Kwikpen Humalog Injection Pens for diabetes (5 trees x 3ml)

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

Ingredient

Composition information	Content
Insulin lispro	100iu

Uses

Indications

Humalog Kwikpen is indicated in the following cases:

Treatment of adults and children with diabetes need insulin to maintain normal glucose home stability. fast.

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 increased glycogen synthesis, fatty acids, glycerol, protein and amino acid absorption, while reducing glycogen resolution, regenerating glucose, producing cetons, greasing, protein catabolism and amino acid production.

Insulin lispro has a quick act (about 15 minutes), so the patient can take the drug close to the meal (within 0 - 15 minutes when eating meals) compared to normal insulin (before 30 - 45 minutes). Insulin lispro achieved faster efficiency and shorter effect time (2-5 hours) compared to short-acting insulin.

Clinical experiments in patients with diabetes in Type 1 and Type 2 show that insulin lispro reduces blood sugar levels after meals compared to soluble human insulin.

Like other insulin preparations, the acting time of insulin lispro may vary depending on each patient or different times on the same patient, and depend on the dose, insulin injection site, blood flow, temperature and physical activity. Information about specific effects after subcutaneous injection is illustrated as follows:

Instructions for using Humalog Kwikpen

The above chart reflects the relative number of glucose over time needed to maintain the patient's total blood concentration close to the concentration of hunger and is an indicator of these insulin effects on glucose metabolism over time.

pharmacokinetic pharmacokinetics

Studies on healthy volunteers and diabetic patients show that humalog is absorbed faster than insulin, short -acting insulin. In healthy volunteers using subcutaneous humalogs with doses ranging from 0.1 to 0.4U/kg, the peak concentration has been achieved within 30 to 90 minutes after taking the drug.

When a healthy volunteer uses the dose equivalent to the short -acting insulin, the peak concentration reaches within 50 to 120 minutes after taking the drug. The same results are in patients with type 1 diabetes.

How to use Humalog Kwikpen

Figure 1: Humalog and serum insulin concentrations after subcutaneous injection, human insulin is short or humalog (0.2U/kg) right before eating a lot of starch of 10 patients with diabetes Type 1.

The basic insulin concentration is maintained by 0.2ml/min/kg human insulin.

Humalog is absorbed at a faster ratio consistently with insulin short -acting in men who volunteer healthy 0.2U/kg under the abdomen, Delta muscles, or thighs. After injection of humalog in the abdomen, the serum concentration is higher and the effect time is slightly shorter than after the injection into Delta or under the thigh skin. Humalog is similar to that of short -acting insulin. Absolute bioavailability after subcutaneous injection between 55% to 77% at a dose of 0.1 - 0.2U/kg.

The average value under the serum insulin concentration curve - The time is not extremely up to 2390pmol HR/L. The average peak serum insulin concentration is 909pmol/l. The average time to reach the maximum concentration is 1.0 hours.

Distribution

When intravenous injection, such as Bolus injection, dose 0.1 and 0.2U/kg in 2 groups of healthy healthy volunteers, the average distribution of humalog decreases when increasing the dose (1.55 and 0.72L/kg, corresponding) in contrast to the short -acting insulin, the distribution integral is the same between the two dose groups (1.37 and 1.12L/kg corresponding to the dose of 0.1 and 0.2).

Metabolism

Studies on human metabolism have not been shown. However, animal studies show that the transformation of humalog is like a short -acting human insulin.

Elimination

After subcutaneous injection Humalog Kwikpen, the selling time is shorter than the short -acting insulin (1 compared to 1.5 hours). When intravenous injection, humalog and insulin -acting insulin show the similar dosage dependent, with an average clearance of 21.0ml/min/kg and 21.4 ml/pH of the corresponding (0.1U/kg dose), and 9.6ml/min/kg and 9.4ml/kg/kg, respectively (dose 0.2U/kg). Accordingly, the average selling time of Humalog is 0.85 hours (51 minutes) and 0.92 hours (55 minutes), corresponding to the dose of 0.1U/kg and 0.2U/kg, and the average selling time of insulin -acting insulin is 0.79 hours (47 minutes) and 1.28 hours (77 minutes), corresponding to 0.1U/kg and 0.2U/kg.

Before taking Kwikpen Humalog Injection Pens for diabetes (5 trees x 3ml)

How to use

When being injected subcutaneously, Humalog Kwikpen starts faster and has a shorter effect time than the short -acting insulin.

