Action and Spectrum

Actions and Spectrum: 

The actions of insulin lispro include: 

• Lowering blood glucose levels: insulin lispro helps to lower blood glucose levels by facilitating the uptake of glucose from the bloodstream into cells, where it can be used for energy or stored for future use. 
• Inhibiting the production of glucose: insulin lispro also helps to inhibit the production of glucose in the liver, which can contribute to elevated blood sugar levels. 

The spectrum of insulin lispro includes: 

• Type 1 diabetes: insulin lispro is approved for use in people with type 1 diabetes, who cannot produce insulin on their own and need to take insulin to regulate their blood sugar levels. 
• Type 2 diabetes: insulin lispro may also be used in people with type 2 diabetes, who are unable to control their blood sugar levels through diet and exercise alone and require insulin therapy to help manage their condition. 
• Gestational diabetes: insulin lispro may be used during pregnancy to help manage gestational diabetes, a condition that can occur during pregnancy when the body cannot produce enough insulin to regulate blood sugar levels. 

Drug Interaction

Adverse Reaction

Frequency Defined 

Admelog 

Severe hypoglycemia, after 52 weeks (13.5%) 

Nasopharyngitis, in combination with insulin glargine (13.1%) 

Humalog (Type 1 Diabetes) 

Pharyngitis (33.3%) 

Flu syndrome (34.6%) 

Rhinitis (29.6%) 

Pain (19.8%) 

Headache (24.7%) 

Infection (13.6%) 

Increased cough (17.3%) 

Humalog (Type 2 Diabetes) 

Headache (11.6%) 

Infection (10.1%) 

Pain (10.8%) 

Admelog 

26 weeks later severe hypoglycemia (2.4%) 

Upper respiratory tract infection (6%) 

Humalog, continuous infusion 

Infusion site reactions (2.6%) 

Humalog (Type 1 Diabetes) 

Diarrhea (8.6%) 

Accidental injury (8.6%) 

Myalgia (7.4%) 

Asthenia (7.4%) 

Abdominal pain (7.4%) 

Bronchitis (7.4%) 

Dysmenorrhea (6.2%) 

Urinary tract infection (6.2%) 

Surgical procedure (6.2%) 

Nausea (6.2%) 

Fever (6.2%) 

Humalog (Type 2 Diabetes) 

Rhinitis (8.1%) 

Pharyngitis (6.6%) 

Surgical procedure (7.4%) 

Frequency not Defined 

Pallor 

Hypoglycemia 

Redness 

Palpitation 

Tachycardia 

Nausea 

Lipohypertrophy 

Hypokalemia 

Local allergic reaction 

Lipodystrophy 

Black Box Warning

Contraindication / Caution

Contraindication/Caution: 

Contraindications: 

• Hypersensitivity: insulin lispro should not be used in people who have a known hypersensitivity to insulin lispro or any of its components. 
• Hypoglycemia: insulin lispro should not be used in people with hypoglycemia (low blood sugar) or a history of severe hypoglycemia. 

Caution/Precautions: 

• Pregnancy and breastfeeding: insulin lispro should be used with caution in pregnant and breastfeeding women, as changes in insulin requirements may occur during these times. 
• Liver or kidney disease: insulin lispro should be used with caution in people with liver or kidney disease, as these conditions can affect the way the body metabolizes insulin. 
• Alcohol intake: Alcohol consumption may affect blood sugar levels and insulin requirements and should be avoided or limited while using insulin lispro. 
• Surgery or illness: Surgery or illness can affect blood sugar levels and insulin requirements and may require adjustments to the insulin lispro dosage. 
• Hypokalemia: insulin lispro may worsen hypokalemia (low potassium levels) and should be used with caution in people with this condition. 

Pregnancy / Lactation

Pregnancy consideration:  

It is not secure to administer insulin lispro during pregnancy. 

Breastfeeding warnings:  

No data about the excretion of insulin lispro in human breast milk is available. Avoid using in lactating women. 

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 
• Category B: No evidence of risk to the fetus is found in animal reproduction studies, and there are not enough studies on pregnant women. 
• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for a human product; Pregnant women must take care of the potential risks. 
• Category D: There is adequate data with sufficient evidence of human fetal risk from various platforms. However, despite potential dangers may be used only in emergencies for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. The drug is not for pregnant women.  
• Category N: No data is available for the drug under this category. 

