Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Insulin lispro may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for Admelog is used to treat diabetes. It works more quickly than normal human insulin because the insulin molecule has been changed slightly. You get diabetes if your pancreas does not make enough insulin to control the level of glucose in your blood. Admelog is a substitute for your own insulin and is used to control glucose in the long term. It works very quickly and lasts a shorter time than soluble insulin (2 to 5 hours). You should normally use Admelog within 15 minutes of a meal. Your doctor may tell you to use Admelog as well as a longer-acting insulin. Each kind of insulin comes with another patient information leaflet to tell you about it. Do not change your insulin unless your doctor tells you to. Be very careful if you do change insulin. Admelog is suitable for use in adults and children.
e Admelog Do not use Admelog
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Admelog Always check the pack and the cartridge label for the name and type of the insulin when you get it from your pharmacy. Make sure you get the Admelog that your doctor has told you to use. Always use this medicine exactly as your doctor has told you. Check with your doctor if you are not sure. To prevent the possible transmission of disease, each cartridge must be used by you only, even if the needle on the delivery device is changed. Dose
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Technische Information / Technical information
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Kontur / Outline
Injecting Admelog
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If hypoglycaemia (low blood sugar) or hyperglycaemia (high blood sugar) is not treated, they can be very serious and cause headaches, feeling sick (nausea), being sick (vomiting), loss of fluids (dehydration), unconsciousness, coma or even death (see "Hypoglycaemia" and "Hyperglycaemia and diabetic ketoacidosis" in section 4 "Possible Side Effects"). Three simple steps to avoid hypoglycaemia or hyperglycaemia are:
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Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any
not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine. Common problems of diabetes A. Hypoglycaemia Hypoglycaemia (low blood sugar) means there is not enough sugar in the blood. This can be caused if:
Severe symptoms are heavy breathing and a rapid pulse. Get medical help immediately. C. Illness If you are ill, especially if you feel sick or are sick, the amount of insulin you need may change. Even when you are not eating normally, you still need insulin. Test your urine or blood, follow your 'sick rules', and tell your doctor.
Admelog Keep out of the sight and reach of children. Do not use Admelog after the expiry date which is stated on the label and the carton. The expiry date refers to the last day of that month.
Marketing Authorisation Holder Sanofi, 410 Thames Valley Park Drive, Reading, Berkshire, RG6 1PT, UK Tel: 0800 035 2525 Email: [email protected] Manufacturer Sanofi-Aventis Deutschland GmbH, D-65926 Frankfurt am Main, Germany. This leaflet does not contain all the information about your medicine. If you have any questions or are not sure about anything, ask your doctor or pharmacist This leaflet was last revised in February 2022
Before the first use store your Admelog in a refrigerator (2°C – 8°C). Do not freeze. Keep the cartridge in the outer carton in order to protect from light. Keep your cartridge in use at room temperature (below 30°C) and dispose of after 4 weeks. Do not put it near heat or in the sun. Keep the pen cap on the pen in order to protect from light. Do not keep your pen or the cartridges you are using in the fridge. The pen with the inserted cartridge should not be stored with the needle attached. Do not use Admelog if it is coloured or it has solid pieces in it. You must use it only if it looks like water. Check this each time you inject yourself. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.
What Admelog contains
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Technische Information / Technical information
PANTONE Process Black C
Kontur / Outline
Admelog 100 units/ml solution for injection in cartridge comes as injection containing 100iu. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Admelog 100 units/ml solution for injection in cartridge is insulin lispro.
Medicines with the same active substance, strength and form include: Admelog 100 units/ml solution for injection in pre filled pen, Admelog 100 units/ml solution for injection in vial, Humalog 100 units/ml Junior KwikPen, solution for injection in a pre-filled pen. In total there are 10 equivalent products. They are interchangeable only if your prescriber or pharmacist says so.
This leaflet reproduces the patient information leaflet approved for Admelog 100 units/ml solution for injection in cartridge, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
For the treatment of adults and children with diabetes mellitus who require insulin for the maintenance of normal glucose homeostasis. Admelog is also indicated for the initial stabilisation of diabetes mellitus.
Posology
The dose should be determined by the physician, according to the requirement of the patient.
Insulin lispro may be given shortly before meals. When necessary insulin lispro can be given soon after meals.
Insulin lispro takes effect rapidly and has a shorter duration of activity (2 – 5 hours) given subcutaneously as compared with regular insulin. This rapid onset of activity allows an Admelog injection (or, in the case of administration by continuous subcutaneous infusion, an Admelog bolus) to be given very close to mealtime. The time course of action of any insulin may vary considerably in different individuals or at different times in the same individual. The faster onset of action compared to soluble human insulin is maintained regardless of injection site. As with all insulin preparations, the duration of action of insulin lispro is dependent on dose, site of injection, blood supply, temperature, and physical activity.
Admelog can be used in conjunction with a longer-acting insulin or oral sulphonylurea medicinal products, on the advice of a physician.
Special populations
Renal impairment
Insulin requirements may be reduced in the presence of renal impairment.
