Package Leaflet: Information for the User
Lyumjev 200 units/ml KwikPen Solution for Injection in Pre-filled Pen
insulin lispro
Each KwikPen Delivers 1 to 60 Units in Increments of 1 Unit.
This medicinal product is subject to additional monitoring, which will allow for quick identification of new safety information. You can help by reporting any side effects you may get. The last section of the package leaflet contains information on how to report side effects.
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
Contents of the Package Leaflet
Lyumjev 200 units/ml KwikPen Solution for Injection in Pre-filled Pen contains the active substance insulin lispro. Lyumjev is used to treat diabetes in adults. It is an insulin that is administered at mealtimes and acts more quickly than other medicines that contain insulin lispro. Lyumjev has components that accelerate the absorption of insulin lispro by the body.
Diabetes is a disease in which the body does not produce enough insulin or does not use insulin effectively, resulting in effects such as high blood sugar levels. Lyumjev is an insulin used to treat diabetes by controlling blood sugar levels. Effective treatment of diabetes, with good blood sugar control, prevents long-term complications of diabetes.
Treatment with Lyumjev helps control blood sugar levels in the long term and prevents complications of diabetes. Lyumjev reaches its maximum effect between 1 and 3 hours after injection and the effect lasts up to 5 hours. You should use Lyumjev when you start eating, or up to 20 minutes after starting a meal.
Your doctor may recommend using Lyumjev in addition to a long-acting or intermediate-acting insulin. Do not change your insulin unless your doctor tells you to.
The Lyumjev 200 units/ml KwikPen is a pre-filled, disposable pen that contains 3 ml (600 units, 200 units/ml) of insulin lispro. A KwikPen contains multiple doses of insulin. The KwikPen marks 1 unit each time. The number of units is shown in the dosing window, always check it before your injection. You can inject from 1 to 60 units in a single injection. If your dose is more than 60 units, you will need to administer more than one injection.
DO NOT use Lyumjev 200 units/ml KwikPen
Warnings and Precautions
Consult your doctor, pharmacist, or nurse before using Lyumjev.
If you have vision problems, you will need the help of a trained person to administer the injections.
A low blood sugar level can be serious and untreated hypoglycemia can even cause death.
Lyumjev starts to lower blood sugar levels faster than other insulins administered at mealtimes. If you experience hypoglycemia, you may notice it soon after a Lyumjev injection. If you often experience hypoglycemia or have difficulty recognizing the symptoms, please discuss this with your doctor or nurse. If your blood sugar levels are well controlled with your current insulin therapy or if you have had diabetes for a long time, you may not perceive the warning symptoms that alert you to the fact that your blood sugar level is dropping too low. Later in this leaflet, the warning symptoms are listed. For more information on symptoms, please consult “Common Problems of Diabetes”.
You should carefully plan when to eat, when to exercise, and to what extent you can do so. You should also closely monitor your blood sugar levels by performing frequent blood sugar tests.
Making changes in the type of insulin you use may cause your blood sugar level to rise or fall too much.
You may need to increase the frequency of blood sugar tests if there is a risk of low blood sugar levels. Your doctor may consider it necessary to make changes in the doses of other medicines you use to treat your diabetes.
Stopping insulin administration or not using enough insulin may cause a high blood sugar level (hyperglycemia) and diabetic ketoacidosis, which are serious disorders that can even cause death. For more information on symptoms, please consult “Common Problems of Diabetes”.
The injection site should be rotated to avoid changes in the skin, such as lumps under the skin. Insulin may not work very well if it is injected into a swollen area (see “How to use Lyumjev 200 units/ml KwikPen”). Contact your doctor if you are currently injecting into a swollen area, before starting to inject into a different area. Your doctor may indicate that you should check your blood sugar levels more closely and adjust the insulin or the dose of your other anti-diabetic medications.
Children and Adolescents
This medicine should not be used in children or adolescents, as there is no experience with the use of this medicine in children and adolescents under 18 years of age.
Other Medicines and Lyumjev
Tell your doctor, nurse, or pharmacist if you are taking, have recently taken, or might take any other medicines. Some medicines affect your blood sugar level, and you may need to change your insulin dose.
Your blood sugar level may decrease (hypoglycemia) if you take:
Your blood sugar level may increase (hyperglycemia) if you take:
Betablockers (used for high blood pressure, arrhythmias, or angina pectoris) may make it more difficult to recognize the warning signs of low blood sugar levels.
Using Lyumjev with Alcohol
If you drink alcohol, your blood sugar levels may increase or decrease. Therefore, you may need to change the amount of insulin you need. You should therefore check your blood sugar level more frequently than usual.