Pharmacology

Pharmacology: 

insulin lispro is a rapid-acting insulin analog that is designed to mimic the physiological action of natural insulin in the body. It works by binding to insulin receptors on the surface of cells, which stimulates the uptake of glucose from the bloodstream into cells, where it can be used for energy or stored for future use. 

insulin lispro has a slightly different chemical structure than natural insulin, which allows it to be absorbed more rapidly after injection. It begins working within 5-15 minutes after injection, with its peak effect occurring in about 1-2 hours, and its duration of action lasting up to 4-6 hours. 

insulin lispro is metabolized by the liver and kidneys and is excreted primarily in the urine. It has a rapid onset of action and a relatively short duration, which makes it useful for controlling blood sugar levels after meals and for correcting high blood sugar levels. 

Pharmacodynamics: 

The pharmacodynamics of insulin lispro are related to its ability to lower blood sugar levels by facilitating the uptake of glucose from the bloodstream into cells and inhibiting the production of glucose in the liver. 

When insulin lispro binds to insulin receptors on the surface of cells, it stimulates the translocation of glucose transporters (GLUT4) from the cytoplasm to the cell membrane. This increases the uptake of glucose from the bloodstream into cells, where it can be used for energy or stored for future use. 

insulin lispro also inhibits the production of glucose in the liver by suppressing the breakdown of glycogen (stored glucose) and inhibiting the release of glucose into the bloodstream by the liver. 

The pharmacodynamics of insulin lispro are characterized by its rapid onset of action, peak effect, and duration of action. It begins working within 5-15 minutes after injection, with its peak effect occurring in about 1-2 hours, and its duration of action lasting up to 4-6 hours. 

Pharmacokinetics: 

Absorption 

The bioavailability is 55-77%, well absorbed subcutaneously 

Time of onset of action is 0.5-5 hours initially and the onset of action is around 5 hours  

Distribution 

The volume of distribution is 1.55 L/kg (for 0.1 unit/kg-dose) and 0.72 L/kg (for 0.2 unit/kg-dose) 

Metabolism 

The metabolism of insulin lispro is same to human insulin 

Elimination and Excretion 

The half-life of subcutaneous dose is 1 hour 

Mean clearance rate for intravenous use is 21.0 mL/min/kg (for 0.1 unit/kg dose) and 9.6 mL/min/kg (for 0.2 unit/kg dose) 

The mean half-life is 0.85 hours (for 0.1 unit/kg) and 0.92 hours (for 0.2 unit/kg) 

Adminstartion

Administration 

insulin lispro is administered by subcutaneous injection using a syringe, insulin pen, or insulin pump. It should not be administered intravenously or by mouth, as it will not be effective and can cause serious side effects. 

The dosage and timing of insulin lispro administration will depend on a variety of factors, including the individual’s blood sugar levels, diet, exercise habits, and other medical conditions. It is important to work closely with a healthcare provider to determine the appropriate dose and timing of insulin lispro administration. 

insulin lispro is typically administered just before meals to control postprandial blood sugar levels. The dose will depend on the individual’s blood sugar level and the amount of carbohydrates they will consume in the upcoming meal. 

insulin lispro should be injected into the subcutaneous tissue of the abdomen, thigh, or upper arm. The injection site should be rotated to avoid lipodystrophy (localized loss of fat tissue) and other injection site reactions. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: insulin lispro 

Pronounced: in-su-lin lis-pro 

Why do we use insulin lispro? 

insulin lispro is used to lower blood sugar levels in people with diabetes. It is a rapid-acting insulin analog that is designed to mimic the physiological action of natural insulin in the body. 

insulin lispro is particularly useful for controlling blood sugar levels after meals, as it has a rapid onset of action, with its peak effect occurring in about 1-2 hours after injection. It is also useful for correcting high blood sugar levels and for maintaining target blood sugar levels in people with diabetes. 

Compared to regular insulin, insulin lispro has a shorter duration of action, which means it has less risk of causing hypoglycemia (low blood sugar) between meals. Additionally, it may be associated with fewer injection site reactions and less variability in blood sugar levels.