Humalog (Insulin Lispro) Dosing Guide

Humalog (insulin lispro) should be administered 0-15 minutes before meals or immediately after meals for optimal glycemic control. 1

Characteristics of Humalog

Humalog is a rapid-acting insulin analog with faster onset of action (5 minutes) and shorter duration (3-4 hours) compared to regular human insulin 2
The peak action time for Humalog occurs at 1-2 hours after injection 2
Humalog's time-action profile more closely mimics the physiological insulin response to food intake than regular human insulin 3
Visual inspection should confirm that Humalog appears clear; any clumping, frosting, precipitation, or change in clarity/color may indicate loss of potency 2

For insulin-naive patients: Start with 10 units per day or 0.1-0.2 units/kg per day 2
For patients switching from other insulin regimens: Consider maintaining the same total daily dose but adjusting the timing of administration 2

Set fasting plasma glucose goals based on individual patient factors 2
Increase dose by 2 units every 3 days to reach fasting plasma glucose goal without hypoglycemia 2
For hypoglycemia without clear cause, lower the dose by 10-20% 2

Inject Humalog within 15 minutes before meals (preferred timing) 1
Alternatively, Humalog can be administered immediately after meals if necessary 4
This flexible injection schedule provides convenience compared to regular human insulin, which requires injection 30-40 minutes before meals 1

Humalog can be mixed with NPH insulin for immediate use or stored for future use 2
When mixing Humalog with intermediate- or long-acting insulin, inject the mixture within 15 minutes before a meal 2
Do not mix Humalog with insulin glargine due to the low pH of glargine's diluent 2
Phosphate-buffered insulins (e.g., NPH) should not be mixed with lente insulins 2

Unopened vials should be refrigerated (36-46°F, 2-8°C) 2
Vials in use may be kept at room temperature to limit local irritation at injection site 2
Avoid extreme temperatures (<36°F or >86°F) and excess agitation to prevent loss of potency 2
Always have a spare bottle of insulin available 2

For hypoglycemia treatment, 4-8 oz of juice or soda is recommended, followed by a fingerstick blood glucose test 15-20 minutes later 2
Patients should wear medical alert identification indicating they have diabetes 2
Consider prescription of glucagon for emergent hypoglycemia 2

In older adults, a simplified sliding scale may be used while adjusting prandial insulin 2:
- For premeal glucose >250 mg/dL (>13.9 mmol/L), give 2 units of Humalog
- For premeal glucose >350 mg/dL (>19.4 mmol/L), give 4 units of Humalog 2
Do not use rapid-acting insulin at bedtime in older adults 2

Humalog provides better postprandial glycemic control compared to regular human insulin 5
The risk of hypoglycemia, particularly nocturnal episodes, may be lower with Humalog than with regular human insulin 3
Patient satisfaction is generally higher with Humalog compared to regular human insulin due to the convenient dosing schedule 4, 3

Failing to inspect insulin for changes in appearance before each use 2
Mixing incompatible insulins (especially insulin glargine with other insulins) 2
Using expired insulin or insulin that has been stored improperly 2
Not adjusting insulin doses appropriately when changing insulin types or formulations 2
Administering Humalog too far in advance of meals, which may increase hypoglycemia risk 1