Humalog Dosage/Direction for Use

Posology: The dose should be determined by the physician, according to the requirement of the patient.
Humalog may be given shortly before meals. When necessary Humalog can be given soon after meals.
Humalog preparations should be given by subcutaneous injection or by continuous subcutaneous infusion pump (see Dosage & Administration) and may, although not recommended, also be given by intramuscular injection.
Humalog takes effect rapidly and has a shorter duration of activity (2 to 5 hours) given subcutaneously as compared with soluble insulin. This rapid onset of activity allows a Humalog injection (or, in the case of administration by continuous subcutaneous infusion, a Humalog bolus) to be given very close to mealtime. The time course of action of any insulin may vary considerably in different individuals or at different times in the same individual. The faster onset of action compared to soluble human insulin is maintained regardless of injection site. As with all insulin preparations, the duration of action of Humalog is dependent on dose, site of injection, blood supply, temperature, and physical activity.
Humalog can be used in conjunction with a longer-acting insulin or oral sulphonylurea agents, on the advice of a physician.
Special populations: Renal impairment: Insulin requirements may be reduced in the presence of renal impairment.
Hepatic impairment: Insulin requirements may be reduced in patients with hepatic impairment due to reduced capacity for gluconeogenesis and reduced insulin breakdown; however, in patients with chronic hepatic impairment, an increase in insulin resistance may lead to increased insulin requirements.
Paediatric population: Humalog can be used in adolescents and children (see Pharmacology: Pharmacodynamics under Actions).
How to use Humalog KwikPen: Always use Humalog KwikPen exactly as prescribed. Advise the patient to check with a doctor if not sure. To prevent the possible transmission of disease, each pen must be used only by the patient, even if the needle is changed.
Dose: Humalog are normally injected within 15 minutes of a meal. It can be injected soon after a meal, if necessary. The doctor will inform exactly how much to use, when to use it, and how often. These instructions are for each individual patient only. The patient should follow them exactly and visit diabetes clinic regularly.
In changing the type of insulin used (for example from a human or animal insulin to a Humalog product), the patient may have to take more or less than before. This might just be for the first injection or it may be a gradual change over several weeks or months.
Humalog KwikPen is only suitable for injecting just under the skin. Advise the patient to speak to a doctor if there's a need to inject insulin by another method.
If the patient forgets to use Humalog: If the patient takes less Humalog than needed or is unsure how much he/she has injected, a high blood sugar may occur. The blood sugar must be checked.
If hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar) is not treated, they can be very serious and cause headaches, nausea, vomiting, dehydration, unconsciousness, coma or even death (see Side Effects).
Three simple ways to avoid hypoglycaemia or hyperglycaemia are: Always keep spare syringes and a spare vial of Humalog, or a spare pen and cartridges, in case the KwikPen is lost or gets damaged.
Diabetics should always carry something to identify their condition.
Sugar must be always on hand.
If the patient stops using Humalog: If the patients takes less Humalog than needed, a high blood sugar may occur. Do not change insulin unless prescribed.
If any further questions may have arise on the use of Humalog KwikPen, patients must be advised by a doctor or pharmacist.
Method of administration: Subcutaneous use.
Humalog preparations should be given by subcutaneous injection.
Subcutaneous administration should be in the upper arms, thighs, buttocks, or abdomen. Use of injection sites should be rotated so that the same site is not used more than approximately once a month, in order to reduce risk of lipodystrophy and cutaneous amyloidosis (see Precautions and Adverse Reactions).
When administered subcutaneously care should be taken when injecting Humalog to ensure that a blood vessel has not been entered. After injection, the site of injection should not be massaged. Patients must be educated to use the proper injection techniques.
Use of Humalog in an insulin infusion pump: For subcutaneous injection of Humalog using a continuous infusion pump, patient may fill the pump reservoir from a Humalog 100 units/ml vial. Some pumps are compatible with cartridges that can be inserted intact into the pump.
Only certain CE-marked insulin infusion pumps may be used to infuse insulin lispro. Before infusing insulin lispro, the manufacturer's instructions should be studied to ascertain the suitability for the particular pump. Use the correct reservoir and catheter for the pump. When filling the pump reservoir avoid damaging it by using the correct needle length on the filling system. The infusion set (tubing and cannula) should be changed in accordance with the instructions in the product information supplied with the infusion set. In the event of a hypoglycaemic episode, the infusion should be stopped until the episode is resolved. If repeated or severe low blood glucose levels occur, notify a health care professional and consider the need to reduce or stop an insulin infusion. A pump malfunction or obstruction of the infusion set can result in a rapid rise in glucose levels. If an interruption to insulin flow is suspected, follow the instructions in the pump product literature. When used with an insulin infusion pump, Humalog should not be mixed with any other insulin.
Intravenous administration of insulin: If necessary, Humalog may also be administered intravenously, for example; for the control of blood glucose levels during ketoacidosis, acute illnesses or during intra and post operative periods.
Humalog 100 units/ml is available in vials if administration of intravenous injection is necessary.
Intravenous injection of insulin lispro should be carried out following normal clinical practise for intravenous injections, for example by an intravenous bolus or by an infusion system. Frequent monitoring of the blood glucose levels is required.
Infusion systems at concentrations from 0.1 units/ml to 1.0 units/ml insulin lispro in 0.9% sodium chloride or 5% dextrose are stable at room temperature for 48 hours. It is recommended that the system is primed before starting the infusion to the patient.