Pharmacy Diabetes

Insulin-Humalog Mix25-KPP

Name of Medicine
Insulin lispro solution [recombinant DNA origin]
  • Humalog Mix 25 – 25% insulin lispro and 75% insulin lispro protamine suspension (NPL).
  • [recombinant DNA origin] is a mixture of insulin lispro, a rapid-acting blood glucose lowering agent and insulin lispro protamine suspension, an intermediate-acting blood glucose lowering agent, adjusted to pH 7.0 to 7.8.
  • Humalog Mix25 is available as a white suspension for parenteral administration in a concentration of 100 units/mL in 3 mL cartridges and 3 mL prefilled insulin delivery device (Humalog Mix25 KwikPen).
Key Practice Points
Therapeutic Indications:
  • Treatment of type 2 diabetes where physical activity and dietary management has not resulted in adequate glycaemic targets.

For the most up to date PBS therapeutic indications for sitagliptin, please see
  • Rosiglitazone can be started at 4mg daily.
  • Dose can be increased to 8mg per day after 6-8 weeks.
  • Dose can be given as once or twice a day with or without food.
  • Renal insufficiency – No dose adjustment is required in individuals with any degrees of renal insufficiency.
  • Liver insufficiency – No dosage adjustment is required in individuals with mild hepatic impairment. However, it is not recommended in moderate to severe hepatic impairment.
  • No dose adjustment is required in the elderly.
  • Bone Fractures – An increased incidence of bone fracture was noted in females taking rosiglitazone. The risk is also associated with men although it is suggested it is not as great.
  • Eye Disorders – There is an increased risk of possibility of macular oedema.
  • Increased risk of cardiac failure when rosiglitazone was added to treatment regimens that contained insulin or sulfonylureas. (annual cycle of care-cardiac screening, Diabetes MedsCheck referral back to GP for screening)
  • Hypoglycaemia – Rosiglitazone in combination with insulin or oral hypoglycaemic agents that cause hypoglycaemia. may be at risk of increased low glucose levels ( ). Encourage blood glucose monitoring and referral to appropriate health care professional for further advise on hypoglycaemia treatment.
    Consider Diabetes MedsCheck
  • Oedema
  • Weight gain (Diabetes MedsCheck, increase knowledge of how weight gain is occurring and referral pathway for help with healthy eating plan)
  • Hypercholesterolemia (Diabetes MedsCheck, annual cycle of care, referral for cholesterol check, cholesterol monitoring in pharmacy)
  • Bone fractures (monitoring for calcium and strong bones in pharmacy, referral pathways back to GP)
  • Hypersensitivity to rosiglitazone or any active ingredient
  • Type 1 diabetes
  • Individuals under the age of 18 years
  • Pregnancy and lactation
  • With NYHA Class I to IV heart failure, or history of cardiac failure
  • Experiencing an Acute Coronary Syndrome (unstable angina, NSTEMI and STEMI)