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The following are questions your patients may have about using HumaPen® LUXURA™ HD:
Why doesn't the screw move out when there is no cartridge in the pen?
The screw may not move out when you push the Injection Button unless there is a cartridge in the pen. This feature of the pen allows you to easily push the screw into the pen body when replacing a cartridge. Once a cartridge is inserted, the screw will move out when the Injection Button is pushed.
Why is it important to prime before every injection?
If you do NOT prime, you may get too much or too little insulin. Priming helps to ensure that the pen and needle are working properly. Once the pen is properly primed, a stream of insulin will flow from the needle. You may need to prime several times before you see a stream of insulin.
Why should I prime to a stream, and why isn't the pen ready for use if I see a drop of insulin on the needle tip?
Priming moves the screw into contact with the Cartridge Plunger and gets the air out of the cartridge. When you are priming your pen:
- You may see a drop of insulin on the tip of the needle when you first attach it. This only shows that the needle is attached and not clogged. You must still prime the pen.
- You may also see no flow at all. This may be because the screw is moving forward to close a gap between the screw and the Cartridge Plunger.
- If there is air in the cartridge, the insulin may sputter or drip until all the air is removed.
- Insulin will flow as a stream only when the pen is properly primed.
- If the Injection Button is hard to push, the needle may be clogged. Attach a new needle. Repeat the priming steps until a stream of insulin is seen.
If you are still unable to see a stream of insulin out of the needle, do NOT use the pen. Contact The Lilly Answers Center at 1-800-LillyRx (1-800-545-5979) or your healthcare professional for assistance or to obtain a replacement.
What should I do if I have an air bubble in the cartridge?
Priming your pen will remove air. Point the pen up, and tap the cartridge gently with your finger so any air bubbles can collect near the top. Repeat the priming steps until a stream of insulin is seen. A small air bubble may remain in the cartridge after completion of the priming steps. If you have properly primed the pen, this small air bubble will not affect your insulin dose.
Why is it difficult to push the Injection Button when I try to inject?
- Your needle may be clogged. Try attaching a new needle, and then prime the pen.
- Pushing the Injection Button down quickly may make the button harder to push. Pushing the button more slowly may make it easier.
- Using a larger diameter needle will make it easier to push the Injection Button during injection. Ask your healthcare professional which needle diameter is best for you.
If none of the above steps resolves the problem, your pen may need to be replaced.
Your Injection Button may also become harder to push if the inside of your pen gets dirty with insulin, food, drink, or other materials. Following the Care and Storage instructions in your user manual should prevent this.
Why doesn't the Dose Knob go to zero when I inject my dose?
This can happen if the Humalog® Insulin Cartridge does not have enough insulin left in it for your entire dose. The number in the Dose Window is the amount you did NOT receive. To get the rest of your dose, remove the needle, change the Insulin Cartridge, attach a new needle and prime the pen. Then complete your dose by dialing the amount that you did NOT receive and injecting only this amount.
How much insulin does the pen hold?
The pen can only be used with Humalog 3 mL (100 U/mL) cartridges, which are filled with enough insulin to ensure the delivery of 300 units.
How and where should I store the pen?
- Remove the needle after every use. Do not store the pen with the needle attached.
- Keep the pen away from moisture, dust, extreme hot or cold temperatures, and direct sunlight.
- Do not store the pen in a refrigerator.
- For your insulin cartridge, do NOT store a cartridge that you are using in the refrigerator. Keep at room temperature below 86°F (36°C) for up to 28 days. Throw away a cartridge 28 days after first use, even if there is insulin left in the cartridge.
Pens are for single-patient use only and should not be shared among patients as infection or disease can be spread from one person to another.
Next Topic: Tools and Resources
Indication for Humalog, Humalog Mix75/25, and Humalog Mix50/50
Humalog® is an insulin analog indicated to improve glycemic control in adults and children with diabetes mellitus.
Humalog® Mix75/25™ and Humalog® Mix50/50™ are indicated in the
treatment of patients with diabetes mellitus for the control of hyperglycemia. All of these insulin
products contain 100 units per mL.
Important Safety Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50
Contraindications
- Humalog, Humalog Mix75/25, and Humalog Mix50/50 are contraindicated during episodes of hypoglycemia and in patients who are hypersensitive
to insulin lispro or any excipients contained in the formulation.
