Insulin lispro
Insulin lispro: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Drug interactions
- 14. Analogs
- 15. Terms and conditions of storage
- 16. Terms of dispensing from pharmacies
- 17. Reviews
- 18. Price in pharmacies
Latin name: Insulin lispro
ATX code: A10AD04
Active ingredient: insulin lispro (Insulin lispro)
Producer: Gan & Lee Pharmaceuticals (China)
Description and photo update: 2019-11-07
Insulin lispro is a hypoglycemic drug, short-acting insulin.
Release form and composition
The drug is available in the form of a solution for intravenous (i / v) and subcutaneous (s / c) administration: transparent liquid without color (3 ml each in colorless glass transparent cartridges, sealed on one side with a bromobutyl rubber stopper and crimped with an aluminum cap, on the other sides - bromobutyl plunger; in blister packs 1 or 5 cartridges, in a cardboard box 1 package; 10 ml each in colorless glass transparent bottles, in a cardboard box 1 bottle and instructions for use of Insulin Lispro).
1 ml of solution contains:
- active substance: insulin lispro - 100 ME (International Units), which corresponds to 3.47 mg;
- auxiliary components: glycerol, sodium phosphate (disubstituted), metacresol, zinc oxide, sodium hydroxide, hydrochloric acid, water for injection.
Pharmacological properties
Pharmacodynamics
Insulin lispro is a hypoglycemic drug belonging to the group of short-acting insulin. Its active ingredient is insulin lispro, a recombinant analog of deoxyribonucleic acid (DNA) of human insulin, which differs from it by the rearrangement of amino acids at positions 28 and 29 in the B-chain of the insulin molecule.
In addition to regulating glucose metabolism, insulin lispro has an anabolic and anti-catabolic effect on body tissues. In muscle fibers, it contributes to an increase in the content of glycogen, glycerol and fatty acids, an increase in the consumption of amino acids, and an increase in protein synthesis. At the same time, inhibition of the processes of glycogenolysis, ketogenesis, gluconeogenesis, lipolysis, release of amino acids, protein catabolism occurs.
Insulin lispro and human insulin are equimolar, but the former has a faster onset and a shorter duration of action. Due to the high absorption rate, the hypoglycemic effect of insulin lispro manifests itself in 1/4 hour after administration, which allows the drug to be used immediately before meals.
The duration of action of the drug is from 2 to 5 hours. It can vary both in different patients and in one patient at different periods of time. The change in the period of action is influenced by the dose, the place of administration of the solution, body temperature, blood supply and physical activity of the patient.
Compared with soluble human insulin, the use of insulin lispro allows to reduce the frequency of episodes of nocturnal hypoglycemia, to more significantly reduce the hyperglycemia that occurs in patients with type 1 and 2 diabetes mellitus after meals.
In adults, children and adolescents, similar pharmacodynamics of insulin lispro are observed.
The glucodynamic response to insulin lispro does not depend on the patient's renal or liver function.
Pharmacokinetics
After subcutaneous administration, insulin lispro is absorbed quickly. The time to reach the maximum concentration (T Cmax) in the blood plasma varies from 1/2 hour to 1 hour 10 minutes.
The half-life (T 1/2) for subcutaneous administration is approximately 1 hour.
In renal failure, the rate of absorption of insulin lispro is higher than that of soluble human insulin. In patients with type 2 diabetes mellitus, the differences in the pharmacokinetic parameters of insulin lispro and soluble human insulin do not depend on renal function.
In liver failure insulin lispro has a higher rate of absorption and excretion compared to soluble human insulin.
Indications for use
The use of Insulin lispro is indicated for the treatment of the following types of diabetes mellitus in adults and children:
- insulin-dependent (type 1 diabetes mellitus): including patients with intolerance to other insulin drugs, with the development of postprandial (after meals) hyperglycemia that cannot be corrected by other insulin preparations, acute subcutaneous insulin resistance (accelerated local insulin degradation);
- non-insulin dependent (type 2 diabetes mellitus): in case of immunity to oral hypoglycemic agents, as well as impaired absorption of other insulin drugs, during surgery, intercurrent diseases, uncorrected postprandial hyperglycemia.
Contraindications
Absolute:
- hypoglycemia;
- hypersensitivity to the components of the drug.
Insulin lispro should be used with caution during pregnancy and lactation.
Insulin lispro, instructions for use: method and dosage
Insulin lispro solution is intended for subcutaneous and intravenous administration. Injections are carried out no earlier than 15 minutes before meals or immediately after meals.
The drug can be administered under the skin as a bolus or as a prolonged subcutaneous injection using an insulin pump.
The introduction of insulin lispro into a vein is indicated for ketoacidosis, acute diseases, in the period between operations or after surgery.
