Category Archives: Prescription Assistance

Humalog Prescription Assistance

Humalog is the brand name for insulin lispro – a fast-acting manufactured insulin that is used to control high blood sugar in people suffering from diabetes mellitus.

For those who do not know, insulin is a naturally occurring hormone that helps maintain the levels of glucose in the blood by initiating its utilization or storage, as per the body’s requirements. When there are higher concentrations of glucose in the blood, insulin signals the liver, fat cells, and muscles to take in glucose. If, at that time, the body is low on energy, the body starts metabolizing the glucose to release energy. But, if the body has sufficient energy, the liver converts glucose into glycogen and stores it for future use.

In people suffering from diabetes, either the pancreas stop producing insulin because of the initiation of autoimmune response within the body (Type 1 diabetes) or the body becomes less sensitive or resistant to insulin and loses its ability to respond to the hormone (Type 2 diabetes).

Humalog – The Man-Made Insulin

Humalog is a manufactured replacement insulin that performs the same function in the body as the natural hormone. However, it acts faster and lasts for a short amount of time as compared to regular insulin. The effects start appearing about 30 minutes after administration and lasts for about 5 hours.

Sold as prescription medicine, Humalog is prescribed to help manage diabetes to both adults and children and works by stimulating the process of glucose absorption by cells, so it can be metabolized and used for energy.

Available Dosage Forms and Strengths of Humalog

Humalog is available in 100 units/ml (U-100) and 200 units/ml (U-200) strengths and in the following varieties:

Humalog 100 units/ml:

  • 100 ml vials
  • 3 ml vials
  • 3 ml cartridges
  • 3 ml Humalog KiwiPen (prefilled)
  • 3 ml Humalog Junior KiwiPen (prefilled)

Humalog 200 units/ml:

  • 3 ml Humalog KiwiPen (prefilled)

Dosage

The right dosage of Humalog for a person depends on a variety of factors and hence, varies across patients. Some of the factors that play a key role in determining the right dosage are:

  • The metabolic needs of the individual
  • Route of administration
  • Blood glucose monitoring results
  • Glycemic control goal

The patient needs to be regularly monitored while taking insulin lispro and the dosage may need to be adjusted if there are changes in:

  • Meal patterns. This includes both the timings of food consumption as well as the nutrient content of the food.
  • Physical activity
  • Hepatic or renal function
  • Changes in overall health

Humalog dosage may also need to be adjusted if:

  • The patient is suffering from an acute illness.
  • It is administered along with certain other drugs.

What Should You Do In Case Of an Overdose?

Taking an excessive amount of insulin can cause hypoglycemia i.e. low blood sugar. In some cases, it may also cause hypokalemia i.e. low blood potassium.

While mild cases of hypoglycemia can be easily treated by oral administration of glucose, a drastic drop in the blood glucose level needs to be treated by intravenous administration of concentrated glucose or intramuscular glucagon.

In rare cases, severe episodes of hypoglycemia may cause neurologic impairment, coma, or seizures.

In case you mistakenly take an overdose of Humalog, continue to monitor your blood sugar levels and immediately drink fruit juice or any other sugary drink if there is a drop in glucose level. Continue to monitor and consume carbohydrate for some time, even after you have apparently recovered because hypoglycemia may recur after some time as the medicine continues to function inside your body.

Seek medical help if the glucose level doesn’t become normal by oral consumption of sugary drinks.

Administration of Humalog

The manufactured insulin can be administered by injection or by an insulin pump.

Taking Humalog via Injection

While there are two ways to administer Humalog via injection i.e. subcutaneous injection and intravenous injection, the latter method is only used by doctors, as and when needed. When a patient is prescribed to take Humalog via injection, it is always through the first method.

Subcutaneous Injection

Humalog needs to be administered about 15 minutes before a meal or immediately after it into the subcutaneous tissues of upper arms, thighs, abdominal wall, or buttocks.

When administered this way, the fast-acting insulin is generally taken along with intermediate or long-acting insulin.

Both dosage strengths of Humalog i.e. U-100 and U-200 can be taken via subcutaneous injections.