Hepatic impairment
Insulin requirements may be reduced in patients with hepatic impairment due to reduced capacity for gluconeogenesis and reduced insulin breakdown; however, in patients with chronic hepatic impairment, an increase in insulin resistance may lead to increased insulin requirements.
Paediatric population
Admelog can be used in adolescents and children (see section 5.1).
Method of administration
Admelog solution for injection should be given by subcutaneous injection or by continuous subcutaneous infusion pump (see section 4.2) and may, although not recommended, also be given by intramuscular injection.
If necessary, Admelog may also be administered intravenously, for example, for the control of blood glucose levels during ketoacidosis, acute illnesses or during intra and post-operative periods.
Subcutaneous administration of Admelog
Subcutaneous administration should be in the upper arms, thighs, buttocks, or abdomen. Injection sites should always be rotated within the same region in order to reduce the risk of lipodystrophy and cutaneous amyloidosis (see section 4.4 and 4.8).
When administered subcutaneously care should be taken when injecting Admelog to ensure that a blood vessel has not been entered. After injection, the site of injection should not be massaged. Patients must be educated to use the proper injection techniques.
Admelog 100 units/ml in cartridges is only suitable for subcutaneous injections from a reusable pen. If administration by syringe, intravenous injection or infusion pump is necessary, a vial should be used (see section 4.4). For further details on handling, see section 6.6.
The Admelog cartridges should only be used with the following pens:
• JuniorSTAR which delivers 1-30 units of insulin lispro in 0.5 unit dose increments
• Tactipen which delivers 1-60 units of insulin lispro in 1 unit dose increments
• AllStar and AllStar PRO which all deliver 1-80 units of insulin lispro in 1 unit dose increments.
These cartridges should not be used with any other reusable pen as the dosing accuracy has only been established with the listed pens (see section 6.6).
Hypersensitivity to the active substance(s) or to any of the excipients listed in section 6.1.
Hypoglycaemia.
Traceability
In order to improve the traceability of biological medicinal products, the name and the batch number of the administered product should be clearly recorded.
Transferring a patient to another type or brand of insulin
Transferring a patient to another type or brand of insulin should be done under strict medical supervision. Changes in strength, brand (manufacturer), type (regular, NPH, lente, etc.), species (animal, human, human insulin analogue), and/or method of manufacture (recombinant DNA versus animal-source insulin) may result in the need for a change in dosage. For fast-acting insulins, any patient also on basal insulin must optimise dosage of both insulins to obtain glucose control across the whole day, particularly nocturnal/fasting glucose control.
Injection technique
Patients must be instructed to perform continuous rotation of the injection site to reduce the risk of developing lipodystrophy and cutaneous amyloidosis. There is a potential risk of delayed insulin absorption and worsened glycaemic control following insulin injections at sites with these reactions. A sudden change in the injection site to an unaffected area has been reported to result in hypoglycaemia. Blood glucose monitoring is recommended after the change in the injection site, and dose adjustment of antidiabetic medications may be considered.
Hypoglycaemia or hyperglycaemia
Conditions which may make the early warning symptoms of hypoglycaemia different or less pronounced include long duration of diabetes, intensified insulin therapy, diabetic nerve disease or medications such as beta-blockers.
A few patients who have experienced hypoglycaemic reactions after transfer from animal-source insulin to human insulin have reported that the early warning symptoms of hypoglycaemia were less pronounced or different from those experienced with their previous insulin. Uncorrected hypoglycaemic or hyperglycaemic reactions can cause loss of consciousness, coma, or death.
The use of doses which are inadequate or discontinuation of treatment, especially in insulin-dependent diabetics, may lead to hyperglycaemia and diabetic ketoacidosis; conditions which are potentially lethal.
Insulin requirements and dosage adjustment
Insulin requirements may be increased during illness or emotional disturbances.
Adjustment of dosage may also be necessary if patients undertake increased physical activity or change their usual diet. Exercise taken immediately after a meal may increase the risk of hypoglycaemia. A consequence of the pharmacodynamics of rapid-acting insulin analogues is that if hypoglycaemia occurs, it may occur earlier after an injection when compared with soluble human insulin.
Combination of Admelog with pioglitazone
Cases of cardiac failure have been reported when pioglitazone was used in combination with insulin, especially in patients with risk factors for development of cardiac heart failure. This should be kept in mind, if treatment with the combination of pioglitazone and Admelog is considered. If the combination is used, patients should be observed for signs and symptoms of heart failure, weight gain and oedema. Pioglitazone should be discontinued, if any deterioration in cardiac symptoms occurs.
Avoidance of medication errors when using Admelog
Patients must be instructed to always check the insulin label before each injection to avoid accidental mix-ups between Admelog and other insulin products.
Admelog 100 units/ml in cartridges is only suitable for subcutaneous injections from a reusable pen. If administration by syringe, intravenous injection or infusion pump is necessary, a vial should be used.
To prevent the possible transmission of disease, each cartridge must be used by one patient only, even if the needle on the delivery device is changed.
