A mixture of 75% insulin lispro protamine suspension and 25% insulin lispro injection (rDNA origin) is indicated in the treatment of patients with diabetes mellitus for the control of hyperglycemia.

A mixture of 50% insulin lispro protamine suspension and 50% insulin lispro injection (rDNA origin) is also indicated in the treatment of patients with diabetes mellitus for the control of hyperglycemia.

Insulin lispro is a short-acting biosynthetic human insulin analogue. Insulin lispro protamine is an intermediate-acting glucose-lowering agent; it is a suspension of crystals produced from combining insulin lispro and protamine sulfate under appropriate conditions for crystal formation. They are used together for the regulation of glucose metabolism.

Combination rapid-onset (faster than regular insulin) and intermediate-acting insulins in fixed dose. Dose regimen varies among patients depending on metabolic needs; typical daily insulin requirements range between 0.5-1 unit/kg

Effects may be increased by: oral antidiabetic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, propoxyphene, salicylates, somatostatin analog (e.g., octreotide), sulfonamide antibiotics. Effects may be decreased by: corticosteroids, niacin, danazol, diuretics, sympathomimetic agents, isoniazid, phenothiazine derivatives, somatropin, thyroid hormones, oral contraceptives, lithium. Signs of hypoglycemia may be masked by: beta-blockers, clonidine.

Insulin Lispro Protamine & Insulin Lispro is contraindicated during episodes of hypoglycemia and in patients sensitive to insulin lispro or any of the excipients contained in the formulation.

Hypoglycemia, hypokalemia, edema, pruritus, palpitation, nausea, rash, hypersensitivity reactions, lipoatrophy or lipohypertrophy with subcutaneous injection.

Pregnancy Category B. Animal reproduction studies have failed to demonstrate a risk to the fetus, and there are no adequate and well-controlled studies in pregnant women. OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

Lactation: It is unknown whether this drug is distributed in breast milk; it is compatible with breastfeeding, but lactating women may require dosage adjustment; caution is advised.

Renal or hepatic impairment; pregnancy, lactation; transferring from other insulin.Monitor serum glucose, potassium, electrolytes, HbA1c and lipid profile. Concomitant illness, especially infections.

Combination Insulin

Store at 2-8°C in a refrigerator. Do not freeze. In the case of insulin for recent use, it need not be refrigerated; try to keep it in a cool place and away from heat and light. The insulin in use can be kept at room temperature for one month.