Note: It is recommended to change the injection site, within the same area, every time you administer Humalog. This is to reduce the risk of lipodystrophy – a disorder of adipose tissues that causes selective loss of body fat.

Taking Humalog via Insulin Pump

Using insulin pump is also a method for subcutaneous infusion of Humalog, but it provides a continuous supply of insulin in small doses as opposed to the quick infusion in slightly higher dosage via injection.

If you are prescribed to administer insulin lisprovia an insulin pump, remember that you should only use Humalog U-100 – Humalog U-200 should not be used via an infusion pump.

Consult your doctor to determine the right infusion rate, both at meal times and otherwise and stick to the recommendations to avoid the chances of overdose.

Note

Make sure to follow the following instructions when you are using Humalog through an insulin pump:

  • Change the infusion set and the insertion site after every 3 days.
  • Change the insulin in the pump reservoir at least after every 7 days.
  • Do not dilute or mix Humalog with any other type of insulin
  • Make sure to not expose the insulin in the pump reservoir to temperatures higher than 98.6 degrees Fahrenheit (37 degrees Centigrade).

Important Instructions

Here are some of the things that you should know and follow while using the manufactured insulin:

  • Never share your Humalog pen, cartridge, or syringe with anyone, even after changing the needle.
  • Store unopened Humalog in the refrigerator – do not freeze.
  • Do not use the insulin if it has been frozen
  • Humalog doesn’t need to be stored in the refrigerator while in use. However, make sure to store it at temperatures below 86 degrees Fahrenheit (30 degrees Centigrade) and use within 28 days of opening.
  • Discard the opened Humalog after 28 days, even if you have not used it completely.
  • Protect the manufactured insulin from direct light and heat.

How Long Does Humalog remain in the Patient’s Body?

As mentioned earlier, the effects of Humalog starts appearing after half an hour and last for about 5 hours.

Possible Side Effects of Humalog

While manufactured insulins are generally safe to use, they may cause some side effects in some cases. This section highlights the effects that you may experience with Humalog.

Common Side Effects

The most common effects that people experience, often due to overdose, are:

  • Hypoglycemia; low blood sugar
  • Hypokalemia; low blood potassium

However, patients may also experience itching, swelling, and/or redness at the site of injection. While these local allergy reactions usually disappear with a few days (they may take a few weeks in some patients), the patient may need to discontinue the use of Humalog in some cases.

Negative Effects of Humalog Observed In Clinical Trial

Humalog has shown a range of side effects during clinical trials. While the frequency of their occurrence was low, one should be always vigilant and consult a doctor if any of the effects last for a long time.

Adverse Effects of Humalog in Patients with Type 1 Diabetes

  • Bronchitis
  • Nausea
  • Cough
  • Fever
  • Headache
  • Abdominal pain
  • Diarrhea
  • Flu syndrome
  • Rhinitis
  • Pharyngitis
  • Different types of infections, such as urinary tract infection
  • Myalgia
  • Dysmenorrhea
  • Asthenia

Adverse Effects of Humalog in Patients with Type 2 Diabetes

  • Flu syndrome
  • Rhinitis
  • Pharyngitis

Long-Term Effects of Humalog

The long-term usage of Humalog may cause:

  • Lipodystrophy, particularly in case of repeated infusions or injections at the same site
  • Sodium retention and peripheral edema, particularly in cases where intense insulin therapy is undertaken to improve poor metabolic control
  • Weight gain
  • Long-term administration of insulin may cause severe, generalized allergies in some patients that could be life-threatening. Generalized insulin allergy may cause body rash, wheezing, anaphylaxis, tachycardia, wheezing, dyspnea, hypotension, or diaphoresis.

Possible Drug Interactions of Humalog

Just like most other medications, Humalog can interact with some drugs and cause negative effects.

The use of Humalog with the following drugs may put the patients at an increased risk of hypoglycemia:

  • Antidiabetic agents
  • ACE inhibitors
  • Monoamine oxidase inhibitors
  • Salicylates
  • Sulfonamide antibiotics
  • Fluoxetine
  • Pramlintide
  • Disopyramide
  • Fibrates
  • Pentoxifylline
  • Propoxyphene
  • Angiotensin II receptor blocking agents
  • Somatostatin analogs, for example, octreotide.

