WHAT HUMALOG MIX25 AND WHAT IT IS USED
Humalog Mix25 is used to treat diabetes. Humalog Mix25 is a premixed suspension . The active substance is insulin lispro. 25% insulin lispro in Humalog Mix25 is dissolved in water and it works faster than regular human insulin because the insulin molecule has been changed slightly. 75% of the insulin lispro Humalog Mix25 in the form of a suspension together with protamine sulphate , so that its action is prolonged.
You get diabetes if your pancreas does not produce enough insulin to control the level of glucose in the blood. Humalog Mix25 substitute for your own insulin and is used to control glucose for prolonged periods. Humalog Mix25 run faster and longer time compared to regular insulin. You should normally use Humalog Mix25 to 15 minutes before meals.
Your doctor may advise you to use Humalog Mix25, as well as longer-acting insulin. Each kind of insulin with another patient information leaflet that explains its properties . Do not change your insulin unless your doctor tells you to. Be very careful if you change your insulin.
2 . BEFORE YOU USE HUMALOG MIX25
Do not use Humalog Mix25
if you suspect hypoglycaemia ( low blood sugar). Later in this leaflet explains what to do with mild hypoglycaemia .
if you are allergic (hypersensitive ) to insulin lispro or any of the other ingredients of Humalog Mix25.
Take special care with Humalog Mix25
If your blood sugar levels are well controlled by current insulin therapy , you may not feel the warning symptoms when blood sugar levels fall too low. Warning signs are listed later in this leaflet. Must think carefully about when to eat , how often and intensive exercise. Should carefully monitor the levels of your blood sugar through frequent measurement of blood sugar.
A few people who have had hypoglycaemia after transfer from animal insulin to human insulin have reported that early warning symptoms were less obvious or different. If you often have hypoglycaemia or have difficulty recognizing it, please discuss this with your doctor.
If you answer YES to any of the following questions, tell your doctor, pharmacist or diabetes nurse .
Have you recently become ill ?
Do you have problems with your kidneys or liver?
Subjected you to more exercise than usual.
The amount of insulin you need may change if you drink alcohol.
You should also tell your doctor , pharmacist or diabetes nurse if you plan to travel abroad. The time difference between countries may mean that you have to have your injections and meals at different times than you are at home .
Some patients with long-standing type 2 diabetes mellitus and heart disease or previous stroke who were treated with pioglitazone and insulin experienced the development of heart failure. Tell your doctor as quickly as possible if you experience signs of heart failure such as unusual shortness of breath or rapid increase in weight or localized swelling ( edema) .
Using other medicines
Your insulin needs may change if you take birth control pills , steroids, hormone replacement therapy thyroid , oral blood glucose lowering , aspirin , antibiotics, containing ” sulfa ” group , octreotide, ” beta-2 stimulants ” (e.g., ritodrine , salbutamol or terbutaline ) , beta- blockers, or some antidepressants ( monoamine oxidase inhibitors or selective serotonin reuptake inhibitors ) , danazol, some angiotensin converting (ACE ) inhibitors (e.g., captopril , enalapril ), and angiotensin blockers II receptor .
Please tell your doctor if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.
Pregnancy and lactation
Are you pregnant or thinking about becoming pregnant , or breast-feeding ? The amount of insulin you need usually falls during the first three months of pregnancy and increases for the remaining six months. If you are breastfeeding you may need to change your insulin intake or diet.
Ask your doctor.
Driving and using machines
Ability to concentrate and react may be reduced if you have hypoglycaemia. Please note this in all situations where you might put yourself and others at risk ( eg driving a car or operating machinery) . You should contact your doctor about the advisability of driving if you have:
frequent episodes of hypoglycemia ;
reduced or absent warning signs of hypoglycaemia.
3 . HOW TO USE HUMALOG MIX25
3 ml cartridge for use with pens of 3 ml. They should not be used in pens of 1,5 ml.
Always check the pack and the cartridge label for the name and type of insulin when you get it from your pharmacy. Make sure you get this Humalog Mix25, which you have been told your doctor.
Always use Humalog Mix25 exactly as your doctor tells you . If you are not sure, ask your doctor.
You should normally inject Humalog Mix25 15 minutes before eating . If necessary , you can inject immediately after eating. But your doctor will tell you exactly how much to use , when to use it and how often. These instructions are only for you. Follow them exactly and visit your diabetes clinic regularly.
