Humalog IV?

[CritterLover, BSN, RN]

I'm curious if anyone out there sees humalog (lispro) given iv.

This came up recently at work. someone said that regular insulin is the only insulin that can be given iv. I said that used to be true, but now there is humalog, and it is safe to give iv.

I swear I've seen it given iv via an insulin drip in the past (at a different facility), but can't find anything in drug books that supports iv administration.

Am I losing my mind and creating memories?

After a Google search, I did come up with a pediatric protocol for a humalog drip at you/chicago for severe dka, which makes me think I am remembering correctly. I'm thinking that iv administration just usually isn't necessary since sq administration has such a rapid onset.

Which makes me wonder what the benefits are of using a humalog insulin drip, vs a regular insulin drip.

Anyone with input?

[SteveNNP, MSN, NP]

All I've ever heard is that the only type of insulin that can be given IV is regular humulin/novolin insulin. I worked PICU, and we'd use Humulin insulin gtts and cover with either humalog or more humulin.

[onyx77]

All through school we had hammered in our heads (and I do mean HAMMERED!) that the only insulin that can be given IV is regular insulin. And this was what was shoved down our throats at the NCLEX review also. I just graduated in December, so I don't know how much that has changed.

[PsychNurseWannaBe, BSN, RN]

onyx77 said:

All through school we had hammered in our heads (and I do mean HAMMERED!) that the only insulin that can be given IV is regular insulin. And this was what was shoved down our throats at the NCLEX review also. I just graduated in December, so I don't know how much that has changed.

Hammered until our ears bled for us too. I think we even had to raise our hand in pharm class and pledge that we would only use regular insulin and that we would never give potassium IV push.

[Nurseboy1]

The guardrails set-up for the insulin drips in my hospital's IV pumps do have a profile for the use of humalog insulin. However in my particular unit we have only used regular insulin.

I did a web search and did find this information on RXmed:

Insulin lispro preparations should be given by s.c. injection but may, although not recommended, also be given by i.m. injection. It may also be administered i.v. under conditions where regular human insulin is given i.v.

Hope this was helpful.

[Trophywife81]

onyx77 said:

All through school we had hammered in our heads (and I do mean HAMMERED!) that the only insulin that can be given IV is regular insulin. And this was what was shoved down our throats at the NCLEX review also. I just graduated in December, so I don't know how much that has changed.

:yeahthat:

[JHRN2BE]

I am an IDDM w/insulin pump (which uses Novolog OR Humalog) and work at a Pedi hospital. Personally, I have only heard of Regular insulin to be given IV. On my floor we don't give insulin via IV, so things may have changed since nursing school. Humalog is rapid acting, so I would 'think' that would be too rapid and cause more problems. ?????

[CritterLover, BSN, RN]

Thanks to all that replied.

I've done some more searches, and have found other protocols calling for iv Humalog.

it leads me to believe that while administration of iv Humalog is safe, it is off-label and thus not officially sanctioned.

I'm speculating that since sq Humalog acts so quickly, the drug companies don't see any benefit in getting it approved for iv use.

Novolog, however, is a different preparation, and I didn't see anything calling for Novolog iv.