Humalog® (insulin lispro): intravenous use

Detailed Information

If necessary, IL-100 may be administered IV, for example for the control of blood glucose levels during :

• ketoacidosis,

• acute illnesses or

• intra and post operative periods.¹

IL-100 is available in vials if administration of IV injection is necessary.¹

IV injection of IL-100 should be carried out following normal clinical practise for IV injections, for example by an IV bolus or by an infusion system.¹

Dosing, Stability and Adsorption

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 IL-100 to IV infusion sets and syringes found that,

• in glass beakers, solutions of IL-100 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 bags and syringes at concentrations of 0.1 and 1 units/mL, the adsorption profile of IL-100 was the same as that of Humulin S.

For both Humulin S and IL-100, the percent expected delivery rates were steady after an initial lag time.

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 Humulin S to each of 20 polyvinyl 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.

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

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

2. Ung 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

3. Quevedo 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

4. Goldberg 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

5. Goldberg 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

Glossary

IL-100 = Humalog® (insulin lispro) 100 units/mL

IV = intravenous