Following drugs can reduce the effectiveness of Humalog in lowering blood glucose levels:

  • Corticosteroids
  • Isoniazid
  • Niacin
  • Estrogens
  • Oral contraceptives
  • Phenothiazines
  • Danazol
  • Diuretics
  • Sympathomimetic agents, such as epinephrine, albuterol, and terbutaline
  • Somatropin
  • Atypical antipsychotics
  • Glucagon
  • Protease inhibitors
  • Thyroid hormones

Lithium salts, clonidine, beta-blockers, and alcohol can also increase or decrease the effectiveness of Humalog in reducing blood glucose levels.

Tell Your Doctor If You Are…

  • Pregnant or planning to get pregnant
  • Suffering from renal or hepatic impairments
  • Nursing mother. While it is not known that whether insulin lispro passes into breast milk or not, caution should be exercised while administering Humalog to nursing mothers.

Who Should Not Take Humalog?

Although Humalog is considered safe for use in both adults and children, its effects have not been studied in children under 3 years of age. So, it should not be used for toddlers unless prescribed by a registered physician or diabetic consultant.

Prescription Assistance for Humalog

The Lilly Cares Foundation Inc. is a non-profit organization that offers patient assistance program to help qualifying patients get prescribed medicines at no cost. The foundation has recently launched a new program to make diabetes medicines more accessible to patients who are not insured or underinsured and cannot afford to buy them either.

If you have not already been registered with a prescription assistance program, call 1-8-333-808-1234 to get in touch with the Lilly Diabetes Solution Center or visit the RX Assist website to check your eligibility for Lilly Care programs

You can also check out the list of programs that offer prescription assistance to diabetic patients at the American Diabetes Association’s website.

Effexor Prescription Assistance

Effexor is the brand name for Venlafaxine – a medication from the class of serotonin-norepinephrine reuptake inhibitors (SNRIs) that is used to treat depression and dysphoric mood that interferes with a person’s daily life.

Due to the fact that Effexor typically has strong side effects, it is generally recommended only to those patients who do not benefit from SSRIs (the most commonly used antidepressants).

In order to be prescribed with Effexor, a patient should be experiencing at least four of the following symptoms and not finding relief from any SSRI medicine:

  • Changes in sleeping patterns
  • Change in appetite
  • Increased fatigue
  • Loss of interest in everyday tasks or usual activities
  • Impaired concentration and/or impaired thinking
  • Feeling worthless or guilty
  • Psychomotor agitation and/or retardation
  • Suicidal thoughts and/or suicidal attempt

How Effexor Works

The medicine helps patients suffering from depression or other psychiatric disorders, like generalized anxiety disorder, get relief from the symptoms and experience improved energy levels and mood by restoring the balance of norepinephrine and serotonin in the brain.

Serotonin and norepinephrine are naturally occurring neurotransmitters that are involved in the regulation of behavior, mood, and emotions.

Serotonin, commonly known as the happy hormone, controls the brain processes that regulate one’s emotions, mood, appetite, sleep, memory, and perception.

On the other hand, norepinephrine, also known as noradrenaline, is a stress hormone that controls parts of the brain related to attention and also plays a role in the flight or fight responses. It is also responsible for boosting the flow of blood to the muscles, releasing glucose from the reserved energy in the body, and increasing heart rate in certain situations.

Patients suffering from depression and anxiety feel down, sad, and hopeless because of the reduced levels of these regulatory hormones. According to mental health experts, the nerve cells of patients suffering from depressive disorders produce these neurotransmitters in lesser quantities.

To counter this condition, SNRI medications prevent the reabsorption of norepinephrine and serotonin into the nerve cells. Reabsorption of the neurotransmitters is a natural process, called reuptake, in which the nerve cells take back the neurotransmitters after they have performed their work.

Effexor’s effects on these neurotransmitters mainly depend on the dosage. When taken in smaller amounts, Effexor only blocks the reuptake of serotonin. But, when a higher dose is taken, Effexor prevents the uptake of both serotonin and norepinephrine.

