Adult Dosing

Diabetes Mellitus

Lantus

• Dosing individualized to patient’s needs, generally used in combination with short- or rapid-acting insulins
• 30%-50% of total insulin requirements may be provided by long-acting insulin
• Exhibits a relatively constant glucose-lowering profile over 24 hrs that permits once-daily dosing. Onset 2-4 hours with 24 hours duration without peak
• Initial dose: 0.2 U/kg/day SC or simply 10 units (adults) SC
• Increase dose gradually until fasting blood glucose meets desired goal. Generally maximum dose is 100 U/day

• Conversion from other insulin analogs to insulin glargine
• Conversion from once-daily NPH insulin: Initially same as the dose of NPH that is being discontinued, then adjust on the basis of patient’s response
• Conversion from twice daily NPH insulin: Initial dose is 80% of the total NPH dose that is being discontinued, then adjust on the basis of patient’s response

Pediatric Dosing

Diabetes Mellitus-Children 6 years

Lantus

• Dosing individualized to patient’s needs, generally used in combination with short- or rapid-acting insulins
• 30%-50% of total insulin requirements may be provided by long-acting insulin
• Exhibits a relatively constant glucose-lowering profile over 24 hrs that permits once-daily dosing. Onset 2-4 hours with 24 hours duration without peak
• Initial dose: 0.2 U/kg/day SC or simply 10 units (adults) SC
• Increase dose gradually until fasting blood glucose meets desired goal. Generally maximum dose is 100 U/day

• Conversion from other insulin analogs to insulin glargine
• Conversion from once-daily NPH insulin: Initially same as the dose of NPH that is being discontinued, then adjust on the basis of patient’s response
• Conversion from twice daily NPH insulin: Initial dose is 80% of the total NPH dose that is being discontinued, then adjust on the basis of patient’s response

[Outline]

• Adult Dosing
• Pediatric Dosing

• To improve glycemic control in Type 1 diabetes mellitus in adults and children
• To improve glycemic control in Type 2 diabetes mellitus in adults

• Hypersensitivity to any of the ingredients of the product
• Intravenous administration

• N/A

Renal Dose Adjustment

• Renal impairment: Careful glucose monitoring and dose reduction recommended but specific dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Careful glucose monitoring and dose reduction recommended but specific dose adjustments not defined

• Hypoglycemia is the most common adverse effect of insulin. Severe hypoglycemia can lead to unconsciousness or convulsions and may result in temporary or permanent impairment of brain function or death. Patients should be educated to recognize and manage hypoglycemia
• Check blood sugar frequently and observe for signs of hypoglycemia. Any change should be made cautiously and only under medical supervision. Change in insulin strength, type, frequency may result in need for a change in the dosage. Concomitant oral treatment may need to be changed
• Do not administer insulin glargine intravenously or via an insulin pump. Do not dilute or mix with any other insulin or solution
• Insulin glargine can cause severe life-threatening, generalized allergy, including anaphylaxis
• As insulin glargine have long duration of action, dose reduction is recommended in patients diabetes and renal impairment because of reduced insulin metabolism
• As insulin glargine have long duration of action, dose reduction is recommended in patients diabetes and hepatic impairment because of reduced capacity for gluconeogenesis and reduced insulin metabolism

Cautions: Use cautiously in

• Renal Impairment
• Hepatic Impairment
• Pediatric population
• Intensified glycemic control
• Geriatric population
• Infection or stress

Pregnancy Category:C

Breastfeeding: No specific data available on the use of insulin glargine during breastfeeding. No adverse reactions have been reported due to insulin in breastmilk, infect insulin in breastmilk may decrease the risk of type 1 diabetes in breastfed infants. In general mothers with diabetes using insulin may nurse their infants, based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 Jan 2011). As per manufacturer data as insulin is excreted in human milk, caution should be exercised when administering to a nursing woman. Insulin glargine is compatible with breastfeeding, but women with diabetes who are lactating may require dose adjustments.

• CNS: Headache, depression
• CV: Hypertension
• METABOLIC: Hypoglycemia, nocturnal hypoglycemia, weight gain
• GI: Diarrhea
• RESP: URTI, influenza, sinusitis, bronchitis, cough, pharyngitis
• EENT: Retinal vascular disorder, cataract, rhinitis
• GU: Urinary tract infection
• MUSC: Arthralgia, pain in extremity, back pain
• MISC: Hypersensitivity and allergic reactions, peripheral edema, infection
• LOCAL: Lipodystrophy

• Long-acting recombinant human insulin analog; stimulates peripheral glucose uptake, especially by skeletal muscle and fat, and inhibits hepatic glucose production. Also inhibits lipolysis and proteolysis, and enhances protein synthesis
• Metabolized partially in the subcutaneous depot to form two active metabolites
• Excretion unknown
• Half life: Unknown

US Trade Name(s)

• Lantus

US Availability

Lantus

• INJ (100 units/mL): 10 mL vial
• INJ (100 units/mL): 3 mL cartridges for OptiClik system
• SoloStar (100 units/mL): 3 mL prefilled disposable injection device

Canadian Trade Name(s)

• Lantus

Canadian Availability

Lantus

• INJ (100 units/mL): 10 mL vial
• INJ (100 units/mL): 3 mL cartridges for OptiPen Pro device and OptiClik device
• INJ (100 units/mL): 3 mL cartridges for OptiClik device only
• OptiSet (100 units/mL): 3 mL prefilled disposable injection device
• SoloStar (100 units/mL): 3 mL prefilled disposable injection device

UK Trade Name(s)

• Lantus

UK Availability

Lantus

• INJ (100 units/mL): 10 mL vial
• INJ (100 units/mL): 3 mL cartridges for OptiPen Pro 1 and AutoPen
• INJ (100 units/mL): 3 mL OptiClik cartridge for OptiClik pen
• OptiSet (100 units/mL): 3 mL prefilled disposable injection device
• SoloStar (100 units/mL): 3 mL prefilled disposable injection device

Australian Trade Name(s)

• Lantus

Australian Availability

Lantus

• INJ (100 units/mL): 10 mL vials
• INJ (100 units/mL): 3 mL cartridges
• SoloStar (100 units/mL): 3 mL prefilled disposable injection device

[Outline]

Endocrine/Metabolic

Antidiabetic Agents

Insulins

Pricing data from www.DrugStore.com in U.S.A.

• Lantus SoloStar 100 UNIT/ML SOLN [Box] (SANOFI-AVENTIS U.S.)
  15 ml = $234.99
  45 ml = $661.95
• Lantus 100 UNIT/ML SOLN [Vial] (SANOFI-AVENTIS U.S.)
  10 ml = $124.99
  30 ml = $348.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.