Humalog pen mix 50/50 kwikpen treatment for diabetes (5 trees x 3ml)

Dosage form Box of 5 trees x 3ml
Specifications Insulin lispro

Ingredient

Composition information	Content
Insulin lispro	100U/ml

Uses

Indications

Humalog Mix 50/50 Kwikpen is indicated in the following cases:

Treatment of patients with diabetes that need insulin to maintain normal glucose home stability. medium).

The main activity of insulin lispro is to regulate glucose metabolism.

In addition, insulin has a number of assimilation and anti -catabolic effects on many different types of tissue. In muscle tissue, this effect includes glycogen synthesis, fatty acids, glycerol, protein and absorbing amino acids, while reducing glycogen decomposition, glucose new creation, kettle, fat decomposition, protein catabolism and amino acid production.

Insulin lispro has an acting effect (about 15 minutes), so the patient can take the drug close to the meal (within 0 - 15 minutes before or after meals) compared to the short -acting insulin (before 30 - 45 minutes). Observed the rapid and early peak of Insulin Lisplo after subcutaneous injection Humalog mix 50/50. Humalog Basal (Insulin Lisplo Protamine) has data on the same effect as the background insulin (NPH) for about 15 hours.

Liver or kidney failure does not affect the dynamic response of glucose with insulin lispro. The dynamic difference of glucose between insulin lispro and insolinated human insulin, as measured in the clamping procedure, holds glucose concentration, is maintained through many levels of kidney function.

insulin lispro represents the equivalent of molar insulin, but insulin lispro is faster and shorter time.

Pharmacokinetics

absorption

Studies on healthy volunteers and patients with diabetes Type 1 (insulin dependent) show that humalog, the fast -acting ingredient of Humalog mix 50/50, is absorbed faster than the short -acting insulin (100U). In healthy volunteers using subcutaneous humalogs with doses ranging from 0.1 to 0.4 U/kg, the peak concentration has been achieved within 30 to 90 minutes after taking the drug. When a healthy volunteer uses the same dose as a short -acting insulin, the peak concentration is reached within 50 to 120 minutes after taking the drug. The results achieved the same in patients with diabetes type 1.

Humalog mix 50/50 absorbed through two stages. The first phase represents the insulin lispro and its own rapid trigger. The later stage represents the prolonged effect of the Insulin Lisplo Protamine. Of the 30 healthy volunteers taking the dose under the Humalog Mix 50/50 (0.3 U/kg), the peak concentration in the serum appeared at 45 minutes to 13.5 hours (60 minutes on average) after taking the drug. In patients with type 1 diabetes, the peak concentration in the serum has appeared within 45 minutes to 120 minutes (on average 60 minutes) after taking the drug. Humalog's rapid absorption properties are maintained with Humalog Mix 50/50.

There is no direct comparative data Humalog mix 50/50 with humulin 50/50. However, a cross -comparative study shown in Figure 1 showed that Humalog Mix 50/50 absorbed faster than Humulin 50/50.

Distribution

The distribution studies marking the radioactive of Humalog Mix 50/50 have not been conducted. However, the distribution of the Humalog injection is like the short -acting insulin, within 0.26 - 0.36 l/kg.

Metabolism

Studies on the metabolism of Humalog Mix 50/50 have not been done. Animal studies have shown the metabolism of humalog, the fast -acting ingredient of Humalog Mix 50/50, like the human insulin is short.

Elimination

Humalog Mix 50/50 has two stages of absorption, a quick stage and a long stage, representing the lislro insulin component and the Insulin Lisplo Protamine. Like other average insulin types, it is impossible to calculate the end of the half -life of semi -exhausted lifetime after using Humalog Mix 50/50 due to the extension of the absorption of the Insulin Lisplo Protamine.

Before taking Humalog pen mix 50/50 kwikpen treatment for diabetes (5 trees x 3ml)

How to use

Humalog Mix 50/50 KWIKPEN used for subcutaneous injection.

Humalog mix 50/50 is only specified for subcutaneous injection. Humalog mix 50/50 must not use intravenous lines. Should be injected under the skin above the arms, thighs, buttocks, or abdomen. Should rotate the injection position so that it does not inject the same position more than once a month.

When subcutaneous injection, need to be cautious when injecting Humalog Mix 50/50 to make sure not to poke the blood vessels. After the injection, no massage of the injection site. Patients should be instructed to use the mature injection technique.

Should check the Humalog mix 50/50 with the eye before use. Only Humalog Mix 50/50 should be used when it is a homogeneous opaque mixture after shaking. Do not use Humalog mix 50/50 after expiry date.