Warnings and Precautions
- Dose Adjustment, Monitoring, and Considerations: Closely monitor blood glucose in all patients treated with insulin. Change insulin regimens
cautiously. Concomitant oral antidiabetic treatment may need to be adjusted.
The time course of action for Humalog, Humalog Mix75/25, and Humalog Mix50/50 may vary in different individuals or at different times in the same individual
and is dependent on many conditions, including the delivery site, local blood supply, or local temperature. Patients who change their level of
physical activity or meal plan, or experience illness, emotional disturbances, or other stress may require insulin dose adjustment.
Humalog differs from regular human insulin by its rapid onset of action and shorter duration of activity. Humalog should be given within 15 minutes
before or immediately after a meal. Humalog Mix75/25 and Humalog Mix50/50 are intended only for subcutaneous administration and should be
given within 15 minutes before a meal.
- Hypoglycemia: Hypoglycemia is the most common adverse effect of Humalog, Humalog Mix75/25, and Humalog Mix50/50. The risk of hypoglycemia
increases with tighter glycemic control. Educate patients to recognize and manage hypoglycemia. Hypoglycemia can happen suddenly and symptoms may vary for
each person and may change over time. Early warning symptoms of hypoglycemia may be different or less pronounced under conditions such as long-standing
diabetes, diabetic nerve disease, use of medications such as beta-blockers, or intensified diabetes control. These situations may result in severe hypoglycemia
and possibly loss of consciousness prior to the patient’s awareness of hypoglycemia. Severe hypoglycemia may be life threatening and can cause seizures or death.
Use caution in patients with hypoglycemia unawareness and who may be predisposed to hypoglycemia. The patient’s ability to concentrate and react may
be impaired as a result of hypoglycemia. Rapid changes in serum glucose levels may induce symptoms similar to hypoglycemia in persons with
diabetes, regardless of the glucose value.
The timing of hypoglycemia usually reflects the time-action profile of the administered insulins. Other factors such as changes in food intake, injection
site, exercise, and concomitant medications may also alter the risk of hypoglycemia.
- Allergic Reactions: Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with Humalog, Humalog
Mix75/25, and Humalog Mix50/50.
- Hypokalemia: Humalog, Humalog Mix75/25, and Humalog Mix50/50 can cause hypokalemia, which, if untreated, may result in respiratory
paralysis, ventricular arrhythmia, and death. Use caution in patients who may be at risk for hypokalemia (eg, patients using potassium-lowering
medications or medications sensitive to serum potassium concentrations).
- Renal or Hepatic Impairment: Frequent glucose monitoring and insulin dose reduction may be required in patients with renal or hepatic impairment.
- Mixing of Insulins: Patients should be advised NOT to mix Humalog Mix75/25 or Humalog Mix50/50 with any other insulin. Humalog for subcutaneous
injection should not be mixed with insulins other than NPH insulin. If Humalog is mixed with NPH insulin, Humalog should be drawn into the syringe
first. Injection should occur immediately after mixing.
- Humalog Use in a Subcutaneous Insulin Infusion Pump: Humalog should not be diluted or mixed when used in an external insulin
pump. Change Humalog in the reservoir at least every 7 days. Change the infusion set and insertion site at least every 3 days.
Malfunction of the insulin pump or infusion set or insulin degradation can rapidly lead to hyperglycemia and ketosis. Prompt correction of the cause of
hyperglycemia or ketosis is necessary. Interim subcutaneous injections with Humalog may be required. Train patients using an insulin pump to administer
insulin by injection and to have alternate insulin therapy available in case of pump failure.
- Humalog Mix75/25 and Humalog Mix50/50 should never be used in a pump.
- Drug Interactions: Some medications may alter glucose metabolism, insulin requirements, and the risk for hypoglycemia or
hyperglycemia. The signs of hypoglycemia may be reduced or absent in patients taking anti-adrenergic drugs. Particularly close monitoring may be required.
Adverse Reactions
- Adverse reactions associated with Humalog, Humalog Mix75/25, and Humalog Mix50/50 include hypoglycemia, hypokalemia, allergic reactions, injection-site
reactions, lipodystrophy, pruritus, rash, weight gain, and peripheral edema.
