Insulin Lispro

About Insulin Lispro

Insulin lispro is a rapid-acting human insulin analog taken at mealtimes; injected doses are generally used with an intermediate- or long-acting insulin. The labels approve it to improve blood sugar control in adults and children with diabetes: Humalog and Admelog are supported in children 3 and older with type 1 diabetes, Lyumjev from age 1, and the Humalog Mix premixes (suspensions of insulin lispro protamine and insulin lispro, usually injected twice a day) in adults only. Humalog, its unbranded version and Admelog are given within 15 minutes before or right after a meal, and Lyumjev at the start of a meal or within 20 minutes after starting. The 100 units per mL solutions can also be used in an insulin pump or, only under medical supervision, given into a vein; the premixes cannot.

There is no boxed warning. It must not be used during an episode of low blood sugar or by anyone allergic to insulin lispro or an ingredient. Low blood sugar is the main risk and can be severe, and any change of insulin product or injection method is made under close medical supervision. Mix-ups between insulins have happened, so the label is checked before each injection, and pens, cartridges, needles and syringes are never shared. Severe allergic reactions and low potassium can occur, pioglitazone or a similar drug can add fluid retention and heart failure, and a pump or infusion set failure can lead to high blood sugar and ketoacidosis. Allergic and injection site reactions, skin changes at injection sites, itching and rash are other side effects.

The U-200 KwikPens of Humalog and Lyumjev are never used in a pump or a vein, mixed with other insulin, or drawn into a syringe; Lyumjev U-100 is not mixed with other insulin either, and the Junior KwikPens dial in half-unit steps. Lilly’s unbranded Insulin Lispro is Humalog under another label, and an unbranded Mix75/25 KwikPen is Humalog Mix75/25. Admelog, approved in 2017 under a drug application and licensed as a biologic since March 2020, is not a biosimilar. Lyumjev (insulin lispro-aabc) also contains treprostinil and sodium citrate. The FDA lists the original Humalog Pen and the Humalog Mix Pens as discontinued.

Taking Insulin Lispro

How to take it

Under the skin of the abdomen, thigh, upper arm or buttocks, rotating sites: Humalog, Admelog and unbranded lispro within 15 minutes before or right after a meal, Lyumjev at the start of a meal or within 20 minutes after starting, and the Mix products within 15 minutes before a meal.

If you miss a dose

If you remember shortly before or soon after the meal, inject the dose right away; if more time has passed, follow your prescriber’s instructions or call to ask. Do not inject a double dose.

Storage

Unopened in the refrigerator, never frozen; throw away insulin that has frozen or overheated. Once in use, vials last 28 days in the refrigerator or at room temperature up to 86°F, solution pens and cartridges 28 days at room temperature only, and Mix pens 10 days at room temperature only.

Interactions to know about

Other diabetes medicines, ACE inhibitors, ARBs, fluoxetine and salicylates can raise the risk of low blood sugar; steroids, diuretics, thyroid hormone and birth control pills can raise blood sugar; alcohol, beta blockers, clonidine and lithium can do either, and beta blockers and clonidine can hide a low.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Insulin Lispro differs from pharmacy to pharmacy

Each lispro product is priced by its own maker, and with no interchangeable biosimilar, the pharmacy dispenses the product the prescription allows: Admelog, Lyumjev and the premixes are separate products and are not substituted for Humalog without the prescriber.

Vials, pens and cartridges are separate products with separate quotes, and how long a fill lasts depends on the dose, the box size and the in-use limit. Pen needles or syringes are quoted as separate items, and each pharmacy adds its own dispensing fee and markup.

Ways to pay less for Insulin Lispro without insurance

• Ask the prescriber whether the prescription can name insulin lispro rather than a brand, and ask the pharmacy which products it can quote.
• If you use pens and can draw doses with a syringe, ask the prescriber whether vials would suit you, and ask for quotes on both.
• Manufacturers run patient programs whose terms change; ask the maker of your insulin whether one applies to someone paying cash.
• Ask for a quantity that matches your dose and the in-use limit, and never stretch or skip doses to make insulin last.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Insulin Lispro

1. 1.Which lispro product is this, and is it the one my prescriber named?
2. 2.With this product, when should I inject relative to my meals?
3. 3.How long can I use this pen, vial or cartridge once it is opened?
4. 4.Which pen needles fit this pen, and do they need their own prescription here?

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