Insulin Glargine

What Is Insulin Glargine

Insulin Glargine (LANTUS) is a long-acting human insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus.

What are the uses of this medicine?

• This medicine is FDA approved to treat adults and children with type 1 diabetes and adults with type 2 diabetes to improve and maintain glycemic control.
• Insulin glargine is a long-acting insulin injected once daily and provides a basal level of insulin throughout the day.

How does this medicine work?

• The primary activity of insulin, including insulin glargine, is regulation of glucose metabolism.
• Insulin glargine is a recombinant analog of human insulin that binds to insulin receptors (IR).
• Insulin glargine has an onset of action of 1.5 to 2 hours.
• It has a long duration of action up to 24 hours.

Who Should Not Use this medicine ?

• This medicine cannot be used in patients with a documented hypersensitivity to the drug or one of its components.
• It also should not be administered during a hypoglycemic episode.

Is this medicine FDA approved

• Insulin glargine was approved for medical use in the United States in 2000.
• In 2018, it was the 26th most commonly prescribed medication in the United States with more than 24 million prescriptions.

How should this medicine be used?

• Dosage based on metabolic needs, blood glucose monitoring, glycemic control, type of diabetes, and prior insulin use.
• Administer subcutaneously into the abdominal area, thigh, or deltoid once daily at any time of day, but at the same time every day.
• Its administration includes a diluent with a pH of 4.0 to maintain the solubility of the drug before use.
• Patients should rotate injection sites to avoid lipodystrophy; these include the top of the thighs, back of the upper arms, buttocks, or abdomen.

What are the dosage forms and brand names of this medicine?

This medicine is avialable in fallowing dosage forms:

• 10 mL multiple-dose vial (3)
• 3 mL single-patient-use SoloStar prefilled pen

Type 1 Diabetes

• The recommended starting dose of LANTUS in patients with type 1 diabetes should be approximately one-third of the total daily insulin requirements.
• Short-acting, premeal insulin should be used to satisfy the remainder of the daily insulin requirements.

Type 2 Diabetes

• The recommended starting dose of LANTUS in patients with type 2 diabetes who are not currently treated with insulin is 0.2 units/kg or up to 10 units once daily.

This medicine is available in following brand names:

• Basaglar®
• Lantus®
• Toujeo®
• Soliqua®( Insulin Glargine and Lixisenatide)

What side effects can this medication cause?

Common possible side effects of this medicine include:

• hypoglycemia
• allergic reactions
• injection site reactions
• lipodystrophy
• pruritus
• rash
• edema
• weight gain.

What special precautions should I follow?

• Never share a LANTUS SoloStar prefilled pen between patients, even if the needle is changed.
• 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.
• Increase frequency of glucose monitoring with changes to: insulin dosage, coadministered glucose lowering medications, meal pattern, physical activity; and in patients with renal or hepatic impairment and hypoglycemia unawareness.
• Instruct patients to check insulin labels before injection.
• Monitor potassium levels in patients at risk of hypokalemia and treat if indicated.

What to do in case of emergency/overdose?

• Excess insulin administration may cause hypoglycemia and hypokalemia.
• Mild episodes of hypoglycemia can usually be treated with oral carbohydrates.
• Adjustments in drug dosage, meal patterns, or exercise may be needed.

• More severe episodes of hypoglycemia with coma, seizure, or neurologic impairment may be treated with intramuscular/subcutaneous glucagon or concentrated intravenous glucose.
• After apparent clinical recovery from hypoglycemia, continued observation and additional carbohydrate intake may be necessary to avoid recurrence of hypoglycemia.
• Hypokalemia must be corrected appropriately.

Can this medicine be used in pregnency?

• Insulin glargine is not FDA-approved in pregnancy, although studies have not shown contraindications to its use or adverse fetal outcomes.
• It is considered a first-line treatment for gestational diabetes after lifestyle modifications have proven insufficient.

Can this medicine be used for Pediatrics?

• Safety and effectiveness of LANTUS have been established in the age group 6 to 15 years with type 1 diabetes.

What should I know about storage and disposal of this medication?

• LANTUS should not be stored in the freezer and should not be allowed to freeze.
• Discard LANTUS if it has been frozen.
• Protect LANTUS from direct heat and light.
• Store unopened insulin glargine vials and pens in the refrigerator.
• Unopened refrigerated insulin glargine can be stored until the date shown on the company's label.
• If a refrigerator is unavailable (for example, when on vacation), store the vials or pens at room temperature and away from direct sunlight and extreme heat.
• Unrefrigerated vials or pens can be used within 28 days; after that time they must be discarded.
• Opened vials can be stored for 28 days at room temperature or in the refrigerator.
• Opened pens must be stored at room temperature and may be used for up to 28 days after the first use.
• Dispose of any insulin that has been exposed to extreme heat or cold.

• Dailymed label info on Insulin Glargine
• FDA Insulin Glargine

Insulin Glargine Resources
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