Use in Specific Populations
- Pediatrics: Humalog has not been studied in children with type 1 diabetes less than 3 years of age or in children with type 2
diabetes. Safety and effectiveness of Humalog Mix75/25 and Humalog Mix50/50 in patients less than 18 years of age have not been established.
Please click to access Full Prescribing Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50.
Please see full user manual that accompanies the pen.
HI BOI HCP ISI 08JUN2011
Indication for Glucagon
Glucagon is indicated as a treatment for severe hypoglycemia.
Because patients with type 1 diabetes may have less of an increase in blood glucose levels compared with a stable type 2 patient, supplementary carbohydrate should be given as soon as possible, especially to a pediatric patient.
Important Safety Information for Glucagon
Contraindications
- Glucagon is contraindicated in patients with known hypersensitivity to it or in patients with known pheochromocytoma.
Warnings
- Glucagon should be administered cautiously to patients with a history suggestive of insulinoma, pheochromocytoma, or both. In patients with insulinoma, intravenous administration of glucagon may produce an initial increase in blood glucose; however, because of glucagon’s hyperglycemic effect the insulinoma may release insulin and cause subsequent hypoglycemia. A patient developing symptoms of hypoglycemia after a dose of glucagon should be given glucose orally, intravenously, or by gavage, whichever is most appropriate.
- Exogenous glucagon also stimulates the release of catecholamines. In the presence of pheochromocytoma, glucagon can cause the tumor to release catecholamines, which may result in a sudden and marked increase in blood pressure.
- Generalized allergic reactions, including urticaria, respiratory distress, and hypotension, have been reported in patients who received glucagon by injection.
Precautions
- Glucagon is effective in treating hypoglycemia only if sufficient liver glycogen is present. Therefore, hypoglycemia associated with states of starvation, adrenal insufficiency, or chronic hypoglycemia should be treated with glucose.
- Patients and family members should become familiar with the technique of preparing glucagon before a severe hypoglycemic emergency arises.
- To prevent severe hypoglycemia, patients and family members should be informed of the symptoms of mild hypoglycemia and how to treat it appropriately. Blood glucose determinations should be obtained to monitor the patient with hypoglycemia until patient is asymptomatic, and patients should be advised to inform their physician when hypoglycemic reactions occur.
- One-half the adult dose should be used in pediatric patients weighing less than 44 lbs (20 kg). Any unused portion should be discarded.
- Pregnancy Category B: There are no adequate and well-controlled clinical studies of the use of glucagon in pregnant or nursing women.
Adverse Reactions
- Severe adverse reactions are very rare, although nausea and vomiting may occur occasionally.
For more safety information, please click to access Information for the User
and Information for the Physician.
HI GLUC HCP ISI 21APR2011
Humalog®, Humalog® KwikPen™, and HumaPen® MEMOIR™ are registered trademarks of Eli Lilly and Company and are available by prescription only.
Humalog® is a registered trademark of Eli Lilly and Company and is available by prescription only.
Humalog® and Humalog® KwikPen™ are registered trademarks of Eli Lilly and Company and are available by prescription only.
Humalog® and Humalog® KwikPen™ are registered trademarks of Eli Lilly and Company and are available by prescription only.
Humalog®, Humalog® KwikPen™, and HumaPen® MEMOIR™ are registered trademarks of Eli Lilly and Company and are available by prescription only.
Humalog® Mix75/25™ and Humalog® Mix50/50™ are trademarks of Eli Lilly and Company and are available by prescription only.
Humalog® Mix75/25™, Humalog® Mix50/50™, Humalog® Mix75/25™ KwikPen™, and Humalog® Mix50/50™ KwikPen™ are trademarks of Eli Lilly and Company and are available by prescription only.
HumaPen® LUXURA™ is a registered trademark of Eli Lilly and Company. HumaPen® LUXURA™ HD is available by prescription only.
The glucagon design is a trademark of Eli Lilly and Company. Glucagon is available by prescription only.
Other product names mentioned herein are the trademarks of their respective owners.
Nutrition in the Fast Lane™ is a trademark of Eli Lilly and Company.
Humulin® is a registered trademark of Eli Lilly and Company.
Managing Your Diabetes® is a registered trademark of Eli Lilly and Company.
BD, BD Logo, and BD AutoShield are trademarks of Becton, Dickinson and Company.
Adobe® Reader® is a registered trademark of Adobe Systems Incorporated.
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