Insulin Lispro is highly effective at lowering mealtime blood sugar levels, but there is a significant risk of causing hypoglycemia, especially when combined with antibiotics and NSAIDs. Dentists should be prepared to manage low blood sugar episodes in patients. Keep on reading to learn more:
Generic Name: Insulin Lispro
Brand Name(s): Admelog, Humalog, Lyumjev
Pronunciation: IN soo lin LISS pro
About this drug:
Insulin Lispro is a rapid-acting type of insulin that begins to work about 15 minutes after injection, peaks in about 1 hour, and continues to work for 2 to 4 hours.
The Admelog and Humalog brands treat diabetes type 2 in adults or diabetes type 1 in adults and children at least 3 years old.
The Lyumjev brand is not approved for anyone under 18 years old.
Dentistry-related tidbits:
Insulin Lispro may cause nasopharyngitis.
Always keep an emergency source of sugar in the office, such as fruit juice, honey, raisins, grapes, glucose tablets, hard candy, and regular (non-diet) soda, or a glucagon pen.
Exercise caution when administering a local anesthetic with Epinephrine to a patient taking Insulin Lispro, as this combination may increase the risk of hypokalemia, hyperglycemia, cardiac arrhythmias, and QT prolongation.
Prescribe steroids for the shortest time necessary to avoid the risk of hypokalemia and possible hyperglycemia.
Combining quinolone antibiotics such as Levofloxacin with Insulin Lispro will increase the risk of severe hypoglycemia or hyperglycemia.
Do not prescribe the narcotic Tramadol, NSAIDs, sulfonamide antibiotic Sulfamethoxazole, oxazolidinone antibiotic Linezolid, or macrolide antibiotic Clarithromycin in combination with Insulin Lispro to avoid an increased risk of hypoglycemia. Prescribe Acetaminophen or Acetaminophen-based narcotics for managing pain.
The antifungal Amphotericin may also increase the risk of cardiac arrhythmias and hypokalemia when combined. Before prescribing any medication, use the Rx Check tool to prevent potential drug interactions or adverse effects.
Fun facts:
Insulin Lispro is an analog hormone that lowers blood glucose by stimulating peripheral glucose uptake by skeletal muscle and fat, inhibiting hepatic glucose production, inhibiting lipolysis and proteolysis, and enhances protein synthesis.
The name “Lispro” comes from the insulin formally named “Lyspro” from its chemical nomenclature [LYS(B28), PRO(B29)].
Concomitant therapy with Insulin Lispro and thiazolidinediones may cause fluid retention and heart failure.
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