Pregnancy and Breastfeeding
If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor, nurse, or pharmacist for advice before using this medicine. The amount of insulin you need usually decreases during the first three months of pregnancy and increases during the next six months. Once you have had your baby, your insulin requirements will probably return to what they were before pregnancy.
During breastfeeding, there are no restrictions on treatment with Lyumjev. If you are breastfeeding, you may need to adjust your insulin dose or diet.
Driving and Using Machines
Your ability to concentrate and react may be reduced if you experience hypoglycemia. Please consider this possible problem, taking into account all situations that may be a risk for you or others (e.g., driving a car or using machines). You should consult your doctor about the suitability of driving if you:
Lyumjev 200 units/ml KwikPen
This medicine contains less than 1 mmol of sodium (23 mg) per dose; i.e., it is essentially “sodium-free”.
Follow the administration instructions for the medication contained in this prospectus or as indicated by your doctor, pharmacist, or nurse. If in doubt, ask your doctor, pharmacist, or nurse.
They will have indicated exactly how much Lyumjev to use, when to use it, and how often. They will also indicate how often you should visit your doctor.
To prevent the possible transmission of diseases, each pen should be used only by you, even if you change the needle.
Do not use Lyumjev 200 units/ml KwikPen injectable solution in an insulin infusion pump.
You should always carry a spare insulin and another injection device to use in case of need.
If you are blind or have reduced vision, you will need the help of a person to administer the injections.
Your doctor may indicate that you use Lyumjev as well as a long-acting or intermediate-acting insulin. Inject them separately. Lyumjev should not be mixed with any other insulin.
When to inject Lyumjev
Lyumjev is an insulin that is administered at mealtime. You should use Lyumjev when you start eating, or one or two minutes before eating; you also have the option of injecting up to 20 minutes after starting the meal.
How much insulin to use
Your doctor will determine the dose based on your blood sugar level and body weight and will explain
Do not use Lyumjev
How to prepare the Lyumjev 200 units/ml KwikPen (please refer to the instructions for use)
How to inject Lyumjev
After the injection
Subsequent injections
If you use more Lyumjev than you should
If you inject too much Lyumjev, or are not sure how much you have injected, you may have low blood sugar. Check your blood sugar.
If your blood sugar is low (hypoglycemia) and you can treat yourself, take glucose tablets, sugar, or drink a sugary drink. Then eat fruit, cookies, or a snack, as your doctor or nurse has indicated, and take a break. This usually helps to overcome a low blood sugar or a mild insulin overdose. Check your blood sugar levels again after 15-20 minutes until your blood sugar stabilizes.
If you are unable to treat yourself (severe hypoglycemia) because you feel too dizzy, weak, confused, have difficulty speaking, loss of consciousness, or have a seizure, you may need treatment with glucagon. This can be administered by someone who knows how to use it. After being treated with glucagon, take glucose or sugar. If you do not respond to glucagon, you should go to the hospital or call emergency services. Ask your doctor to inform you about glucagon.
Inform the people around you that you have diabetes. Tell them what the consequences of low blood sugar might be, including the risk of losing consciousness.
Tell them that if you become unconscious, they should do the following: lay you on your side to prevent choking, seek immediate medical attention, and do not give you anything to eat or drink, as you may choke.
If you forgot to use Lyumjev
If you forget to use your insulin or use less than you should, or are not sure how much you have injected, your blood sugar level may become very high (hyperglycemia). Check your blood sugar level to decide if an insulin dose is needed. Resume your usual dosing schedule at the next meal.
If you interrupt treatment with Lyumjev
Do not interrupt treatment or change insulin unless your doctor indicates it. If you use less Lyumjev than you should, you may have high blood sugar.
If high blood sugar (hyperglycemia) is not treated properly, it can be very serious and cause headache, nausea, vomiting, abdominal pain, dehydration, loss of consciousness, coma, and even death (see section 4).
Three simple measuresto reduce the risk of hypoglycemia or hyperglycemia are:
If you have any other questions about the use of this medication, ask your doctor, pharmacist, or nurse.
Like all medications, this medication can cause side effects, although not everyone will experience them.
Low blood sugar (hypoglycemia)is very common with insulin treatment (it can affect more than 1 in 10 people). It can be very serious. If your blood sugar level drops too low, you may lose consciousness. Severe hypoglycemia can cause brain damage and put your life at risk. If you have symptoms of low blood sugar, act immediatelyto increase your blood sugar level. See section 3 "If you use more Lyumjev than you should".
Allergic reactionsare common (they can affect up to 1 in 10 people). They can be serious and include the following symptoms:
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If you have a severe allergic reaction(including anaphylactic shock) to insulin or any of the components of Lyumjev, stop using this medication and contact emergency medical services immediately.