Availability

The antidepressant medication is available in the form of an extended release capsule.

Dosage

The dosage of Effexor varies across patients, depending on the severity of their condition and their body’s response. Usually, doctors start with a low dosage and then gradually increase it as the patient builds a tolerance.

The dosage of Effexor can range from 37.5 mg to 300 mg per day. But, on average, the extended release capsule is prescribed to be taken once a day.

An important thing to note here is that it may take you several weeks to really experience the benefits of Effexor. Many people stop taking the medicine on their own because they can’t feel improvement in their condition, which is a mistake. Make sure to continue taking the medicine as per your doctor’s recommendation to experience the effects.

What to Do If You Miss a Dose?

In case you miss a dose of Effexor, take it as soon as you remember. However, you should skip the missed dose if it is almost time for the next dose. Do not take a double dose of Effexor at the same time to make up for the missed one.

What Should You Do In Case Of an Overdose?

If you mistakenly take too much of Effexor, immediately call you doctor, seek emergency medical treatment, or call a poison control center.

How Should The Medicine Be Taken?

The medicine should be taken orally with food, at the same time every day. Do not crush, chew, divide or dissolve the medicine in water. However, if you have difficulty in swallowing the capsule, you can sprinkle its contents onto a spoonful of apple sauce and immediately swallow it without chewing. Also, drink a glass of water immediately after taking the medicine.[1]

How Long Does Effexor Remain in the Patient’s Body?

The amount of time for which the drug stays in a patient’s system depends on the dosage. Effexor has a half life of about 5 hours (+/- 2 hours), which is less than that of most antidepressants.

This means half of the taken dosage is cleared from a patient’s system within the first 5 hours of administering it. It will take the body another 5 hours to clear half of the remaining amount from the system. This process continues until the patient’s body is completely free of the drug.

In addition to the dosage, some other factors also play a role in determining how long the body takes to flush the drug out of the system. These include age, liver function, genetics, and body composition. It is due to these factors that two people taking the same dosage of the drug at the same time may require different amounts of time to fully clear the drug from the system.

Possible Side Effects of Effexor

Just like all other prescription medicines, Effexor should only be taken when and as prescribed by your doctor. While most people do not experience any major side effects when taking Effexor, sticking to the prescribed dosage is recommended to avoid misuse, overdose, or addiction. However, in some cases, the side effects may occur even when the medicine is taken as recommended.

Common Side Effects

Common side effects of Effexor include:

  • Drowsiness
  • Dizziness
  • Nausea
  • Dry mouth
  • Loss of appetite
  • Constipation
  • Trouble sleeping
  • Excessive yawning
  • Nervousness
  • Blurred vision
  • Excessive sweating

Effexor may also cause an increase in the blood pressure, so it is highly important to regularly check your blood pressure while you are taking this medicine.

Serious Side Effects of Effexor

In rare cases, Effexor may cause some serious side effects. These include:

  • Shortness of breath
  • Excessive bleeding or bruising
  • Chest pain
  • Muscle weakness or cramps
  • Pounding or severe headaches
  • Tremors or shaking
  • Vomit that looks like coffee grounds
  • Bloody or black stools
  • Swelling, redness, or pain in eyes
  • Changes in vision, such as seeing rainbow colors around lights, at night.
  • Widened pupils
  • Seizures
  • Decreased sexual desire and changes in sexual ability

Although it’s rare, Effexor may possibly cause an increase in the levels of serotonin in the body and could lead to ‘serotonin syndrome’. Therefore, it is important to be cautious of the symptoms you experience while taking venlafaxine and immediately consult your doctor if you experience any serious effects or symptoms that don’t go away within a few days of starting the medicine.

Following are some of the common symptoms of serotonin syndrome that you should watch out for when taking Effexor:

  • An irregular or fast heart beat
  • Loss of coordination
  • Twitching muscles
  • Severe dizziness
  • Unexplained fever
  • Severe nausea, diarrhea, or vomiting
  • Excessive or unusual restlessness or agitation
  • Hallucinations

Long-Term Effects of Effexor

Just like all other antidepressants, taking Effexor for a long time can create dependency.

