Insulin lispro
Insulin lispro (Humalog, Admelog) is available as a 100-units/mL (U-100) injection solution in 3- or 10-mL multiple-dose vials and 3-mL prefilled injection pens or cartridges.4051; 4052 Each mL of Humalog U-100 contains insulin lispro 100 units, dibasic sodium phosphate 1 mg, glycerin 16 mg, metacresol 3.15 mg, trace amounts of phenol, and zinc oxide (adjusted to provide 0.0197 mg zinc ion) in water for injection with hydrochloric acid and/or sodium hydroxide for pH adjustment.4051 Each mL of Admelog contains insulin lispro 100 units, dibasic sodium phosphate 1.88 mg, glycerin 16 mg, metacresol 3.15 mg, and zinc oxide (adjusted to provide 0.0197 mg zinc ion) in water for injection with hydrochloric acid and/or sodium hydroxide for pH adjustment.4052
Insulin lispro (Humalog) also is available as a 200-units/mL (U-200) injection solution in 3-mL prefilled injection pens.4051 Each mL of Humalog U-200 contains insulin lispro 200 units, glycerin 16 mg, metacresol 3.15 mg, trace amounts of phenol, tromethamine 5 mg, and zinc oxide (adjusted to provide 0.046 mg zinc ion) in water for injection with hydrochloric acid and/or sodium hydroxide for pH adjustment.4051
A 10-mL vial containing Sterile Diluent for Humalog U-100 and Humulin R U-100 is available separately.4051 Each mL of Sterile Diluent for Humalog U-100 and Humulin R U-100 contains glycerin 16 mg, metacresol 1.6 mg, phenol 0.65 mg, sodium phosphate dibasic 3.8 mg and hydrochloric acid and/or sodium hydroxide in water for injection.4051
Insulin lispro-aabc
Insulin lispro-aabc (Lyumjev) is available as a 100-units/mL (U-100) injection solution in 10-mL multiple-dose vials and 3-mL prefilled injection pens or cartridges.4056 Each mL of Lyumjev U-100 contains insulin lispro-aabc 100 units, glycerol 12.1 mg, magnesium chloride hexahydrate 1.02 mg, metacresol 3.15 mg, sodium citrate dihydrate 4.41 mg, treprostinil sodium 1.06 mcg, and zinc oxide (adjusted to provide 0.039 mg zinc ion) in water for injection with hydrochloric acid and/or sodium hydroxide for pH adjustment.4056
Insulin lispro-aabc (Lyumjev) also is available as a 200-units/mL (U-200) injection solution in 3-mL prefilled injection pens.4056 Each mL of Lyumjev U-200 contains insulin lispro-aabc 200 units, glycerol 12.1 mg, magnesium chloride hexahydrate 1.02 mg, metacresol 3.15 mg, sodium citrate dihydrate 4.41 mg, treprostinil sodium 1.06 mcg, and zinc oxide (adjusted to provide 0.052 mg zinc ion) in water for injection with hydrochloric acid and/or sodium hydroxide for pH adjustment.4056
pH
Trade Name(s)
Admelog, HumaLOG, Lyumjev
Insulin lispro and insulin lispro-aabc U-100 may be administered by subcutaneous injection, continuous subcutaneous infusion using an insulin pump, or by intravenous infusion.4051; 4052; 4056 Insulin lispro and insulin lispro-aabc U-200 are administered by subcutaneous injection only and should not be administered intravenously or by subcutaneous infusion.4051; 4056 Because U-200 prefilled injection pens are calibrated to deliver the 200-units/mL concentration, insulin lispro and insulin lispro-aabc U-200 must not be transferred from prefilled injection pens to a syringe.4051; 4056
For continuous subcutaneous infusion using an insulin pump, insulin lispro and insulin lispro-aabc U-100 should not be diluted or mixed with other insulins.4051; 4052; 4056
For subcutaneous injection, insulin lispro U-100 may be diluted according to the following recommendations:
Humalog U-100: Dilute only with Sterile Diluent for Humalog U-100 and Humulin R U-100 (available separately) 1 or 9 parts to 1 part insulin lispro U-100 to yield a concentration of 50 units/mL (U-50) or 10 units/mL (U-10), respectively.4051
Admelog: Dilute with 1 part sodium chloride 0.9% to 1 part insulin lispro U-100 to yield a concentration of 50 units/mL (U-50).4052
For intravenous infusion, insulin lispro and insulin lispro-aabc U-100 should be diluted according to the following recommendations:
Humalog U-100, Admelog: Dilute with sodium chloride 0.9% to a concentration of 0.1 to 1 unit/mL.4051; 4052
Lyumjev U-100: Dilute with sodium chloride 0.9% or dextrose 5% to a concentration of 1 unit/mL; concentrations below 1 unit/mL are not recommended,4056
Insulin lispro and insulin lispro-aabc are clear, colorless solutions.4051; 4052; 4056 Intact vials. cartridges, or prefilled injection pens should be stored at 2 to 8°C and protected from direct heat and light.4051; 4052; 4056 Do not freeze.4051; 4052; 4056
Although refrigerated storage is recommended, intact vials, cartridges, and prefilled injection pens also may be stored at room temperature below 30°C for up to 28 days.4051; 4052; 4056 Once opened (in-use), vials may be stored at room temperature or refrigerated for up to 28 days.4051; 4052; 4056 Opened (in-use) cartridges and prefilled injection pens should be stored at room temperature for up to 28 days and should not be refrigerated.4051; 4052; 4056
When used in an insulin pump for continuous subcutaneous infusion, insulin lispro (Humalog, Admelog) should be changed at least every 7 days and insulin lispro-aabc (Lyumjev) should be changed at least every 9 days, or according to the pump user manual, whichever is shorter, or after any exposure to temperature exceeding 37°C.4051; 4052; 4056
Diluted solutions for subcutaneous injection (diluted with Sterile Diluent for Humalog U-100 and Humulin R U-100) should be stored according to the following recommendations:
Humalog U-100: Diluted solutions for subcutaneous injection (10 or 50 units/mL) may be stored for 28 days when refrigerated at 5°C or 14 days at room temperature up to 30°C.4051
Admelog: Diluted solutions for subcutaneous injection (50 units/mL) may be used for 24 hours when stored at 2 to 8°C or 4 hours when stored at room temperature up to 30°C.4052
Diluted solutions for intravenous infusion should be stored according to the following recommendations:
Humalog U-100: Diluted solutions for intravenous infusion may be stored for 48 hours at 2 to 8°C and may be used for an additional 48 hours at room temperature.4051
Admelog: Diluted solutions for intravenous infusion are stated to be stable for 24 hours at 2 to 8°C or may be used at room temperature for up to 4 hours.4052
Lyumjev U-100: Diluted solutions for intravenous infusion may be stored for up to 4 days at 2 to 8°C or up to 12 hours at room temperature.4056
The physical and chemical stability of insulin lispro 100 units/mL in MiniMed507c, H-TRONplus, and D-TRON CSII insulin infusion devices stored at 37°C and subjected to mechanical shaking at 100 strokes/min was evaluated over 7 days. The insulin lispro solution remained clear and free of aggregation and precipitation, and concentrations remained at 95%.2638
For a list of references cited in the text of this monograph, search the monograph titled References.