Insulin Lispro

Insulin lispro is a prescription medication used to treat type 1 diabetes. It can also be used to treat some patients with type 2 diabetes.

Insulin lispro is a fast-acting form of insulin and is often used with other forms of insulin. Insulin lispro is administered with meals.

Insulin is naturally produced by the body to control the amount of sugar (glucose) in the blood. In patients with type 1 diabetes, the body does not make insulin and must be replaced by injections of insulin. In patients with type 2 diabetes, the body makes insulin but does not use it efficiently or appropriately.

This medication comes in an injectable form available in vials and prefilled pens. Insulin lispro should be injected just under the skin 15 minutes before a meal or immediately after a meal. It may also be injected by an insulin pump or directly into a vein (IV) by a healthcare provider.

Common side effects of insulin lispro include redness, swelling, or itching in the place where you injected insulin lispro or changes in the feel of your skin such as skin thickening or a little indentation in the skin.

Insulin lispro can also cause low blood sugar, which can cause drowsiness and dizziness. Do not drive or operate heavy machinery until you know how insulin lispro affects you.

Insulin lispro is a prescription medication used to treat type 1 diabetes. It can also be used to treat some patients with type 2 diabetes. It is a fast-acting form of insulin.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Insulin Lispro may be found in some form under the following brand names:

• Admelog

• Humalog

• Humalog Mix

• Lispro PRC

Serious side effects have been reported with insulin lispro. See the “Insulin Lispro Precautions” section.

Common side effects of insulin lispro include the following:

• hypoglycemia (low blood sugar)
• allergic reactions
• injection site reactions
• changes in the feel of your skin such as skin thickening or a little indentation in the skin (lipodystrophy)
• itching
• rash

This is not a complete list of insulin lispro side effects. Ask your doctor or pharmacist for more information.

Tell your doctor if you have any side effect that bothers you or that does not go away.

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

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril, (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)
• angiotensin receptor blockers such as azilsartan (Edarbi), candesartan (Atacand, in Atacand HCT), eprosartan (Teveten, in Teveten HCT), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, Benicar HCT), telmisartan (Micardis, in Micardis HCT), and valsartan (Diovan, in Diovan HCT, Exforge)
• atypical antipsychotics such as risperidone, olanzapine, quetiapine, aripiprazole, lurasidone, paliperidone
• beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
• certain cholesterol-lowering medications such as fenofibrate (Antara, Lofibra, TriCor, Triglide), gemfibrozil (Lopid), and niacin (Niacor, Niaspan, in Advicor); certain medications for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) including atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), saquinavir (Invirase), and tipranavir (Aptivus)
• clonidine (Catapres, in Clorpres)
• danazol
• digoxin (Digitek, Lanoxin)
• disopyramide (Norpace)
• diuretics ('water pills')
• fluoxetine (Prozac, Sarafem, in Symbyax)
• hormone replacement therapy
• isoniazid (INH, Nydrazid)
• lithium (Eskalith, Lithobid)
• medications for asthma and colds
• medications for mental illness and nausea
• monoamine oxidase inhibitors including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl) and tranylcypromine (Parnate)
• octreotide (Sandostatin)
• oral contraceptives (birth control pills)
• oral medications for diabetes such as pioglitazone (Actos, in Actoplus Met and others) and rosiglitazone (Avandia, in Avandamet and others)
• oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone)
• pentamidine (NebuPent, Pentam)
• pentoxifylline (Trental)
• phenothiazine derivatives such as prochlorperazine, chlorpromazine, fluphenazine, perphenazine, trifluoperazine, and thioridazine
• pramlintide (Symlin)
• propoxyphene
• reserpine
• salicylate pain relievers such as aspirin, choline magnesium trisalicylate (Trisalate), choline salicylate (Arthropan), diflunisal (Dolobid), magnesium salicylate (Doan's, others), and salsalate (Argesic, Disalcid, Salgesic)
• somatropin (Nutropin, Serostim, others)
• sulfa antibiotics
• thyroid medications

This is not a complete list of insulin lispro drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with insulin lispro including the following:

• Low blood sugar (hypoglycemia). Low blood sugar can occur with changes in insulin regimens or dose miscalculations. Monitor blood glucose levels regularly. Signs and symptoms of low blood sugar include:
  • sweating
  • dizziness or lightheadedness
  • shakiness
  • hunger
  • fast heart beat
  • tingling of lips and tongue
  • trouble concentrating or confusion
  • blurred vision
  • slurred speech
  • anxiety, irritability or mood changes
  • headache
• Hypersensitivity (severe allergic reaction). Tell your healthcare provider about any signs or symptoms of hypersensitivity, including rash, chest pain, difficulty breathing or swallowing, or swelling of the face, eyes, lips, tongue, arms, or leg
• Low potassium in your blood (hypokalemia).
• Fluid retention and heart failure can occur with use of Admelog with thiazolidinediones (TZDs)
• Insulin lispro may also cause the following side effects. Tell your doctor right away if you experience any of the following signs and symptoms:
  • rash and itching
  • difficulty breathing
  • hives
  • wheezing
  • fast heartbeat
  • sweating
  • weakness
  • muscle cramps
  • abnormal heartbeat
  • shortness of breath
  • large weight gain in a short period of time
  • swelling of the arms, hands, feet, ankles, or lower legs

Insulin lispro can cause low blood sugar, which can cause dizziness and drowsiness. Do not drive or operate heavy machinery until you know how insulin lispro affects you.

While using this insulin avoid:

• Alcohol. Alcohol, including beer and wine, may affect your blood sugar when you inject this insulin.
• Driving and operating machinery. You may have difficulty concentrating or reacting if you have low blood sugar (hypoglycemia). Be careful when you drive a car or operate machinery.  

Do not take insulin lispro if you:

• are allergic to insulin lispro or to any of its ingredients
• have low blood sugar

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of insulin lispro, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking insulin lispro, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to insulin lispro or to any of its ingredients
• have kidney problems
• have liver problems
• have heart problems, including congestive heart failure
• have ever had nerve damage caused by diabetes
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X - are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Insulin lispro falls into category B. There are no well-done studies that have been done in humans with insulin lispro. In animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if insulin lispro crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using insulin lispro.

Inject insulin lispro exactly as prescribed.

Insulin lispro comes in injectable form and is taken with meals. Administer the dose of insulin lispro just under the surface of the skin within 15 minutes before a meal or immediately after a meal.

Change (rotate) your injection site within the chosen area (for example, stomach or upper arm) with each dose. Do not inject into the exact same spot as the last injection.

Do not inject insulin lispro if you do not plan to eat right after your injection or bolus pump infusion.

If you miss a dose and remember it before or shortly after your meal, inject the missed dose right away. If some time has passed since your meal, follow the instructions provided by your doctor or call your doctor to find out whether you should inject the missed dose. Do not inject a double dose to make up for a missed one.

Inject insulin lispro exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• other medical conditions you have
• other medications you are taking
• how you respond to this medication

The recommended starting dose of insulin lispro is based on the route of administration, a patient’s blood glucose goals, physical activity levels, meal patterns, and changes in kidney or liver function.

If you inject too much insulin lispro, your blood sugar may fall low (hypoglycemia). You can treat mild low blood sugar (hypoglycemia) by drinking or eating something sugary right away (fruit juice, sugar candies, or glucose tablets). It is important to treat low blood sugar (hypoglycemia) right away because it could get worse and you could pass out (become unconscious). Call your healthcare provider or local Poison Control Center or seek emergency medical attention right away if you inject too much insulin lispro.

If insulin lispro is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if an overdose is suspected, seek emergency medical attention.

• Do not reuse or share needles or syringes. 
• Store insulin lispro in a refrigerator (36° to 46°F [2° to 8°C]). Do not freeze.
• Some prefilled pens and administration devices can be stored at room temperature for up to 28 days. Throw away opened vials and prefilled pens after 28 days of use, even if there is insulin lispro left in the vial or prefilled pen. 
• Protect insulin lispro from exposure to heat and light.
• Keep this and all medicines out of the reach of children.