The temperature of the injected solution should be at room temperature.
Before administration, the contents of the cartridge or vial should be visually assessed for suitability. The liquid should be clear and colorless. If it turns out to be cloudy, thickened, weakly colored, or foreign particles are found in it, the solution must be disposed of.
The doctor determines the dose and mode of administration of Insulin Lispro individually, depending on the concentration of glucose in the blood.
Subcutaneous injection using a syringe pen
S / C Insulin Lispro can be injected into the subcutaneous tissue of the abdomen, shoulder, thigh or buttocks, avoiding the solution entering the blood vessel. The injection sites should be regularly rotated, avoiding the use of the same site more often than 1 time per month. After the injection, do not massage the injection site.
The cartridges must be used with EndoPen syringe pens manufactured by Beijing Gangan Technology Co. Ltd. (China), since the dosing accuracy is set exclusively for the specified syringe pens.
When prescribing the drug, the doctor must teach the patient the technique of self-administered subcutaneous injection, and make sure that the patient is correctly injected with insulin and the ability to use a syringe pen.
The cartridge must be installed in a syringe pen and injected in strict accordance with the manufacturer's manual for the syringe pen.
Step-by-step instructions for administering a dose of Insulin lispro:
- Wash hands thoroughly.
- Choose an injection site.
- Prepare the skin at the injection site as recommended by your doctor.
- Remove the outer protective cap from the needle.
- Fix the skin.
- Insert the needle under the skin, inject in accordance with the instructions for the syringe pen.
- Remove the needle, gently press the injection site with a cotton swab for a few seconds; do not rub the injection site.
- Unscrew the needle with the outer protective cap and dispose of it.
- Put the cap on the pen syringe.
Subcutaneous injection through an insulin pump
Your insulin pump can be used with a CE marked subcutaneous insulin system. Before each injection, you must ensure the suitability of a particular pump and strictly follow all the requirements of the instructions for its operation. Use the correct reservoir and pump catheter, and change your insulin set regularly. In a hypoglycemic episode, drug administration should be discontinued until the episode resolves. If a very low blood glucose concentration is found, you should immediately consult a doctor. It is necessary to provide for dose reduction or discontinuation of insulin lispro.
A disruption in the supply of solution caused by a blockage in the delivery system or a malfunctioning insulin pump can cause the patient to rapidly rise in glucose concentration. Therefore, at the slightest suspicion of any violations in the system, it is necessary to follow the instructions and inform the doctor if necessary.
Do not mix Insulin Lispro with other insulins when using the pump.
Intravenous injection
IV insulin can be administered as a bolus or drip, accompanied by frequent monitoring of blood glucose concentration.
For infusion administration, insulin lispro can be dissolved in 5% dextrose solution or 0.9% sodium chloride solution. When the concentration of insulin in the infusion solution is in the range of 0.1–1 IU per 1 ml, the finished solution remains stable for 48 hours at room temperature.
Side effects
- on the part of metabolism and nutrition: often - hypoglycemia [including severe cases of hypoglycemia with loss of consciousness (hypoglycemic coma) and death];
- from the immune system: allergic reactions at the injection site (redness, swelling or itching); rarely - generalized allergic reactions (including fever, increased sweating, shortness of breath, pruritus, urticaria, angioedema, low blood pressure, tachycardia), including life-threatening;
- local reactions: lipodystrophy;
- others: the development of edema is possible (more often after a very rapid normalization of glycemia against the background of intensive therapy for unsatisfactory initial glycemic control).
Overdose
An overdose is accompanied by the following symptoms characteristic of the development of hypoglycemia: hunger, lethargy, headache, increased sweating, dizziness, tachycardia, vomiting, tremors, confusion.
To relieve mild hypoglycemic episodes, you must immediately take 20 g of glucose orally by eating a sugar cube or a sugar-containing product. Patients with diabetes mellitus are advised to always have a few cubes of refined sugar with them.
In moderately severe hypoglycemia or coma, SC or intramuscular administration of glucagon is indicated. If there is no reaction to glucagon, the patient is injected with an intravenous dextrose (glucose) solution. After stabilizing the condition (or restoring the patient's consciousness), he needs to take a diet rich in carbohydrates. Careful monitoring of the patient's blood glucose concentration and continued intake of carbohydrates is required due to the high risk of recurrence of hypoglycemia.
special instructions
You should switch to another drug or type of insulin only on the recommendation and under the strict supervision of a doctor. The need to change the dose may arise when the manufacturer (brand name), the patient's activity, the type and species of insulin (human, human or animal), and / or the method of its production change.
When switching from insulin of animal origin to human insulin, patients with hypoglycemic reactions should be informed about the possible change in those early symptoms of hypoglycemia that occurred during treatment with the previous drug. It should be borne in mind that after injection of a human insulin analogue of rapid action, hypoglycemia can develop much earlier than after the use of soluble human insulin.
