Insulin Lispro (25%/50%) + Insulin Lispro Protamine (75%/50%) mix

Indications

Insulin Lispro (25%/50%) + Insulin Lispro Protamine (75%/50%) mix is used for: Diabetes mellitus

Adult Dose

Subcutaneous Diabetes Mellitus Combination rapid-onset (faster than regular insulin) and intermediate-acting insulins in fixed dose Dose regimen varies among patients depending on metabolic needs; typical daily insulin requirements range between 0.5-1 unit/kg Initially, 10 units with the largest meal of the day, dose adjustments may be made on a wkly basis according to blood glucose levels. Dose should not be increased if there is hypoglycaemic episode (<70 mg/dl) during a 3-day period.

Child Dose

Safety and efficacy not established

Renal Dose

Renal impairment: Dose adjustments may be required.

Administration

Administer SC BID (ie, before breakfast and evening meal); each dose intended to cover 2 meals or a meal and snack Inject SC into abdominal wall, thigh, or upper arm

Contra Indications

Hypoglycaemia. Hypersensitivity to any of the components.

Precautions

Renal or hepatic impairment; pregnancy, lactation; transferring from other insulin. Monitor serum glucose, potassium, electrolytes, HbA1c and lipid profile. Concomitant illness esp infections. Lactation: Unknown whether distributed in breast milk; compatible with breast feeding, but lactating women may require dosage adjustment; caution advised

Pregnancy-Lactation

Interactions

Effects may be increased by: oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, propoxyphene, salicylates, somatostatin analog (e.g., octreotide), sulfonamide antibiotics. Effects may be decreased by: corticosteroids, niacin, danazol, diuretics, sympathomimetic agents, isoniazid, phenothiazine derivatives, somatropin, thyroid hormones, oral contraceptives, lithium. Signs of hypoglycaemia may be masked by beta-blockers, clonidine.

Adverse Effects

Side effects of Insulin Lispro (25%/50%) + Insulin Lispro Protamine (75%/50%) mix : Hypoglycaemia; hypokalemia, oedema; pruritus; pulpitation, nausea, rash; hypersensitivity reactions; lipoatropy or lipohypertrophy with SC Inj.

Mechanism of Action

Insulin lispro is a short-acting biosynthetic human insulin analogue. Insulin lispro protamine is an intermediate-acting glucose-lowering agent; it is a suspension of crystals produced from combining insulin lispro and protamine sulfate under appropriate conditions for crystal formation. They are used together for the regulation of glucose metabolism.