What are Humalog Mix 25/75 Cartridges?
Humalog 25/75 Cartridges are cartridges filled with a sterile suspension containing 25% insulin lispro and 75% insulin lispro protamine. Humalog insulin lispro is a fast-acting insulin analog that differs from naturally occurring insulin in that it has been genetically modified in order to make it faster acting. Humalog lispro protamine is an intermediate-acting insulin analog suspension that has small proteins called protamines added to the insulin to help slow down the onset and increase the duration of insulin action. When combined, the fast and intermediate-acting insulin analogs work together to provide an entire day of coverage against the daily spikes in blood sugar levels.
What are they used for?
Insulin lispro and lispro protamine in Humalog Mix 25/75 are used for the treatment of people living with Type 1 or Type 2 diabetes. The combination of the fast-acting and intermediate-acting insulin helps to better satisfy insulin requirements over an entire day. The suspension was created by changing the properties of naturally occurring insulin in order to extend the duration of its blood sugar-lowering effects, minimize dose frequency, and to decrease the burden of treatment. Insulin lispro and lispro protamine have also shown some effectiveness in helping with diabetic nephropathy prevention, diabetic neuropathy prevention, and cardiovascular disease prevention, although neither has been officially approved for treating or preventing any these conditions.
How does it work?
Man-made insulin, like insulin lispro and insulin lispro protamine, are designed to simulate the way naturally occurring insulin works in the body. Insulin regulates blood sugar levels by absorbing excess sugar from the blood and storing it away. It also blocks the production and release of sugar into the blood, and converts excess sugars into fat.
Insulin lispro is what is called a mealtime or bolus insulin which is used to prevent blood sugar level spikes during and after meals. It is rapidly absorbed with a shorter delay of onset compared to naturally occurring insulin. This allows for greater flexibility with mealtime injections, because you do not have to wait a long time to eat after your injection. Lispro protamine, on the other hand, is a longer-acting insulin, with a slower onset and longer duration of action. It is an intermediate-acting insulin that has a similar absorption and activity to NPH insulin, also known as isophane insulin, which is another common intermediate-acting insulin analog.
The combination of both lispro and lispro protamine together closely resembles the action of naturally produced insulin in those without diabetes. Providing a steady release of insulin throughout the day, coupled with mealtime blood sugar level regulation, can help reduce your symptoms and increase your overall well-being.
Common negative effects may include:
- Injection site irritation
- Hypoglycemia (low blood sugar)
Less common negative effects may include:
Injection site reactions, such as pain, redness and irritation have been reported in some people. If you experience any of these effects and they get worse or do not go away, contact your doctor.
This medication may also cause hypoglycemia (low blood sugar). This may occur if you do not eat enough calories or if you have taken too much insulin lispro.
The symptoms of low blood sugar include
- cold sweat
- blurred vision
- rapid heart rate
- tingling of the hands or feet.
It is a good habit to carry gel or glucose (sugar) tablets to treat low blood sugar. You can also quickly raise your blood sugar level by eating a source of sugar such as an apple, table sugar, candy, honey, or you can drink juice.
Taking insufficient amount of insulin lispro can cause symptoms of hyperglycemia (high blood sugar).
Symptoms of high blood sugar include
- excessive thirst
- rapid breathing
- increased urination
- fruity breath odor.
If any of these symptoms occur, contact your doctor immediately.
Other side effects can include lipodystrophy, which is a disorder where body is unable to produce fat, and hypokalemia, which is the sudden appearance of low levels of potassium (K+) in the blood.
Other serious side effects may include anaphylaxis, which is a serious allergic reaction and other hypersensitivity or allergic reactions.
How to take this medication
As with all insulin therapies, the duration of Humalog Mix 25/75 varies with different people, and can even vary in the same person according to the dose, injection site, temperature, blood flow, and level of physical activity.
Humalog Mix 25/75 is a white suspension, and should not be taken if it is clumpy or discolored. It should be administered by subcutaneous (under the skin) injection only and must not be given intravenously (into the vein or muscle). This medicine starts to lower blood sugar more quickly than naturally occurring insulin, and should be given within 15 minutes before a meal. If necessary, it may be given shortly after a meal as well (within 20 minutes of when you started eating).
Subcutaneous injections should be taken in the upper arms, thighs, buttocks or abdomen. Injection sites can be rotated so that the same site is not used more than approximately once a month. The injection site should not be massaged after.
Your specific dosage of Humalog Mix 25/75 is determined by your doctor in accordance with your specific needs. Your dose and number of insulin injections should be adjusted in order to maintain your blood sugar levels as close to normal as possible.
You should inject your dose within 15 minutes before the start of your meal or immediately after the meal (within 20 minutes of when you started eating). The injection sites you can use are the tissue of the abdomen, thigh, upper arm, or buttocks. Ask your doctor if you are not sure where to administer your injections.
For new patients receiving insulin for the first time, you may be started on Humalog Mix 25/75 in the same manner as you were taking other types of insulin. You should be monitored closely during any adjustment period.
For patients being transferred onto this medication, you will likely use the same dose and dosage schedule as your other insulin. However, some patients transferring to Humalog may require a change in dosage from their previous insulin. In order to get you the best blood sugar level control, changes in your total daily dosage, the number of injections per day, and the timing of your injections may be necessary when using Mix 25. Once you are using this insulin, your doctor may perform a reassessment and adjustment of your insulin regimen (dosage and number of injections), which has been shown to get you better overall blood sugar level control.
Warnings and Precautions
This insulin should not be used:
- When your blood sugar is too low (hypoglycemia)
- If you are allergic to anything in Humalog insulin
Before using this insulin, talk to you doctor if:
- You have kidney or liver trouble
- You drink alcohol
- You exercise more than usual, or if you want to change your usual diet
- You are ill
- You are traveling across more than 2 time zones
- You are pregnant