What if Humalog (insulin lispro) is clear but has bubbles in it?

Humalog (Insulin Lispro) with Bubbles: Safety and Handling

Humalog that is clear with bubbles at the top is safe to use and the bubbles themselves are not dangerous, though they should be removed before injection to ensure accurate dosing.

Understanding Humalog's Appearance

Humalog (insulin lispro) is a rapid-acting insulin that should always appear clear, not cloudy or discolored. According to guidelines:

• Rapid-acting insulins like Humalog should be clear upon visual examination 1
• Any changes in appearance such as clumping, frosting, precipitation, or change in clarity or color may signify a loss in potency 1
• The presence of bubbles alone in clear insulin does not indicate a problem with the insulin's potency

Proper Handling of Bubbles in Insulin

When bubbles are present in your Humalog:

1. Remove bubbles before injection:

   • Hold the syringe or pen upright (with needle pointing up)
   • Tap the barrel of the syringe or pen gently with your finger to bring bubbles to the surface 1
   • Push the plunger slightly to expel the air bubbles 1

2. Why bubble removal matters:

   • Air bubbles themselves are not dangerous 1
   • However, they can cause the injected dose to be decreased, affecting glycemic control 1

Pen-Specific Considerations

If using an insulin pen:

• Ensure proper priming before injection to verify free flow 1
• Priming involves seeing at least a drop of insulin at the tip of the needle 1
• Once free flow is verified, dial the desired dose and inject 1
• Do not leave needles attached to the pen after use as air or contaminants can enter the cartridge 1

Syringe-Specific Considerations

If using a syringe:

• When drawing up insulin from a vial, first draw air into the syringe equal to or slightly greater than the dose of insulin to be given 1
• Inject this air into the vial to facilitate withdrawal of insulin 1
• After drawing the insulin, inspect for air bubbles 1
• Hold the syringe vertically with needle up, tap on the barrel to bring bubbles to the surface, then push the plunger up to clear the air bubbles 1

Storage Considerations

Proper storage is important for maintaining insulin potency:

• Unopened insulin should be refrigerated
• After opening, insulin can be stored at room temperature (15-30°C or 59-86°F) for up to 30 days 1
• If room temperatures exceed 30°C (86°F), store insulin in current use in a refrigerator 1
• Allow refrigerated insulin to warm up before injection (can roll between palms to warm) 1
• Avoid extreme temperatures and excess agitation 1

Common Pitfalls to Avoid

1. Never use insulin that appears cloudy when it should be clear - this indicates a potential loss of potency
2. Don't ignore bubbles - they affect dosing accuracy
3. Don't shake insulin vigorously - this produces more bubbles 1
4. Don't reuse needles - they are no longer sterile after use and may become blunted 1

By following these guidelines, you can ensure safe and effective use of your Humalog insulin despite the presence of bubbles.