Dosage

The dose mode of Humalog Mix 50/50 will vary among patients and need to be decided by doctors who have experience in patient metabolic needs, eating habits, and other living habits. Humalog has shown the effect equivalent to the short -acting insulin in the molar unit.

A humalog unit has the same hypoglycemic effect as a short -acting insulin unit, but the effect of humalog tries faster and shorter time. Humalog's faster hypoglycemia is associated with faster absorption rate of insulin lispro from subcutaneous tissue.

There is no direct comparative data between Humalog Mix 50/50 and Humulin 50/50. However, a cross -comparative study showed that Humalog Mix 50/50 had the same time as Humulin 50/50.

Insulin absorption rate and therefore, the beginning of the effect is known to be affected by the injection site, physical activity and other factors. Like all other types of insulin, the effect of Humalog Mix 50/50 may vary between patients and right on the same patient. Insulin products dose, u/kg The peak time, the number of hours after taking the drug The percentage of the total effect appears in the first 4 hours

humalog 0.3 4.3) 70% (49 - 89%)

(0.26 - 0.37)

4,4 (4.0 - 5.5) 54% (38 - 65%) 70/30 0.3 4.4 (1,5 - 16) 32% (14 - 60%) 69%)

(0.27 - 0.40)

5.5 (3.5 - 9.5) 14% (3.0 - 48%) The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Hypoglycemia may be the result of an excessive activity of insulin compared to the amount of food and the energy.

Hypoglycemia can lead to listless, confused, brushed chest, headache, sweating and vomiting.

Mild hypoglycemia can be processed by taking glucose or sugar or saccharat products.

The treatment of severe severe hypoglycemia may be by intramuscularly or injecting under the glucagon skin, then eating or taking carbohydrates when the patient has completely recovered. Patients who do not respond to glucagon must be infusion of glucose solution.

If a patient has a coma, intramuscularly or under the skin of Glucagon. However, it is necessary to use intravenous glucose if there is no glucagon or if the patient does not respond to Glucagon. Patients need to eat immediately after awake.

Maintain the amount of carbohydrate introduced and need to monitor because hypoglycemia may reappear immediately after clinical recovery.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Humalog Mix 50/50 Kwikpen, you may experience unwanted effects (ADR).

Clinical studies compare Humalog mix 50/50 with human insulin mixture does not show the difference in frequency of the appearance of unwanted effects between the two treatments.

Unwanted effects are common related to human insulin treatments including:

Systemic body: allergic reactions Hypoglycemia can lead to unconsciousness, and in the most severe case of death. There is no specific frequency of hypoglycemia, because hypoglycemia is the result of both insulin dose factors and other factors, such as the patient's diet and physical exercise.

Local allergies in common patients (1/100 to

There may be an erythema, swelling and itching allergy in the insulin injection. This situation usually passes after a few days to a few weeks. In some cases, this condition may be related to factors other than insulin, such as stimulants in skin cleansing or improper injection techniques.

is an allergic reaction of insulin. Can cause a whole body rash, shortness of breath, wheezing, reducing blood pressure, fast pulse, or sweating. Cases of heavy allergic allergies can be life -threatening.

Hypotension, fat disorders in the injection site.

The local reactions will gradually end during treatment.

Atrophy of subcutaneous fat tissue can be cured by injection of pure animal insulin or human insulin inside or around the atrophy.

Fatty tissue hypertrophy can be avoided by rotating the injection position.

Hypoglycemia: Patients must identify the warning signs of hypoglycemia (for example, sweating, dizziness, tremor) and can be overcome by eating food or drinking sugar.

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Humalog Mix 50/50 KWIKPEN contraindications in the following cases:

Hypersensitivity to insulin lispro or any excipients of the drug.

Hypoglycemia.

Be cautious when using

in any case, it is not allowed to use humalog mix 50/50 intravenous line.

When transferring patients to use another type of insulin or other insulin brand, it is necessary to perform under tight medical supervision. Changes in concentration, brand (manufacturer), type (short effect, NPH, slow, etc.), species (animal insulin, human insulin, human substance similar to human insulin), and/or production methods (recombinant DNA compared to animal -based insulin) can lead to the need to change the dose.

Conditions that make the early or less or less pronounced warning symptoms of hypoglycemia, including prolonged diabetes, positive insulin therapy, diabetes or medication as beta blockers.

Some patients with hypoglycemia reactions after transferring from animal -based insulin to insulin have reported less premature hypoglycemic warning symptoms or different from the symptoms they have encountered when using the previous insulin. Hypoglyc or hyperglycemia reactions may cause unconsciousness, coma or death.

