Indications
Insulin Lispro is a rapid-acting insulin used to control blood sugar in adults and children with diabetes mellitus, mainly to cover the rise in blood sugar after meals. It is usually used together with a longer-acting (basal) insulin. Premixed forms combine Insulin Lispro with an intermediate-acting insulin to give both mealtime and background cover.
How It Works
Insulin is the hormone that lets sugar move from the blood into the body’s cells to be used for energy, and stops the liver releasing too much sugar. Insulin Lispro is a slightly modified human insulin that is absorbed faster after injection. It starts working within about 15 minutes, peaks in 1 to 2 hours and lasts about 3 to 5 hours.
Dosage and Administration
Use exactly as prescribed; the dose is individual and depends on blood sugar readings, meals and activity. It is injected under the skin of the abdomen, thigh, upper arm or buttock, usually within 15 minutes before a meal or right after eating. Rotate injection sites to avoid lumps. It may also be given in an insulin pump or, in hospital, into a vein by a doctor or nurse. Premixed forms are given only under the skin. Never share pens or needles.
Interactions
Many medicines change blood sugar. Other diabetes medicines, ACE inhibitors, Salicylates, Fluoxetine, MAO inhibitors and alcohol may increase the risk of low sugar. Corticosteroids, Thiazide diuretics, Thyroid hormones, oral contraceptives, Salbutamol and some antipsychotics may raise blood sugar. Beta blockers can hide the warning signs of low sugar. Pioglitazone with insulin can cause fluid retention and heart failure.
Contraindications
Do not use during an episode of low blood sugar (hypoglycaemia) or if you are allergic to Insulin Lispro or any ingredient.
Side Effects
The most common side effect is low blood sugar, with sweating, shaking, hunger, fast heartbeat, headache, confusion or irritability. Others include redness, swelling or itching at the injection site, thickening or hollowing of the skin where it is often injected, weight gain, low potassium and fluid swelling.
Get urgent medical help if low blood sugar causes confusion, fits or loss of consciousness, or if there are signs of a severe allergic reaction such as widespread rash, swelling of the face or difficulty breathing. For mild low sugar, take sugar, glucose tablets or a sweet drink straight away.
Pregnancy and Lactation
Insulin Lispro can be used during pregnancy and breastfeeding. Good blood sugar control is very important for the baby. Insulin needs usually fall in early pregnancy and rise later, and change again after delivery, so close monitoring and dose adjustment by the doctor are needed.
Precautions and Warnings
Check blood sugar regularly and learn to recognise and treat low sugar. Doses may need changing with illness, exercise, changes in diet, alcohol, travel across time zones, or kidney or liver problems. Never mix up insulin types or strengths; check the label before each injection. Do not drive if your sugar is low.
Overdose
Too much insulin causes low blood sugar, which can be severe. Take sugar immediately if awake; if unconscious, a glucagon injection or intravenous glucose is needed, so call emergency services. Low sugar can return, so keep eating and monitoring.
Therapeutic Class
Rapid-acting insulin analogue (antidiabetic).
Storage
Store unopened pens, cartridges and vials in a refrigerator at 2 to 8°C. Do not freeze; do not use if it has been frozen. Once in use, keep below 30°C away from heat and light for up to 28 days. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.