If you change the type of insulin you use (for example human or animal insulin product Humalog- ov ) , maybe you should not take more or less than before. This can only be for the first injection or may be a gradual change over several weeks or months.
Inject Humalog Mix25 subcutaneously. You should not use it otherwise . Under no circumstances should Humalog Mix25 be given intravenously.
Preparation of Humalog Mix25
Before using Humalog Mix25 cartridges should be rotated between the palms of the hands and rotate 180 ° ten times to insulin to mix so that it appears uniformly cloudy or milky. If not , repeat the above procedure until contents are mixed. Cartridges contain a small glass bead to assist mixing . Do not shake vigorously as this may result in the formation of foam, which will interfere with the measurement of the dose . The cartridges should be checked frequently and should not be used if there are lumps or if the walls or bottom solid white particles , giving them a frosted appearance . Check each time you inject .
Getting the pen ready for use
First wash your hands . Disinfect the rubber membrane of the cartridge.
You must use Humalog Mix25 cartridges in compatible CE marked pens . Please make sure that Humalog or Lilly cartridges are mentioned in the leaflet accompanying your pen. 3 ml cartridges are suitable only for pens of 3 ml.
Follow the instructions that come with the pen. Insert the cartridge into the pen.
Adjust the dosage of 1 or 2 units. Then hold the pen with the needle pointing up and tap the pen so that any bubbles float to the top. As you continue to hold the pen still up, press the injection mechanism. Do this until a drop of Humalog Mix25 needle . There may be still be some small air bubbles in the pen. They are harmless, but if the air bubble is too big, it can make the dose of injection less accurate.
Injection of Humalog Mix25
Before you make an injection, clean your skin as you have been instructed . Inject under the skin , as you said. Can not be injected directly into a vein. After your injection, leave the needle in the skin for five seconds to make sure that you take the entire dose . Do not rub the area you have just injected. Make sure you inject at least half an inch ( 1 cm) from the last injection and that you change injection sites , as you have been taught.
Once you have done the injection, unscrew the needle from the pen using the outer needle cap. This will keep the Humalog Mix25 sterile and prevent leaking. It also stops air entering the pen and the needle clogging. Do not share your needles . Do not share your pen . Put the cap back on your pen.
Leave the cartridge in the pen. Before each injection, dial 1 or 2 units and press the pen up until a drop of Humalog Mix25 the needle. You can see how Humalog left by looking at the gauge on the side of the cartridge . The distance between the bars is about 20 units . If there is not enough for your dose, change the cartridge.
Do not mix any other insulin in cartridges Humalog Mix25. Once the cartridge is empty, do not use it again.
If you use more than the amount of Humalog Mix25
If you take more Humalog Mix25, than you need , you may experience low blood sugar. Check your blood sugar. If your blood sugar is low, eat glucose tablets, sugar or drink a sugary drink. Then eat fruit , biscuits or a sandwich, as your doctor has advised and rest . In most cases this will help you over mild hypoglycaemia or low insulin overdose . If you feel worse and your breathing is shallow and your skin gets pale, call your doctor. Too severe hypoglycemia can be treated with glucagon injection . Eat glucose or sugar after the glucagon injection. If there is no response to glucagon, you will need to go to hospital. Ask your doctor to tell you about glucagon .
If you forget to use Humalog Mix25
If you use less Humalog Mix25, than you need , you may experience high blood sugar . Check your blood sugar.
If hypoglycemia ( low blood sugar) or hyperglycemia ( high blood sugar) is not treated they can be very serious and cause headaches, nausea, vomiting, dehydration , unconsciousness, coma or even death ( see A and B in section 4 . ” Possible side effects”).
Always keep spare syringes and a spare vial of Humalog Mix25, or a spare pen and cartridges, in case you lose your pen or cartridges or they get damaged .
Always wear something that shows that you are diabetic.
Always carry sugar with you.
If you stop using Humalog Mix25
If you use less Humalog Mix25, than you need , you may experience high blood sugar . Do not change your insulin you, unless your doctor tells you .
If you have any further questions on the use of this product, ask your doctor or pharmacist.
4 . POSSIBLE SIDE EFFECTS
Like all medicines , Humalog Mix25 can cause side effects , although not everybody gets them.
