Insulin-Formulation- Humalog

• For use in type 1 and type 2 diabetes mellitus.

For the latest PBS indications for Humalog please see
https://www.pbs.gov.au/pbs/search?term=humalog&analyse=false&search-type=medicines

• Humalog takes effect rapidly and has a shorter duration of activity (2 to 5 hours).
• Humalog can be given by subcutaneous injection. It may also be administered intravenously. In adults, Humalog, can be given immediately (up to 15 minutes before a meal). When necessary, Humalog can be given soon after meals (within 20 minutes of the start of the meal).
• In individuals with type 2 diabetes, Humalog may be administered in combination therapy with oral sulfonylurea agents.
• Subcutaneous administration should be in the abdomen or thighs. The injection sites should be rotated so that the same site is not used more than approximately once a month in order to reduce the risk of lipodystrophy and localised cutaneous amyloidosis. After injection, the site of injection should not be massaged. Note: Diabetes MedsCheck with referral to HCP for education on injection technique and managing hypoglycaemia.
• The shorter acting Humalog should be drawn into the syringe first, to prevent contamination of the vial by the longer acting insulin. Note: Diabetes MedsCheck with referral to healthcare team for education on injection technique and hypoglycaemia.
• Use in Renal Impairment: Humalog can be used in renal impairment. As with all insulins, glucose monitoring should be intensified, and dosage adjustment should occur on an individual basis.
• Use in Liver Impairment: Humalog can be used in hepatic impairment. As with all insulins, glucose monitoring should be intensified, and dosage adjustment should occur on an individual basis.

• There is no data available.

• In clinical studies involving children and adolescents (ages 3 to 19 years), HUMALOG has been shown to be safe, effective, and well-tolerated.

• Hypoglycaemia.
• Hypersensitivity to insulin lispro or one of its excipients.

• Hypoglycaemia: Hypoglycaemia is the most common adverse effect of insulins. As with all insulins, particular caution (including intensified blood glucose monitoring) should be exercised in individuals who are at greater risk of clinically significant sequelae from hypoglycaemic episodes.
• Some people experience hypoglycaemic reactions after transfer from animal source insulin to human insulin. Early warning symptoms of hypoglycaemia were less pronounced or different from those experienced with their previous insulin. Note: Diabetes MedsCheck with counselling on hypoglycaemia, blood glucose monitoring, side effect profile – counselling that hypoglycaemia is part of side effect profile and were happening regularly may need to be referred to prescriber for dose adjustment.

• Hypoglycaemia: Hypoglycaemia is the most common adverse effect of insulins. As with all insulins, particular caution (including intensified blood glucose monitoring) should be exercised in individuals who are at greater risk of clinically significant sequelae from hypoglycaemic episodes. Note: Diabetes MedsCheck with counselling on hypoglycaemia, blood glucose monitoring, side effect profile – counselling that hypoglycaemia is part of side effect profile and were happening regularly may need to be referred to prescriber for dose adjustment.
• Injection site and allergic reactions. As with any insulin therapy, lipodystrophy may occur at the injection site and delay insulin absorption. Other injection site reactions with insulin therapy include redness, pain, itching, hives, swelling and inflammation. Note: Diabetes MedsCheck with education about side effects and referral to healthcare team to establish correct injection technique.
• Skin and subcutaneous tissue disorders: Individuals must be instructed to perform continuous rotation of the injection site to reduce the risk of developing lipodystrophy and cutaneous amyloidosis. There is a potential risk of delayed insulin absorption and destabilised glycaemic management following insulin injections at sites with these reactions. A sudden change in the injection site to an unaffected area has been reported to result in hypoglycaemia. Note: Diabetes MedsCheck with referral to CDE for correct injection technique.