Humalog 75/25
Humalog 75/25 is an insulin mix that contains 75% insulin lispro protamine (an intermediate-acting insulin) and 25% insulin lispro (a rapid-acting insulin). It's used to control blood sugar levels in adults with Type 1 diabetes or Type 2 diabetes. Humalog 75/25 is injected under the skin, typically twice daily 15 minutes before a meal. Some side effects of this medication include low blood sugar (hypoglycemia) and reactions at the injection site. Humalog 75/25 comes as a vial and pen (KwikPen), and is available as a generic medication.
What is Humalog 75/25?
What is Humalog 75/25 used for?
Type 1 diabetes in adults
Type 2 diabetes in adults
How Humalog 75/25 works
Humalog 75/25 is a mix of two types of insulin:
Insulin lispro protamine (an intermediate-acting insulin)
Insulin lispro (a rapid-acting human insulin)
Insulin is a hormone that your body normally makes to control blood sugar levels. It helps your body absorb and store sugar from the bloodstream after a meal. Insulin also stops your liver from making glucose (sugar).
People with diabetes either can't make insulin, don't make enough insulin, or don't respond to insulin as they should. So to help control their blood sugar levels, they sometimes need insulin from an outside source, like Humalog 75/25. The mix of insulin in Humalog 75/25 works long enough to help control blood sugar levels over 2 meals, or a meal and a snack.
Drug Facts
What are the side effects of Humalog 75/25?
Common Side Effects
- Low blood sugar levels
- Reactions where the medication is injected (e.g., redness, swelling, itching)
Other Side Effects
- Fat deposits under the skin or pitting of the skin where the medication is injected
- Weight gain
- Swelling (e.g., in the legs, ankles, or feet)
Serious Side Effects
- Severely low blood sugar: dizziness, shakiness, feeling confused, feeling irritable or anxious, feeling faint, sweating, extreme hunger, can't think clearly
- Dangerously low potassium levels: weakness, muscle cramps or twitches, constipation, abnormal heartbeat, tiredness, trouble breathing
- Severe allergic reaction: rash; hives; swelling of the face, tongue, and throat; trouble breathing
Source: DailyMed
Pros and cons of Humalog 75/25
Pros
Starts to work in 15 minutes to lower blood sugar levels
Helps to manage high blood sugar from meals and control blood sugar through 2 meals or a meal and a snack
Can be stored at room temperature for short periods, so convenient for travel
Cons
Needs to be given as an injection under the skin
Can't customize the dose of each type of insulin in Humalog 75/25
Not studied in children
Pharmacist tips for Humalog 75/25
Inject Humalog 75/25 under the skin 15 minutes before a meal. Don't use Humalog 75/25 if you don't plan to eat, unless your diabetes care specialist specifically told you otherwise. Skipping meals and injecting Humalog 75/25 raises your risk for dangerously low blood sugar (hypoglycemia).
Ask your diabetes specialist about when you should check your blood sugar during the day. Jot down your blood sugar readings and share them with your care team at your office visits. This helps keep track of how well Humalog 75/25 is working for you and check whether you need any dose adjustments.
Make sure you and your family members know how to recognize and treat low blood sugar. Watch out for symptoms like shakiness, anxiety, and hunger. Keep fast-acting sugar, such as glucose tablets, with you at all times so you can take it if your blood sugar level drops too low. Follow the "15-15 rule" to treat low blood sugar levels (below 70 mg/dL).
Store unopened vials and pens in the refrigerator up until their expiration date. You can also keep them at room temperature, but only for up to 10 days (for the pens) or up to 28 days (for the vials).
Store opened pens at room temperature for up to 10 days after opening; don't put them back into the refrigerator. For opened vials, keep them either at room temperature or in the refrigerator for up to 28 days after opening.
Tips on how to use Humalog 75/25:
It's important that you know how to use Humalog 75/25 properly and safely. This helps avoid accidentally hurting yourself or wasting medication. Carefully review the instructions for use for the Humalog 75/25 vial or Humalog 75/25 KwikPen. Ask your care team for specific directions and for any questions you have.
Because Humalog 75/25 is a suspension, you must mix the medication in the vial or KwikPen before using by rolling it in between your hands. It's easier to mix the insulin when it's at room temperature.
How to mix the insulin in the Humalog 75/25 vial: Roll the vial gently at least 10 times in your hands and slowly turn the vial upside down at least 10 times. After mixing, the liquid in the vial should be uniform, white, and cloudy. Don't use it if it looks clear or contains any lumps or particles (solid chunks).
How to mix the insulin in the Humalog 75/25 KwikPen: Slowly roll the pen between your hands 10 times. Then, move the pen up and down 10 times. The insulin should look white and cloudy after you mix it.
How to prime the Humalog 75/25 KwikPen: Prime the pen each time before you use it to make sure you get the right amount of insulin when you inject. Turn the dose knob to "2 units." Hold the pen with the needle pointing up and tap it to get air bubbles to the top. Keep the needle pointing up and press and hold in the knob. You should see a small amount of insulin at the needle tip.
Where to inject Humalog 75/25: Inject the insulin under the skin in the stomach area, upper legs (thighs), buttocks, or upper arms. For each injection, pick a different place within the area that you choose. This helps prevent hard lumps from forming in the skin, pitted skin, and irritated skin.
After you inject Humalog 75/25, throw the needle or syringe away in a sharps container or a heavy-duty plastic container (e.g., empty milk carton, laundry detergent bottle). Throw away empty KwikPens in the same type of container. This helps lower the risk of needle-stick injuries. Don't throw away injection supplies into the regular trash.
Frequently asked questions about Humalog 75/25
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What are the risks and warnings for Humalog 75/25?