Excipients
This medicinal product contains less than 1 mmol sodium (23 mg) per dose, that is to say essentially “sodium-free”.
Insulin requirements may be increased by medicinal products with hyperglycaemic activity, such as oral contraceptives, corticosteroids, or thyroid replacement therapy, danazol, beta2 stimulants (such as ritodrine, salbutamol, terbutaline).
Insulin requirements may be reduced in the presence of medicinal products with hypoglycaemic activity, such as oral hypoglycaemics, salicylates (for example, acetylsalicylic acid), sulpha antibiotics, certain antidepressants (monoamine oxidase inhibitors, selective serotonin reuptake inhibitors), certain angiotensin converting enzyme inhibitors (captopril, enalapril), angiotensin II receptor blockers, beta-blockers, octreotide or alcohol.
The physician should be consulted when using other medicinal products in addition to Admelog (see section 4.4).
Pregnancy
Data on a large number of exposed pregnancies do not indicate any adverse effect of insulin lispro on pregnancy or on the health of the fetus/newborn.
It is essential to maintain good control of the insulin-treated (insulin-dependent or gestational diabetes) patient throughout pregnancy. Insulin requirements usually fall during the first trimester and increase during the second and third trimesters. Patients with diabetes should be advised to inform their doctor if they are pregnant or are contemplating pregnancy. Careful monitoring of glucose control, as well as general health, is essential in pregnant patients with diabetes.
Breast-feeding
Patients with diabetes who are breast-feeding may require adjustments in insulin dose, diet or both.
Fertility
Insulin lispro did not induce fertility impairment in animal studies (see section 5.3).
The patient's ability to concentrate and react may be impaired as a result of hypoglycaemia. This may constitute a risk in situations where these abilities are of special importance (e.g. driving a car or using machines).
Patients should be advised to take precautions to avoid hypoglycaemia whilst driving, this is particularly important in those who have reduced or absent awareness of the warning signs of hypoglycaemia or have frequent episodes of hypoglycaemia. The advisability of driving should be considered in these circumstances.
Summary of the safety profile
Hypoglycaemia is the most frequent adverse reaction of insulin therapy that a patient with diabetes may suffer. Severe hypoglycaemia may lead to loss of consciousness, and in extreme cases, death. No specific frequency for hypoglycaemia is presented, since hypoglycaemia is a result of both the insulin dose and other factors e.g. a patient`s level of diet and exercise.
Tabulated list of adverse reactions
The following related adverse reactions from clinical investigations are listed below by system organ class and in order of decreasing incidence (very common: ≥1/10; common: ≥1/100 to <1/10; uncommon: ≥1/1,000 to <1/100; rare: ≥1/10,000 to <1/1,000; very rare: <1/10,000) and not known (cannot be estimated from the available data).
Within each frequency grouping, adverse reactions are presented in order of decreasing seriousness.
MedDRA system organ classes
Common
Uncommon
Rare
Not known
Immune system disorders
Local allergy
X
Systemic allergy
X
Skin and subcutaneous tissue disorders
Lipodystrophy
X
Cutaneous amyloidosis
X
Description of selected adverse reactions
Local allergy
Local allergy in patients is common. Redness, swelling, and itching can occur at the site of insulin injection. This condition usually resolves in a few days to a few weeks. In some instances, this condition may be related to factors other than insulin, such as irritants in the skin cleansing agent or poor injection technique.
Systemic allergy
Systemic allergy, which is rare but potentially more serious, is a generalised allergy to insulin. It may cause a rash over the whole body, shortness of breath, wheezing, reduction in blood pressure, fast pulse, or sweating. Severe cases of generalised allergy may be life-threatening.
Skin and subcutaneous tissue disorders
Lipodystrophy and cutaneous amyloidosis may occur at the injection site and delay local insulin absorption. Continuous rotation of the injection site within the given injection area may help to reduce or prevent these reactions (see section 4.4).
Oedema
Cases of oedema have been reported with insulin therapy, particularly if previous poor metabolic control is improved by intensified insulin therapy.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Insulins have no specific overdose definitions because serum glucose concentrations are a result of complex interactions between insulin levels, glucose availability and other metabolic processes. Hypoglycaemia may occur as a result of an excess of insulin activity relative to food intake and energy expenditure.
Hypoglycaemia may be associated with listlessness, confusion, palpitations, headache, sweating and vomiting.
Mild hypoglycaemic episodes will respond to oral administration of glucose or other sugar or saccharated products.
Correction of moderately severe hypoglycaemia can be accomplished by intramuscular or subcutaneous administration of glucagon, followed by oral carbohydrate when the patient recovers sufficiently. Patients who fail to respond to glucagon must be given glucose solution intravenously.
If the patient is comatose, glucagon should be administered intramuscularly or subcutaneously. However, glucose solution must be given intravenously if glucagon is not available or if the patient fails to respond to glucagon. The patient should be given a meal as soon as consciousness is recovered.
Sustained carbohydrate intake and observation may be necessary because hypoglycaemia may recur after apparent clinical recovery.
Ask anything about Admelog 100 units/ml solution for injection in cartridge. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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