DrugindexOnline^{2nd edition}

Generic Name: Insulin Lispro Protamine and Lispro 75/25 (IN-su-lin LYE-sproe)
Brand Name: Humalog Mix 75/25

Any change of insulin should be made cautiously and only under medical supervision. Changes in purity, strength, brand (manufacturer), type (regular, NPH, lente), species (beef, pork, beef-pork, human), and/or method of manufacture may result in the need for a change in dosage. If an adjustment is needed, it may occur with the first dose or during the first several weeks or months.

Insulin Lispro Protamine and Lispro is used for:

Treating diabetes mellitus.

Insulin Lispro Protamine and Lispro is a combination of hormones that are produced by the pancreas and are necessary for the body's correct use of food, especially sugar. Diabetes occurs when the pancreas does not make enough insulin to meet your body's needs. Insulin helps to keep your blood glucose at a nearly normal level.

Do NOT use Insulin Lispro Protamine and Lispro if:

• you are allergic to any ingredient in Insulin Lispro Protamine and Lispro
• you are having an episode of low blood sugar

Contact your doctor or health care provider right away if any of these apply to you.

Before using Insulin Lispro Protamine and Lispro :

Some medical conditions may interact with Insulin Lispro Protamine and Lispro . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines or other substances
• if you consume alcoholic beverages

Some MEDICINES MAY INTERACT with Insulin Lispro Protamine and Lispro . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Diltiazem, gemfibrozil, or tocolytics (eg, ritodrine) because the effectiveness of Insulin Lispro Protamine and Lispro may be decreased
• Beta-blockers (eg, metoprolol, propranolol), ethanol, fenfluramine, monoamine oxidase (MAO) inhibitors (eg, phenelzine), penicillamine, salicylates (eg, aspirin), or tetracyclines because side effects, such as low blood sugar, may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Insulin Lispro Protamine and Lispro may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Insulin Lispro Protamine and Lispro :

Use Insulin Lispro Protamine and Lispro as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• If you are using Insulin Lispro Protamine and Lispro at home, carefully follow the injection procedures taught to you by your health care provider. If the medicine contains particles, is discolored, or if the vial/container is cracked or damaged in any way, do not use it.
• This bottle must be carefully shaken or rotated before each injection so that the contents are evenly mixed. This combination insulin should look uniformly cloudy or milky.
• Be sure you have purchased the correct insulin. Insulin comes in a variety of containers including vials, cartridges, and pens. Make sure that you understand how to properly measure and prepare your dose. If you have any questions about measuring and preparing your dose, contact your doctor, nurse, or pharmacist for information.
• Insulin Lispro Protamine and Lispro begins lowering blood sugar within 30 minutes after an injection. The peak effect occurs from 1 to 2 hours after a dose. The effects last up to 5 hours.
• Follow each dose of this insulin with a meal starting within 15 minutes of the injection unless your doctor tells you otherwise.
• It is very important to follow your insulin regimen exactly. Do NOT miss any doses. Ask your doctor for specific instructions to follow in case you ever miss a dose of insulin.

Ask your health care provider any questions you may have about how to use Insulin Lispro Protamine and Lispro .

Important safety information:

• Insulin Lispro Protamine and Lispro may cause drowsiness, dizziness, blurred vision, or lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Insulin Lispro Protamine and Lispro . Using Insulin Lispro Protamine and Lispro alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
• Do not drink alcohol without discussing it with your doctor.
• Inject each dose of insulin in a different area to prevent skin irritation.
• Illness, especially with nausea and vomiting, may cause your insulin requirements to change. Even if you are not eating, you still require insulin. You and your doctor should establish a sick day plan to use in case of illness. When you are sick, test your blood/urine frequently and call your doctor as instructed.
• If you will be traveling across more than 2 time zones, consult your doctor concerning adjustments in your insulin schedule.
• Proper diet, regular exercise, and regular testing of blood sugar are important for best results when using Insulin Lispro Protamine and Lispro . Follow your doctor's instructions carefully. If your blood sugar level is often higher than it should be and you are taking Insulin Lispro Protamine and Lispro according to directions, check with your doctor.
• Carry an identification card at all times that says you have diabetes.
• Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for selecting an appropriate container and properly disposing of the container when full.
• An insulin reaction resulting from low blood sugar levels (hypoglycemia) may occur if you take too much insulin, skip a meal, or exercise too much. Signs of hypoglycemia include increased heartbeat, headache, chills, sweating, tremor, increased hunger, changes in vision, nervousness, weakness, dizziness, drowsiness, or fainting. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you do not have a reliable source of glucose available, eat a quick source of sugar, such as table sugar, honey, or candy, or drink a glass of orange juice or non-diet soda to quickly raise your blood sugar level. Tell your doctor immediately about the reaction.
• Developing a fever or infection, eating significantly more than prescribed, or missing your dose of insulin may cause high blood sugar (hyperglycemia). Symptoms of hyperglycemia include a drowsy feeling, flushed face, thirst, increased urination, confusion, loss of appetite, heavy breathing, rapid pulse, and fruity odor on the breath. If not treated, loss of consciousness, coma, or death may occur. Obtain medical assistance immediately if you have hyperglycemia.
• LAB TESTS, such as fasting blood glucose levels or glycosylated hemoglobin levels, may be required to monitor your progress or to check for side effects. Be sure to keep all appointments.
• Use Insulin Lispro Protamine and Lispro with extreme caution in CHILDREN; safety and effectiveness have not been established.
• If you plan on becoming pregnant, discuss with your doctor the benefits and risks of using Insulin Lispro Protamine and Lispro during pregnancy. It is unknown if Insulin Lispro Protamine and Lispro is excreted in breast milk. If you are or will be breast-feeding, check with your doctor to discuss the benefits and risks to your baby.

Possible side effects of Insulin Lispro Protamine and Lispro :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Depression in the skin; enlargement of thickening of the skin; redness, swelling, or itching at the injection site.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); changes in vision; chills; dizziness; drowsiness; fainting; headache; increased heartbeat; increased hunger; loss of consciousness; nervousness; seizures; sweating; tremor; weakness.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center ( http://www.aapcc.org/findyour.htm) or emergency room immediately. Symptoms may include chills; dizziness; drowsiness; fainting; headache; increased heartbeat; increased hunger; loss of consciousness; nervousness; seizures; shakiness; sweating; tremor; vision changes; weakness.

Proper storage of Insulin Lispro Protamine and Lispro :

Store insulin in a cold place, preferably in a refrigerator. Do not allow it to freeze. If refrigeration is not possible, the bottle of insulin that you are currently using can be kept unrefrigerated as long as it is kept as cool as possible (below 86 degrees F; 30 degrees C) and away from heat and light. Protect insulin from direct sunlight. Read the information that came with your insulin for instructions on how to store your open container, including when to discard the insulin container you are currently using. The length of time a package of insulin may be used for depends on whether it is in a vial, cartridge, pen, or other device. Ask your pharmacist if you have questions about how to properly store or when to discard your insulin. Do not use a bottle of insulin after the expiration date stamped on the label. Keep Insulin Lispro Protamine and Lispro , as well as syringes and needles, out of the reach of children and away from pets.

General information:

• If you have any questions about Insulin Lispro Protamine and Lispro , please talk with your doctor, pharmacist, or other health care provider.
• Insulin Lispro Protamine and Lispro is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Insulin Lispro Protamine and Lispro . If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.