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Contraindications 
MERILOG is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to insulin aspart products or any of the excipients in MERILOG.

Warnings and Precautions
Never share a MERILOG SoloStar^® prefilled pen between patients, even if the needle is changed: Sharing poses a risk for transmission of blood-borne pathogens. 

Make changes to a patient’s insulin regimen (e.g., insulin strength, manufacturer, type, injection site or method of administration) under close medical supervision with increased frequency of blood glucose monitoring. Changes in insulin regimen may affect glycemic control and predispose to hyperglycemia or hypoglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis may result in hyperglycemia; sudden change in the injection site (to unaffected area) has been reported to result in hypoglycemia. Advise patients to rotate injection site to unaffected areas and closely monitor for hypoglycemia. 

Hypoglycemia is the most common adverse reaction associated with insulins, including MERILOG and may be life-threatening. 

Accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. To avoid medication errors between MERILOG and other insulins, instruct patients to always check the insulin label before each injection. 

Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including MERILOG. If hypersensitivity reactions occur, discontinue MERILOG, treat per standard of care and monitor until symptoms and signs resolve. 

All insulin products, including MERILOG, can cause hypokalemia. Untreated hypokalemia may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia. 

Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs) which are peroxisome proliferator-activated receptor (PPAR)-gamma agonists, and particularly when used with insulin. Observe for signs and symptoms of heart failure. Consider dosage reduction or discontinuation of TZD if heart failure occurs. 

Adverse Reactions
Adverse reactions observed with insulin aspart products include hypoglycemia, allergic reactions, local injection site reactions, lipodystrophy, rash, and pruritus. 

Drug Interactions
Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and reserpine). 

Important Safety Information for MERILOG SoloStar
MERILOG SoloStar is a disposable single-patient-use prefilled insulin pen. To help ensure an accurate dose each time, patients should follow the steps in the Instruction Leaflet accompanying the pen; otherwise, they may not get the correct amount of insulin, which may affect their blood glucose levels.

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