New High-Strength Insulin

Humalog® U200, a double strength formulation of insulin lispro, has recently been added to the Pharmaceutical Benefits Scheme (PBS). This ultra-short-acting insulin is indicated for the management of type 1 and type 2 diabetes mellitus.

The range of products containing insulin lispro is shown in Table 1.

Table 1. Insulin lispro products available

This new high-strength formulation is only available in the disposable KwikPen® device. The prescribed dose is dialled up in units for both the 200 units/mL and the 100 units/mL KwikPen® device. Therefore, no dose conversion is required when a patient changes to the new strength. To avoid dosing errors, the solution from the pre-filled pen must not be mixed with any other insulin or transferred to any other insulin delivery device. Drawing insulin out of the Humalog U200 KwikPen® and measuring the dose using an insulin needle with unit markings would result in a two-fold dosing error.

Insulin is considered high-strength when the concentration exceeds 100 units/mL. High-strength insulins such as Humalog® U200 and Toujeo® (insulin glargine 300 units/mL) may be beneficial for patients needing high daily doses as lower injection volumes are required. This can reduce the pain of injection and may also limit variability in absorption.