Insulin lispro and Insulin lispro protamine are combined in this medicine.
This medicine is used on its own or together with other medicines to treat diabetes by keeping your blood sugar in control.
Diabetes is a condition where your body is unable to produce enough insulin to control your blood sugar levels or insulin becomes ineffective (insulin resistance).
Insulin lispro + Insulin lispro protamine is meant to be used as part of a complete diabetes management programme that should include exercise, a healthy diet and regular monitoring of blood sugar.
Use Insulin lispro + Insulin lispro protamine exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor as small changes in the amount of this medicine may affect your blood sugar levels.
Insulin lispro + Insulin lispro protamine is to be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm or abdomen area) within 15 minutes before or immediately after a meal. Try to administer it at the same time each day.
This medicine is available as a vial, cartridge or pre-filled pen. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist. This medicine may become ineffective if your insulin pen does not work properly.
How to use the pre-filled pen:
- Prepare the injection pen as instructed by your doctor or nurse.
- Attach the needle to the injection pen. Ensure that the needle is screwed on securely.
- Dial the correct dose.
- Swab the injection site area with alcohol.
- Hold the injection pen with your thumb over the injection button.
- Press the injection pen against your body using the subcutaneous (under the skin) injection method.
- Use your thumb to push the injection button until it stops. Continue to hold the injection button in that position while slowly counting to 5 to get a full dose.
- Withdraw the injection pen from your body.
- Remove the needle from the pen. Never store the injection pen with the needle attached.
- Reset your pen as instructed by your healthcare provider.
- Throw away the used needle. Recap your pen and store below 25°C.
- Use a new needle in every administration of Insulin lispro + Insulin lispro. protamine.
How to use insulin vial:
- Wash your hands.
- If using a new vial, flip off the plastic protective cap. Do not remove the stopper.
- Draw air into the syringe equal to the prescribed insulin dose.
- Wipe the top of the vial with a swab.
- Put the needle through rubber top of the vial and inject the air into the vial.
- Turn the vial and syringe upside down. Hold the vial and syringe firmly in one hand.
- Withdraw the correct dose into the syringe.
- Before removing the needle from the vial, check the syringe for air bubbles. If bubbles are present, hold the syringe straight up and tap its side until the bubbles float to the top. Push them out with the plunger and withdraw the correct dose.
- Remove the needle from the vial and hold it in your hand that will inject the medicine.
- Wipe the selected injection site with alcohol swab and pinch the skin using your other hand. Push the plunger of the syringe as far as it will go to deliver your dose.
- Slowly let go of the skin and gently pull the needle out of the skin. Do not recap the needle.
- Place a cotton ball over the injection site and press for several seconds.
- Dispose your used needles and syringes according to your doctor or pharmacist’s instructions. Use new needle and syringe for each injection.
Ensure that you are using the correct type of syringe. Check with your doctor or nurse if you are not sure.
Remember to rotate the injection sites. Do not inject into the same area all the time. Do not inject near the navel (belly button). New injection sites should be at least 1.5 inches away from the previous injection site.
Do not dilute or mix this medicine with any other insulin formulation or solution.
DO NOT administer this medicine intravenously (into a vein), intramuscularly (into a muscle) or by infusion pump.
Do not share your insulin injection with anyone else.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of your treatment depending on your condition and response to the medication.
Insulin lispro + Insulin lispro protamine must be used regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor. If you suddenly stop using this medicine, it may lead to hyperglycaemia (high blood sugar level).
If you missed a dose of this medicine, administer the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule. Check your blood sugar levels and ask your doctor on how to adjust your insulin doses if needed.
A missed dose may lead to hyperglycaemia (high blood sugar level). If you often forget to inject your medicine, let your doctor and pharmacist know. They can give you advise that can help you remember your dosing schedule.
DO NOT double a dose under any circumstances.
Do not use Insulin lispro + Insulin lispro protamine if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any of its ingredients.
