Posology : מינונים

4.2   Posology and method of administration

Posology
The dosage should be determined by the physician, according to the requirement of the patient.

Humalog may be given shortly before meals. When necessary Humalog can be given soon after meals.

Humalog takes effect rapidly and has a shorter duration of activity (2 to 5 hours) given subcutaneously as compared with soluble insulin. This rapid onset of activity allows a Humalog injection to be given very close to mealtime. The time course of action of any insulin may vary considerably in different individuals or at different times in the same individual. The faster onset of action compared to soluble human insulin is maintained regardless of injection site. The duration of action of Humalog is dependent on dose, site of injection, blood supply, temperature, and physical activity.

Humalog can be used in conjunction with a longer-acting insulin or oral sulphonylurea medicinal products, on the advice of a physician.

Humalog KwikPens

Humalog KwikPen is available in two strengths. The Humalog KwikPen 200 units/ml (and Humalog KwikPen 100 units/ml, see separate SmPC) delivers 1 – 60 units in steps of 1 unit in a single injection.
The number of insulin units is shown in the dose window of the pen regardless of strength and no dose conversion should be done when transferring a patient to a new strength or to a pen with a different dose step.

Humalog KwikPen 200 units/ml should be reserved for the treatment of patients with diabetes requiring daily doses of more than 20 units of rapid-acting insulin. The insulin lispro solution containing 200 units/ml should not be withdrawn from the pre-filled pen (the KwikPen) or mixed with any other insulin (see section 4.4 and section 6.2).

Special populations

Renal impairment
Insulin requirements may be reduced in the presence of renal impairment.
Hepatic impairment
Insulin requirements may be reduced in patients with hepatic impairment due to reduced capacity for gluconeogenesis and reduced insulin breakdown; however, in patients with chronic hepatic impairment, an increase in insulin resistance may lead to increased insulin requirements.

Method of administration

Humalog solution for injection should be given subcutaneously.
Subcutaneous administration should be in the upper arms, thighs, buttocks, or abdomen. Use of injection sites should be rotated so that the same site is not used more than approximately once a month, in order to reduce the risk of lipodystrophy and cutaneous amyloidosis (see section 4.4 and 4.8).

When administered subcutaneously care should be taken when injecting Humalog to ensure that a blood vessel has not been entered. After injection, the site of injection should not be massaged. Patients must be educated to use the proper injection techniques.

Humalog KwikPen 200 units/ml solution for injection should not be used in an insulin infusion pump.

Humalog KwikPen 200 units/ml solution for injection should not be used intravenously.