Rapid-acting Insulin Analogue Pregnancy: Data on a large number of exposed pregnancies do not indicate an adverse effect on pregnancy or the health of the fetus/newborn. Maintain good glucose control throughout pregnancy; insulin requirements usually fall during the first trimester and increase during the second and third. Breast-feeding patients may require insulin dose and/or diet adjustments.

Insulin Lispro

Brand names: Humalog, Admelog

Insulin lispro is a rapid-acting recombinant insulin analogue used at mealtimes to control postprandial glucose in type 1 and type 2 diabetes, and in insulin pumps.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Individualised (no fixed dose stated) - determined by the physician according to the patient's requirement

Route: Subcutaneous injection or continuous subcutaneous pump infusion; may also be given intramuscularly (not recommended) or intravenously if necessary (e.g. for ketoacidosis, acute illness, intra-/post-operative periods)

Frequency: Shortly before meals (may be given soon after meals when necessary)

Rapid-acting insulin analogue (SPC: Admelog 100 units/ml). Rapid onset with a shorter duration of activity (2-5 hours) subcutaneously than regular insulin, allowing dosing very close to mealtime. May be used with a longer-acting insulin or an oral sulphonylurea on the advice of a physician. Give subcutaneously in the upper arms, thighs, buttocks or abdomen and rotate sites to reduce lipodystrophy/cutaneous amyloidosis. Paediatric: can be used in adolescents and children. Cases of cardiac failure have been reported when pioglitazone is combined with insulin, especially with risk factors for heart failure. Interaction list drawn from the US product label (ADMELOG) as the captured UK SPC sections did not include section 4.5.

Dose adjustments

Renal

Insulin requirements may be reduced in renal impairment. In hepatic impairment requirements may be reduced, though chronic hepatic impairment may increase insulin resistance and requirements.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to insulin lispro or to any of the excipients
Hypoglycaemia

Side effects

Hypoglycaemia (most frequent) - severe hypoglycaemia may lead to loss of consciousness and, in extreme cases, death
Local allergy (common) - redness, swelling and itching at the injection site (usually resolves within days to weeks)
Systemic allergy (rare) - generalised rash, shortness of breath, wheezing, reduced blood pressure, fast pulse, sweating; severe cases may be life-threatening
Lipodystrophy and cutaneous amyloidosis at the injection site (may delay local insulin absorption)
Oedema (particularly when previous poor metabolic control is improved by intensified insulin therapy)

Interactions

Drugs that may increase the risk of hypoglycaemia (may need dose adjustment and more frequent glucose monitoring): other antidiabetic agents, ACE inhibitors, angiotensin II receptor blockers, disopyramide, fibrates, fluoxetine, MAO inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogues (e.g. octreotide), sulfonamide antibiotics
Drugs that may reduce the blood-glucose-lowering effect: atypical antipsychotics (e.g. olanzapine, clozapine), corticosteroids, danazol, diuretics, oestrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens, protease inhibitors, somatropin, sympathomimetics (e.g. albuterol, adrenaline, terbutaline), thyroid hormones
Alcohol, beta-blockers, clonidine and lithium salts may increase or decrease the glucose-lowering effect; pentamidine may cause hypoglycaemia sometimes followed by hyperglycaemia; beta-blockers may mask hypoglycaemia warning symptoms

Clinical monograph

How it works

It binds the insulin receptor to stimulate glucose uptake and suppress hepatic glucose output; reversal of two amino acids reduces hexamer formation, allowing faster subcutaneous absorption than soluble human insulin.

Prescribing in practice

Because of its rapid onset, hypoglycaemia can develop quickly if a meal is delayed or omitted, so dosing is timed close to eating.
Used as the bolus insulin in basal-bolus regimens and in continuous subcutaneous infusion pumps; rotate injection sites.
Be aware of different concentrations of lispro products and ensure the correct strength is prescribed and dispensed.

Monitoring

Monitor capillary blood glucose around meals and HbA1c, adjusting the mealtime dose to carbohydrate intake and response.

Counselling the patient

Inject just before your meal and skip the dose if you will not be eating.
Always carry fast-acting sugar to treat low blood glucose.
Rotate injection sites and do not share insulin devices.

Evidence & guidelines

Rapid-acting analogue insulins are well established for mealtime cover and pump therapy in UK diabetes care.

Reference: NICE NG17 (Type 1 DM); NICE NG28 (Type 2 DM); MHRA Insulin Safety Alert; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Insulin Glulisine · Rapid-acting Insulin Analogue

Pathways