You can’t always be with your patients. But your guidance can be.We understand that it takes more than just medicineto help your patients with type 2 diabetes startingon mealtime insulin therapy. So Lilly Diabetessupports your ef<strong>for</strong>ts with an array of insulinproducts, delivery options, and educationalresources to help your patients fit Humalog intotheir lives, even when you can’t be there.Contact your Lilly Diabetes sales representative,call The Lilly Answers Center at 1-800-LillyRx(1-800-545-5979), or visit www.Humalog.com.<strong>ADVANCE</strong> <strong>for</strong> <strong>NPs</strong> & <strong>PAs</strong>3
Important Safety In<strong>for</strong>mation <strong>for</strong> HumalogContraindications• Humalog ® is contraindicated during episodes of hypoglycemiaand in patients who are hypersensitive to Humalog or any ofits excipients.Warnings and Precautions• Dose Adjustment and Monitoring: Closely monitor bloodglucose in all patients treated with insulin. Change insulinregimens cautiously. Concomitant oral antidiabetictreatment may need to be adjusted.The time course of action <strong>for</strong> Humalog may vary in differentindividuals or at different times in the same individual and isdependent on many conditions, including delivery site, localblood supply, or local temperature. Patients who change theirlevel of physical activity or meal plan may require insulindose adjustment.• Hypoglycemia: Hypoglycemia is the most common adverseeffect of Humalog. The risk of hypoglycemia increases withtighter glycemic control. Educate patients to recognize andmanage hypoglycemia. Hypoglycemia can happen suddenlyand symptoms may vary <strong>for</strong> each person and may changeover time. Early warning symptoms of hypoglycemia maybe different or less pronounced under conditions such aslong-standing diabetes, diabetic nerve disease, use ofmedications such as beta-blockers, or intensified diabetescontrol. These situations may result in severe hypoglycemiaand possibly loss of consciousness prior to the patient’sawareness of hypoglycemia. Severe hypoglycemia may belife threatening and can cause seizures or death.Use caution in patients with hypoglycemia unawareness andwho may be predisposed to hypoglycemia. The patient’s abilityto concentrate and react may be impaired as a result ofhypoglycemia. Rapid changes in serum glucose levels mayinduce symptoms similar to hypoglycemia in persons withdiabetes, regardless of the glucose value.Timing of hypoglycemia usually reflects the time-action profileof administered insulins. Other factors such as changes in foodintake, injection site, exercise, and concomitant medicationsmay alter the risk of hypoglycemia.• Allergic Reactions: Severe, life-threatening, generalized allergy,including anaphylaxis, can occur with Humalog.• Hypokalemia: Humalog can cause hypokalemia, which, ifuntreated, may result in respiratory paralysis, ventriculararrhythmia, and death. Use caution in patients who may be atrisk <strong>for</strong> hypokalemia (eg, patients using potassium-loweringmedications or medications sensitive to serumpotassium concentrations).• Renal or Hepatic Impairment: Frequent glucose monitoringand insulin dose reduction may be required in patients withrenal or hepatic impairment.Important Safety In<strong>for</strong>mation <strong>for</strong> Humalog, continuedWarnings and Precautions, continued• Mixing of Insulins: Humalog <strong>for</strong> subcutaneous injection shouldnot be mixed with insulins other than NPH insulin. If Humalogis mixed with NPH insulin, Humalog should be drawn into thesyringe first. Injection should occur immediately after mixing.• Subcutaneous Insulin Infusion Pump: Humalog should notbe diluted or mixed when used in an external insulin pump.Change Humalog in the reservoir at least every 7 days. Changethe infusion set and insertion site at least every 3 days.Malfunction of the insulin pump or infusion set or insulindegradation can rapidly lead to hyperglycemia and ketosis.Prompt correction of the cause of hyperglycemia or ketosisis necessary. Interim subcutaneous injections withHumalog may be required. Train patients using an insulinpump to administer insulin by injection and to havealternate insulin therapy available in case of pump failure.• Drug Interactions: Some medications may alter glucosemetabolism, insulin requirements, and the risk <strong>for</strong>hypoglycemia or hyperglycemia. Signs of hypoglycemiamay be reduced or absent in patients taking anti-adrenergicdrugs. Particularly close monitoring may be required.Adverse Reactions• Adverse reactions associated with Humalog includehypoglycemia, hypokalemia, allergic reactions, injection-sitereactions, lipodystrophy, pruritus, rash, weight gain, andperipheral edema.Use in Specific Populations• Pediatrics: Humalog has not been studied in children withtype 1 diabetes less than 3 years of age or in children withtype 2 diabetes.Dosage and Administration• Humalog should be given within 15 minutes be<strong>for</strong>e orimmediately after a meal.Please see Brief Summary of Prescribing In<strong>for</strong>mation onadjacent pages.Please see full user manual that accompanies the pen.HI HCP ISI 08JUN2011Humalog ® and Humalog ® KwikPen are registered trademarksof Eli Lilly and Company and are available by prescription only.Humalog Small Steps Support• Tools and resources <strong>for</strong> your patients and staff• For introducing, initiating, and continuing therapy• May rein<strong>for</strong>ce your instructions• Helps patients fit Humalog into their livesYour patients can enroll at www.Humalog.com/mysmallsteps,you can provide them with a postage-paid enrollment<strong>for</strong>m, or they can call 1-877-700-STEP (7837).HI76441 0212 PRINTED IN USA ©Lilly USA, LLC 2012. All rights reserved.4 <strong>ADVANCE</strong> <strong>for</strong> <strong>NPs</strong> & <strong>PAs</strong>
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