Other side effects include
Common
Reactions at the injection site. In some people, redness, pain, inflammation, or itching may appear at the insulin injection site. These reactions usually disappear within a few minutes to a few weeks without needing to interrupt Lyumjev. If you have reactions at the injection site, talk to your doctor.
Uncommon(can affect up to 1 in 100 people)
Changes in the skin at the injection site: If you inject insulin too frequently in the same spot, the fatty tissue can shrink (lipoatrophy) or become thicker (lipohypertrophy). Lumps under the skin can also occur due to the accumulation of a protein called amyloid (cutaneous amyloidosis). Insulin may not work very well if injected into a thickened area. Change the injection site to help avoid these skin changes.
Other possible side effects
Swelling in the arms or legs due to fluid retention (edema), especially at the start of insulin treatment or during a change in your diabetes medications.
Reporting side effects
If you experience any side effects, consult your doctor or pharmacist, even if it is a possible side effect not listed in this prospectus. You can also report them directly through the national reporting system included in Appendix V. By reporting side effects, you can help provide more information on the safety of this medication.
Common diabetes problems
Low blood sugar
Low blood sugar (hypoglycemia) means you do not have enough sugar in your blood.
This can happen if:
See section "If you use more Lyumjev than you should".
The first symptoms of low blood sugar usually appear quickly and include:
If you are not sure how to recognize the warning signs, avoid situations such as driving a car, in which you or others could be in danger if hypoglycemia occurs.
High blood sugar (hyperglycemia)and diabetic ketoacidosis
Hyperglycemia (too much sugar in the blood) means that the glucose levels in your body are too high. Hyperglycemia can be caused by:
The first symptoms of hyperglycemia are:
Hyperglycemia can lead to diabetic ketoacidosis. The first symptoms appear slowly, over many hours or several days. These symptoms include:
If you have any of these symptoms and high blood sugar, seek medical attention immediately.
See section "If you forgot to use Lyumjev".
Illness
If you are sick, especially if you have nausea or vomiting, the amount of insulin you need may vary. Even if you are not eating as usual, you still need to receive insulin.Perform urine or blood tests, follow the instructions you have been given for these cases, and inform your doctor.
Keep this medication out of sight and reach of children.
Do not use this medication after the expiration date shown on the label and carton. The expiration date is the last day of the month indicated.
Store in the outer packaging to protect from light.
Before first use
Store in the refrigerator (between 2°C - 8°C).
Do not freeze.
After first use
Do not store above 30°C.
Do not freeze.
Do not refrigerate.
The Lyumjev 200 units/ml KwikPen should not be stored with the needle attached. Keep the cap on the pen to protect it from light.
Discard after 28 days even if some solution is left.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of the packaging and any unused medication. This will help protect the environment.
Composition of Lyumjev 200 units/ml KwikPen injectable solution
Appearance of the Product and Container Contents
Lyumjev 200 units/ml KwikPen injectable solution is a clear, colorless, aqueous solution in a pre-filled pen. Each pre-filled pen contains 600 units (3 milliliters). It is available in packs of 2 or 5 or in a multipack of 10 pre-filled pens (2 packs of 5 pre-filled pens). Not all presentations may be marketed.
The Lyumjev 200 units/ml KwikPen pen is gray-brown in color. The dosing button is gray-brown with raised markings on the side. The label is white with a blue bar and a checkered design. On the carton and label, the insulin concentration appears highlighted in a yellow background box.
The yellow warning label on the cartridge holder reminds you to "Use only with this pen, otherwise a serious overdose may occur".
Each Lyumjev 200 units/ml KwikPen administers from 1 to 60 units in increments of 1 unit.
Marketing Authorization Holder
Eli Lilly Nederland B.V., Papendorpseweg 83, 3528 BJ Utrecht, Netherlands.
Manufacturer
Lilly France S.A.S., Rue du Colonel Lilly, 67640 Fegersheim, France.
