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Humalog KwikPen manual

Humalog KwikPen 75/25 manual

Humalog KwikPen 50/50 manual

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Hypothetical patient profile. 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. Select Safety Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50 • 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 of the excipients contained in the formulation. • Closely monitor blood glucose in all patients treated with insulin. Change insulin regimens cautiously. • Humalog, Humalog Mix 75/25, and Humalog Mix50/50 should be given within 15 minutes before a meal. Humalog can also be given immediately after a meal. • Hypoglycemia is the most common adverse effect of insulin therapy, including Humalog, Humalog Mix75/25, and Humalog Mix50/50 therapy. The risk of hypoglycemia increases with tighter glycemic control. Severe hypoglycemia may be life threatening and can cause seizures or death. Click here for additional Important Safety Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50. 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. Select Safety Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50 • 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 of the excipients contained in the formulation. • Closely monitor blood glucose in all patients treated with insulin. Change insulin regimens cautiously. • Humalog, Humalog Mix 75/25, and Humalog Mix50/50 should be given within 15 minutes before a meal. Humalog can also be given immediately after a meal. • Hypoglycemia is the most common adverse effect of insulin therapy, including Humalog, Humalog Mix75/25, and Humalog Mix50/50 therapy. The risk of hypoglycemia increases with tighter glycemic control. Severe hypoglycemia may be life threatening and can cause seizures or death. Click here for additional Important Safety Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50. 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. Select Safety Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50 • 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 of the excipients contained in the formulation. • Closely monitor blood glucose in all patients treated with insulin. Change insulin regimens cautiously. • Humalog, Humalog Mix 75/25, and Humalog Mix50/50 should be given within 15 minutes before a meal. Humalog can also be given immediately after a meal. • Hypoglycemia is the most common adverse effect of insulin therapy, including Humalog, Humalog Mix75/25, and Humalog Mix50/50 therapy. The risk of hypoglycemia increases with tighter glycemic control. Severe hypoglycemia may be life threatening and can cause seizures or death. • 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. Click here for additional Important Safety Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50. 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. Select Safety Information for Glucagon • Glucagon is contraindicated in patients with known hypersensitivity to it or in patients with known pheochromocytoma. • 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. Click here for additional Important Safety Information for glucagon. 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. Select Safety Information for Humalog Use in Pumps • Adverse reactions associated with Humalog in patients receiving continuous subcutaneous insulin infusion: - In a 12-week, randomized, crossover study in adult patients with type 1 diabetes (n=39), the rates of catheter occlusions (0.09/month versus 0.10/month) and infusion-site reactions (2.6% versus 2.6%) were similar for Humalog versus regular human insulin treated patients, respectively. - In a randomized, 16-week, open-label, parallel design study of children and adolescents with type 1 diabetes, adverse event reports related to infusion-site reactions were similar for insulin lispro and insulin aspart (21% of 100 patients versus 17% of 198 patients, respectively). In both groups, the most frequently reported infusion-site adverse events were infusion-site erythema and infusion-site reaction. • Humalog Mix75/25 and Humalog Mix50/50 should never be used in a pump.* Click here for additional Important Safety Information for Humalog, Humalog Mix75/25, and Humalog Mix50/50. 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. 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. The following are questions your patients may have about using KwikPen^™: Why should I use a new needle for each injection? This will help ensure sterility. If needles are reused, you may get the wrong amount of insulin, a clogged needle, or a jammed pen. How much insulin is in the pen? Each pen contains a 3 mL (100 U/mL) cartridge, which is filled with enough insulin to ensure the delivery of 300 units. What should I do if I am not sure how much insulin remains in my cartridge? Hold the pen with the needle end pointing down. The scale on the clear Cartridge Holder shows an estimate of the number of units remaining. These numbers should NOT be used for measuring an insulin dose. Why should I prime my pen before each dose? Ensures that the pen is ready to dose. Confirms that a stream of insulin comes out of the tip of the needle when you push the Dose Knob in. Removes air that may collect in the needle or insulin cartridge during normal use. What should I do if I cannot completely push in the Dose Knob when priming the pen? Attach a new needle. Prime the pen. What should I do if I see an air bubble in the cartridge? You need to prime the pen. Remember, do not store the pen with the needle attached, as this may cause air bubbles to collect in the insulin cartridge. A small air bubble will not affect your dose and you can continue to take your dose as usual. Why is it difficult to push the Dose Knob when I try to inject? Your needle may be clogged. Try attaching a new needle. When you do this you may see insulin come out of the needle. Then prime the pen. Pressing the Dose Knob quickly may make the Dose Knob harder to push. Pressing the Dose Knob more slowly may make it easier. Using a larger diameter needle will make it easier to push the Dose Knob during your injection. See your healthcare professional to determine which needle size is best for you. If the Dose Knob continues to be difficult to push after following the steps above, try the steps below under "What should I do if my pen is jammed?" What should I do if my pen is jammed? Your pen may be jammed if it is difficult to inject a dose or dial a dose. To clear the jam: Attach a new needle. When you do this you may see insulin come out of the needle. Prime the pen. Dial your dose and inject. If the Dose Knob is still difficult to push, contact The Lilly Answers Center at 1-800-LillyRx (1-800-545-5979). Why is insulin leaking from the needle after I finish injecting my dose? You may have removed the needle from your skin too quickly. Make sure you see a 0 in the Dose Window to confirm you received the complete dose. For the next dose, push and hold the Dose Knob in and count to 5 slowly before removing the needle. What should I do if my dose is dialed and the Dose Knob is accidentally pushed in without a needle attached? Dial back to zero. Attach a new needle. When you do this you may see insulin come out of the needle. Prime the pen. Dial your dose and inject. What should I do if I dial a wrong dose (too high or too low)? Turn the Dose Knob backward or forward to correct the dose before injecting. What should I do if I see insulin leaking from the pen needle while dialing the dose or correcting the dose? Do not inject the dose because you may not get your complete dose. Dial the pen down to zero and prime the pen again. Dial your dose and inject. What should I do if my full dose cannot be dialed? The pen will not allow you to dial a dose greater than the number of insulin units remaining in the cartridge. For example, if you need 31 units and only 25 units remain in the cartridge, you will not be able to dial past 25. Do not attempt to dial past this point. You may either: Inject the partial dose and then inject the remaining dose using a new pen, or Inject the full dose with a new pen. Why can I not dial the dose to use the small amount of insulin that remains in my cartridge? The pen is designed to deliver at least 300 units of insulin. The pen design prevents the cartridge from being completely emptied because the small amount of insulin that remains in the cartridge cannot be delivered. How and where should I store my pen? Pens that have not been used should be stored in the original carton in a refrigerator but not in a freezer. Do not use a pen if it has been frozen. Do not store the pen with the needle attached. If the needle remains attached, insulin may leak from the pen, insulin may dry inside the needle causing the needle to clog, or air bubbles may form inside the cartridge. The pen you are currently using should be kept at room temperature and away from heat and light. Keep the pen out of the reach of children. Dispose of used needles in a puncture-resistant container or as directed by your healthcare professional. Dispose of used pens as instructed by your healthcare professional and without the needle attached. Humalog^® KwikPen^™ should be discarded 28 days after first use. Humalog^® Mix75/25^™ KwikPen^™ and Humalog^® Mix50/50^™ KwikPen^™ should be discarded 10 days after first use. Be sure to also check the expiration date printed on the pen's label. Do not use a pen after the expiration date printed on the carton and label. 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: HumaPen LUXURA HD 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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