Friday, October 21, 2016

insulin lispro protamine and insulin lispro Subcutaneous


IN-su-lin LIS-pro PROE-ta-meen, ree-KOM-bi-nant, IN-su-lin LIS-pro, ree-KOM-bi-nant


Commonly used brand name(s)

In the U.S.


  • Humalog Mix 50/50

  • Humalog Mix 75/25

Available Dosage Forms:


  • Suspension

Therapeutic Class: Antidiabetic


Pharmacologic Class: Insulin Lispro, Recombinant


Uses For insulin lispro protamine and insulin lispro


Insulin lispro protamine and insulin lispro is a combination of a fast-acting insulin and an intermediate-acting type of human insulin. Insulin is used by people with diabetes to help keep blood sugar levels under control. If you have diabetes, your body cannot make enough or does not use insulin properly. So, you must take additional insulin to regulate your blood sugar and keep your body healthy. This is very important as too much sugar in your blood can be harmful to your health.


insulin lispro protamine and insulin lispro is available only with your doctor's prescription.


Before Using insulin lispro protamine and insulin lispro


In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For insulin lispro protamine and insulin lispro, the following should be considered:


Allergies


Tell your doctor if you have ever had any unusual or allergic reaction to insulin lispro protamine and insulin lispro or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.


Pediatric


Appropriate studies have not been performed on the relationship of age to the effects of insulin lispro protamine and insulin lispro combination in the pediatric population. Safety and efficacy have not been established.


Geriatric


Although appropriate studies on the relationship of age to the effects of insulin lispro protamine and insulin lispro combination have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of insulin lispro protamine and insulin lispro in the elderly. However, elderly patients are more likely to have age-related heart, liver, or kidney problems which may require an adjustment of dose in patients receiving insulin lispro protamine and insulin lispro.


Pregnancy








Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding


There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.


Interactions with Medicines


Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking insulin lispro protamine and insulin lispro, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Using insulin lispro protamine and insulin lispro with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Alatrofloxacin

  • Balofloxacin

  • Ciprofloxacin

  • Clinafloxacin

  • Enoxacin

  • Fleroxacin

  • Flumequine

  • Gatifloxacin

  • Gemifloxacin

  • Grepafloxacin

  • Levofloxacin

  • Lomefloxacin

  • Moxifloxacin

  • Norfloxacin

  • Ofloxacin

  • Pefloxacin

  • Prulifloxacin

  • Rufloxacin

  • Sparfloxacin

  • Temafloxacin

  • Tosufloxacin

  • Trovafloxacin Mesylate

Using insulin lispro protamine and insulin lispro with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.


  • Acebutolol

  • Alprenolol

  • Atenolol

  • Betaxolol

  • Bevantolol

  • Bisoprolol

  • Bitter Melon

  • Bucindolol

  • Carteolol

  • Carvedilol

  • Celiprolol

  • Clorgyline

  • Dilevalol

  • Esmolol

  • Fenugreek

  • Glucomannan

  • Guar Gum

  • Iproniazid

  • Isocarboxazid

  • Labetalol

  • Levobunolol

  • Mepindolol

  • Metipranolol

  • Metoprolol

  • Moclobemide

  • Nadolol

  • Nebivolol

  • Nialamide

  • Oxprenolol

  • Pargyline

  • Penbutolol

  • Phenelzine

  • Pindolol

  • Procarbazine

  • Propranolol

  • Psyllium

  • Selegiline

  • Sotalol

  • Talinolol

  • Tertatolol

  • Timolol

  • Toloxatone

  • Tranylcypromine

Interactions with Food/Tobacco/Alcohol


Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.


Other Medical Problems


The presence of other medical problems may affect the use of insulin lispro protamine and insulin lispro. Make sure you tell your doctor if you have any other medical problems, especially:


  • Emotional disturbances or

  • Illness or

  • Stress—These conditions increase blood sugar and may increase the amount of insulin you need.

  • Hypoglycemia (low blood sugar)—Should not be used in patients with this condition. If you have low blood sugar and take insulin, your blood sugar may reach dangerously low levels.

  • Hypokalemia (low potassium in the blood)—May make this condition worse and increase your chance of having serious side effects.

  • Kidney disease or

  • Liver disease—Effects of insulin lispro protamine and insulin lispro combination may be increased because of the slower removal of the medicine from the body.

Proper Use of insulin lispro protamine and insulin lispro


Each package of insulin lispro protamine and insulin lispro combination contains a patient information leaflet. Read this leaflet carefully before beginning your treatment and each time you refill for any new information, and make sure you understand:


  • How to prepare the medicine.

  • How to inject the medicine.

  • How to use disposable insulin delivery device.

  • How to dispose of syringes, needles, and injection devices.

It is best to use a different place on the body for each injection (e.g., under the skin of your abdomen, thigh, or upper arm). If you have questions about this, contact a member of your health care team.


