Insulin lispro and insulin lispro protamine

Insulin is a hormone that lowers blood glucose (sugar) levels. Insulin lispro is a fast-acting insulin, while insulin lispro protamine is an intermediate-acting insulin. This combination insulin starts to work within 10 to 20 minutes after injection, reaches its highest effect in 2 hours, and continues to work for up to 24 hours.

Insulin lispro and insulin lispro protamine is a combination medication used to help control blood sugar in adults with diabetes mellitus. Insulin lispro and insulin lispro protamine may be used for type 1 or type 2 diabetes.

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

Follow all instructions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Insulin is injected under the skin. A healthcare provider can teach you how to use the medication on your own. Do not inject insulin lispro and insulin lispro protamine into a vein.

Use this medication within 15 minutes before eating a meal.

If you use an injection pen, use only the injection pen that comes with insulin lispro and insulin lispro protamine. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe.

Your care provider will show you the best places on your body to inject this insulin. Use a different spot each time you give an injection. Do not inject into the same spot two times in a row.

Do not inject this medicine into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.

Never share an injection pen, cartridge, or syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Make sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Insulin is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Keep this medicine in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) insulin lispro and insulin lispro protamine:

• Refrigerate and use until expiration date; or
• Store at room temperature and use the vial within 28 days or use the injection pen within 10 days.

Storing opened (in use) insulin lispro and insulin lispro protamine:

• Store the vial in a refrigerator or at room temperature and use within 28 days.
• Store the injection pen at room temperature (do not refrigerate) and use within 10 days. Do not store the injection pen with a needle attached.

This medicine should look cloudy. Do not use the medicine if it looks clear or has particles in it. Call your pharmacist for new medicine.

In case of emergency, wear or carry medical identification to let others know you have diabetes.

Never share an injection pen, cartridge, or syringe with another person, even if the needle has been changed.

You should not use this medicine if you are allergic to insulin lispro, or if you are having a low blood sugar episode (hypoglycemia).

Insulin lispro and insulin lispro protamine is not approved for anyone under 18 years old.

Tell your doctor if you have ever had:

• liver or kidney disease; or
• low levels of potassium in your blood (hypokalemia).

Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes found in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while using insulin may increase your risk of serious heart problems.

Tell your doctor if you are pregnant or breastfeeding.

Follow your doctor's instructions about using insulin if you are pregnant or become pregnant. It is very important to control diabetes during pregnancy, and having high blood sugar may cause complications for both the mother and the baby.

Get emergency medical help if you have signs of an insulin allergy: redness or swelling at the injection site, itchy skin rash all over your body, trouble breathing, fast heartbeats, feeling faint, or swelling in your tongue or throat.

Insulin lispro and insulin lispro protamine may cause serious side effects. Call your doctor immediately if you have:

• fluid retention--weight gain, swelling in your hands or feet, feeling short of breath; or
• low potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or feeling limp.

Common side effects of insulin lispro and insulin lispro protamine may include:

• low blood sugar;
• itching, mild skin rash; or
• thickening or hollowing of the skin at the injection site.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Usual Adult Dose for Diabetes Type 2:

Individualize dose based on glucose treatment goals, metabolic needs, eating habits, and other lifestyle variables. Available as:-Humalog Mix 75/25 (75% insulin lispro protamine suspension and 25% insulin lispro)-Humalog Mix 50/50 (50% insulin lispro protamine suspension and 50% insulin lispro)Usual dose: Administer prescribed units subcutaneously within 15 minutes before or after meal initiationComments: -Duration of action may vary according to the dose, injection site, blood flow, temperature, and level of physical activity. Use: To improve glycemic control in patients with diabetes mellitus.

Usual Adult Dose for Diabetes Type 1:

Individualize dose based on glucose treatment goals, metabolic needs, eating habits, and other lifestyle variables. Available as:-Humalog Mix 75/25 (75% insulin lispro protamine suspension and 25% insulin lispro)-Humalog Mix 50/50 (50% insulin lispro protamine suspension and 50% insulin lispro)Usual dose: Administer prescribed units subcutaneously within 15 minutes before meal initiationComments: -Total daily insulin requirements are estimated to be between 0.5 and 1 unit/kg/day. -Duration of action may vary according to the dose, injection site, blood flow, temperature, and level of physical activity. Use: To improve glycemic control in patients with diabetes mellitus.

Since insulin lispro and insulin lispro protamine is taken before meals, you might not have a set dosing schedule. Whenever you take the medicine, make sure to eat a meal within 15 minutes. Do not take two doses at the same time.

Always keep insulin nearby. Get your prescription refilled before you run out of medicine completely.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222. An insulin overdose can lead to serious low blood sugar (hypoglycemia). Symptoms may include feeling very sleepy, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, unsteady or jerky movements, seizures (convulsions), or passing out.

Insulin can make your blood sugar low. Do not drive or operate machinery until you understand how this medicine affects you.

Prevent medication mistakes by always checking the medicine label before injecting your insulin.

Do not drink alcohol. It can cause low blood sugar and may disrupt your diabetes treatment.

Many other medicines can change your blood sugar levels, and some can make insulin work stronger or weaker. Some drugs can also reduce the symptoms of low blood sugar, making it harder to notice when your blood sugar is low. Inform all your health care providers about every medicine you are currently taking and any new medicine you begin or stop. This includes prescription and over-the-counter medicines, vitamins, and herbal products.