section name header

Indications ⬇

High Alert

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

Endo: HYPOGLYCEMIA

F and E: hypokalemia

Local: cutaneous amyloidosis, lipodystrophy, pruritus, erythema, swelling

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions ⬆ ⬇

Drug-drug:

Drug-Natural Products:

Availability ⬆ ⬇

  • Solution for injection (Basaglar, Rezvoglar): 100 units/mL (prefilled pens)
  • Solution for injection (Lantus, Semglee): 100 units/mL (vials and prefilled pens)
  • Solution for injection (Toujeo): 300 units/mL (prefilled pens)

Route/Dosage ⬆ ⬇

Toujeo has a lower glucose lowering effect than Basaglar, Lantus, Rezvoglar, or Semglee on a unit-to-unit basis.

    Basaglar, Lantus, Rezvoglar, or Semglee

    • SC (Adults and Children ≥6 yr): Type 1 diabetes (insulin naive): 1/3 of the total daily insulin dose given once daily, then adjust on the basis of patient's needs (remainder of insulin dose should be given as a short-acting insulin) (usual starting total daily insulin dose = 0.2–0.4 units/kg); Type 2 diabetes (insulin naive): 0.2 units/kg or up to 10 units once daily; then adjust on the basis of patient's needs; Type 1 or 2 diabetes (and converting from Toujeo): Give 80% of Toujeo dose as Basaglar, Lantus, or Semglee once daily, then adjust on the basis of patient's needs; Type 1 or 2 diabetes (and converting from once daily NPH): Give the same dose once daily, then adjust on the basis of patient's needs; Type 1 or 2 diabetes (and converting from twice daily NPH): Give 80% of the total daily NPH dose once daily, then adjust on the basis of patient's needs.

    Toujeo

    • SC (Adults ): Type 1 diabetes (insulin naive): ⅓–½ of the total daily insulin dose given once daily, then adjust on the basis of patient's needs (range = 1–80 units/day), (remainder of insulin dose should be given as a short-acting insulin) (usual starting total daily insulin dose = 0.2–0.4 units/kg); Type 2 diabetes (insulin naive): 0.2 units/kg once daily, then adjust on the basis of patient's needs; Type 1 or 2 diabetes (and converting from intermediate or long-acting insulin): Use same total daily dose and give once daily, then adjust on the basis of patient's needs;Type 1 or 2 diabetes (and converting from NPH insulin): Use 80% of the total daily NPH and give once daily, then adjust on the basis of patient's needs.

US Brand Names ⬆ ⬇

Basaglar KwikPen, Basaglar Tempo Pen, Lantus, Lantus SoloStar, Rezvoglar KwikPen, Semglee, Toujeo Max SoloStar, Toujeo SoloStar

Action ⬆ ⬇

  • Lowers blood glucose by :
    • stimulating glucose uptake in skeletal muscle and fat,
    • inhibiting hepatic glucose production.
  • Other actions of insulin:
    • inhibition of lipolysis and proteolysis,
    • enhanced protein synthesis.
Therapeutic effects:
  • Control of hyperglycemia in patients with type 1 or type 2 diabetes.

Classifications ⬆ ⬇

Therapeutic Classification: hormones, antidiabetics

Pharmacologic Classification: pancreatics

Pharmacokinetics ⬆ ⬇

Absorption: Provides slower prolonged absorption and a relatively constant concentrations over 24 hr.

Distribution: Identical to endogenous insulin.

Metabolism/Excretion: Partially metabolized at the site of injection to active insulin metabolites. Metabolized by liver, spleen, kidney, muscle.

Half-Life: 5–6 min (prolonged in diabetic patients; biological half-life is longer).

Time/Action Profile ⬆ ⬇

(hypoglycemic effect)

ROUTEONSETPEAKDURATION
SUBQ3–4 hrnone‡24 hr

‡Small amounts of insulin glargine are slowly released resulting in a relatively constant effect over time.

Patient/Family Teaching ⬆ ⬇

  • Instruct patient on proper technique for administration. Include type of insulin, equipment (syringe, cartridge pens, alcohol swabs), storage, and place to discard syringes. Discuss the importance of selection and rotation of injection sites, and compliance with therapeutic regimen.
  • Caution patient not to share pen device with another person, even if needle is changed; may risk transmission of blood-borne pathogens.
  • Explain to patient that this medication controls hyperglycemia but does not cure diabetes. Therapy is long term.
  • Instruct patient in proper testing of serum glucose and ketones. These tests should be closely monitored during periods of stress or illness and health care professional notified of significant changes.
  • Emphasize the importance of compliance with nutritional guidelines and regular exercise, as directed by health care professional.
  • Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications or alcohol.
  • Advise patient to notify health care professional of medication regimen prior to treatment or surgery.
  • Advise patient to notify health care professional if nausea, vomiting, or fever develops, if unable to eat regular diet, or if blood sugar levels are not controlled.
  • Instruct patient on signs and symptoms of hypoglycemia and hyperglycemia and what to do if they occur.
  • Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
  • Patients with diabetes mellitus should carry a source of sugar (candy, glucose gel) and identification describing their disease and treatment regimen at all times.
  • Emphasize the importance of regular follow-up, especially during first few wk of therapy.

Pronunciation ⬆ ⬇

IN-su-lin GLAR-jeen

Pill Image

insulinglargine_195-8887.jpg

Code ⬆

NDC Code