High-Alert Medications - Humalog (insulin lispro)

 

Extra care is needed because Humalog is a high-alert medicine.

High-alert medicines have been proven to be safe and effective. But these medicines can cause serious injury if a mistake happens while taking them. This means that it is very important for you to know about this medicine and take it exactly as directed.

Top 10 List of Safety Tips for Humalog

When taking your medicine
1. Know your insulin. Humalog is a rapid-acting form of insulin that should be injected below the skin within 15 minutes before or immediately after a meal. Have food ready before injection. After injecting the insulin, do not skip a meal or delay eating.
2. Prepare your insulin. An intermediate- or long-acting insulin is often prescribed with Humalog. Humalog can be mixed with insulin NPH (intermediate-acting insulin), but always draw Humalog into the syringe first. Never mix Humalog with Lantus. Do not mix Humalog with other insulins if using an insulin pen or external pump. Do not vigorously shake insulin before use.
3. Don't reuse or recycle. Dispose of used syringes/needles, pens, and lancets in a sealable hard plastic or metal container (e.g., empty detergent bottle, special sharps container from your pharmacy). When the container is full, seal the lid before placing it in the trash. Do not reuse or recycle syringes/needles or lancets.
4. Don't share. Even if you change the needle, sharing an insulin pen or syringe may spread diseases carried in the blood, including hepatitis and HIV.
To avoid serious side effects
5. Avoid mix-ups. If you use more than one type of insulin, make each vial or pen look different by putting a rubber band around one type of insulin.
6. Check your medicine. Humalog can be confused with NovoLog or Humulin (other insulins). When you pick up your insulin at the pharmacy, be sure it's the right type of insulin.
7. Treat low blood sugar (hypoglycemia). Carry a quick source of sugar, such as glucose tablets, candy, or juice, to treat low blood sugar. Signs of low blood sugar are listed on the other side of the page.
8. Test your blood sugar level. Ask your doctor how often you should test your blood sugar level. Keep a log of your blood sugar levels and how much insulin you take each day. Bring the log with you each time you visit your doctor.
9. Get a periodic lab test. You should have a hemoglobin A1c test at least twice a year to determine how well your diabetes is being controlled. The test shows an average of your blood sugar control over a 6- to 12-week period. Your goal is a hemoglobin A1c of 7% or less.
When you should call your doctor
10. Call for illness or changes in habits. Your insulin needs may change because of illness, stress, changes in eating habits or physical activity, and other medicines you take. Call your doctor if you experience these conditions. Never change your insulin dose unless advised by your doctor.

Signs of hypoglycemia (low blood sugar)

  • hunger
  • feeling shaky
  • fast heartbeat
  • lightheadedness
  • dizziness
  • sweating
  • headache
  • confusion
  • irritability

Hypoglycemia is caused by too much insulin or increased work or exercise without eating. Symptoms of hypoglycemia may be different for each person and can change from time to time. Hypoglycemia can affect your ability to think and react quickly, so driving a car could be risky. Severe hypoglycemia can lead to loss of consciousness, seizures, brain damage, or even death. Know the symptoms of hypoglycemia and treat it quickly by drinking juice or a sugar-containing beverage, or eating sugar or candy. Talk to your doctor if hypoglycemia is a problem for you.

 

 Topics Fast Facts
Generic name
  • insulin lispro (pronounced IN soo lin LYE spro) (no generic available)
Common brand names
  • Humalog, Humalog KwikPen, HumaPen, other Humalog pens
Type of insulin, onset, duration
  • Rapid-acting insulin; begins working in 15 to 30 minutes and lasts for 5 hours or less
Uses
  • Treatment of type 1 and type 2 diabetes mellitus to improve control of blood glucose
When to take the insulin
  • Humalog should be injected under the skin within 15 minutes before or immediately after a meal
Usual dose
  • The frequency and dose of insulin are unique to each individual
  • Daily doses of insulin are based upon body weight, diet, activity level, age, individual sensitivity to insulin, type of diabetes (1 or 2)
  • Multiple daily doses according to blood glucose levels are typical
Injecting the insulin
  • See safety tip #2 to determine if Humalog can be mixed with another insulin before injection
  • Ask your doctor, nurse, or pharmacist to show you how to draw your dose of insulin into a syringe and inject it, select the dose on a pen device and inject the insulin, or use an insulin pump
  • Before injecting a dose, take the chill off refrigerated insulin by gently rolling the vial, pen, or cartridge between the palm of both hands (do not shake the insulin vigorously)
  • Using a syringe or insulin pen, inject the insulin below the skin (not in the muscle) in the upper thighs, upper arms, buttocks, or abdomen; the site of the injection should be changed (rotated) with each dose
  • Don't use Humalog if the insulin appears cloudy instead of clear and colorless
Special instructions and precautions
  • Meals should be eaten no longer than 15 minutes before or immediately after injection
  • Follow the diet prescribed by your doctor
  • Keep your eating habits and exercise regular
  • Tell the doctor who prescribes insulin about any new medicines you are taking
  • Do not share insulin pens, cartridges, or syringes/needles with others
Safety during pregnancy/breastfeeding
  • Talk to your doctor about managing your diabetes during pregnancy and breastfeeding
Storage and disposal
  • Store unopened vials, cartridges, and pens in the refrigerator until first use (do not freeze)
  • After first use, store vials in the refrigerator or at room temperature; discard after 28 days
  • After first use, store cartridges and insulin pens at room temperature (do not refrigerate); discard after 28 days
  • Safely dispose of used syringes/needles, pens, and lancets (safety tip #3)
Most common side effects
  • Hypoglycemia (low blood sugar); see signs and treatment of hypoglycemia above
  • Low potassium blood levels, fast heart rate, fatigue, headache, hunger
Other conditions to report to your doctor
  • Chest pain or palpitations, persistent fatigue, confusion, numbness of mouth, lips, or tongue, muscle weakness or tremors, vision changes, flu-like symptoms
  • Swelling, itching, redness, warmth, or pain at the injection site
Herbals that should not be taken with Humalog
  • These herbals can lower your blood glucose: chromium, garlic, gymnema
Prescription medicines that should not be taken with Humalog
  • Many prescription medicines can affect your blood sugar levels and insulin needs
  • Tell your doctor about all the medicines you take, particularly new medicines
Special tests your doctor may prescribe
  • Patients are often asked to test their own blood glucose using home testing equipment, test their urine for sugar and acetone, and take their blood pressure regularly
  • To monitor your diabetes, your doctor may periodically test your blood levels for hemoglobin A1c, potassium, cholesterol, and substances that measure kidney function

This information does not replace the need to follow your doctor's instructions and read the drug information leaflet provided with your prescription.

This project was supported by grant number R18HS017910 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not represent the official views of the Agency for Healthcare Research and Quality.

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