or concerns, consult your doctor.
Storage and Disposal
Store unopened containers in the refrigerator. Do not freeze the medication, and do not use it if it has been frozen.
Missed Dose
If you miss a dose, be aware of what to do. If you are unsure, consult your doctor.
Lifestyle & Tips
- Follow your healthcare provider's instructions for diet and exercise.
- Monitor your blood glucose levels regularly as instructed.
- Do not skip meals or delay meals after injecting this insulin.
- Always carry a source of fast-acting sugar (e.g., glucose tablets, juice) to treat low blood sugar.
- Rotate injection sites within the same region (e.g., abdomen) to prevent lipodystrophy.
- Never share insulin pens or needles with others, even if the needle is changed, due to risk of infection.
Available Forms & Alternatives
Available Strengths:
- Humalog Insulin (vl-7510) 10ml
- Humalog Mix 75/25 Vial 10ml
- Humalog Cartridge 3ml
- Humalog Mix 50/50 Inj, 10ml
- Humalog Mix 50/50 Kwikpen Inj 3ml
- Humalog 100 U/ml Kwik Pen Inj 3ml
- Humalog Mix 75/25 Kwikpen Inj 3ml
- Humalog 100u/ml Vial 3ml
- Humalog 200 U/ml Kwikpen Inj 3ml
- Humalog Jr 100u/ml Kwikpnhalf Unit
- Humalog Tempo Pen 100u/ml Inj 3ml
Dosing & Administration
Adult Dosing
Condition-Specific Dosing:
Pediatric Dosing
Dose Adjustments
Renal Impairment:
Hepatic Impairment:
Pharmacology
Mechanism of Action
Pharmacokinetics
Absorption:
Distribution:
Elimination:
Pharmacodynamics
Safety & Warnings
Side Effects
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
Signs of low potassium levels, including:
+ Muscle pain or weakness
+ Muscle cramps
+ An irregular heartbeat
Injection site reactions, such as:
+ Thick skin
+ Pits or lumps
Swelling in the arms or legs
Shortness of breath
Low blood sugar symptoms, which may include:
+ Dizziness or fainting
+ Blurred vision
+ Mood changes
+ Slurred speech
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
+ Seizures
If you experience low blood sugar, follow your doctor's instructions for treatment, which may include taking glucose tablets, liquid glucose, or consuming some fruit juices.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Irritation at the injection site
Weight gain
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, don't hesitate to reach out to your doctor.
Reporting Side Effects
To report side effects, you can contact the FDA at 1-800-332-1088 or visit their website at https://www.fda.gov/medwatch. Your doctor is also available to provide guidance on managing side effects.
Seek Immediate Medical Attention If You Experience:
- Symptoms of low blood sugar (hypoglycemia): sweating, shaking, dizziness, confusion, hunger, irritability, headache. Treat immediately with fast-acting sugar.
- Symptoms of high blood sugar (hyperglycemia): increased thirst, frequent urination, fatigue, blurred vision. Contact your doctor if persistent.
- Symptoms of allergic reaction: rash, itching, swelling of face/tongue/throat, severe dizziness, trouble breathing. Seek immediate medical attention.
Before Using This Medicine
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 medication may interact with other medications or health conditions. Therefore, it is crucial to provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Any natural products or vitamins you are using
* Your existing health problems
Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to ensure your safety. It is your responsibility to verify that it is safe to take this medication in combination with your other medications and health conditions.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
Caution with Daily Activities
Until you understand how this medication affects you, avoid driving and other tasks that require alertness.
Risk of Low Blood Sugar
This medication can cause low blood sugar, which may lead to seizures, loss of consciousness, permanent brain damage, and even death. Consult your doctor to discuss this risk.
Risk of Low Blood Potassium
This medication can also cause low blood potassium levels, which can lead to abnormal heart rhythms, severe breathing problems, and death if left untreated. Talk to your doctor about this potential risk.
Interactions with Other Diabetes Medications
If you are taking diabetes medications like pioglitazone or rosiglitazone, using insulin with these drugs may increase the risk of heart failure, especially if you already have heart failure. Discuss this risk with your doctor.
Proper Insulin Product Handling
Ensure you have the correct insulin product and understand how to measure and prepare your dose. Insulin products come in various containers, such as vials, cartridges, and pens. If you have any questions, consult your doctor or pharmacist.
Blood Sugar Control During Stressful Situations
Stressful events like fever, infection, injury, or surgery can make it more challenging to control your blood sugar levels. Changes in physical activity, exercise, or diet can also affect your blood sugar levels.
Medical Alert Identification
Wear a medical alert ID to identify your condition.
Driving Precautions
Do not drive if you have experienced low blood sugar, as this can increase your risk of being involved in an accident.
Monitoring Your Condition
Check your blood sugar levels as directed by your doctor and have regular blood work done as recommended.
Alcohol Consumption
Consult your doctor before consuming alcohol or using products that contain alcohol.
Insulin Product Sharing
Do not share your insulin product, including pens, cartridge devices, needles, or syringes, with anyone else, even if the needle has been changed. Sharing can spread infections, including those you may not be aware of having.
Special Precautions for Older Adults and Pregnant or Breastfeeding Women
If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects. If you are pregnant, plan to become pregnant, or are breastfeeding, discuss the benefits and risks of this medication with your doctor.