Local allergy is common (> = 1/100 to <1 /10): Some people get redness , swelling or itching around the injection of insulin. Usually this resolves in a few days to a few weeks. If this happens to you, tell your doctor.
Systemic allergy is rare (> = 1/10 , 000 to < 1/1 , 000) . The symptoms are the following :
rash all over the body ;
difficulty breathing ;
wheezy breathing ;
drop in blood pressure;
fast heartbeat ;
If you think you have this type of insulin allergy with Humalog Mix25, tell your doctor immediately .
Lipodystrophy (thickening or pitting of the skin ) is uncommon (> = 1 /1, 000 to <1 /100). If you notice a thickening or pitting at the injection site, tell your doctor.
If any of the side effects gets serious , or you notice other effects not listed in this leaflet , please tell your doctor or pharmacist.
Common problems of diabetes
Hypoglycemia (low blood sugar ) means that there is not enough sugar in the blood. It can be caused if:
take too much Humalog Mix25 or other insulin;
miss or delay meals or change your diet;
exercise or work too hard just before or after a meal;
you have an infection or illness ( especially diarrhea or vomiting);
there is a change in your insulin;
have a problem with your kidneys or liver, which gets worse .
Alcohol and some medicines can affect the levels of your blood sugar.
The first symptoms of low blood sugar usually come on quickly and include the following:
nervousness or tremor ;
fast heartbeat ;
feeling sick ;
cold sweat .
Until you are confident that recognizing your warning symptoms , avoid situations eg driving a car , in which you or others would be put at risk by hypoglycaemia.
B. Hyperglycaemia and diabetic ketoacidosis
Hyperglycemia (too much sugar in the blood) means that your body does not have enough insulin. Hyperglycemia may be caused by the fact that:
not take Humalog, designed for you or other insulin;
taking less insulin than your doctor tells you ;
eating a lot more than your diet allows;
fever, infection or emotional stress.
Hyperglycemia can lead to diabetic ketoacidosis . The first symptoms appear slowly over many hours or days. The symptoms include the following:
red face ;
lack of appetite ;
odor of breath fruits;
feeling sick or vomiting.
Severe symptoms are heavy breathing and a rapid pulse. Seek medical help immediately.
If you are sick / on , especially if you feel sick or are sick / a, the amount of insulin you need may change. Even when you are not eating normally, you still need insulin. Test your urine or blood, follow your ‘sick rules ‘, and tell your doctor.
5 . HOW TO STORE HUMALOG MIX25
Before use, store Humalog Mix25, designed for you in a refrigerator ( 2 ° C – 8 ° C). Do not freeze. Keep the cartridge in use at room temperature to ( 15-30 ° C) and discard after 28 days. Do not put it near sources of heat and light. The pen or the cartridges you are using in the refrigerator. Pen with a cartridge must not be stored with a needle attached .
Keep out of the reach of children.
Do not use Humalog Mix25 after the expiry date stated on the label and carton. Expiry date refers to the last day of that month.
Do not use Humalog Mix25, if there is a ” rags ” or if solid white particles stick to the bottom or wall of the cartridge looks frosted . Check each time you inject .
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required . These measures will help to protect the environment.
6 . ADDITIONAL INFORMATION
What does Humalog Mix25 100U/ml suspension for injection in a cartridge
The active substance is insulin lispro. Insulin lispro is made in the laboratory by a ‘recombinant DNA technology’ process . This is a modified form of human insulin , and therefore is different from other human and animal insulins. Insulin lispro is closely related to human insulin, which is a natural hormone produced by the pancreas .
The other ingredients are protamine sulfate , m-cresol , phenol , glycerol, dibasic sodium phosphate 7H2O, zinc oxide and water for injection . Sodium hydroxide or hydrochloric acid may have been used to adjust acidity .
Looks like Humalog Mix25 100U/ml, suspension for injection in a cartridge and contents of the pack
Humalog Mix25 100U/ml, suspension for injection is a white, sterile suspension and contains 100 units of insulin lispro in each milliliter (100 U / ml) suspension for injection . 25% insulin lispro in Humalog Mix25 is dissolved in water. 75% of the insulin lispro Humalog Mix25 in the form of a suspension together with protamine sulfate . Each cartridge contains 300 units ( H milliliters). The cartridges come in packs of 5 cartridges or a pack of 2 x 5 cartridges .
Not all pack sizes may be marketed.