As it has long been identified by the Federal Drug Administration, antidepressants may also increase the risks for suicidal thoughts and/or suicidal attempts among patients.

While some healthcare professionals refute this claim, some believe that long-term use of antidepressants can lead to the development of type II diabetes.

In view of all these factors, it is highly important to be careful in using Effexor or any other anti-depressant and immediately report to your doctor if you experience any negative effects.

Effexor Addiction

While this antidepressant medication is not known to cause addiction like some other drugs, patients may develop a dependency on the effects. This is more likely to happen when antidepressants are taken without a prescription or when wrongly prescribed.

According to a research study published in the Journal of Clinical Psychiatry, majority of the people who are taking antidepressants do not qualify for them. Researchers found that around 69% of the people taking antidepressant medications did not meet the criteria for clinical depression, also called major depressive disorder. Furthermore, 38% of the people did not even meet the criteria for other psychiatric disorders that may need antidepressants, such as panic disorder, generalized anxiety disorder, obsessive compulsive disorder, or social phobia.

Following are some signs and symptoms associated with Effexor misuse, so if you or a loved one is taking the medicine, it is important to be vigilant for the following signs:

  • Change in appetite
  • Bloodshot eyes
  • Slurred speech
  • Changes in sleeping patterns or strange sleep habits
  • Diminished appearance
  • Difficulty in concentrating or managing things that often leads to financial difficulties

Who Should Not Take Effexor?

Effexor should be avoided during pregnancy, especially during the last three months, because it can cause harm to the fetus.

Effexor has also been found to transfer into breast milk and hence, should be avoided by nursing mothers.

It is important to tell your doctor if you are pregnant, planning to get pregnant, or a nursing mother. Since Effexor can cause developmental damage to the baby, especially in the long-run, it is only prescribed to pregnant and nursing women when severely needed, even then for shorter periods.

You should also avoid Effexor if you are suffering from uncontrolled angle-closure glaucoma or are allergic to any ingredient present in Effexor.

Possible Drug Interactions of Effexor

Since many medicines can interact with other drugs and cause negative effects, it is important to tell about all the medications you are already taking whenever you go to a doctor for any problem.

Effexor may interact with many over-the-counter and prescription medicines and hence, should be avoided to be used with them. For example, taking Effexor with blood thinners, like Aspirin, may cause bruising and bleeding.

NSAIDs, like naproxen and ibuprofen, should also be avoided while taking this antidepressant medicine.

Medicines that fall into the category of inhibitors and inducers can affect the metabolism of Effexor by interfering with the enzyme that is responsible for the task. Inhibitors reduce its functioning whereas inducers cause enhanced activation of the liver enzyme that metabolizes Effexor.

Effexor can also interact with the medications used for:

  • Anxiety
  • Pain relief
  • Seizure
  • Migraine
  • Weight loss

The medicine should also not be used with:

  • Diuretics
  • Sedatives
  • Cimetidine
  • Clozapine
  • Duloxetine
  • Haloperidol
  • Imipramine
  • Indinavir
  • Ketoconazole
  • Linezolid
  • Lithium
  • Methadone
  • Methylene Blue
  • Phentermine
  • Ritonavir
  • Sibutramine
  • Tramadol

Do not take Effexor if you are taking or have taken, within the last 14 days, any medication that falls into the category of monoamine oxidase inhibitors (MAOIs).  MAOIs should also not be taken within 7 days of discontinuing Effexor. Methylene blue and linezolid are some of the common MAOIs.

Prescription Assistance for Effexor

Pfizer Rx Pathways, a patient assistance program that is jointly run by the Pfizer Inc. and the Pfizer Patient Assistance Foundation, connects patients to many assistance programs that offer free medicines, co-pay help, and insurance support.

If you have not already been registered with a prescription assistance program, visit the Pfizer Rx Pathways’ website, enter the name of the desired medicine, and answer a few questions to find out the right program(s) for you.

You can also check out the eligibility for Pfizer Patient Assistance Program at RX Assist’s website.

Since Effexor is manufactured by Pfizer, Pfizer Rx Pathways provides prescription assistance for the medicine.

[1] https://www.effexorxr.com/faqs#taking-eff