Humalog ® (insulin lispro)

This information is intended for UK registered healthcare professionals only as a scientific exchange in response to your search for information.For current prescribing information for all Lilly products, including Summaries of Product Characteristics, Patient Information Leaflets and Instructions for Use, please visit: www.medicines.org.uk (England, Scotland, Wales) or www.emcmedicines.com/en-GB/northernireland/ (Northern Ireland).

How to administer Humalog® (insulin lispro) 100 units/mL intravenously?

If necessary, Humalog 100 units/mL may be administered intravenously by following normal clinical practice for IV injections, for example by an IV bolus or by an infusion system, while frequently monitoring the blood glucose levels.

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en-GB

Detailed Information

Intravenous administration of Humalog 100 units/mL

If necessary, Humalog (insulin lispro) 100 units/mL may be administered intravenously (IV), for example, for the control of blood glucose levels during 

  • ketoacidosis,
  • acute illnesses, or
  • during intra and post operative periods.1 

Humalog 100 units/mL is available in vials if administration of IV injection is necessary.1

IV administration of Humalog 100 units/mL should be carried out following normal clinical practice for IV injections, for example by an IV bolus or by an infusion system.1

Dosing, stability and adsorption of Humalog 100 units/mL to IV delivery systems

Infusion systems at concentrations from 0.1 units/mL to 1.0 units/mL insulin lispro in 0.9% sodium chloride or 5% dextrose are stable at room temperature for 48 hours.1

A study that investigated the potential adsorption of Humalog 100 units/mL to IV infusion sets and syringes found that

  • in glass beakers, solutions of Humalog 100 units/mL diluted with 0.9% sodium chloride and 5% dextrose to concentrations of 0.25 to 2 units/mL and 0.025 to 0.2 units/mL were stable for 48 hours at room temperature, and
  • in both, IV bags and syringes at concentrations of 0.1 and 1 units/mL, the adsorption profile of Humalog 100 units/mL was the same as that of Humulin R U-100 (insulin human) 100 units/mL.2

For both, Humulin R U-100 and Humalog 100 units/mL, the percent expected delivery rates were steady after an initial lag time.2

The study found several ways to substantially decrease the lag time, specifically higher product concentration, prewash of the infusion tubing, and faster flow rate.2

Priming of IV Sets

It is recommended that the system is primed before starting the infusion to the patient.1

The priming of IV sets to accommodate the adsorption of insulin is included in several institutional protocols.3-5

A study designed to quantify the insulin adsorption losses to IV lines

  • added 100 units of Regular Human Insulin to each of 20 polyvinyl chloride bags containing 100 mL of 0.9% sodium chloride for injection
  • delivered the resultant solutions (1 unit/mL) through standard polypropylene infusion sets, and
  • collected samples at 10-mL intervals from 0 to 50 mL.5

The authors concluded that, for standard IV insulin infusions, a priming volume of 20 mL was sufficient to minimize the effect of insulin adsorption losses to IV lines.5

References

1Humalog [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.

2Ling J, Hu M, Hagerup T, Campbell RK. Lispro insulin: adsorption and stability in selected intravenous devices. Diabetes Educ. 1999;25(2):237-245. http://dx.doi.org/10.1177/014572179902500209

3Quevedo SF, Sullivan E, Kington R, Rogers W. Improving diabetes care in the hospital using guideline-directed orders. Diabetes Spectr. 2001;14(4):226-233. http://dx.doi.org/10.2337/diaspect.14.4.226

4Goldberg PA, Roussel MG, Inzucchi SE. Clinical results of an updated insulin infusion protocol in critically ill patients. Diabetes Spectr. 2005;18(3):188-191. http://dx.doi.org/10.2337/diaspect.18.3.188

5Goldberg PA, Kedves A, Walter K, et al. “Waste not, want not”: determining the optimal priming volume for intravenous insulin infusions. Diabetes Technol Ther. 2006;8(5):598-601. http://dx.doi.org/10.1089/dia.2006.8.598

Date of Last Review: 12 December 2022


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