Alert your doctor if you have episodes of hypoglycaemia (low blood sugar) as this medicine may not be suitable for you.
Inform your doctor if you have the following conditions:
- long-term diabetes
- recurring hypoglycaemia (low blood sugar)
- nerve damage caused by diabetes
- kidney disease
- liver disease
Let your doctor know if you are pregnant or breastfeeding.
If you are under stress, have an injury, infection or fever, inform your doctor as these conditions may affect your blood sugar level.
Exercise will also change your insulin requirement. Consult your doctor if you change your exercise routine or start on a new exercise program.
Do not change the brand or type of insulin you are using without first consulting your doctor.
Alert your doctor if you regularly drink alcohol, especially if you drink a lot.
If you are going to have an operation, including minor operations and dental work, inform your doctor or dentist that you are using this medicine.
If you are travelling, discuss with your doctor about how to adjust your injection schedule. Carry your insulin in your hand-carry luggage. Do not put insulin in your check-in luggage as it may freeze.
For as long as you are using Insulin lispro + Insulin lispro protamine, you will need to have regular blood tests (e.g. blood sugar level, liver and kidney function) to check your body’s response to the medicine. Your doctor will advise you about how often you need to have these blood tests.
If you are using this medicine, you may have been warned about hypoglycaemia (low blood sugar).
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is the medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, sweating. These signs are your body’s way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 grams of glucose tablet at first sign of hypoglycaemia, wait for 15 minutes and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 grams of glucose tablet.
If you don’t have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms did not improve after second serving.
Insulin lispro + Insulin lispro protamine may cause hypoglycaemia which may affect your ability to concentrate and react. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: weight gain, redness, swelling and itching on the injection site; rashes, lipoatrophy (depression in the skin) or lipohypertrophy (enlarged or lump area under the skin), swelling in the ankles, legs or feet; weakness, fatigue, muscle cramps and spasms.
If you develop rashes, breathlessness, swollen mouth or eyes, stop using this medicine and inform your doctor immediately. These could be signs of an allergic reaction.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- other medicines for diabetes e.g. pioglitazone, rosiglitazone, pramlintide
- medicines for heart disease or high blood pressure e.g. captopril, losartan, metoprolol, hydrochlorothiazide, clonidine, guanethidine, reserpine
- medicines for depression e.g. fluoxetine, phenelzine
- medicines for pain and inflammation e.g. aspirin, prednisolone
- growth-hormone medicines e.g. octreotide
- antibiotics e.g. sulfamethoxazole
- asthma medicines e.g. terbutaline
- birth control pills
- other medicines such as thyroid hormones, danazol
This list does not include all medicines that may interact with this medicine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol. Alcohol will worsen the hypoglycaemia (dizziness, tremor, shaky hands) caused by Insulin lispro + Insulin lispro protamine.
It is important for you to maintain a healthy diet and weight in order to help keep your diabetes under control.
It may be helpful to discuss your diet plan with your doctor or dietitian to manage your weight and blood sugar levels.
If you have not yet opened it, store Insulin lispro + Insulin lispro protamine in a refrigerator between 2-8°C.
Once opened, this medicine may be stored at room temperature not exceeding 30°C away from direct heat or sunlight. Vials may also be refrigerated between 2-8°C. At room temperature, all opened vials will expire after 28 days and the opened injection pens or cartridge will expire after 10 days. Throw away any remaining injection solution, even if the vial or injection pen is not empty.
Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used.
Do not use Insulin lispro + Insulin lispro protamine if it has changed colour, has a frosted appearance or if you see lumps floating in the liquid or stuck to the side of the glass. This medicine should be milky or cloudy white in appearance. It should not have any lumps or solid material.
Make sure you know how to store your medicine. This medicine may become ineffective if not stored properly. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
Keep away from heat, sunlight and from the reach of children.
Medicines must not be used past the expiry date.