The use of insufficient dose or stop treatment, especially in diabetes dependent insulin can lead to hyperglycemia and diabetes metonic acidosis, this condition is likely to be fatal.

Insulin demand may be reduced in the case of kidney failure, in patients with liver failure, insulin demand may be reduced due to reduced glucose ability and decreased insulin decomposition, however, in patients with chronic liver failure, insulin resistance can lead to increased insulin demand.

Insulin demand may increase during illness or emotional disorders.

may need to adjust the dose if the patient increases physical activity or changes the normal diet. Physical exercise right after a meal can increase the risk of hypoglycemia.

Lipers and hypersensitivity is one of the other unwanted effects related to the use of all types of insulin.

allergies

Local allergies: As with any insulin therapy, patients may be red, swollen, or itchy at the injection site. Mild reactions usually pass after a few days to a few weeks. In some cases, these reactions may be related to other non -insulin factors, such as stimulants in skin cleansing or improper injections.

Systemic allergies: less common, but more serious, is an allergic reaction of insulin, which can cause rash (including itching) throughout the body, shortness of breath, wheezing, reducing blood pressure, fast vessels, or sweating. The serious case of systemic allergies, including anaphylactic reaction, may be life -threatening. The local reaction and spreading muscle pain have been reported with the use of cresol as an excipient.

Antibodies: In clinical trials, antibodies have been observed with human insulin and insulin lispro in both human mixed and insulin lispro mixture groups.

It is necessary to consider when using insulin lispro for children under 12 years old, only used in case of more beneficial than using short -acting insulin.

Thiazolidinediones (TZDS) is used in combination with insulin: TZDS when used with insulin is associated with increased risk of edema and heart failure; Especially in patients with heart disease.

There have been reports on heart failure when using insulin in combination with pioglitazon, especially in patients with risk factors for developing cardiovascular diseases. This should be noted, if the balance of the Humalog Mix 50/50 combination with Pioglitazon. If used in combination, patients should be monitored with signs and symptoms of heart failure, weight gain and edema. Pioglitazon should be stopped if any symptoms of heart activity.

Instructions for use and operation

To prevent the possibility of infection, each pen is only used for one patient, even if the needle is changed.

The ability to drive and operate machinery

The patient's concentration and reaction ability may be impaired as a result of hypoglycemia. This can be dangerous in situations where these possibilities are of special importance (such as driving or operating machinery).

Advise patients to be cautious to avoid hypoglycemia while driving. This is very important in patients who are difficult to identify whether or not to recognize the warning signs of hypoglycemia or in people who often have hypoglycemia, consider whether to drive or not in these cases.

Pregnancy

insulin, a natural hormone, is a chosen medicine to treat pancreatic diabetes in pregnant women to avoid birth defects for children. If diabetes appear during pregnancy, the mother needs to be treated as soon as possible with insulin and must be closely monitored by a specialist.

The large number of research data used for pregnant women using insulin lispro does not show any adverse effects of the drug during pregnancy or for the health of the fetus/babies.

It is necessary to maintain good control of patients treated with insulin (diabetes dependent insulin or diabetes due to pregnancy) during pregnancy. Insulin demand usually drops in the first three months of pregnancy and increases in the middle and the last three months of pregnancy. It is necessary to advise patients with diabetes to notify the doctor if they are pregnant or intend to get pregnant. Thoroughly monitor blood sugar as well as general health is essential in patients with diabetes.

The period of breastfeeding

It is unknown whether the insulin lispro is excreted in breast milk or not. Mothers with nursing diabetes may need to adjust insulin dose, diet or both.

Interactive drug

Insulin demand may be increased due to drugs that have hyperglycemia such as oral contraceptives, corticosteroids, or thyroid hormone replacement therapy, danazol, beta 2 stimulants (such as ritodrin, salbutamol, terbutalin).

Insulin demand may be reduced by hypoglycemic drugs such as oral hypoglycemic drugs, salicylate (eg acetylsalicyllc acid), sulpha antibiotics, some antidepressants (monoamin oxidase inhibitors, selective reconciliation inhibitors), some enzyme inhibitors transferred angiotensin (cagrillil, caprillils, cagrilillils, caplillil, caprillil enalapril), Angiotensin II receptor blockers, beta blockers, octreotid or alcohol.

There is no study on mixing Mix 50/50 with other insulin.

Should consult a doctor when using other drugs with Humalog Mix 50/50 KWIKPEN.

Storage

Do not freeze. Do not leave too hot or direct sunlight.

Injectable pump pen is not used: Store in the refrigerator (2 - 8 ° C).

After first use: Store below 30 ° C. Do not leave in the refrigerator. Do not preserve the pump pen available when the needle is attached.

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