At a glance
Insulin Lispro is a rapid-acting human insulin analog used for the control of hyperglycemia in adults and children with diabetes mellitus.
Indications
- Control of hyperglycemia in adults and children with diabetes mellitus
Pharmacology
Insulin Lispro is a rapid-acting human insulin analog. Chemically, it is Lys(B28), Pro(B29) human insulin analog, created when the amino acids at positions 28 and 29 on the insulin B-chain are reversed. The blood glucose lowering effect of insulin is due to the facilitated uptake of glucose following binding of insulin to receptors on muscle and fat cells and to the simultaneous inhibition of glucose output from the liver.
Dosage
Adult Dose (Subcutaneous):
- Type 1 Diabetes: Approximately one third of total daily insulin requirements; usual daily maintenance range: 0.5-1 unit/kg/day in divided doses; nonobese: 0.4-0.6; obese: 0.8-1.2
- Type 2 Diabetes (inadequately controlled on oral medication): 10 units/day SC (or 0.1-0.2 units/kg/day) at bedtime; OR rapid-acting insulin before meals
- Has a more rapid onset of action and shorter duration than regular human insulin
- Hepatic impairment: Dose reduction may be needed
Child Dose (Type 1, ≥3 years): 0.8-1.2 units/kg/day during growth spurts; otherwise adult dosing
Side effects
Side Effects:
- Hypoglycemia
- Hypokalemia
- Edema
- Pruritus
- Palpitations
- Nausea
- Rash
- Hypersensitivity reactions
- Lipoatrophy or lipohypertrophy (with SC injection)
Use in pregnancy
Use in Pregnancy: Category B; essential for patients with diabetes to maintain good metabolic control before conception and throughout pregnancy; insulin requirements decrease during 1st trimester, increase during 2nd and 3rd, decline after delivery.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Precautions & warnings
Precautions:
- Caution in renal or hepatic impairment
- Caution in pregnancy and lactation
- Caution when transferring from other insulin
- Monitor serum glucose, potassium, electrolytes, HbA1c and lipid profile
- Caution in concomitant illness, especially infections
- Lactation: Considered safe for use during breastfeeding
Overdose effects
Overdose: Excess insulin may cause hypoglycemia and hypokalemia; mild episodes treated with oral glucose; severe episodes (coma, seizure, neurologic impairment) treated with IM/SC glucagon or IV glucose; hypokalemia must be corrected appropriately.
Storage conditions
Store at 2°C-8°C in refrigerator; do not freeze; during use can be kept at room temperature for one month.