• Medication errors involving insulins have resulted in serious patient harm and death. Clarify all ambiguous orders and do not accept orders using the abbreviation “u” for units, which can be misread as a zero or the numeral 4 and has resulted in tenfold overdoses. Insulins are available in different types and strengths. Check type, dose, and expiration date with another licensed nurse. Do not interchange insulins without consulting physician or other health care professional.

• Do not confuse Humalog with Humulin or Novolog. Do not confuse Humalog Mix 72/25 with Humulin 70/30.
• Due to the short duration of action, insulin lispro must be used with a longer acting insulin, insulin infusion pump or in combination with oral sulfonylurea agents.
• Use only insulin syringes to draw up dose. The unit markings on the insulin syringe must match the insulin’s units/mL. Special syringes for doses <50 units are available. Do not draw up dose into a syringe from the Kwik Pens; syringe markings do not match up and could lead to a medication error. Use only U-100 insulin syringes to draw up insulin lispro dose. Prior to withdrawing dose, rotate vial between palms to ensure uniform solution; do not shake.
  • When mixing insulins, draw insulin lispro into syringe first to avoid contamination of regular insulin vial.
  • Humalog U-200 and Lyumjev U-200 should not be mixed with other insulins, administered IV, or used in insulin pumps.
  • Insulin should be stored in a cool place but does not need to be refrigerated.
• SC: Administer Admelog and Humalog within 15 min before or immediately after a meal. Administer Lyumjev at the start of a meal or within 20 minutes after starting a meal. Rotate injection sites to prevent lipodystrophy and cutaneous amyloidosis. Repeated insulin injections into areas of localized cutaneous amyloidosis may cause hyperglycemia; a sudden change to an unaffected injection site may cause hypoglycemia.
  • May be administered via disposable external insulin pump. Do not administer solution that appears thickened, cloudy, or discolored or contains particles. Store cartridges for pump in refrigerator. Do not mix with other insulins or solutions when used with pump. Choose a new infusion site and insertion site at least every 3 days. Discard cartridges after 7 days (9 days for Lyumjev), even if solution remains.

• May be diluted with sterile diluent for Humalog, Humulin N, Humulin 50/50, and Humulin 70/30 to a concentration of 1:10 or 1:2.

IV Administration:

• Administer Humalog-U-100 IV under medical supervision ONLY with close monitoring of blood glucose and potassium levels to avoid hypoglycemia and hypokalemia. Concentration: 0.1 unit/mL to 1.0 unit/mL. Diluent: 0.9% NaCl. Solutions of insulin lispro and 0.9% NaCl can be stored for 48 hr in refrigerator, then used at room temperature for another 48 hr.