In the case of the simultaneous use of short-acting and basal insulin, a very careful selection of the dose of each of the drugs is required, which would ensure the maintenance of the optimal concentration of glucose in the blood during the day, especially on an empty stomach and at night.
Patients should be informed about a possible change in the symptoms of hypoglycemic precursors, about a decrease in their severity with a long course of diabetes mellitus and diabetic neuropathy, as well as with concomitant therapy with other drugs, including beta-blockers. The consequence of uncorrected hypo- or hyperglycemic reactions in time can be loss of consciousness, coma or death.
The cause of hyperglycemia or diabetic ketoacidosis is more often the use of inadequate doses of insulin or discontinuation of treatment, especially in patients with type 1 diabetes mellitus.
Correction of the dose of Insulin Lispro should be made taking into account changes in diet and increased physical activity.
An increase in the need for insulin can be observed in case of certain diseases or stresses that cause emotional stress in the patient.
The simultaneous use of other drugs in addition to insulin is indicated only as directed by a doctor.
The pen and cartridge are intended for use by one patient only. It should be borne in mind that replacing the needle does not exclude the transmission of an infectious disease.
Influence on the ability to drive vehicles and complex mechanisms
During the period of use of Insulin Lispro when driving vehicles or working with complex mechanisms, it is necessary to take into account the possible violation of the speed of psychomotor reactions and the ability to concentrate during the development of hypo- or hyperglycemia due to inadequate dosing regimen. Particular care is recommended to be observed in patients with frequent episodes of hypoglycemia, with a reduced sensation of symptoms, precursors of hypoglycemia, or their absence. It is necessary to conduct an individual assessment of the appropriateness of driving.
Application during pregnancy and lactation
The use of Insulin Lispro during gestation contributes to the maintenance of good glycemic control in patients with diabetes mellitus treated with insulin, and does not have an undesirable effect both on the course of pregnancy and childbirth, and on the condition of the fetus and newborn.
Caution is advised due to changes in glycemia at different stages of pregnancy. In the first trimester, a decrease is usually observed, and in the second and third trimesters - an increase in insulin requirements. In addition, during delivery and immediately after childbirth, a sharp decrease in insulin requirements is possible.
When planning or getting pregnant, women with diabetes should seek medical advice.
During the period of breastfeeding, correction of the insulin dosing regimen should be made taking into account changes in the mother's diet.
Pediatric use
In children, it is preferable to switch from the use of soluble human insulin to Insulin lispro only when it is necessary to quickly start the action of insulin.
With impaired renal function
In patients with renal insufficiency, the need for insulin may decrease.
For violations of liver function
In patients with hepatic impairment, the need for insulin may decrease. At the same time, one should take into account its increase in chronic hepatic insufficiency, due to a decrease in insulin sensitivity.
Drug interactions
With the simultaneous use of Insulin lispro:
- glucocorticosteroids, beta2-adrenergic agonists (including ritodrin, terbutaline, salbutamol), tricyclic antidepressants, thiazide diuretics, oral contraceptives, chlorprothixene, iodine-containing thyroid hormones, isoniazid, diazoxide, danazine derivatives, lithium drugs decrease in the severity of the hypoglycemic effect of the drug;
- oral hypoglycemic drugs, beta-blockers, anabolic steroids, guanethidine, tetracyclines, salicylates (including acetylsalicylic acid), sulfonamide antibiotics, antidepressants (monoamine oxidase inhibitors), angiotensin-converting enzyme inhibitors, capitol ethanol-containing drugs): against the background of concomitant therapy with the listed drugs, the hypoglycemic activity of insulin lispro increases;
- thiazolidinediones: Increase the risk of edema and chronic heart failure, especially in the presence of risk factors for chronic heart failure and cardiovascular disease.
Analogs
An analogue of Insulin lispro is Humalog.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures between 2 and 8 ° C, keep away from freezing.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Insulin lispro
On specialized sites today there are no reviews about Insulin lispro from patients and their relatives.
Experts recommend using a fast-acting insulin analogue subcutaneously, insulin lispro, in the case of a life-threatening diabetic coma resulting from uncontrolled diabetes (diabetic ketoacidosis), instead of standard therapy (rapid intravenous administration of regular insulin). Because it then acts faster than normal human insulin and avoids the continuous IV infusion of the solution, which usually requires hospitalization of the patient in an intensive care unit.
The price of Insulin Lispro in pharmacies
The price of Insulin Lispro for a package containing 1 cartridge with a solution can be from 252 rubles, 5 cartridges - from 1262 rubles, 1 bottle (10 ml) - from 841 rubles.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
