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- Brand: International Agency (BD) Ltd
- Product ID: Insulin Lispro Protamine + Insulin Lispro
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Humalog Mix 50/50 KwikPen – Insulin Lispro Protamine/Lispro by Eli Lilly
| Generic Name | Insulin Lispro Protamine / Insulin Lispro (50/50) |
| Brand Name | Humalog Mix 50/50 |
| Manufacturer | Eli Lilly and Company (USA) |
| Dosage Form | Suspension for Injection — Pre-filled KwikPen (3 ml) |
| Strength | 100 IU/ml (50% intermediate + 50% rapid-acting) |
| Pack Size | 5 KwikPens × 3 ml = 1,500 IU total |
| Drug Class | Premixed Insulin Analogue (Biphasic, 50/50) |
| Prescription Required | Yes — Rx Only |
| Onset / Peak / Duration | Onset: 15 min | Peak: 30 min–2.5 hrs | Duration: ~18–22 hrs |
What is Humalog Mix 50/50 KwikPen?
Humalog Mix 50/50 KwikPen is a premixed biphasic insulin analogue by Eli Lilly combining equal parts: 50% insulin lispro protamine suspension (intermediate-acting) and 50% insulin lispro solution (rapid-acting). The 50/50 ratio provides stronger rapid-acting mealtime coverage than Mix 75/25, making it suited to patients with significant post-meal glucose spikes. It covers both mealtime and basal insulin requirements in a single twice-daily injection. Each KwikPen holds 3 ml (300 IU) with 1-unit dose steps up to 60 IU per injection.
Generic Name & Composition
Each ml contains 50 IU insulin lispro protamine crystals (intermediate, ~18–22 hrs) and 50 IU soluble insulin lispro (rapid, onset 15 min, peak 30–90 min). Protamine precipitates lispro into crystals for slow basal dissolution; soluble lispro provides immediate post-meal control. Must be resuspended before each injection.
Indications
- Type 2 diabetes mellitus — twice-daily premixed analogue regimen
- Patients with pronounced post-meal glucose spikes requiring more rapid-acting coverage
- High-carbohydrate meal patterns needing strong mealtime control
- Transitioning from 50/50 human insulins to analogue premix
How It Works — Mechanism of Action
After injection and resuspension, the soluble lispro (50%) is absorbed rapidly (onset 15 min, peak 30 min–2.5 hrs) for immediate post-meal glucose control. The lispro protamine (50%) dissolves slowly over ~18–22 hours supplying basal coverage. Both components activate insulin receptors: GLUT-4 mediated glucose uptake, hepatic glucose suppression, glycogen synthesis.
Dosage & Administration
Regimen: Twice daily within 15 minutes before or immediately after breakfast and dinner. KwikPen use: Roll 10 times, invert 10 times until milky-white suspension is fully uniform. Dial dose, inject subcutaneously, hold 5 seconds. Rotate sites (abdomen, thigh, upper arm).
Side Effects
Very common: Hypoglycaemia — elevated risk due to 50% rapid component. Missing a meal after injection can cause rapid-onset hypoglycaemia.
Common: Injection site reactions, lipohypertrophy, weight gain.
Uncommon: Lipoatrophy, peripheral oedema.
Rare: Anaphylaxis, severe allergic reactions.
Drug Interactions
Increase hypoglycaemia risk: Sulphonylureas, GLP-1 agonists, SGLT-2 inhibitors, ACE inhibitors, MAO inhibitors, salicylates, alcohol.
Reduce insulin effect: Corticosteroids, glucagon, thyroid hormones, thiazides, sympathomimetics, oral contraceptives.
Caution: Beta-blockers mask hypoglycaemia symptoms.
Contraindications
- Hypersensitivity to insulin lispro, protamine, or any excipient
- Active hypoglycaemia
- Subcutaneous injection only — not for IV use
Pregnancy & Lactation
Pregnancy: Insulin lispro may be used under specialist supervision. Dose requirements change during gestation. Lactation: Not expected in breast milk at clinically significant concentrations.
Precautions & Warnings
- Mandatory resuspension: Roll 10×, invert 10× before every injection. Incorrect ratio if skipped.
- Eat within 15 minutes: 50% rapid component acts immediately.
- Higher hypoglycaemia risk than Mix 75/25 — monitor closely when initiating.
Overdose
Hypoglycaemia. Mild: oral glucose. Severe: IV dextrose or IM glucagon. Monitor for extended period (intermediate component lasts 18–22 hrs).
Storage Instructions
- Unopened: 2–8°C. Do not freeze.
- In-use pen: Below 30°C. Do not refrigerate.
- Discard 28 days after first use.
Frequently Asked Questions (FAQs)
Q1: Who should use Mix 50/50 instead of Mix 75/25?
Patients with significant post-meal blood sugar spikes benefit more from Mix 50/50's higher rapid component. Mix 75/25 suits those with mainly fasting hyperglycaemia. Your diabetologist will assess your glucose pattern.
Q2: Is Humalog Mix 50/50 the same as Mixtard 50/50?
No — Mixtard uses regular human insulin (onset 30 min); Humalog Mix uses insulin lispro analogue (onset 15 min). Humalog Mix provides better post-meal control and greater injection flexibility.
Q3: Why is resuspension critical for Humalog Mix 50/50?
It's a suspension — protamine crystals settle between uses. Without rolling (10×) and inverting (10×), you inject incorrect insulin ratio causing either hypoglycaemia or poor coverage.
Q4: Who manufactures Humalog Mix 50/50?
Eli Lilly and Company (Indianapolis, USA).
⚕ Medical Disclaimer: For educational purposes only. Humalog Mix 50/50 is Rx-only. Consult your diabetologist before changing insulin therapy. DiabetesStore.com.bd is a licensed online pharmacy.