Overdose Information
Overdose Symptoms:
- Severe hypoglycemia (extremely low blood sugar)
- Confusion
- Seizures
- Unconsciousness
- Hypokalemia (low potassium levels)
What to Do:
For mild to moderate hypoglycemia, consume fast-acting carbohydrates. For severe hypoglycemia, administer glucagon injection or seek immediate medical attention. Call 911 or 1-800-222-1222 (Poison Control Center).
Drug Interactions
Major Interactions
- Pramlintide (increased risk of severe hypoglycemia; reduce insulin dose)
- Thiazolidinediones (TZDs) (increased risk of fluid retention and heart failure)
Moderate Interactions
- Beta-blockers (may mask symptoms of hypoglycemia, prolong recovery from hypoglycemia)
- ACE inhibitors (may enhance insulin's glucose-lowering effect)
- Angiotensin Receptor Blockers (ARBs) (may enhance insulin's glucose-lowering effect)
- Salicylates (e.g., aspirin) (may enhance insulin's glucose-lowering effect)
- Sulfonamide antibiotics (may enhance insulin's glucose-lowering effect)
- MAO inhibitors (may enhance insulin's glucose-lowering effect)
- Alcohol (may potentiate or diminish insulin's glucose-lowering effect)
- Corticosteroids (may decrease insulin's glucose-lowering effect)
- Diuretics (e.g., thiazides, loop diuretics) (may decrease insulin's glucose-lowering effect)
- Sympathomimetics (e.g., decongestants, beta-2 agonists) (may decrease insulin's glucose-lowering effect)
- Niacin (may decrease insulin's glucose-lowering effect)
- Oral contraceptives (may decrease insulin's glucose-lowering effect)
- Thyroid hormones (may decrease insulin's glucose-lowering effect)
- Atypical antipsychotics (e.g., olanzapine, clozapine) (may decrease insulin's glucose-lowering effect)
- Protease inhibitors (may decrease insulin's glucose-lowering effect)
Monitoring
Baseline Monitoring
Rationale: To establish baseline glycemic control and guide initial dosing.
Timing: Prior to initiation of therapy
Rationale: To establish baseline glucose levels.
Timing: Prior to initiation of therapy
Rationale: To assess kidney function, as insulin clearance can be affected by renal impairment.
Timing: Prior to initiation of therapy
Rationale: To assess liver function, as insulin metabolism can be affected by hepatic impairment.
Timing: Prior to initiation of therapy
Routine Monitoring
Frequency: Multiple times daily (e.g., pre-meal, 2-hour 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) or Hyperglycemia (>180-250 mg/dL depending on target)
Frequency: Every 3-6 months
Target: Individualized, typically <7%
Action Threshold: >7% (consider dose adjustment or therapy change)
Frequency: Daily, ongoing
Target: N/A
Action Threshold: Presence of symptoms (e.g., sweating, tremor, confusion, hunger, dizziness)
Frequency: Daily, ongoing
Target: N/A
Action Threshold: Presence of symptoms (e.g., polyuria, polydipsia, polyphagia, fatigue, blurred vision)
Frequency: Daily
Target: N/A
Action Threshold: Presence of lipodystrophy, redness, swelling, or pain
Symptom Monitoring
- Hypoglycemia: Sweating, tremor, dizziness, confusion, hunger, irritability, headache, blurred vision, rapid heartbeat, anxiety, weakness, slurred speech, seizures, unconsciousness.
- Hyperglycemia: Increased thirst, increased urination, increased hunger, fatigue, blurred vision, headache, dry mouth, fruity breath odor (in severe cases).
Special Patient Groups
Pregnancy
Insulin is the preferred treatment for managing diabetes in pregnancy, as it does not cross the placenta in significant amounts. Humalog Mix 75/25 can be used, but careful monitoring and dose adjustments are crucial to maintain strict glycemic control.
Trimester-Specific Risks:
Lactation
Insulin is compatible with breastfeeding. Insulin is a normal component of breast milk and is not harmful to the infant. Insulin requirements may be lower in breastfeeding mothers.
Pediatric Use
Dosing must be individualized and carefully monitored in pediatric patients. Insulin requirements can vary significantly with age, puberty, and growth spurts. Close supervision by a healthcare professional experienced in pediatric diabetes is essential.
Geriatric Use
Older adults may be more susceptible to hypoglycemia due to impaired renal/hepatic function, polypharmacy, and reduced awareness of hypoglycemic symptoms. Dosing should be conservative, and blood glucose monitoring should be frequent. Glycemic targets may be less stringent to avoid hypoglycemia.
Clinical Information
Clinical Pearls
- Humalog Mix 75/25 is a suspension; it must be gently rolled between the palms 10 times and inverted 10 times immediately before each injection to ensure uniform mixing.
- Administer 15 minutes before a meal or immediately after a meal. Consistency in timing relative to meals is important.
- Never administer intravenously. This product is for subcutaneous injection only.
- Do not mix with other insulins or solutions.
- Patients should be educated on recognizing and treating hypoglycemia, and on proper injection technique and site rotation.
- Unopened pens should be stored in the refrigerator (36°F-46°F [2°C-8°C]). Once opened, pens can be stored at room temperature (below 86°F [30°C]) for up to 10 days. Do not freeze.
- Insulin requirements may change during illness, stress, or changes in diet/exercise.
Alternative Therapies
- Basal-bolus insulin regimens (e.g., long-acting insulin + rapid-acting insulin)
- Oral antidiabetic medications (e.g., metformin, sulfonylureas, SGLT2 inhibitors, GLP-1 receptor agonists) for Type 2 Diabetes
- Other insulin regimens (e.g., multiple daily injections, continuous subcutaneous insulin infusion)