When used as a mealtime insulin, this insulin combination should be taken within 15 minutes before a meal.


Follow carefully the special meal plan your doctor gave you. This is the most important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.


You should never mix insulin lispro protamine and insulin lispro combination with other insulin injections without checking with your doctor first. These injections are usually done separately. If you have questions about this, ask your doctor or pharmacist.


Dosing


The dose of insulin lispro protamine and insulin lispro will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of insulin lispro protamine and insulin lispro. If your dose is different, do not change it unless your doctor tells you to do so.


The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


  • For injection dosage form:
    • For diabetes mellitus:
      • Adults—The dose is based on your blood sugar and must be determined by your doctor.

      • Children—Use and dose must be determined by your doctor.



Missed Dose


If you miss a dose of insulin lispro protamine and insulin lispro, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.


Storage


Keep out of the reach of children.


Do not keep outdated medicine or medicine no longer needed.


Ask your healthcare professional how you should dispose of any medicine you do not use.


Store in the refrigerator. Do not freeze.


After a cartridge has been inserted into a pen, you may store the cartridge and pen at room temperature, not in the refrigerator, for up to 10 days.


Precautions While Using insulin lispro protamine and insulin lispro


Never share insulin pens or cartridges with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles or pens can result in transmission of hepatitis viruses, HIV, or other blood-borne illnesses.


Your doctor will want to check your progress at regular visits, especially during the first few weeks you take insulin lispro protamine and insulin lispro. Blood tests may be needed to check for unwanted effects.


It is very important to follow carefully any instructions from your health care team about:


  • Alcohol—Drinking alcohol (including beer and wine) may cause severe low blood sugar. Discuss this with your health care team.

  • Other medicines—Do not take other medicines during the time you are taking insulin lispro protamine and insulin lispro unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.

  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.

  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to:


  • Wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.

  • Keep an extra supply of insulin and syringes with needles or injection devices on hand in case high blood sugar occurs.

  • Keep some kind of quick-acting sugar handy to treat low blood sugar.

  • Have a glucagon kit and a syringe and needle available in case severe low blood sugar occurs. Check and replace any expired kits regularly.

insulin lispro protamine and insulin lispro may cause a serious allergic reaction, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash; itching; shortness of breath; swelling of the face, tongue, and throat; trouble breathing; or chest pain after you get the injection.


Too much insulin lispro protamine and insulin lispro combination can cause hypoglycemia (low blood sugar). Symptoms of low blood sugar include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; depression; difficulty in thinking; dizziness or lightheadedness; drowsiness; excessive hunger; fast heartbeat; headache; irritability or abnormal behavior; nervousness; nightmares; restless sleep; shakiness; slurred speech; and tingling in the hands, feet, lips, or tongue.


If symptoms of low blood sugar occur, eat glucose tablets or gel to relieve the symptoms. Also, check your blood for low blood sugar. Get to a doctor or a hospital right away if the symptoms do not improve. Someone should call for emergency help immediately if severe symptoms such as convulsions (seizures) or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your household also should know how to use it.


Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.


Symptoms of high blood sugar include blurred vision; drowsiness; dry mouth; flushed, dry skin; fruit-like breath odor; increased urination; ketones in urine; loss of appetite; stomachache, nausea, or vomiting; tiredness; troubled breathing (rapid and deep); unconsciousness; or unusual thirst.


If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.


insulin lispro protamine and insulin lispro Side Effects


Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.


Check with your doctor immediately if any of the following side effects occur:


Incidence not known
  • Anxiety

  • blurred vision

  • chills

  • cold sweats

  • coma

  • confusion

  • convulsions

  • cool, pale skin

  • cough

  • decreased urine

  • depression

  • difficulty swallowing

  • dizziness

  • dry mouth

  • fast heartbeat

  • flushing or redness of the skin

  • headache

  • hives

  • increased hunger

  • increased thirst

  • irregular heartbeat

  • itching

  • loss of appetite

  • mood changes

  • muscle pain or cramps

  • nausea or vomiting

  • nervousness

  • nightmares

  • numbness or tingling in the hands, feet, or lips

  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

  • seizures

  • shakiness

  • shortness of breath

  • skin rash

  • slurred speech

  • sweating

  • swelling

  • tightness in the chest

  • unusual tiredness or weakness

  • unusually warm skin

  • wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:


Incidence not known
  • Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

  • redistribution or accumulation of body fat

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.


Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.



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More insulin lispro protamine and insulin lispro Subcutaneous resources


  • Insulin lispro protamine and insulin lispro Subcutaneous Use in Pregnancy & Breastfeeding
  • Insulin lispro protamine and insulin lispro Subcutaneous Drug Interactions
  • Insulin lispro protamine and insulin lispro Subcutaneous Support Group
  • 1 Review for Insulin lispro protamine and insulin lispro Subcutaneous - Add your own review/rating


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