Insulin Glargine

DEA Class; Rx

Common Brand Names; Lantus, Lantus SoloStar, Toujeo, Basaglar, Semglee, insulin glargine-yfgn, Rezvoglar, insulin glargine-aglr

Indicated for the treatment of type 1 diabetes mellitus. Long-acting basal insulin indicated to improve glycemic control

Documented hypersensitivity to drug or excipients

During episodes of hypoglycemia

Headache

Influenza-like symptoms

Dyspepsia

Diarrhea

Back pain

Pharyngitis

Lipodystrophy

Lipohypertrophy

Pallor

Palpitation

Tachycardia

Local allergic reaction

Hypokalemia

Peripheral edema

Localized cutaneous amyloidosis

Pediatric patients

• Rhinitis

Toujeo and Lantus are not interchangeable

Not recommended for treating diabetic ketoacidosis; use IV short-acting insulin instead

Never share insulin pens between patients, even if the needle is changed; pen sharing poses a risk for transmission of blood-borne pathogens

To avoid dosing errors and potential overdose, never use a syringe to remove drug from TOUJEO SoloStar or TOUJEO Max SoloStar prefilled pen into a syringe

Decreased insulin requirements: Diarrhea, nausea/vomiting, malabsorption, hypothyroidism, renal impairment, hepatic impairment

Increased insulin requirements include fever, hyperthyroidism, trauma, infection, surgery

Increase frequency of glucose monitoring with changes to insulin dosage, coadministered glucose lowering medications, meal pattern, or physical activity; and in patients with renal or hepatic impairment and hypoglycemia unawareness

Accidental mix-ups between insulin products can occur; instruct patients to check insulin labels before injection

Rapid changes in serum glucose may induce symptoms of hypoglycemia

Hypoglycemia is the most common cause of adverse reactions (eg, headache, tachycardia)

May cause a shift in potassium from extracellular to intracellular space, possibly leading to hypokalemia; caution when coadministered with potassium-lowering drugs or conditions that may decrease potassium

Frequent glucose monitoring and insulin dose reduction may be required with renal or hepatic impairment; not recommended during periods of rapidly declining renal or hepatic function because of risk for prolonged hypoglycemia

Exercise caution when administering this therapy to geriatric patients with diabetes; initial dosing, dose increments, and maintenance dosage should be conservative to avoid hypoglycemia

Use caution during pregnancy

Published data do not report a clear association with insulin glargine products and major birth defects, miscarriage, or adverse maternal or fetal outcomes when insulin glargine products used during pregnancy

There are no data on presence of insulin glargine in human milk, effects on breastfed infant, or on milk production

Insulin Glargine

injectable solution

• 100 units/mL

  • Lantus (10mL vial)
  • Semglee (10mL vial)

prefilled pen

• 100 units/mL

  • Lantus SoloSTAR (3mL)
  • Basaglar KwikPen (3mL)
  • Semglee (3mL)
  • Rezvoglar KwikPen (3mL)

• 300 units/mL

  • Toujeo SoloStar (1.5mL)
  • Toujeo Max SoloStar (3mL)

Interchangeable biosimilar

• Semglee and Rezvoglar are biosimilars that are interchangeable with the reference product Lantus