Short answer: Both are insulin lispro mealtime insulins for adults and children with diabetes, in U-100 and U-200.12 Lyumjev (insulin lispro-aabc) adds treprostinil and sodium citrate and is injected at the start of a meal or within 20 minutes after. Humalog is injected within 15 minutes before or right after a meal. In the PRONTO trials against Humalog, Lyumjev met the set HbA1c margin.
| Lyumjev | Humalog | |
|---|---|---|
| What is in it | Insulin lispro-aabc; inactive ingredients include treprostinil and sodium citrate1 | Insulin lispro2 |
| When injected | At the start of a meal or within 20 minutes after starting a meal1 | Within 15 minutes before a meal or immediately after a meal2 |
| How fast (label studies) | Appeared in the blood about 1 minute after a dose; peak level at 57 minutes1 | Peak serum levels 30 to 90 minutes after a dose in healthy volunteers2 |
| PRONTO-T1D, adults, 26 weeks | HbA1c change −0.12% mealtime, +0.1% after the meal1 | −0.04% mealtime1 |
| PRONTO-T2D, adults, 26 weeks | HbA1c change −0.36%1 | −0.38%1 |
| PRONTO-Pump-2, 16 weeks | HbA1c change −0.06%1 | −0.09%1 |
| Insulin pump (U-100 only) | Change the reservoir at least every 9 days1 | Change the reservoir at least every 7 days2 |
| Mixing in a syringe | Not mixed with other insulins1 | U-100 may be mixed with NPH insulin only; U-200 not mixed2 |
| Missed dose | Check glucose to decide if a dose is needed; resume at the next meal1 | No instruction in the label2 |
| Boxed warning | None1 | None2 |
Four Lyumjev trials used Humalog as the comparator, each with a non-inferiority margin of 0.4% HbA1c, and all met it. In adults with type 1 diabetes, HbA1c changed −0.12% on mealtime Lyumjev and −0.04% on mealtime Humalog; Lyumjev injected after the meal also met the margin. In type 2 diabetes the changes were −0.36% vs −0.38%, on a pump −0.06% vs −0.09%, and in children 0.06% in every group. Insulin doses were similar across groups.1
The Lyumjev label notes that treprostinil and sodium citrate have been linked to site reactions with other, non-insulin products. Injection site reactions occurred in 2.7% of adults and 6.2% of children on Lyumjev, and on a pump, infusion site reactions were reported in 37.7% of adults, with 3.3% stopping because of them.1 The Lyumjev label lists side effects at 5% or more and at the same rate or higher than on Humalog, but does not print a Humalog column.
Which, if either, fits is for your prescriber. More detail: Lyumjev side effects, the Lyumjev dosing schedule, the Lyumjev and Humalog missed-dose pages, how to store Lyumjev, how to store Humalog and Humalog vs NovoLog: what is different between the two mealtime insulins?.