The drug can be used: subcutaneous injection, continuous subcutaneous line (insulin pump), intravenously used line.

Always check eye injection products to see if there are strange particles or any color changes.

Dosage

The dose of the Humalog Kwikpen pen should depend on each patient. The monitoring of blood sugar is essential for all insulin treatments.

Total daily insulin demand may vary and usually from 0.5 to 1 unit/kg/day. Insulin demand may change when stressed, seriously ill, or when changing physical exercise, eating, or when using other drugs simultaneously.

Sugar under the skin

Should use Humalog Kwikpen 15 minutes before meals or right after meals.

Insulin Humalog Kwikpen injection pen is often used in the skin, which is often used in the regimen with an average or prolonged insulin.

Should be injected under Humalog Kwikpen into the abdominal wall, thighs, biceps or buttocks. The injection site should be rotated in one area (abdomen, thighs, biceps, or buttocks), from an injection site to the next position to avoid the risk of fat dysplasia (see the "unwanted effect").

Continuous subcutaneous transmission (Insulin pump)

Humalog can be used in a continuous subcutaneous line with an external insulin pump. Do not use diluted insulin or insulin mixed in insulin pumps to outside. Should turn the infusion site in an area to reduce the risk of fat dysplasia. Replace the humalog in the container of the pump at least every 7 days, replace the infusion kit and the transmission position at least every 3 days.

When starting the therapy using insulin transmission pumps to outside, it is necessary to rely on the total daily insulin dose in the previous regimen. Despite the significant change among patients, about 50% of the total doses are often used as a bolus humalog at meals and the rest is used as a background infusion dose. Humalog is recommended to use with pump systems suitable for insulin transmission such as minimed, disetronic, and other pumps equivalent.

Variasis line

Humalog may use intravenous sugar under medical monitoring and closely monitor blood sugar and blood potassium concentration to avoid hypoglycemia and potassium hypokarin (see the section "Special warning and caution when used"). Humalog should be used at a concentration of 0.1U/ml of 1.0U/ml temple in the infusion solution containing 0.9%sodium chloride.

Note: The above dose of Humalog Kwikpen 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 consumption energy.

Hypoglycemia can lead to listless, confused, brushed chest drums, sweating headaches 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 glucose intravenously.

If a patient has a coma, an intramuscular or subcutaneous injection should be injured, however, an intravenous glucose solution should be used 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 forgetting 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 Kwikpen, you may experience unwanted effects (ADR).

Common

influenza syndrome, pharyngitis, rhinitis, headache, pain, cough increased symptoms.

Infection. muscle.

Urinary tract infections.

Details of unwanted reactions please look closely at the user manual.

Instructions on how to handle ADR

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 regular injection site.

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

Warnings

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

Contraindicated

Humalog Kwikpen drugs are contraindicated in the following cases:

Hypersensitivity to insulin lispro or any excipients of the drug.

Hypoglycemia.

Caution when using

When transferring the patient to use another type of insulin or other insulin brand, it is necessary to perform under tight medical supervision. Changes in concentration, brands (manufacturers), types (short effects, NPH, slow, etc.), species (animal insulin, human insulin, human substance similar to human insulin) 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 Humalog Mix 75/25 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 changes.

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 drug chosen 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.

Breastfeeding period

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

Medicinal interaction

Insulin demand may increase due to drugs that have hyperglycemia such as oral contraceptives, corticosteroids, or thyroid hormone replacement therapy, danazol, beta2 stimulants (such as ritodrin, salbutamol, terbutalin).

Insulin needs can be reduced due to drugs that have hypoglycemia such as oral hypoglycemic drugs, salicylate (eg acetylsalicylic acid), sulpha antibiotics, some antidepressants (Monoamine inhibitors of oxidase, selective Serotonin recovery inhibitors), some enzyme inhibitors transferred angiotensin (cagootensin, cap enalapril), Angiotensin II receptor blockers, beta blockers, octreotid or alcohol.

Consult your doctor when using other drugs along with the Humalog Kwikpen injection pen (see "Special Warning and Precautions").

Cavalry

Do not mix humalog preparations with insulin products of other manufacturers or animal insulin products.

Storage

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

Humalog Kwikpen injection pen pumps unused drugs 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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