Humalog Mix 50/50 Kwik Pen

✔️ Uses of Humalog Mix 50/50 Kwik Pen

• Treats diabetes mellitus (both type I and type II)

✔️ How does Humalog Mix 50/50 Kwik Pen work?

Humalog Mix 50/50 Kwik Pen aids your body's use of circulating blood glucose. It aids in the transportation of glucose from the bloodstream to the muscles and fat tissues. It also prevents the liver from producing glucose. As a result, it regulates blood sugar levels and improves glycemic control in people with diabetes.

✔️ Side Effects of Humalog Mix 50/50 Kwik Pen

• Low blood sugar (Hypoglycaemia)
• Lightheadedness
• Dizziness
• Anxiety
• Nervousness
• Lipodystrophy (shrinkage of fat tissues beneath the skin)
• Lumps under the skin
• Weight gain, swelling of body parts
• Hypoglycemia (Low blood sugar levels)
• Tiredness
• Feeling hungry
• Visual disturbances
• Headache
• Shaking
• Sweating
• Pale skin
• Problem in vision
• Painful neuropathy (pain caused by nerve damage)
• Skin rashes
• Pain, redness, and swelling at the injection site.

✔️ Quick Suggestions:

• Take it 15 minutes before a meal or within 20 minutes after starting a meal.
• Injection below the skin of the abdomen results in faster absorption as compared to other injection sites such as the skin of the upper arms, thighs, or buttocks. After injection, the site of injection should not be massaged.
• Injection sites must be rotated to prevent hard lumps from developing at one site.
• Consume short, frequent meals and avoid prolonged fasting.
• Be aware of symptoms of hypoglycemia, such as sweating, dizziness, palpitations, shivering, intense thirst, dry mouth, dry skin, and frequent urination. If these symptoms occur, immediately consume 5-6 candies, three glucose biscuits, or three teaspoons of honey/sugar, and contact your physician. Keep these items with you, especially during long travels.
• Avoid consuming alcohol, as it increases the risk of hypoglycemia (low blood sugar) and lactic acidosis (a condition where lactic acid accumulates in the body, affecting various organs).
• Consider quitting smoking.
• Limit your intake of carbohydrate-rich foods such as potatoes, rice, mangoes, bread, and sugar.
• Avoid eating sugary foods and opt for low-calorie options.
• If traveling across more than two time zones, consult your doctor for potential adjustments to your insulin schedule.
• Change to another type or brand of insulin should be done under strict medical supervision as it may require a change in dosage.
• Hypoglycemia (low blood sugar level) may occur when taken along with other antidiabetic medicines, alcohol, or by delaying/skipping a meal. Carry a sugar source with you for immediate relief.
• Do not share your insulin device with other people, even if the needle has been changed. You may give other people a serious infection or get a serious infection from them.
• Opened vials/cartridges stay good at room temperature for up to 4 weeks, while unopened vials must be placed in the refrigerator (2°C–8°C).

✔️ Indication

A combination of insulin-lispro-protamine suspension and insulin-lispro injection (rDNA origin) is used in the treatment of diabetes mellitus to manage high blood sugar levels (hyperglycemia).

One formulation consists of a mixture containing 75% insulin-lispro-protamine suspension and 25% insulin-lispro injection (rDNA origin). This combination provides a specific ratio of insulin-lispro-protamine, which has an intermediate duration of action, and insulin-lispro, which acts rapidly. By using this mixture, it helps regulate blood sugar levels effectively in individuals with diabetes.

Another formulation consists of a mixture containing equal parts (50% each) of insulin-lispro-protamine suspension and insulin-lispro injection (rDNA origin). This combination also provides a balanced ratio of insulin-lispro-protamine and insulin-lispro to achieve optimal blood sugar control in people with diabetes.

Both formulations are aimed at managing hyperglycemia and are prescribed based on individual patient needs and medical advice. It is important to follow the recommended dosing instructions and guidelines provided by your healthcare professional when using these mixtures to ensure effective diabetes management.

✔️ Pharmacology

Insulin lispro is a synthesized human insulin analog with a short half-life. Insulin-lispro-protamine is an intermediate-acting hypoglycemic medication; it is a crystal suspension formed by mixing insulin lispro and protamine sulfate under crystal-forming conditions. They work cooperatively to control glucose metabolism.

✔️ Dosage & Administration of Humalog Mix 50/50 Kwik Pen

Dosage recommendations for insulin lispro vary based on the specific condition and patient population. Here is a paraphrased summary of the dosing information for different groups:

Adult Dose:

• Type 1 diabetes mellitus: Typically, one-third of the total daily insulin requirements are given subcutaneously (SC). The remaining daily insulin requirements are met with rapid-acting or short-acting premeal insulin. The usual daily maintenance range is 0.5-1 unit/kg/day, divided into multiple doses. Nonobese individuals may require 0.4-0.6 unit/kg/day, while obese individuals may require 0.8-1.2 units/kg/day.
• Type 2 diabetes mellitus inadequately controlled with oral medication: For adults, the usual range is 0.5-1 unit/kg/day given subcutaneously. Rapid-acting formulations like insulin lispro are typically administered before meals, along with an intermediate- or long-acting insulin dose of 10 units/day (or 0.1-0.2 unit/kg/day) given at bedtime.

Continuous Subcutaneous Infusion (Insulin Pump):

• Insulin pump therapy can be used for continuous subcutaneous infusion. However, diluted or mixed insulins should not be used in external insulin pumps. Rotation of infusion sites within the same region is recommended to reduce the risk of lipodystrophy. It's important to note that Insulin Lispro U-200 is not recommended for use with insulin pumps; only Insulin Lispro U-100 should be used.

