Insulin lispro

FDA label

Read the full label on DailyMed ↗

Renal May be at increased hypoglycemia risk; more frequent dose adjustment and glucose monitoring may be needed

Hepatic May be at increased hypoglycemia risk; more frequent dose adjustment and glucose monitoring may be needed

When switching from another insulin, dose may need to change; regimen changes require close supervision + increased glucose monitoring

Instructions

• SC injection into abdomen, thigh, upper arm, or buttocks within 15 min before or immediately after a meal; rotate sites (lipodystrophy/localized cutaneous amyloidosis risk); do not inject into affected areas
• Generally use with an intermediate- or long-acting insulin (SC injection regimens)
• Insulin pump (CSII): U-100 ONLY; change reservoir insulin at least q7d; do not dilute or mix in pump
• IV: U-100 ONLY, diluted to 0.1–1 unit/mL in 0.9% NaCl, under medical supervision with glucose and potassium monitoring
• Do NOT give U-200 by pump or IV; do NOT transfer U-200 from pen to syringe (overdose risk)
• No dose conversion with U-100/U-200 pens — dose window shows units to deliver
• Mixing: U-100 may be mixed with NPH only (draw lispro first, inject immediately); U-200 must not be mixed
• Never share pens, cartridges, or needles between patients
• Inspect before use: solution should be clear and colorless

Contraindications

• During episodes of hypoglycemia

Cautions

• Never share pens/cartridges/syringes between patients (blood-borne pathogen risk)
• Hyper- or hypoglycemia with any insulin regimen change — close supervision, increased glucose monitoring
• Hypoglycemia — most common reaction; may be life-threatening; impaired awareness with longstanding diabetes, neuropathy, beta-blockers, recurrent hypoglycemia
• Medication errors: accidental insulin mix-ups; check labels; U-200 pen-to-syringe transfer causes overdose
• Severe hypersensitivity/anaphylaxis — discontinue
• Hypokalemia (may be life-threatening) — monitor at-risk patients, esp. IV use
• Fluid retention and heart failure with concomitant thiazolidinediones — observe; consider TZD dose reduction/stop
• Hyperglycemia/ketoacidosis from insulin pump malfunction — inject SC if pump fails

Adverse reactions

• Hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash
• Trials (≥5%): flu syndrome, pharyngitis, rhinitis, headache, pain, increased cough, infection

Pregnancy Published data: no association with major birth defects, miscarriage, or adverse maternal/fetal outcomes; poorly controlled diabetes itself carries maternal & fetal risks

Lactation Transferred into human milk; no adverse reactions reported in breastfed infants; weigh benefit vs maternal need