Humalog 75/25 can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of infections from sharing injection supplies
Never share Humalog 75/25 pens, any syringes, or any needles with anyone else. Sharing Humalog 75/25 and other injection supplies with someone can raise the risk of spreading very dangerous infections to each other.
Risk of changes to blood sugar levels with changes to your insulin regimen
Risk factors: Changes in insulin strength | Changes in type of insulins you take | Change in insulin brand-name products | Changes in injection site
Changing your insulin or insulin routine, such as where you inject Humalog 75/25 or switching to a different brand name of your insulins, can affect how your body responds to insulin. This can lead to either high or low blood sugar levels. In addition, injecting Humalog 75/25 repeatedly into areas of skin that show signs of lipodystrophy, such as pitting or thickened skin, can result in high blood sugar levels.
Be sure to check your blood sugar levels more often if your diabetes care team instructs you to make certain changes to your insulin or insulin routine. This helps you see how the changes affect your blood sugar levels. Don't make changes to your Humalog 75/25 dose or routine without first checking in with your diabetes care team.
Dangerously low blood sugar levels (hypoglycemia)
Risk factors: Changes in diet and exercise | Drinking alcohol | Taking other diabetes medications with Humalog 75/25 | Liver or kidney problems
Humalog 75/25 can cause hypoglycemia, or low blood sugar levels. When your blood sugar level is too low, it can be dangerous and even life-threatening, especially if it's not treated in time. Check your blood sugar level regularly to make sure it's within a safe range.
Check that you're taking the correct insulin at the right time by reading the label of the insulins you have if you're prescribed multiple types of insulins. This helps prevent accidental mix-ups between your insulin products and possible low blood sugar.
Let your diabetes care team know if you make any changes to your diet or meal patterns, other medications, or amount of exercise you do. These changes can affect your blood sugar levels, so your care team might need to adjust the dose of Humalog 75/25 and your other diabetes medications.
Be familiar with symptoms of hypoglycemia, such as feeling shaky, being nervous or anxious, sweating, having body chills, and being very hungry. Keep fast-acting sugars, such as glucose tablets, with you at all times so you can treat hypoglycemia quickly. Get medical help right away if your blood sugar levels don't improve even after you try to treat it.
Low blood potassium levels
Risk factors: Taking other medications that lower potassium levels
Humalog 75/25 can lower the levels of potassium in your blood, which can sometimes be dangerous. You're more at risk if you're already taking medications that lower your potassium, like certain diuretics (water pills). If needed, your prescriber might check your potassium levels regularly and give you medications to keep your potassium in the normal range. Tell your prescriber if you have symptoms of low potassium, such as weakness, muscle cramps, nausea, vomiting, or abnormal heartbeats, while you're taking Humalog 75/25.
Swelling from fluid buildup and risk of heart failure when taken with certain diabetes medications
Risk factors: Taking glitazones together with insulin | History of heart failure
Taking insulin, including Humalog 75/25, with medications called glitazones (also known as thiazolidinediones), like pioglitazone (Actos), can cause your body to hold onto fluid. This can lead to or worsen heart failure because the additional fluid can put stress on the heart. Let your prescriber know if you notice symptoms of fluid buildup or heart failure, such as sudden weight gain, swelling, trouble breathing, and tiredness. Your prescriber might need to make changes to your diabetes treatment.
Humalog 75/25 dosage forms
Typical dosing for Humalog 75/25
Your diabetes care team will determine your dose of Humalog 75/25. The dose depends on different factors, including whether you have Type 1 diabetes or Type 2 diabetes and how well your body respond to insulin.
Adults: In general, Humalog 75/25 is injected under the skin into the fatty tissue of the stomach, thigh, upper arm, or buttocks, within 15 minutes before a meal. Humalog 75/25 is typically injected twice per day, with each dose intended to cover 2 meals or a meal and a snack.
Humalog 75/25 contraindications
Use during episodes of low blood sugar (hypoglycemia)
What are alternatives to Humalog 75/25?
Type 1 diabetes in adults and children
Type 2 diabetes in adults
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References
Best studies we foundAmerican Diabetes Association. (n.d.). Low blood glucose (hypoglycemia).
Buse, J. B., et al. (2011). The DURAbility of Basal versus Lispro mix 75/25 insulin Efficacy (DURABLE) trial: Comparing the durability of lispro mix 75/25 and glargine. Diabetes Care.
Chelliah, A., et al. (2004). Insulin edema in the twenty-first century: Review of the existing literature. Journal of Investigative Medicine.
Clinical Diabetes. (2012). Hypoglycemia? Low blood glucose? Low blood sugar?
Eli Lilly and Company. (2020). Lower-priced versions of Humalog® Mix75/25™ KwikPen® and Humalog® Junior KwikPen® now available. PRNewswire.
Eli Lilly and Company. (2023). Humalog Mix75/25 - insulin lispro injection, suspension; Humalog Mix75/25 Kwikpen - insulin lispro injection, suspension [package insert]. DailyMed.
Kadiyala, P., et al. (2014). Insulin induced lipodystrophy. The British Journal of Diabetes.
Lewis, J. L, 3rd. (2023). Hypokalemia (low level of potassium in the blood). Merck Manual Consumer Version.
Novo Nordisk. (2023). Novolog Mix 70/30- insulin aspart injection, suspension [package insert]. DailyMed.
Novo Nordisk Pharma, Inc. (2023). Insulin aspart protamine and insulin aspart mix 70/30- insulin aspart injection, suspension [package insert]. DailyMed.
Russell-Jones, D., et al. (2007). Insulin-associated weight gain in diabetes--causes, effects and coping strategies. Diabetes, Obesity & Metabolism.
Sharabi, K., et al. (2015). Molecular pathophysiology of hepatic glucose production. Molecular Aspects of Medicine.
You and Your Hormones. (2021). Insulin.
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