Intravenous Administration:

• Intravenous administration of Insulin Lispro U-100 should only be done under medical supervision and with close monitoring of blood glucose and potassium levels. The insulin should be diluted with 0.9% sodium chloride in concentrations ranging from 0.1 unit/mL to 1.0 unit/mL. This route of administration requires careful monitoring to avoid hypoglycemia and hypokalemia.

Child Dose:

• Type 1 Diabetes Mellitus: In children over 3 years of age, the usual dosing range is 0.8-1.2 units/kg/day subcutaneously during growth spurts. Otherwise, the adult dosing range of 0.5-1 unit/kg/day is used. Safety and efficacy of insulin lispro in children under 3 years of age have not been established.

Renal Dose:

• Dose reduction may be necessary in patients with renal impairment. Individualized dosing and close monitoring are important in such cases.

It is crucial to consult with a healthcare professional for personalized dosing instructions, as insulin requirements can vary based on individual factors, including stress, illness, exercise, meal patterns, and concurrent medication use. Regular blood glucose monitoring is essential for all patients receiving insulin therapy.

✔️ Administration of Humalog Mix 50/50 Kwik Pen

• Administer this medication subcutaneously (into the fatty tissue just under the skin) in the thighs, buttocks, upper arm, or abdomen. Do not inject it directly into a vein or muscle.
• Inject the medication at least 10 minutes before meals.
• To avoid low blood sugar, eat a meal or snack containing carbohydrates within 20 minutes of the injection.
• Before administration, gently roll the vial or cartridge between your hands until the liquid becomes uniformly white and cloudy.
• While injecting, ensure that the needle remains under the skin for at least 6 seconds to ensure the full dose is delivered.
• Before use, visually inspect the vial or cartridge for any visible particulate matter or discoloration. If present, do not use the medication.
• After use, discard the needle and syringe. Do not share needles with others to prevent the risk of infection transmission.
• Rotate the injection sites to avoid skin damage. Avoid injecting repeatedly in the same area. Consult your doctor before changing the injection site.
• Do not mix Humalog Mix 50 injection with any other insulins before use.
• Do not stop therapy with Humalog Mix 50 injection without consulting your doctor. The correct dose and frequency of administration will be determined by your doctor based on factors such as your age, body weight, and health condition.

✔️ Interaction

Humalog Mix 50 Kwikpen 100IU/ml may interact with several medications and have potential drug-food and drug-disease interactions. Here is a paraphrased summary of the interactions:

Drug Interactions:

• Antidiabetic medications (e.g., pioglitazone), thyroid hormones (e.g., levothyroxine), blood pressure-lowering medications (e.g., metoprolol, hydrochlorothiazide, irbesartan, candesartan), bronchodilators (e.g., metaproterenol), pain killers (e.g., aspirin), and antidepressant medications (e.g., sertraline) may interact with Humalog Mix 50 Kwikpen 100IU/ml. It's important to inform your doctor about all the medications you are taking to identify and manage any potential interactions.

Drug-Food Interactions:

• Alcoholic beverages should be avoided while using Humalog Mix 50 Kwikpen 100IU/ml, as they can affect blood sugar levels, potentially increasing or decreasing them.

Drug-Disease Interactions:

• Prior to taking Humalog Mix 50 Kwikpen 100IU/ml, inform your doctor if you have or have had kidney disease, hepatic impairment or liver disease, hypoglycemia (low blood sugar), or hypokalemia (low potassium levels). These conditions may require special precautions or adjustments to your treatment plan.

✔️ Contraindications

Insulin Lispro Protamine & Insulin Lispro is contraindicated in patients who are hypersensitive to insulin lispro or any of the excipients in the formulation, as well as during bouts of hypoglycemia.

✔️ Pregnancy & Lactation

Pregnancy Classification B. There are no appropriate and well-controlled studies in pregnant women OR animal reproduction research that have failed to indicate harm to the fetus. Although animal research has revealed a negative effect, adequate and well-controlled investigations in pregnant humans have found no risk to the fetus in any trimester.

Lactation: It is unknown whether this substance is dispersed in breast milk; it is compatible with breastfeeding, although lactating women may need to adjust their dosage; caution is advised.

✔️ Precautions & Warnings

• If you have any allergies to the components of Humalog Mix 50 Kwikpen 100IU/ml, it is important to inform your doctor.
• This medication is not approved for use in individuals under the age of 18. Prior to taking Humalog Mix 50 Kwikpen 100IU/ml, it is important to inform your doctor if you have a history of liver or kidney disease, as well as low potassium levels (hypokalemia) in your blood.
• If you are pregnant or breastfeeding, consult your doctor before using this medication.
• When using Humalog Mix 50 Kwikpen 100IU/ml, exercise caution while driving and ensure that you are alert, as it may cause hypoglycemia.
• Alcohol consumption should be avoided while using this medication. Regular potassium level tests may be recommended by your doctor while using Humalog Mix 50 Kwikpen 100IU/ml, as it can potentially cause hypokalemia (low potassium levels).
• It is important to adhere to the recommended timing for injecting Humalog Mix 50 Kwikpen 100IU/ml, which is typically within 15 minutes of a meal.
• Additionally, always ensure you use a new sterile needle for each injection to maintain proper hygiene and prevent the risk of infection.
• Remember that Humalog Mix 50 Kwikpen 100IU/ml is a cold chain medicine and should be stored in the refrigerator between 2-8°C to maintain its effectiveness.
• Do not freeze it. It is important to keep your doctor informed about your health condition and any other medications you are taking to monitor for potential side effects.

✔️ Storage Conditions

• Keep out of reach of children
• Store the unopened pack in the refrigerator at 2-8°C. Do not freeze
• During use or when carried as a spare, keep it at room temperature
• Always place the vial/cartridge in the outer carton to protect it from light