You can request more information about this medicinal product by contacting the local representative of the marketing authorization holder:
Belgium/België/Belgien Eli Lilly Benelux S.A./N.V. Tel: + 32-(0)2 548 84 84 | Lithuania Eli Lilly Lietuva Tel: +370 (5) 2649600 |
Luxembourg/Luxemburg Eli Lilly Benelux S.A./N.V. Tel: + 32-(0)2 548 84 84 | |
Czech Republic ELI LILLY CR, s.r.o. Tel: + 420 234 664 111 | Hungary Lilly Hungária Kft. Tel: + 36 1 328 5100 |
Denmark Eli Lilly Danmark A/S Tel: +45 45 26 6000 | Malta Charles de Giorgio Ltd. Tel: + 356 25600 500 |
Germany Lilly Deutschland GmbH Tel: + 49-(0) 6172 273 2222 | Netherlands Eli Lilly Nederland B.V. Tel: + 31-(0) 30 60 25 800 |
Estonia Eli Lilly Nederland B.V. Tel: +372 6817 280 | Norway Eli Lilly Norge A.S. Tel: + 47 22 88 18 00 |
Greece ΦΑΡΜΑΣΕΡΒ-ΛΙΛΛΥ Α.Ε.Β.Ε. Tel: +30 210 629 4600 | Austria Eli Lilly Ges. m.b.H. Tel: + 43-(0) 1 711 780 |
Spain Dista S.A. Tel: + 34-91 663 50 00 | Poland Eli Lilly Polska Sp. z o.o. Tel: +48 22 440 33 00 |
France Lilly France Tel: +33-(0) 1 55 49 34 34 | Portugal Lilly Portugal - Produtos Farmacêuticos, Lda Tel: + 351-21-4126600 |
Croatia Eli Lilly Hrvatska d.o.o. Tel: +385 1 2350 999 | Romania Eli Lilly România S.R.L. Tel: + 40 21 4023000 |
Ireland Eli Lilly and Company (Ireland) Limited Tel: + 353-(0) 1 661 4377 | Slovenia Eli Lilly farmacevtska družba, d.o.o. Tel: +386 (0) 1 580 00 10 |
Iceland Icepharma hf. Tel: + 354 540 8000 | Slovakia Eli Lilly Slovakia s.r.o. Tel: + 421 220 663 111 |
Italy Eli Lilly Italia S.p.A. Tel: + 39- 055 42571 | Finland Oy Eli Lilly Finland Ab Tel: + 358-(0) 9 85 45 250 |
Cyprus Phadisco Ltd Tel: +357 22 715000 | Sweden Eli Lilly Sweden AB Tel: + 46-(0) 8 7378800 |
Latvia Eli Lilly (Suisse) S.A Parstavnieciba Latvija Tel: +371 67364000 | United Kingdom (Northern Ireland) Eli Lilly and Company (Ireland) Limited Tel: + 353-(0) 1 661 4377 |
Date of Last Revision of this Leaflet:
Detailed information on this medicinal product is available on the European Medicines Agency website: http://www.ema.europa.eu/.
Instructions for Use
Lyumjev 200 units/ml KwikPen injectable solution in a pre-filled pen
insulin lispro
PLEASE READ THESE INSTRUCTIONS BEFORE USING
Read the instructions for use before starting to use Lyumjev and each time you start another Lyumjev KwikPen. There may be new information. This information does not replace a direct conversation with your healthcare professional about your disease or treatment.
Do not share your Lyumjev KwikPen with other people, even if the needle has been changed. Do not reuse or share needles with other people. You may give them a serious infection, or they may give you a serious infection.
Lyumjev 200 units/ml KwikPen ("pen") is a pre-filled pen that contains 3 ml (600 units, 200 units/ml) of insulin lispro injectable solution.
This pen is designed to allow you to give more doses than other pens you may have used. Dial your usual dose as directed by your healthcare professional.
Lyumjev KwikPen is available in two presentations, 100 units/ml and 200 units/ml. Inject Lyumjev 200 units/ml only with your pen. Do not transfer insulin from your pen to another insulin delivery device. Syringes and insulin pumps will not dose 200 units/ml of insulin correctly. A serious overdose may occur, producing very low blood sugar levels, which can be life-threatening.
Blind or visually impaired people should not use the pen without the help of a trained person in the use of the pen.
Parts of Lyumjev KwikPen
How to Recognize Your Lyumjev KwikPen
Materials Needed to Inject
Preparing Your Pen
Step 1:
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Step 2:
Do notuse it if its appearance is cloudy, colored, or if it has particles or clumps. | |
Step 3:
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Step 4:
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Step 5:
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Priming Your Pen
Prime before each injection.
Step 6:
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Step 7:
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Step 8:
Insulin should appear at the tip of the needle.
Small air bubbles are normal and will not affect your dose. |
Selecting Your Dose
This pen has been designed to deliver the dose shown in the dosing window. Dial your usual dose as directed by your healthcare professional.
Step 9:
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Giving the Injection
Step 10:
Lyumjev is injected under the skin (subcutaneously) in the abdominal area, buttocks, thighs, or upper arms.
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Step 11:
Do nottry to inject your insulin by turning the dosing button. Turning the dosing button will notdeliver the insulin. | |
Step 12:
With each injection, the plunger moves only a little, so you may not notice the movement. If you see blood in your skin after removing the needle, press the injection site lightly with a piece of gauze or cotton ball. Do notrub the area. |
After Your Injection
Step 13:
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Step 14: >
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Step 15:
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Disposal of Pens and Needles
Troubleshooting
If you have any questions or problems with Lyumjev 200 units/ml KwikPen, consult your healthcare professional or contact Lilly in Spain.
Date of the last revision of this document: