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Lantus solostar side effects: Common and Rare Side Effects for Lantus Solostar U-100 Insulin subcutaneous

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Learn How to Inject Lantus

SUPER: Prescription Lantus® is a long-acting insulin used to treat adults with type 2 diabetes and adults and pediatric patients (children 6 years and older) with type 1 diabetes for the control of high blood sugar. Do not use Lantus® to treat diabetic ketoacidosis.

Laura: Hi, my name is Laura. I’d like to take a few minutes to tell you what you need to know about starting Lantus® (insulin glargine injection) 100 Units/mL using the SoloSTAR® pen. You’ve taken an important step by adding Lantus® to your diabetes treatment plan. One dose of Lantus® at the same time each day works all day and all night. Prescription Lantus® is a long-acting insulin used to treat adults with type 2 diabetes and adults and pediatric patients (children 6 years and older) with type 1 diabetes for the control of high blood sugar. Do not use Lantus® to treat diabetic ketoacidosis.

SUPER: Important Safety Information. Do not take Lantus®:

  • during episodes of low blood sugar
  • if you are allergic to insulin or any of the inactive ingredients in Lantus®.

Important Safety Information. Do not take Lantus® during episodes of low blood sugar or if you are allergic to insulin or any of the inactive ingredients in Lantus®.

SUPER: The Lantus® SoloSTAR® pen delivers the dose you dial time after time.

Laura: The Lantus® SoloSTAR® pen delivers the dose you dial time after time. Today, I’ll be demonstrating the correct way to use the Lantus® SoloSTAR® pen.

SUPER: The Lantus® SoloSTAR® pen features:

  • small, thin needles
  • a large print dosing window
  • dial-in dose
  • push-button injection.

Laura: The Lantus® SoloSTAR® pen can fit into your daily routine. It features small, thin needles, a large print dosing window, dial-in dose, and push-button injection.

SUPER: Do NOT:

  • share needles, insulin pens, or syringes with others
  • reuse needles

Laura: Do not share needles, insulin pens, or syringes with others. Do not reuse needles.

To demonstrate how to correctly use the Lantus® SoloSTAR® pen, I’ll be taking you through these 6 steps:

  • Checking the insulin
  • Attaching the needle
  • Performing a safety test
  • Selecting the dose
  • Injecting the dose
  • Removing and discarding the needle

Super: WHAT WE’LL COVER:

Step One: Inject the insulin

Step Two: Attach the Needle

Step Three: Perform a Safety Test

Step Four: Select the Dose

Step Five: Inject the Dose

Step Six: Remove and Discard Needle

It is important that you go over these instructions carefully before you using your SoloStar pen.

Step one: check the insulin.

SUPER: An unopened SoloSTAR® Pen should be refrigerated until first use. Do not store an opened SoloSTAR® pen in a refrigerator.

Laura: If your SoloSTAR® pen is in cool storage, take it out 1 to 2 hours before you inject to allow it to warm up. Cold insulin may be painful to inject.

SUPER: Check the label on your SoloSTAR® pen.

Laura: First, check the label on your SoloSTAR® pen to make sure you have the correct pen and insulin. The Lantus® SoloSTAR® pen is gray with a purple injection button.

Check the expiration date on the label of your pen. Do not use a SoloSTAR® pen after the expiration date.

SUPER: Do not use the pen if the insulin is cloudy, colored, or has particles.

Laura: Take off the pen cap. Check the appearance of the insulin. Lantus® is a clear insulin. Do not use the pen if the insulin is cloudy, colored, or has particles.

Step two: attach the needle.

Laura: Do not reuse needles. Always use a new sterile needle for each injection. This helps prevent contamination and potential needle blocks.

SUPER: Wipe the rubber seal.


Laura: Wipe the rubber seal with alcohol.

SUPER: Remove the protective seal.

Laura: Remove the protective seal from a new needle.

SUPER: Keep the needle straight as you attach it.

Laura: Line up the needle with the pen, and keep it straight as you attach it. Depending on the needle type, it may be pushed on or screwed on. If the needle is not kept straight while you attach it, it can damage the rubber seal and cause leakage, or break the needle.

Step three: perform a safety test.

SUPER: Do NOT use a syringe to remove Lantus® from your SoloSTAR® pen.

Laura: Always perform the safety test before each injection.

Performing the safety test ensures you get an accurate dose. It ensures that the pen and needle work properly, and it also removes air bubbles in the insulin.

SUPER: Select a dose of 2 units

Laura: Select a dose of 2 units by turning the dosage selector.

SUPER: Take off the outer needle cap.

Laura: Take off the outer needle cap and keep it to remove the used needle after injection.

Take off the inner needle cap and discard it.

Hold the pen with the needle pointing upwards. Then tap the insulin reservoir so that any air bubbles rise up towards the needle.

SUPER: Check if insulin comes out of the needle tip.

Laura: Press the button all the way in. Check if insulin comes out of the needle tip. You may have to perform the safety test several times before insulin is seen. If no insulin comes out, check for air bubbles and repeat the safety test two more times to remove them.

SUPER: If insulin still does not come out, the needle may be blocked. Change the needle and try again. If no insulin comes out after changing the needle, your SoloSTAR® pen may be damaged. Do not use it. Do NOT use a syringe to remove Lantus® from your SoloSTAR® pen.

Laura: If insulin still does not come out, the needle may be blocked. Change the needle and try again. If no insulin comes out after changing the needle, your SoloSTAR® pen may be damaged. Do not use it.

Step four: select the dose.

Laura: You can set the dose in steps of 1 unit, from a minimum of 1 unit to a maximum of 80 units. If you need a dose greater than 80 units, you should give it as two or more doses.

Check that the dose window shows “0” following the safety test.

SUPER: Select your required dose. Ask for help if you have problems handling the pen, for example, if you have problems with your eyesight.

Laura: Select your required dose. If you turn past your dose, you can turn the dial back down. Do not push the injection button while turning, as insulin will come out.

You cannot turn the dosage selector past the number of units left in the pen. Do not force the dosage selector to turn. If what remains is less than you need, either you can inject what is remaining in the pen and complete your dose with a new SoloSTAR pen, or you can use a new SoloSTAR® pen for your full dose.

Step five: inject the dose.

Laura: Use the injection method as instructed by your healthcare professional.

SUPER: The injection site should be changed each time you inject within the area you selected. DO NOT use the exact spot for each injection.

Laura: You can inject Lantus® in three areas of your body

Anywhere in your stomach area, except for a two-inch radius around your navel.

In the fatty tissue on the outer back area of your upper arm.

Or in your thighs. Remember, the injection site should be changed each time you inject.

Clean the injection site with an alcohol swab. Then insert the needle into the skin.

SUPER: Deliver the dose by pressing the injection button in all the way.

Laura: Deliver the dose by pressing the injection button in all the way. The number in the dose window will return to “0” as you inject.

SUPER: Keep the button pressed, and slowly count to 10.

Laura: Keep the button pressed all the way in. Slowly count to 10 before you withdraw the needle from the skin. This ensures that the full dose will be delivered.

Step six: remove and discard the needle.

Laura: Always remove the needle after each dose and store your SoloSTAR® pen without a needle attached. This helps prevent contamination and/or infection, as well as entry of air into the insulin reservoir and leakage of insulin, which can cause inaccurate dosing.

SUPER: Put the outer needle cap back on the needle, and use it to unscrew the needle from the pen.

Laura: Put the outer needle cap back on the needle, and use it to unscrew the needle from the pen. To reduce the risk of accidental needle injury, never replace the inner needle cap. If your injection is given by another person, special caution should be taken by this person when removing and disposing of the needle. Be sure to follow recommended safety measures for removal and disposal of needles in order to reduce the risk of accidental needle injury and transmission of infectious diseases.

Now I’m going to show you how to safely dispose of the needle.

SUPER: Used needles should be placed in Sharps containers.

Laura: Used needles should be placed in sharps containers (such as red biohazard containers), hard plastic containers (such as detergent bottles), or metal containers (such as an empty coffee can). Such containers should be sealed and disposed of properly. If you are giving an injection to a third person, you should remove the needle in an approved manner to avoid needle-stick injuries.

SUPER: Always put the pen cap back on the pen before storing the pen.

Laura: Always put the pen cap back on the pen before storing the pen until your next injection.

Storing your pen.

Laura: Please review the leaflet that came with your Lantus® prescription for complete instructions on how to use and store the Lantus® SoloSTAR® pen. If your SoloSTAR® pen is in cool storage, take it out 1 to 2 hours before you use it to allow it to warm up. Cold insulin may be painful to inject. Keep the SoloSTAR® pen out of the reach and sight of children.

Keep your unopened SoloSTAR® pen in cool storage until first use. Cool storage is between 36 and 46 degrees Fahrenheit, or 2 and 8 degrees Celsius. Do not allow it to freeze. Do not put it next to the freezer compartment of your refrigerator, or next to a freezer pack.

Once you take your SoloSTAR® pen out of cool storage, for use or as a spare, you can use it for up to 28 days. During this time it can be safely kept at room temperature, up to 86 degrees Fahrenheit or 30 degrees Celsius. Do not use it after this time.

Do not use a SoloSTAR® pen after the expiration date printed on the label of the pen or the label on the carton. Protect your SoloSTAR® pen from light. Discard your used SoloSTAR® pen as required by your local authorities

Caring for your SoloSTAR® pen.

Laura: Protect your SoloSTAR® pen from dust and dirt. You can clean the outside of your SoloSTAR® pen by wiping it with a damp cloth. Do not soak, wash, or lubricate the pen as this may damage it. Your SoloSTAR® pen is designed to work accurately and safely. It should be handled with care. Avoid situations where the SoloSTAR® pen might be damaged. If you are concerned that your SoloSTAR® pen may be damaged, use a new one. If you have any further questions about the Lantus® SoloSTAR® pen or managing your diabetes, be sure to speak to your doctor, nurse, or pharmacist.

Thanks for joining me on this walk through how to use the Lantus® SoloSTAR® pen. I hope that you found these instructions helpful. Now, I will present the full Important Safety Information for Lantus®.

What is Lantus® (insulin glargine injection) 100 Units/mL?

Laura: Prescription Lantus® is a long-acting insulin used to treat adults with type 2 diabetes and adults and pediatric patients (children 6 years and older) with type 1 diabetes for the control of high blood sugar.

Do not use Lantus® to treat diabetic ketoacidosis.

Lantus (Insulin Glargine) – Side Effects, Interactions, Uses, Dosage, Warnings

Use Lantus (Insulin Glargine) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Insulin glargine is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.

Insulin glargine must not be given with an insulin pump, or mixed with other insulins. Do not inject insulin glargine into a vein or a muscle.

Do not inject this medicine into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.

Read and carefully follow any Instructions for Use provided with your medicine. Do not use insulin glargine if you don’t understand all instructions for proper use. Ask your doctor or pharmacist if you have questions.

The Toujeo brand of insulin glargine contains 3 times as much insulin per milliliter (mL) as the Lantus or Basaglar brands. There are 300 units of insulin in 1 mL of Toujeo, and 100 units in 1 mL of Lantus or Basaglar.

If there are any changes in the brand, strength, or type of insulin you use, your dosage needs may change.

If you use an injection pen, use only the injection pen that comes with insulin glargine. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe.

Never share an injection pen or syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Keep this medicine in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) Basaglar or Lantus:

  • Refrigerate and use until expiration date; or
  • Store at room temperature and use within 28 days.

Storing unopened (not in use) Toujeo:

  • Refrigerate and use until expiration date.

Storing opened (in use) Basaglar or Lantus:

  • Store the vial in a refrigerator or at room temperature and use within 28 days.
  • Store the injection pen at room temperature (do not refrigerate) and use within 28 days.

Storing opened (in use) Toujeo:

  • Store the injection pen at room temperature (do not refrigerate) and use within 42 days.

Do not store an injection pen with the needle attached.

Do not use the medicine if it looks cloudy, has changed colors, or has any particles in it. Call your pharmacist for new medicine.

Wear a diabetes medical alert tag in case of emergency. Any medical care provider who treats you should know that you have diabetes.

Use a needle and syringe only once and then place them in a puncture-proof “sharps” container. Follow state or local laws about how to dispose of this container. Keep it out of the reach of children and pets.

Insulin Glargine (rDNA origin) Injection: MedlinePlus Drug Information

Insulin glargine products come as a solution (liquid) to inject subcutaneously (under the skin). They are injected once a day. You should use insulin glargine products at the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use insulin glargine products exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

Never use insulin glargine products when you have symptoms of hypoglycemia (low blood sugar) or if you have checked your blood sugar and found it to be low.

Insulin glargine products control diabetes but do not cure it. Continue to use insulin glargine products even if you feel well. Do not stop using insulin glargine products without talking to your doctor. Do not switch to another brand or type of insulin or change the dose of any type of insulin you are using without talking to your doctor. Always check the insulin label to make sure you received the right type of insulin from the pharmacy.

Insulin glargine products come in vials and in dosing pens that contain cartridges of medication. Be sure you know what type of container your insulin glargine product comes in and what other supplies, such as needles, syringes, or pens, you will need to inject your medication.

If your insulin glargine product comes in vials, you will need to use syringes to inject your dose. Ask your doctor or pharmacist to show you how to inject insulin glargine using a syringe. Ask your doctor or pharmacist if you have questions about the type of syringe you should use.

If your insulin glargine product comes in pens, be sure to read and understand the manufacturer’s instructions. Ask your doctor or pharmacist to show you how to use the pen. Follow the directions carefully, and always perform the safety test before use.

Never reuse needles or syringes and never share needles, syringes, or pens. If you are using an insulin pen, always remove the needle right after you inject your dose. Discard needles and syringes in a puncture-resistant container. Ask your doctor or pharmacist how to dispose of the puncture-resistant container.

Do not dilute insulin glargine products and do not mix insulin glargine products with any other type of insulin.

You can inject your insulin glargine in your upper arm, thigh, or stomach. Never inject insulin glargine into a vein or muscle. Change (rotate) the injection site within the chosen area with each dose; try to avoid injecting the same site more often than once every 1 to 2 weeks.

Always look at your insulin glargine product before you inject it. It should be clear and colorless. Do not use your insulin glargine product if it is colored, cloudy, or contains solid particles, or if the expiration date on the bottle has passed.

Do not use insulin glargine products in an external insulin pump.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Toujeo Max SoloStar vs Lantus Solostar

What is Lantus® (insulin glargine injection) 100 Units/mL?

Prescription Lantus is a long-acting insulin used to treat adults with type 2 diabetes and adults and pediatric patients (children 6 years and older) with type 1 diabetes for the control of high blood sugar.

  • Do not use Lantus to treat diabetic ketoacidosis.

Important Safety Information

Do not take Lantus during episodes of low blood sugar or if you are allergic to insulin or any of the inactive ingredients in Lantus.

Do not share needles, insulin pens, or syringes with others. Do NOT reuse needles.

Before starting Lantus, tell your doctor about all your medical conditions, including if you have liver or kidney problems, if you are pregnant or planning to become pregnant or if you are breast-feeding or planning to breast-feed.

Change (rotate) your injection sites within the area you chose with each dose to reduce your risk of getting lipodystrophy (pitted or thickened skin) and localized cutaneous amyloidosis (skin with lumps) at the injection sites. Do not use the same spot for each injection or inject where the skin is pitted, thickened, lumpy, tender, bruised, scaly, hard, scarred or damaged.

Heart failure can occur if you are taking insulin together with certain medicines called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems. If you already have heart failure, it may get worse while you take TZDs with Lantus. Your treatment with TZDs and Lantus may need to be changed or stopped by your doctor if you have new or worsening heart failure. Tell your doctor if you have any new or worsening symptoms of heart failure, including:

  • Shortness of breath
  • Swelling of your ankles or feet
  • Sudden weight gain

Tell your doctor about all the medications you take, including OTC medicines, vitamins, and supplements, including herbal supplements.

Lantus should be taken once a day at the same time every day. Test your blood sugar levels while using insulin, such as Lantus. Do not make any changes to your dose or type of insulin without talking to your healthcare provider. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Lantus with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Lantus must only be used if the solution is clear and colorless with no particles visible. Always make sure you have the correct insulin before each injection.

While using Lantus, do not drive or operate heavy machinery until you know how Lantus affects you. You should not drink alcohol or use other medicines that contain alcohol.

The most common side effect of insulin, including Lantus, is low blood sugar (hypoglycemia), which may be serious and life threatening. It may cause harm to your heart or brain. Symptoms of serious low blood sugar may include shaking, sweating, fast heartbeat, and blurred vision.

Lantus may cause serious side effects that can lead to death, such as severe allergic reactions. Get medical help right away if you have:

  • A rash over your whole body
  • Trouble breathing
  • A fast heartbeat
  • Sweating
  • Swelling of your face, tongue, or throat
  • Shortness of breath
  • Extreme drowsiness, dizziness, or confusion

Other possible side effects may include swelling, weight gain, low potassium levels, injection site reactions, including changes in fat tissue at the injection site, and allergic reactions.

Important Safety Information for Lantus® (insulin glargine injection) SoloStar®

Lantus SoloSTAR is a disposable single-patient-use prefilled insulin pen. Please talk to your healthcare provider about proper injection technique and follow instructions in the Instruction Leaflet that accompanies the pen

  • for Full Prescribing Information for Lantus.
  • for information on Sharps Medical Waste Disposal.
  • to learn more about Sanofi’s commitment to fighting counterfeit drugs.

Lantus, Toujeo (insulin glargine) dosing, indications, interactions, adverse effects, and more

  • acarbose

    Monitor Closely (1)acarbose, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • agrimony

    Minor (1)agrimony increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • albiglutide

    Monitor Closely (1)albiglutide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • alogliptin

    Monitor Closely (1)alogliptin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • American ginseng

    Minor (1)American ginseng increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • amitriptyline

    Minor (1)amitriptyline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • amoxapine

    Minor (1)amoxapine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • anamu

    Minor (1)anamu increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

  • aripiprazole

    Monitor Closely (1)aripiprazole, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • asenapine

    Monitor Closely (1)asenapine, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • aspirin

    Monitor Closely (1)aspirin increases effects of insulin glargine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

  • aspirin/citric acid/sodium bicarbonate

    Minor (1)aspirin/citric acid/sodium bicarbonate increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

  • atazanavir

    Monitor Closely (1)atazanavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • azilsartan

    Monitor Closely (1)azilsartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • balsalazide

    Minor (1)balsalazide increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

  • benazepril

    Monitor Closely (1)benazepril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Enhanced hypoglycemic effects; Monitor blood glucose.

  • bendroflumethiazide

    Minor (1)bendroflumethiazide decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

  • bexarotene

    Minor (1)bexarotene increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • bitter melon

    Monitor Closely (1)bitter melon increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.

  • budesonide

    Minor (1)budesonide decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • canagliflozin

    Monitor Closely (2)canagliflozin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

    insulin glargine, canagliflozin.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with canagliflozin.

  • candesartan

    Monitor Closely (1)candesartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • captopril

    Monitor Closely (1)captopril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Both drugs decrease blood glucose. Monitor blood glucose.

  • chlorothiazide

    Minor (1)chlorothiazide decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

  • chlorpropamide

    Monitor Closely (1)chlorpropamide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • chlorthalidone

    Minor (1)chlorthalidone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

  • chromium

    Minor (1)chromium increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • cinnamon

    Monitor Closely (1)cinnamon increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.

  • ciprofibrate

    Monitor Closely (1)ciprofibrate increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

  • clomipramine

    Minor (1)clomipramine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • clonidine

    Minor (2)clonidine, insulin glargine. Other (see comment). Minor/Significance Unknown.
    Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

    clonidine decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.

  • clozapine

    Monitor Closely (1)clozapine, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • coenzyme Q10

    Minor (1)coenzyme Q10 increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Monitor insulin requirements.

  • cornsilk

    Minor (1)cornsilk increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

  • cortisone

    Minor (1)cortisone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • cyclopenthiazide

    Minor (1)cyclopenthiazide decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

  • damiana

    Minor (1)damiana decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.

  • danazol

    Minor (1)danazol increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • dapagliflozin

    Monitor Closely (2)dapagliflozin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

    insulin glargine, dapagliflozin.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with dapagliflozin.

  • darunavir

    Monitor Closely (1)darunavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • deflazacort

    Monitor Closely (1)insulin glargine and deflazacort both decrease serum potassium. Use Caution/Monitor.Minor (1)deflazacort decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • desipramine

    Minor (1)desipramine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • devil’s claw

    Minor (1)devil’s claw increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • dexamethasone

    Minor (1)dexamethasone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • dexfenfluramine

    Monitor Closely (1)dexfenfluramine increases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Dexfenfluramine enhances glucose uptake in peripheral tissue, increasing risk of hypoglycemia.

  • dichlorphenamide

    Monitor Closely (1)dichlorphenamide and insulin glargine both decrease serum potassium. Use Caution/Monitor.

  • diflunisal

    Minor (1)diflunisal increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

  • disopyramide

    Monitor Closely (1)disopyramide increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and disopyramide may require insulin dosage adjustment and increased glucose monitoring.

  • doxepin

    Minor (1)doxepin increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • dulaglutide

    Monitor Closely (1)dulaglutide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • elderberry

    Minor (1)elderberry increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).

  • empagliflozin

    Monitor Closely (1)empagliflozin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with SGLT2 inhibitors.

  • enalapril

    Monitor Closely (1)enalapril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • eprosartan

    Monitor Closely (1)eprosartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • ertugliflozin

    Monitor Closely (1)ertugliflozin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with ertugliflozin.

  • ethanol

    Serious – Use Alternative (1)ethanol, insulin glargine. Other (see comment). Avoid or Use Alternate Drug.
    Comment: Alcohol may either increase or decrease the blood glucose lowering effect of insulin; alcohol may decrease endogenous glucose production (increased hypoglycemia risk) or worsen glycemic control by adding calories.

  • ethinylestradiol

    Monitor Closely (1)ethinylestradiol decreases effects of insulin glargine by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

  • eucalyptus

    Minor (1)eucalyptus increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

  • exenatide injectable solution

    Monitor Closely (1)exenatide injectable solution, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • exenatide injectable suspension

    Monitor Closely (1)exenatide injectable suspension, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • fenfluramine

    Monitor Closely (1)fenfluramine increases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Fenfluramine enhances glucose uptake in peripheral tissue, increasing risk of hypoglycemia.

  • fenofibrate

    Monitor Closely (1)fenofibrate increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

  • fenofibrate micronized

    Monitor Closely (1)fenofibrate micronized increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

  • fenofibric acid

    Monitor Closely (1)fenofibric acid increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

  • fleroxacin

    Monitor Closely (1)fleroxacin increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

  • fludrocortisone

    Minor (1)fludrocortisone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • fluoxetine

    Monitor Closely (1)fluoxetine increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and fluoxetine may require insulin dosage adjustment and increased glucose monitoring.

  • fluoxymesterone

    Minor (1)fluoxymesterone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • fo-ti

    Minor (1)fo-ti increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • forskolin

    Minor (1)forskolin increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.

  • fosamprenavir

    Monitor Closely (1)fosamprenavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • fosinopril

    Monitor Closely (1)fosinopril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • gemfibrozil

    Monitor Closely (1)gemfibrozil increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

  • gemifloxacin

    Monitor Closely (1)gemifloxacin increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

  • glimepiride

    Monitor Closely (1)glimepiride, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • glipizide

    Monitor Closely (1)glipizide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • glucagon

    Monitor Closely (1)glucagon decreases effects of insulin glargine by pharmacodynamic antagonism. Use Caution/Monitor. Endogenous glucagon is a regulatory hormone that increases blood glucose levels; exogenous glucagon is often used to treat hypoglycemia in patients with diabetes mellitus.

  • glucagon intranasal

    Monitor Closely (1)glucagon intranasal decreases effects of insulin glargine by pharmacodynamic antagonism. Use Caution/Monitor. Endogenous glucagon is a regulatory hormone that increases blood glucose levels; exogenous glucagon is often used to treat hypoglycemia in patients with diabetes mellitus.

  • glyburide

    Monitor Closely (1)glyburide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • gotu kola

    Minor (1)gotu kola increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

  • guanfacine

    Minor (2)guanfacine, insulin glargine. Other (see comment). Minor/Significance Unknown.
    Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

    guanfacine decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.

  • gymnema

    Minor (1)gymnema increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • horse chestnut seed

    Minor (1)horse chestnut seed increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • hydrochlorothiazide

    Minor (1)hydrochlorothiazide decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

  • hydrocortisone

    Minor (1)hydrocortisone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • iloperidone

    Monitor Closely (1)iloperidone, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • imidapril

    Monitor Closely (1)imidapril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • imipramine

    Minor (1)imipramine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • indapamide

    Minor (1)indapamide decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

  • indinavir

    Monitor Closely (1)indinavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • irbesartan

    Monitor Closely (1)irbesartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • isocarboxazid

    Monitor Closely (1)isocarboxazid increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.

  • isoniazid

    Minor (1)isoniazid decreases effects of insulin glargine by unspecified interaction mechanism. Minor/Significance Unknown.

  • juniper

    Minor (1)juniper increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

  • ketotifen, ophthalmic

    Monitor Closely (1)ketotifen, ophthalmic, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.

  • lanreotide

    Monitor Closely (1)lanreotide increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and somatostatin analogs may require insulin dosage adjustment and increased glucose monitoring.

  • levofloxacin

    Monitor Closely (1)levofloxacin increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

  • linagliptin

    Monitor Closely (1)linagliptin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • linezolid

    Monitor Closely (1)linezolid increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.

  • liraglutide

    Monitor Closely (1)liraglutide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • lisinopril

    Monitor Closely (1)lisinopril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • lithium

    Monitor Closely (1)lithium, insulin glargine. unspecified interaction mechanism. Use Caution/Monitor. Lithium salts may cause either hypoglycemia or hyperglycemia. Insulin dosage adjustment and increased glucose monitoring may be required.

  • lixisenatide

    Monitor Closely (1)lixisenatide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of hypoglycemia increased when coadministered with basal insulins. Basal insulin dose reduction may be required.

  • lofepramine

    Minor (1)lofepramine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • lopinavir

    Monitor Closely (1)lopinavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • losartan

    Monitor Closely (1)losartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • lurasidone

    Monitor Closely (1)lurasidone, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • lycopus

    Minor (1)lycopus increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

  • macimorelin

    Serious – Use Alternative (1)insulin glargine, macimorelin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Drugs that may transiently elevate growth hormone (GH) concentrations may impact the accuracy of the macimorelin diagnostic test. Allow sufficient washout time of drugs affecting GH release before administering macimorelin.

  • magnesium salicylate

    Monitor Closely (1)magnesium salicylate increases effects of insulin glargine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

  • maitake

    Minor (1)maitake increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).

  • maprotiline

    Minor (1)maprotiline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • marijuana

    Monitor Closely (1)marijuana decreases effects of insulin glargine by pharmacodynamic antagonism. Use Caution/Monitor.

  • mecasermin

    Monitor Closely (1)mecasermin increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.

  • mesalamine

    Minor (1)mesalamine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

  • mesterolone

    Minor (1)mesterolone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • metformin

    Monitor Closely (1)metformin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • methylprednisolone

    Minor (1)methylprednisolone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • methyltestosterone

    Monitor Closely (1)methyltestosterone increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. It is important to monitor all patients with type 2 diabetes on antidiabetic agents receiving androgens for changes in glycemic control. Potential for hypoglycemia.

  • metoclopramide intranasal

    Monitor Closely (1)metoclopramide intranasal increases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Increased GI motility by metoclopramide may increase delivery of food to the intestines and increase blood glucose. Monitor blood glucose and adjust insulin dosage regimen as needed.

  • metolazone

    Minor (1)metolazone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

  • metreleptin

    Monitor Closely (1)insulin glargine, metreleptin.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of metreleptin with insulin and/or insulin secretagogues (eg, sulfonylureas, meglitinide derivatives) may increase risk for hypoglycemia; may require lower dose of insulin or insulin secretagogue.

  • miglitol

    Monitor Closely (1)miglitol, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • moexipril

    Monitor Closely (1)moexipril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • moxifloxacin

    Monitor Closely (1)moxifloxacin increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

  • nadolol

    Monitor Closely (1)nadolol, insulin glargine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

  • nateglinide

    Monitor Closely (1)nateglinide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • nelfinavir

    Monitor Closely (1)nelfinavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • nettle

    Minor (1)nettle increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

  • niacin

    Monitor Closely (1)niacin decreases effects of insulin glargine by pharmacodynamic antagonism. Use Caution/Monitor. Concomitant use of insulin and niacin may require insulin dosage adjustment and increased glucose monitoring.

  • nortriptyline

    Minor (1)nortriptyline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • octreotide

    Monitor Closely (1)octreotide increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and somatostatin analogs may require insulin dosage adjustment and increased glucose monitoring.

  • ofloxacin

    Monitor Closely (1)ofloxacin increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.Minor (1)ofloxacin, insulin glargine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

  • olanzapine

    Monitor Closely (1)olanzapine, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • olmesartan

    Monitor Closely (1)olmesartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • opuntia ficus indica

    Monitor Closely (1)opuntia ficus indica increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • oxandrolone

    Minor (1)oxandrolone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • oxymetholone

    Minor (1)oxymetholone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • paliperidone

    Monitor Closely (1)paliperidone, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • panax ginseng

    Minor (1)panax ginseng increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • pasireotide

    Monitor Closely (1)pasireotide increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and somatostatin analogs may require insulin dosage adjustment and increased glucose monitoring.

  • pegvisomant

    Minor (1)pegvisomant increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • pentamidine

    Monitor Closely (1)pentamidine, insulin glargine. unspecified interaction mechanism. Use Caution/Monitor. Pentamidine may cause either hypoglycemia or hyperglycemia followed by the opposing effect. Insulin dosage adjustment and increased glucose monitoring may be required.

  • perindopril

    Monitor Closely (1)perindopril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • phenelzine

    Monitor Closely (1)phenelzine increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.

  • pindolol

    Monitor Closely (1)pindolol, insulin glargine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

  • pioglitazone

    Monitor Closely (2)insulin glargine increases toxicity of pioglitazone by unknown mechanism. Use Caution/Monitor. Insulin may increase the fluid retention associated with thiazolidinediones (peroxisome proliferator-activated receptor [PPAR]-gamma agonists).

    pioglitazone, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • potassium acid phosphate

    Minor (1)potassium acid phosphate increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

  • potassium chloride

    Minor (1)potassium chloride increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

  • potassium citrate

    Minor (1)potassium citrate increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

  • pramlintide

    Contraindicated (1)insulin glargine, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.

  • prednisolone

    Minor (1)prednisolone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • prednisone

    Minor (1)prednisone decreases effects of insulin glargine by pharmacodynamic antagonism. Minor/Significance Unknown.

  • procarbazine

    Monitor Closely (1)procarbazine increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.

  • propranolol

    Monitor Closely (1)propranolol, insulin glargine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

  • protriptyline

    Minor (1)protriptyline increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • pseudoephedrine

    Monitor Closely (1)pseudoephedrine decreases effects of insulin glargine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Sympathomimetics increase blood glucose by stimulating alpha and beta receptors; this action results in increased hepatic glucose production, glycogenolysis, and decreased insulin secretion.

  • quetiapine

    Monitor Closely (1)quetiapine, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • quinapril

    Monitor Closely (1)quinapril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • ramipril

    Monitor Closely (1)ramipril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • rasagiline

    Monitor Closely (1)rasagiline increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.

  • risperidone

    Monitor Closely (1)risperidone, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • ritonavir

    Monitor Closely (1)ritonavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • rosiglitazone

    Monitor Closely (2)insulin glargine increases toxicity of rosiglitazone by unknown mechanism. Use Caution/Monitor. Insulin may increase the fluid retention associated with thiazolidinediones (peroxisome proliferator-activated receptor [PPAR]-gamma agonists).

    rosiglitazone, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • sacubitril/valsartan

    Monitor Closely (1)sacubitril/valsartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • sage

    Minor (1)sage increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • salicylates (non-asa)

    Minor (1)salicylates (non-asa) increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

  • salsalate

    Monitor Closely (1)salsalate increases effects of insulin glargine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with high doses of salicylates (3 g/day or more) may increase risk for hypoglycemia. Insulin dose adjustment and increased frequency of glucose monitoring may be required.

  • saquinavir

    Monitor Closely (1)saquinavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • saxagliptin

    Monitor Closely (1)saxagliptin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • selegiline

    Monitor Closely (1)selegiline increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.

  • semaglutide

    Monitor Closely (1)semaglutide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin with GLP-1 agonists may increase hypoglycemia risk. Lowering the insulin dose may reduce hypoglycemia risk.

  • shark cartilage

    Monitor Closely (1)shark cartilage increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.

  • Siberian ginseng

    Minor (1)Siberian ginseng increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • sitagliptin

    Monitor Closely (1)sitagliptin, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • sodium sulfate/?magnesium sulfate/potassium chloride

    Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

  • sodium sulfate/potassium sulfate/magnesium sulfate

    Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.

  • sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol

    Monitor Closely (1)insulin glargine and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.

  • somapacitan

    Monitor Closely (1)somapacitan decreases effects of insulin glargine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .

  • somatropin

    Monitor Closely (1)somatropin decreases effects of insulin glargine by pharmacodynamic antagonism. Use Caution/Monitor.

  • sulfadiazine

    Monitor Closely (1)sulfadiazine increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

  • sulfamethoxypyridazine

    Monitor Closely (1)sulfamethoxypyridazine increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

  • sulfasalazine

    Minor (1)sulfasalazine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

  • sulfisoxazole

    Monitor Closely (1)sulfisoxazole increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and sulfonamide antibiotics may require insulin dosage adjustment and increased glucose monitoring.

  • telmisartan

    Monitor Closely (1)telmisartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • testosterone

    Minor (1)testosterone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • testosterone buccal system

    Minor (1)testosterone buccal system increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • testosterone intranasal

    Monitor Closely (1)testosterone intranasal increases effects of insulin glargine by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Androgens may decrease blood glucose and, therefore, may necessitate a decrease in the dose of antidiabetic medication.

  • testosterone topical

    Minor (1)testosterone topical increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • timolol

    Monitor Closely (1)timolol, insulin glargine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers delay recovery of normoglycemia after insulin induced hypoglycemia; however, they also inhibit insulin secretion, so long term beta blocker Tx may result in reduced glucose tolerance. Insulin induced hypoglycemia may induce hypertension during non selective beta blocker Tx.

  • tipranavir

    Monitor Closely (1)tipranavir decreases effects of insulin glargine by Other (see comment). Use Caution/Monitor.
    Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

  • tolazamide

    Monitor Closely (1)tolazamide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • tolbutamide

    Monitor Closely (1)tolbutamide, insulin glargine.
    Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

  • tongkat ali

    Minor (1)tongkat ali increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.

  • trandolapril

    Monitor Closely (1)trandolapril increases effects of insulin glargine by pharmacodynamic synergism. Use Caution/Monitor.

  • tranylcypromine

    Monitor Closely (1)tranylcypromine increases effects of insulin glargine by unknown mechanism. Use Caution/Monitor.

  • trazodone

    Minor (1)trazodone increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • triamcinolone acetonide injectable suspension

    Monitor Closely (1)triamcinolone acetonide injectable suspension decreases effects of insulin glargine by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.

  • trimipramine

    Minor (1)trimipramine increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • valsartan

    Monitor Closely (1)valsartan increases effects of insulin glargine by unspecified interaction mechanism. Use Caution/Monitor. Concomitant use of insulin and ARBs may require insulin dosage adjustment and increased glucose monitoring.

  • vanadium

    Minor (1)vanadium increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.

  • willow bark

    Minor (1)willow bark increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown. Large dose of salicylate.

  • xipamide

    Monitor Closely (1)xipamide decreases levels of insulin glargine by increasing renal clearance. Use Caution/Monitor.

  • ziprasidone

    Monitor Closely (1)ziprasidone, insulin glargine. Other (see comment). Use Caution/Monitor.
    Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

  • Differences, similarities, and which is better for you

    Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

    Diabetes mellitus is a disease that affects over 10% of the United States population, with 1.5 million newly diagnosed cases each year. Diabetes mellitus presents in two forms: Type 1 and Type 2. With Type 1 diabetes, the body does not produce the insulin needed to adequately control blood glucose levels, sometimes called blood sugar. In this instance, insulin injections are the first-line treatment. The body of a Type 2 diabetic makes some insulin but does not utilize it properly. Type 2 is much more prevalent in the United States. In some cases, diet, exercise, and/or oral diabetic medications may adequately control blood sugar. In many cases, however, insulin injections may be necessary to control blood glucose levels for Type 2 diabetics as well.

    Tresiba and Lantus are two examples of basal insulin, sometimes called “background” or long-acting insulin. This type of insulin ensures consistent blood sugar levels throughout the day.

    What are the main differences between Tresiba and Lantus?

    Tresiba (insulin degludec) is a prescription-only injectable basal insulin used in the treatment of both Type 1 and Type 2 diabetes mellitus and is manufactured by Novo Nordisk, Inc. Tresiba facilitates the reuptake of glucose into muscle and adipose (fat) tissues. Insulin also plays a role in regulating fat and protein metabolism. Biosynthetic insulins act as a replacement therapy to help diabetic patients restore their fat, protein, and carbohydrate utilization.

    Tresiba’s half-life is 25 hours and has no obvious peak. Tresiba’s long duration of action provides fairly consistent blood sugar control throughout the day while only being dosed once daily. There is no generic version of Tresiba available.

    Lantus (insulin glargine) is also a prescription-only injectable basal insulin used in the treatment of both Type 1 and Type 2 diabetes mellitus. Lantus is manufactured by Sanofi. Lantus and Tresiba work in a similar manner to promote the proper utilization of fat, protein, and carbohydrates in diabetic patients. The half-life of Lantus is about 12 hours and typically dosed once per day. Lantus is delivered subcutaneously and is available as an injectable solution in a 10 ml vial in a concentration of 100 units/ml. It is also available in a Lantus Solostar pen delivery device in the same concentration.

    There is no FDA approved generic for Lantus. Basaglar, also insulin glargine, is a biosimilar insulin to Lantus and may be more affordable in some cases. Toujeo, also insulin glargine, is a new product that is more concentrated at 300 units/ml. This product may be useful in patients on higher doses to limit injection volume.

    Main differences between Tresiba and Lantus
    Drug class Biosynthetic insulin (insulin analog) Biosynthetic insulin (insulin analog)
    Brand/generic status Brand Brand
    What is the generic name?
     
    Insulin degludec Insulin glargine
    What form(s) does the drug come in? Injectable solution in a FlexPen delivery device Injectable solution in a vial or Solostar pen delivery device
    What is the standard dosage? Dependent on blood glucose levels Dependent on blood glucose levels
    How long is the typical treatment? Indefinite Indefinite
    Who typically uses the medication? Children and adults Children 6 and older, adults

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    Conditions treated by Tresiba and Lantus

    Tresiba and Lantus are each indicated in the treatment of Type 1 and Type 2 diabetes mellitus. People with Type 1 diabetes are deficient in insulin, and injectable biosynthetic insulins such as Tresiba and Lantus act as replacement therapy. People with Type 2 may be somewhat deficient in insulin, but are also insulin resistant, meaning their body does not utilize the insulin it makes properly. Tresiba and Lantus act as insulin replacement and supplementation in this type of disease.

    Diabetes mellitus Type 1 Yes Yes
    Diabetes mellitus Type 2 Yes Yes

    Is Tresiba or Lantus more effective?

    A meta-analysis of 15 clinical studies published in 2019 looked at data from more than 16,000 participants combined. Tresiba produced a larger decrease in blood sugar levels, but overall, the effects of Tresiba and Lantus on hemoglobin A1C (HbA1C) were similar. Tresiba did have a statistically significant less chance of causing hypoglycemia. Researchers concluded that while overall glycemic control was similar, Tresiba may be preferred due to the decreased chance of hypoglycemia.

    A meta-analysis published in 2018 had similar findings. Tresiba was significantly less likely to cause hypoglycemia events. For this reason, Tresiba may be preferred over Lantus.

    This article is not intended to provide medical advice. Your healthcare provider will decide which types of insulin options are best for you.

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    Coverage and cost comparison of Tresiba vs. Lantus

    Tresiba is a prescription insulin that is typically covered by commercial insurances and Medicare drug plans. With some plans, there may be formulary restrictions, and you may want to check your coverage with your plan or pharmacy. The average cost of one 3 ml pen of Tresiba Flextouch 100 unit/ml is about $400 without insurance. You could pay a discounted price of about $350 with a coupon from SingleCare.

    Lantus is a prescription insulin that is typically covered by commercial insurances as well as many Medicare drug plans. Formulary restrictions may also affect Lantus coverage. The average cost of one 3 ml pen is about $100, but with a coupon from SingleCare, you could pay about $70.

    It is important to note that one pen of each type of insulin will not last the same amount of time for each patient. This is dependent upon the insulin dose prescribed for each patient.

    Typically covered by insurance? Yes Yes
    Typically covered by Medicare Part D? Yes Yes
    Standard dosage 1, 3 ml Flextouch 100 unit/ml pen 1, 3 ml Solostar 100 unit/ml pen
    Typical Medicare copay Varies depending on plan factors Varies depending on plan factors
    SingleCare cost $350+ $70+

    Common side effects of Tresiba vs. Lantus

    Tresiba and Lantus both have the ability to cause hypoglycemia, or low blood sugar. This tendency tends to vary based on factors such as whether the patient is a Type 1 or Type 2 diabetic, what other insulin or diabetic therapies the patient may be using, and diet. When using Tresiba or Lantus with short-acting or rapid-acting insulins, this risk increases.

    Patients must have the ability to monitor their blood glucose levels with either a traditional meter or a continuous glucose monitoring system (CGMS). Patients should also be taught the signs and symptoms of severe hypoglycemia, as it can be life-threatening. These include shakiness, lightheadedness, mental confusion, nausea, blurred vision, and headache. Hypoglycemia can be reversed with the ingestion of glucose or administration of injectable Glucagon.

    Injection site reactions may be bothersome to the patient. These can include redness, itching, or bruising. Rotating injection sites can help reduce or alleviate these symptoms.

    This list is not intended to be a comprehensive list of potential side effects. Please consult your healthcare provider for a complete list.

    Side effect Applicable? Frequency Applicable? Frequency
    Allergic reactions Yes 0.9% Yes Not defined
    Itching Yes Not defined Yes Not defined
    Rash Yes Not defined Yes Not defined
    Injection site reaction Yes 3.8% Yes Not defined
    Skin thickening or pitting at the injection site (lipodystrophy) Yes 0.3% Yes Not defined
    Headache Yes 12% Yes 5-10%
    Weight gain Yes Not defined Yes Not defined
    Hypoglycemia (low blood sugar) Yes 10-12% Yes 6-10%
    Swelling of hands and feet (peripheral edema) Yes 0.9-3% Yes 20%

    Source: Tresiba (DailyMed) Lantus (DailyMed)

    Drug interactions of Tresiba vs. Lantus

    There are many classes of antidiabetic drugs, and oftentimes, people with Type 2 diabetes may need a combination of different antidiabetics to prevent hyperglycemia (elevated blood sugar). Unfortunately, the combination of multiple drugs intended to lower blood sugar may decrease the glucose levels too much, resulting in hypoglycemia. Patients should be monitored closely when using Tresiba and Lantus in combination with other antidiabetic medications such as metformin and glyburide. Thiazolidinediones, such as pioglitazone, may make patients especially prone to hypoglycemia. Your dose of Tresiba or Lantus may need to be adjusted frequently.

    A common class of antihypertensive drugs known as angiotensin-converting enzyme (ACE) inhibitors have been shown to increase insulin sensitivity. When using these drugs to treat high blood pressure in diabetic patients also taking Tresiba or Lantus, the risk of hypoglycemia is increased. Patients should be monitored for signs of hypoglycemia if this combination is deemed necessary.

    This is not intended to be a complete list of drug interactions for Tresiba and Lantus. Please consult your pharmacist or healthcare provider for a complete list.

    Benazepril
    Captopril
    Enalapril
    Fosinopril
    Lisinopril
    Quinapril
    Angiotensin-converting enzyme (ACE) inhibitors Yes Yes
    Isocarboxazid
    Selegiline
    Phenelzine
    Monoamine oxidase (MAO) inhibitors Yes Yes
    Metformin
    Glyburide
    Glipizide
    Repaglinide
    Pioglitazone
    Sitagliptin
    Saxagliptin
    Antidiabetic drugs Yes Yes
    Sulfamethoxazole Sulfonamide antibiotics Yes Yes
    Hydrochlorothiazide
    Furosemide
    Chlorthalidone
    Diuretics Yes Yes
    Prednisone
    Methylprednisolone
    Corticosteroids Yes Yes
    Chlorpromazine
    Fluphenazine
    Prochlorperazine
    Phenothiazine derivatives Yes Yes
    Lithium
    Clozapine
    Olanzapine
    Antipsychotics Yes Yes
    Estradiol
    Ethinyl Estradiol
    Norethindrone
    Norgestimate
    Desogestrel
    Progesterone
    Oral contraceptives Yes Yes
    Atenolol
    Bisoprolol
    Carvedilol
    Labetalol
    Metoprolol
    Sotalol
    Beta blockers Yes Yes
    Levothyroxine
    Liothyronine
    Thyroid hormones Yes Yes
    Aspirin
    Magnesium salicylate
    Bismuth subsalicylate
    Salicylates Yes Yes
    Fluoxetine Selective serotonin reuptake inhibitor (SSRI) Yes Yes

    Warnings of Tresiba and Lantus

    Tresiba and Lantus carry the risk of hypoglycemia, or low blood glucose levels. Patients on Tresiba or Lantus should know the signs and symptoms of hypoglycemia, which include shakiness, lightheadedness, mental confusion, nausea, blurred vision, and headache.

    Hypokalemia, or low potassium levels, is also a possible adverse event related to Tresiba or Lantus use. This is especially important to consider in patients who have impaired renal function or may be on potassium-wasting medications such as furosemide.

    Insulin delivery devices, such as Flextouch or Solostar pens, as well as pen needles and syringes, should not be shared between patients. There is a risk of cross-contamination with bloodborne pathogens and diseases. Patients should receive education and counseling on basic diabetes care, including the safe use of needles.

    Tresiba and Lantus are intended for subcutaneous dosing only. They should never be administered intramuscularly or intravenously.

    Frequently asked questions about Tresiba vs. Lantus

    What is Tresiba?

    Tresiba (insulin degludec) is a long-acting basal insulin that is typically dosed only once daily. It is available only as a prescription. Tresiba is available in a FlexTouch pen delivery system in concentrations of 100 units/ml and 200 units/ml.

    What is Lantus?

    Lantus (insulin glargine) is a long-acting basal insulin that is typically dosed only once daily. It is available only as a prescription. Lantus is available in a Solostar pen delivery system in a concentration of 100 units/ml and in a 10 ml vial of the 100 units/ml concentration.

    Are Tresiba and Lantus the same?

    Tresiba and Lantus are each long-acting, basal insulins, but they are not the same. Tresiba is insulin degludec and has a longer half-life of 25 hours. Lantus is insulin glargine and has a shorter half-life of 12 hours. Both are dosed once daily.

    Is Tresiba or Lantus better?

    While glycemic control is similar between Tresiba and Lantus, data shows that Tresiba may be less likely to lead to dangerous hypoglycemic events. For this reason, Tresiba may be preferred, especially in patients who are prone to or have a history of hypoglycemia.

    Can I use Tresiba or Lantus while pregnant?

    Tresiba is classified as pregnancy category C by the Food and Drug Administration (FDA). There are clinical studies to support its use and safety in pregnancy. Lantus is category B due to the fact that studies have shown there is low risk of fetal harm. Lantus is considered generally safe in pregnancy.

    Can I use Tresiba or Lantus with alcohol?

    The concurrent use of Tresiba or Lantus with alcohol carries the risk of hypoglycemia. Alcohol consumption, especially on an empty stomach, inhibits gluconeogenesis. This leads to a prolonged risk of low blood sugar.

    What insulin is comparable to Lantus?

    Basaglar is biosimilar to Lantus, though it is not an FDA-approved generic for Lantus and is not substitutable for Lantus. Both Lantus and Basaglar are insulin glargine in a concentration of 100 units/ml.

    What is the best time to take Tresiba?

    Tresiba can be given at any time of the day without regard to mealtime, but it is important to administer the medication at the same time every day.

    What is a good alternative to Tresiba?

    Toujeo is a basal insulin available in a higher concentration of 300 units/ml. Higher concentrations in basal insulins allow patients with high necessary doses to inject less volume.

    Lantus – Uses, Side Effects, Interactions

    How does this medication work? What will it do for me?

    Insulin is a naturally occurring hormone made by the pancreas that helps our body use or store the glucose (sugar) it gets from food. For people with diabetes, either the pancreas does not make enough insulin to meet the body’s requirements, or the body cannot properly use the insulin that is made. As a result, glucose cannot be used or stored properly and accumulates in the bloodstream. Insulin injected under the skin helps to lower blood glucose levels.

    There are many different types of insulin and they are absorbed at different rates and work for varying periods of time. Insulin glargine is an extended, long-acting insulin. It takes about 90 minutes to begin working after injection, and it stops working after about 24 hours. After injection, insulin glargine is released slowly and constantly into the bloodstream.

    This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

    Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.

    Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

    What form(s) does this medication come in?

    Vial
    Each mL of sterile solution contains 100 units of insulin glargine. Nonmedicinal ingredients: glycerol, m-cresol, polysorbate 20 (10 mL vial only), water for injection, and zinc. Hydrochloric acid and sodium hydroxide may have been added to adjust for pH.

    Cartridge
    Each mL of sterile solution contains 100 units of insulin glargine. Nonmedicinal ingredients: glycerol, m-cresol, polysorbate 20 (10 mL vial only), water for injection, and zinc. Hydrochloric acid and sodium hydroxide may have been added to adjust for pH.

    SoloSTAR disposable pen
    Each mL of sterile solution contains 100 units of insulin glargine. Nonmedicinal ingredients: glycerol, m-cresol, polysorbate 20 (10 mL vial only), water for injection, and zinc. Hydrochloric acid and sodium hydroxide may have been added to adjust for pH.

    How should I use this medication?

    Your required dose of insulin depends on how much natural insulin your pancreas is producing and how well your body is able to use the insulin. Your doctor or diabetes educator will determine the appropriate dose for you according to various lifestyle factors and the blood glucose values obtained while monitoring your blood glucose.

    Your dose of insulin should be injected subcutaneously (under the skin) exactly as instructed by your doctor or diabetes educator. Do not inject insulin glargine into the vein and do not use insulin glargine in insulin infusion pumps. The dose of insulin is measured in international units (IU). Each 1 mL of insulin contains 100 IU. Insulin glargine is injected under the skin once daily. In addition to insulin glargine, doses of a fast-acting insulin are usually used to control the impact of food intake on blood sugar levels during the day. There are many variations of insulin dosing.

    Insulin glargine should be clear and colourless. Do not use the insulin if you notice anything unusual in the appearance of the solution, such as cloudiness, discoloration, or clumping. It is not necessary to shake or rotate the vial before use. It should not be mixed with other insulins.

    Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

    It is very important to use this medication exactly as prescribed by your doctor. The timing of insulin with respect to your meals is crucial to keeping blood sugar under control and preventing unwanted side effects.

    Keep unopened bottles of insulin in the refrigerator until needed. They may be used until the expiry date on the label. Never allow insulin to freeze. Insulin that is currently in use may be kept at room temperature for no more than 28 days and then discarded. Do not expose insulin to extremely hot temperatures or to sunlight. Keep insulin out of the reach of children.

    Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

    Who should NOT take this medication?

    Do not use insulin glargine if you:

    • are allergic to insulin or to any of the ingredients of the medication
    • have diabetic coma
    • have low blood sugar (hypoglycemia)

    What side effects are possible with this medication?

    Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

    The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

    Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

    • redness, itching, or swelling at the site of the injection

    Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

    Check with your doctor as soon as possible if any of the following side effects occur:

    • signs of low blood glucose:
      • anxiety
      • blurred vision
      • confusion
      • difficulty concentrating
      • difficulty speaking
      • dizziness
      • drowsiness
      • fast heartbeat
      • headache
      • hunger
      • nausea
      • nervousness
      • numbness or tingling of the lips, fingers, or tongue
      • sweating
      • tiredness
      • trembling
      • weakness

    Stop taking the medication and seek immediate medical attention if any of the following occur:

    • rash or blisters all over the body
    • seizures
    • symptoms of a serious allergic reaction (e.g., swelling of the face or throat, difficulty breathing, wheezing, or itchy skin rash)
    • unconsciousness

    Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

    Are there any other precautions or warnings for this medication?

    Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

    Allergic reactions: If you notice signs of a serious allergic reaction (swelling of the face or throat, difficulty breathing, wheezing, or itchy skin rash), stop using the medication and seek immediate medical attention.

    Appearance of insulin: The contents of the vial of insulin glargine should be clear and colourless. Do not use this medication if you notice anything unusual about its appearance, such as cloudiness, discoloration, or clumping.

    Blood glucose monitoring: It is important for anyone using insulin to monitor their blood glucose levels regularly, as recommended by their doctor or diabetes educator. It is especially important to test blood glucose more often when your insulin dose or schedule changes, or when you are ill or under stress. If blood tests consistently show high or low blood glucose levels, contact your doctor or diabetes educator.

    Changes at injection site: Fatty tissue under the skin at the injection site may shrink or thicken if you inject yourself too often at the same site. To help avoid this effect, change the site with each injection. Talk to your doctor or diabetes educator if you notice your skin pitting or thickening at the injection site.

    Changes in insulin requirements: Many things can affect blood glucose levels and insulin requirements. These include:

    • certain medical conditions (e.g., infections, thyroid conditions, or kidney or liver disease)
    • certain medications that increase or decrease blood glucose levels
    • diet
    • exercise
    • illness
    • injury
    • stress
    • surgery
    • travelling over time zones

    It is important your doctor know your current health situation and any changes that may affect the amount of insulin you need. Blood glucose should be monitored regularly as recommended by your doctor or diabetes educator.

    Diabetes identification: It is important to either wear a bracelet (or necklace) or carry a card indicating you have diabetes and are taking insulin.

    Family and friends: Educate your family and friends about the signs and symptoms of hypoglycemia (low blood glucose). Keep a glucagon kit available and instruct them on its proper use in case you experience severe low blood glucose and you lose consciousness.

    High blood glucose (hyperglycemia): Hyperglycemia may occur if your insulin dose is too low or you miss a dose of insulin. Symptoms of hyperglycemia generally build up over hours or days. If you experience symptoms of hyperglycemia, such as increased need to urinate, nausea, vomiting, drowsiness, dry mouth, flushed dry skin, loss of appetite, and a fruity odour to your breath, contact your doctor or diabetes educator immediately.

    If hyperglycemia is allowed to continue, a condition known as diabetic ketoacidosis may occur. In this condition, your body starts to use body fat as fuel, eventually leading to a large concentration of acid in the blood stream. This can result in unconsciousness, coma, or death. To prevent this from occurring, you may need to have your insulin dose adjusted.

    Kidney function: Kidney disease or reduced kidney function may change the amount of insulin needed by the body. If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your kidney function regularly with blood tests while you are taking this medication.

    Liver function: Liver disease or reduced liver function may change the amount of insulin needed by the body. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

    Low blood glucose (hypoglycemia): Hypoglycemia may occur if too much insulin is used, if meals are missed, or if you exercise more than usual. Symptoms of mild to moderate hypoglycemia may occur suddenly and can include cold sweat, nervousness or shakiness, fast heartbeat, headache, hunger, confusion, lightheadedness, weakness, and numbness or tingling (tongue, lips, or fingers). Mild to moderate hypoglycemia may be treated by eating foods or drinks that contain sugar. People taking insulin should always carry a quick source of sugar, such as hard candies, glucose tablets, juice, or regular soft drinks (not diet soft drinks).

    Signs of severe hypoglycemia can include disorientation, loss of consciousness, and seizures. People who are unable to take sugar by mouth or who are unconscious may require an injection of glucagon or treatment with intravenous (into the vein) glucose.

    Pregnancy: It is essential to maintain good blood glucose control throughout pregnancy. Insulin requirements usually decrease during the first trimester and increase during the second and third trimesters. Therefore, contact your doctor if you are pregnant or are thinking about pregnancy.

    Breast-feeding: It is not known if insulin glargine passes into breast milk. If you are a breast-feeding mother and are using this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Breast-feeding mothers may require adjustments in insulin dose or diet.

    Children: The safety and effectiveness of using this medication have not been established for children under 6 years of age.

    Seniors: The signs and symptoms of hypoglycemia may be more difficult to recognize in seniors.

    What other drugs could interact with this medication?

    There may be an interaction between insulin glargine and any of the following:

    • ACE inhibitors (e.g., ramipril, enalapril, lisinopril)
    • alcohol
    • anabolic steroids (e.g., testosterone)
    • antipsychotics (e.g., aripiprazole, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
    • beta-blockers (e.g., atenolol, metoprolol, pindolol, propranolol, sotalol)
    • birth control pills
    • bismuth subsalicylate
    • bromocriptine
    • buserelin
    • certain diuretics (e.g., hydrochlorothiazide)
    • corticosteroids (e.g., prednisone, prednisolone)
    • danazol
    • decongestants (e.g., pseudoephedrine)
    • epinephrine
    • estrogens
    • everolimus
    • glucagon
    • growth hormone
    • HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
    • lanreotide
    • linezolid
    • liraglutide
    • MAO inhibitors (e.g., phenelzine, tranylcypromine)
    • mifepristone
    • niacin
    • octreotide
    • oral medications for diabetes (e.g., gliclazide, glyburide, pioglitazone, rosiglitazone)
    • phenytoin
    • progesterone
    • quinine
    • quinolone antibiotics (e.g., ciprofloxacin, norfloxacin)
    • salicylates (e.g., ASA) in daily doses greater than 1.5 g
    • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
    • sirolimus
    • somatropin
    • sulfa antibiotics (e.g., sulfamethoxazole, sulfadiazine)
    • tacrolimus
    • testosterone
    • thyroid replacement therapy (if beginning or changing dose)
    • triptorelin

    If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

    • stop taking one of the medications,
    • change one of the medications to another,
    • change how you are taking one or both of the medications, or
    • leave everything as is.

    An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

    Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

    All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Lantus

    Lantus SoloStar instructions for use: indications, contraindications, side effects – description Lantus SoloStar solution for n / a 100 IU / ml: 3 ml cartridges in SoloStar® syringe pens 5 pcs. (24252)

    Lantus ® SoloStar ® should be administered s / c 1 time / day at any time of the day, but every day at the same time.

    In patients with type 2 diabetes mellitus Lantus ® SoloStar ® can be used both as monotherapy and in combination with other hypoglycemic drugs.

    Target values ​​for blood glucose concentrations, as well as the dose and timing of administration or administration of hypoglycemic drugs should be determined and adjusted individually.

    A dose adjustment may also be required, for example, when the patient’s body weight, lifestyle changes, the time of administration of the insulin dose is changed, or in other conditions that may increase the predisposition to the development of hypo- or hyperglycemia. Any changes in insulin dose must be done with caution and under medical supervision.

    Lantus ® SoloStar ® is not the insulin of choice for the treatment of diabetic ketoacidosis. In this case, preference should be given to intravenous administration of short-acting insulin. For treatment regimens that include basal and prandial insulin injections, 40-60% of the daily insulin dose is usually administered in the form of insulin glargine to meet the basal insulin requirement.

    In patients with type 2 diabetes mellitus taking hypoglycemic drugs for oral administration, combination therapy begins with a dose of insulin glargine 10 units 1 time / day and subsequently the treatment regimen is adjusted individually.

    Monitoring of blood glucose concentration is recommended in all patients with diabetes mellitus.

    Switching from treatment with other hypoglycemic drugs to Lantus ® SoloStar ®

    When transferring a patient from a treatment regimen with medium-duration or long-acting insulin to a treatment regimen with Lantus ® SoloStar ® it may be necessary to adjust the amount (doses) and time of administration of short-acting insulin or its analog during the day, or to change the doses of oral hypoglycemic drugs.

    In order to reduce the risk of hypoglycemia when transferring patients from a single dose of Tudzheo (insulin glargine 300 U / ml) per day to a single dose of Lantus ® SoloStar ® , an initial dose of Lantus ® is recommended SoloStar ® , constituting 80% of the dose of the drug Tudgeo, the use of which is discontinued.

    When transferring patients from a single injection of insulin-isophane during the day to a single injection of the drug Lantus ® SoloStar ® during the day, the initial doses of insulin usually do not change (i.e.that is, the amount of IU of the drug Lantus ® SoloStar ® per day is used equal to the amount of IU of insulin-isophane per day).

    When transferring patients from a double injection of insulin-isophane per day to a single administration of Lantus ® SoloStar ® before bedtime, in order to reduce the risk of hypoglycemia in the night and early morning hours, the initial, daily dose of insulin glargine is usually reduced by 20% (compared to the daily dose of insulin-isophane), and then it is adjusted depending on the patient’s response.

    When switching from human insulin to Lantus ® SoloStar ® and during the first weeks after it, careful metabolic monitoring (control of blood glucose concentration) is recommended under medical supervision, with correction, if necessary, of the insulin dosing regimen. As with other analogs of human insulin, this is especially true for patients who, due to their antibodies to human insulin, require high doses of human insulin.In such patients, with the use of insulin glargine, a significant improvement in the response to insulin administration may be observed.

    With an improvement in metabolic control and the resulting increase in tissue sensitivity to insulin, it may be necessary to adjust the insulin dosing regimen.

    Mixing and dilution

    Lantus ® SoloStar ® must not be mixed with other insulins. Mixing can change the time / effect ratio of Lantus ® SoloStar ® , as well as lead to precipitation.

    Special patient groups

    Lantus ® SoloStar ® can be used in children over 2 years old . The use in 90,099 children under the age of 2 years 90,100 has not been studied.

    In elderly patients with diabetes mellitus, the use of moderate initial doses, their slow increase and the use of moderate maintenance doses are recommended. Elderly patients may have difficulty recognizing developing hypoglycemia.

    Method of application

    Lantus ® SoloStar ® is administered as a subcutaneous injection. Lantus ® SoloStar ® is not intended for intravenous administration.

    Long duration of action of insulin glargine is observed only when it is introduced into the subcutaneous fat. IV administration of the usual subcutaneous dose can cause severe hypoglycemia.

    Lantus ® SoloStar ® should be injected into the subcutaneous fat of the abdomen, shoulders or thighs.The injection sites should be alternated with each new injection within the recommended areas for subcutaneous administration of the drug.

    As in the case of other types of insulin, the degree of absorption, and therefore the onset and duration of its action, can change under the influence of physical activity and other changes in the patient’s condition.

    Lantus ® SoloStar ® is a clear solution, not a suspension. Therefore, resuspension is not required before use.

    In case of a malfunction of the Lantus syringe pen ® SoloStar ® insulin glargine can be removed from the cartridge into a syringe (suitable for insulin 100 IU / ml) and the necessary injection can be made. In this case, the syringe should not contain residues of other drugs.

    Rules for the use and handling of the pre-filled injector pen SoloStar ®

    Before the first use, the syringe pen must be held at room temperature for 1-2 hours.

    Before use, inspect the cartridge inside the pen. It should only be used if the solution is clear, colorless, contains no visible solid particles and resembles water in consistency.

    Empty SoloStar ® Syringe Pens must not be reused and must be destroyed.

    To prevent infection, the pre-filled pen should be used by one patient only and should not be passed on to another person.

    Before using the SoloStar ® syringe pen, you should carefully read the information on use.

    Before each use, carefully connect the new needle to the pen and carry out a safety test. Use only needles compatible with SoloStar ® .

    Special precautions must be taken to avoid needle-related accidents and transmission of infection.

    In no case should you use the SoloStar ® injector pen if it is damaged or if you are not sure that it will work properly.

    You should always have a spare SoloStar ® syringe pen in hand in case you lose or damage your existing SoloStar ® syringe pen.

    If the SoloStar ® syringe pen is stored in the refrigerator, it should be removed 1-2 hours before the intended injection so that the solution reaches room temperature.Refrigerated insulin delivery is more painful.

    The used SoloStar ® syringe pen must be destroyed.

    The SoloStar ® Syringe Pen must be protected from dust and dirt. The outer side of the SoloStar ® syringe pen can be cleaned by wiping it with a damp cloth. Do not immerse in liquid, rinse and lubricate the SoloStar ® syringe pen, as this can damage it.

    Syringe-pen SoloStar ® accurately doses insulin and is safe to use.It also requires careful handling. Avoid situations in which damage to the SoloStar ® syringe pen may occur. If you suspect that the existing copy of the SoloStar ® syringe pen is damaged, a new pen should be used.

    Stage 1. Insulin control

    It is necessary to check the label on the SoloStar ® syringe pen to ensure that it contains the correct insulin. For Lantus ® , a gray SoloStar ® syringe pen with a purple button for injection.After removing the cap of the pen-syringe, they control the appearance of the insulin contained in it: the insulin solution should be transparent, colorless, not contain visible solid particles and resemble water in consistency.

    Step 2. Needle attachment

    Only use needles that are compatible with the SoloStar ® injector pen. A new sterile needle is always used for each subsequent injection. After removing the cap, the needle must be carefully installed on the syringe pen.

    Stage 3: Perform Safety Test

    Before each injection, a safety test should be performed to ensure that the pen and needle are working well and air bubbles are removed.

    Measure the dose equal to 2 units.

    Outer and inner needle caps must be removed.

    Positioning the pen with the needle up, gently tap the insulin cartridge with your finger so that all air bubbles are directed towards the needle.

    Press the injection button fully.

    If insulin appears at the tip of the needle, it means that the pen and needle are working correctly.

    If no insulin appears at the tip of the needle, stage 3 can be repeated until insulin appears at the tip of the needle.

    Stage 4. Dose selection

    The dose can be set with an accuracy of 1 unit from the minimum dose (1 unit) to the maximum dose (80 units).If it is necessary to administer a dose in excess of 80 units, 2 or more injections should be given.

    The dosage window shall show “0” after completion of the safety test. The required dose can then be set.

    Stage 5. Dose administration

    The patient should be informed of the injection technique by a healthcare professional.

    The needle must be inserted under the skin.

    The injection button must be fully depressed.It is held in this position for another 10 seconds until the needle is removed. This ensures that the selected dose of insulin is completely delivered.

    Step 6. Removing and discarding the needle

    In all cases, the needle must be removed and discarded after each injection. This prevents contamination and / or infection, air entering the insulin container and insulin leakage.

    Special precautions must be taken when removing and discarding the needle.Recommended safety precautions for removing and disposing of needles (eg one-handed cap technique) should be followed to reduce the risk of needle-related accidents and to prevent infection.

    After removing the needle, close the SoloStar ® syringe pen with a cap.

    Lantus Solostar Pen – instructions for use, dosages, composition, analogs, side effects / Pillintrip

    P / c, into the subcutaneous fat of the abdomen, shoulder or thigh, always at the same time 1 time per day.The injection sites should be alternated with each new injection within the recommended areas for subcutaneous administration of the drug.

    Intravenous administration of the usual dose, intended for s / c administration, may cause the development of severe hypoglycemia.

    The dose of Lantus and the time of day for its administration are selected individually. In patients with type 2 diabetes mellitus, Lantus can be used both as monotherapy and in combination with other hypoglycemic drugs.

    Switching from treatment with other hypoglycemic drugs to Lantus. When replacing the treatment regimen with medium-acting or long-acting insulins with the Lantus treatment regimen, it may be necessary to adjust the daily dose of basal insulin, and it may also be necessary to change the concomitant antidiabetic therapy (doses and regimen of additionally used short-acting insulins or their analogs or doses of oral hypoglycemic drugs). When transferring patients from double administration of insulin-isophane during the day to a single administration of Lantus in order to reduce the risk of hypoglycemia at night and early morning, the initial dose of basal insulin should be reduced by 20-30% in the first weeks of treatment.During the period of dose reduction, you can increase the dose of short insulin, and then the dosage regimen must be adjusted individually.

    Lantus should not be mixed or diluted with other insulin preparations. When mixed or diluted, its profile of action can change over time, and mixing with other insulins can cause precipitation.

    As with other analogs of human insulin, in patients receiving high doses of drugs due to the presence of antibodies to human insulin, when switching to Lantus, an improvement in the response to insulin administration may be observed.

    During the transition to Lantus and in the first weeks thereafter, careful monitoring of blood glucose is required.

    In case of improved regulation of metabolism and the resulting increase in insulin sensitivity, further adjustment of the dosage regimen may become necessary. A dose adjustment may also be required, for example, when the patient’s body weight, lifestyle changes, the time of day for drug administration, or when other circumstances appear that contribute to an increase in the predisposition to the development of hypo- or hyperglycemia.

    The drug should not be administered intravenously. The duration of action of Lantus is due to its introduction into the subcutaneous tissue.

    Lantus Solostar Injectable in Russian – Product

  • Is it safe to drive or operate heavy equipment while using this product?

    If you feel drowsiness, dizziness, hypotension or headache while taking Lantus Solostar Injectable, then you may need to give up driving and heavy industrial equipment.You should stop driving if taking the drug makes you drowsy, dizzy, or hypotensive. Doctors recommend to stop drinking alcohol with such drugs, because alcohol significantly increases side effects and drowsiness. Please check your body’s response while taking Lantus Solostar Injectable. Be sure to contact your healthcare professional for advice based on your body and overall health.

  • Is this medication (product) addictive or addictive?

    Most drugs are not addictive or addictive. In most cases, the government classifies drugs that can be addictive as controlled dispensing drugs. For example, an H or X chart in India and an II-V chart in the United States. Please review the information on the drug packaging to make sure this drug is not a controlled drug.In addition, do not self-medicate or accustom your body to medication without consulting your healthcare professional.

  • Can I stop using this product immediately or do I need to slowly stop using it?

    Some drugs need to be discontinued gradually due to the recovery effect. Be sure to contact your healthcare professional for advice based on your body, general health, and other medications you are taking.

  • insulin (glargine) Solostar, Makita and other forms of release

    Lantus is a hypoglycemic insulin preparation and contains glargine as the main active substance.

    The nature of the duration of action of this component is influenced by factors such as physical activity and nutrition.

    Slow absorption after subcutaneous injection makes it possible to use this insulin substitute once a day. Since it has a large number of benefits and a long-lasting effect, many specialists prescribe Lantus to their patients.

    Lantus release form

    Produced in the form of 3 ml cartridges. This dosage contains 300 IU of insulin glargine and excipients.

    Indications for use

    It is prescribed to patients of endocrinologists who suffer from diabetes of both types. Mostly these are adults and children over six years old.

    Method of application

    Lantus has been developed for the treatment of disorders associated with high and low sugar levels.It needs to be injected only under the skin and is prohibited – intravenously.

    Long-term effect of the drug is due to the fact that it is injected into the subcutaneous fat. It should not be forgotten that the introduction of the usual dose intravenously can provoke the development of severe hypoglycemia.

    Insulin (glargine) Lantus Solostar

    During the period of treatment with this insulin substitute, you should adhere to a healthy lifestyle and correctly inject this drug under the skin.According to the doctors’ comments, there is no significant difference between the introduction of the drug into the abdominal area, deltoid muscle or into the buttocks.

    It is very important to select a new, intact skin fragment with each injection. It is forbidden to use Lantus with other drugs, the combination of which has not been clinically proven. Also, the prohibition applies to the dilution of insulin liquid with various drugs.

    After a specialist prescribes Lantus Makita, it is important to learn from him about all the intricacies of administration in order to avoid mistakes during use.

    Dosage

    Diabetes is afraid of this drug like fire!

    You just need to apply …

    Reducing sugar

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    Solution for injection contains long-acting insulin, which is recommended to be administered once a day at about the same time.

    As for the duration of use, dosing and administration regimen, all this is clarified with the attending physician.It is allowed to be used by people with type 2 diabetes in combination with some antidiabetic agents.

    It should not be forgotten that the units of action of Lantus insulin differ significantly from the units of action of similar solutions for injections against violations of the concentration of sugar in the blood plasma.

    In elderly patients, due to progressive disorders of the excretory system organs, a gradual decrease in the need for pancreatic hormone is likely.But in people who have kidney problems, the need for this hormone can be much lower than in completely healthy people.

    A decrease in insulin requirements can overtake people who have impaired liver function.

    Switching to Lantus from other types of insulin

    In the process of switching from drugs of medium duration of action to the solution in question, it is likely that the need to adjust the dose of basal insulin, as well as in concomitant treatment, will arise.

    To reduce the risk of a drop in blood glucose levels, mainly at night, people who change the mode of using basal pancreatic hormone from a double dose to a single dose should carefully reduce the dose of the former by about half during the first weeks of treatment.

    In this case, do not forget to slightly increase the dose of insulin, which is administered in connection with food intake. After fourteen days, you need to adjust the existing dose.

    In persons who have antibodies to insulin, when using insulin glargine, which is part of Lantus Solostar, a change in the body’s response to its administration is traced. As a consequence, a dose change may be necessary.

    Side effects

    Important to know! Problems with sugar levels over time can lead to a whole bunch of diseases, such as vision problems, skin and hair conditions, ulcers, gangrene and even cancerous tumors! People who have learned from bitter experience use …
    Read more … “

    Lowering blood sugar is the most common consequence of insulin therapy.

    As a rule, the introduction of too much pancreatic hormone can contribute to this. This is due to the fact that the body does not need such a large amount of this substance.

    The patient has attacks of severe hypoglycemia, especially frequently recurring ones, which can lead to damage to the nervous system. Moments of prolonged and pronounced hypoglycemia can threaten the lives of people with diabetes.

    Psychoneurological disorders against the background of low sugar are preceded by signs of adrenergic counterregulation (persistent hunger, aggressiveness, apathy, cold sweat, accelerated heartbeat).

    Many more patients note a decrease in visual function on the background of injections of this type of insulin.

    Prolonged glucose normalization lowers the risk of developing diabetic retinopathy.

    Treatment with pancreatic hormone can lead to temporary deterioration in the course of vascular lesions in the retina of the eyeball.

    In individuals with proliferative retinopathy who are not treated with photocoagulation, periods of severe hypoglycemia can lead to transient vision loss.

    In order to avoid complications, it is important to follow the prescribed dosage exactly.

    Contraindications

    It should not be administered to people who have an intolerance to the main substance and additional components.

    Lantus is prohibited from taking patients suffering from a regular drop in blood sugar levels.

    As for the treatment of children with this solution, in pediatrics it can be used to treat babies over two years old.

    It is important to note that Lantus’s insulin glargine is not a substance that helps in the treatment of diabetic ketoacidosis. Another important point is the following: the drug should be used with caution by those people who have a health risk during attacks of hypoglycemia.

    Extreme caution should be observed in patients who may not show signs of a decrease in sugar levels in any way. This also applies to patients with autonomic neuropathy, long-term diabetes mellitus, mental disorders, as well as the elderly and people who have recently switched from animal insulin to human insulin.

    When treating with this solution, care should be taken in patients at risk of developing severe hypoglycemia, including with an increase in sensitivity to the pancreatic hormone.

    It is important to note that if the patient neglects the advice and recommendations of doctors regarding the abuse of heavy physical exertion, unbalanced food and bad habits, then he can also provoke the occurrence of side effects.

    Therefore, if all requirements are not met, it is better to completely refrain from treatment with this drug.It is also very important to avoid various activities that involve increased attention, since with the development of hypo- or hyperglycemia, visual impairment and concentration are likely.

    As for its use during pregnancy, according to clinical studies, there is absolutely no negative effect of this substance on the body of a woman and a fetus. This type of insulin called Lantus, according to the radar, can be prescribed by the attending doctor during the period of gestation.

    But it is important not to forget to keep blood sugar under control, as well as to regularly see your doctor.

    There is a possibility of a decrease in the need for pancreatic hormone in the first trimester of pregnancy, and in the second and third – on the contrary, a sharp increase.

    Immediately after the birth of a child, the body’s need for insulin immediately decreases and there is a risk of hypoglycemia. During breastfeeding, the use of Lantus solution is allowed, subject to careful control of the insulin dose.

    If this hormone enters the digestive tract, it breaks down into amino acids and is unable to harm a baby who is still breastfed. At the moment, there is no confirmation of the entry of pancreatic hormone into breast milk.

    You should not use Lantus insulin on your own during pregnancy, since the doctor must personally determine the appropriate dosage that will keep the blood glucose level in good order.

    Overdose

    Using high doses of this hormone can lead to prolonged and dangerous hypoglycemia, which can seriously harm human health.

    Mild and subtle cases of overdose are usually stopped by the intake of carbohydrates.

    You should also review the prescribed dosage and adjust the patient’s lifestyle. Severe episodes, which occur when the prescribed amount of the drug is exceeded, require immediate intramuscular or subcutaneous administration of glucagon.

    Taking into account the long-term effect of Lantus, even after the general condition of the patient has improved, a long-term intake of carbohydrates is needed.

    Video on the topic

    What is the drug Lantus, what insulin action is it and other important points that you need to know about this drug, in the video:

    This article contains detailed information about what Lantus is and how it is use correctly. With a competent approach to the treatment of insulin-dependent diabetes mellitus, an excellent result is noted.In addition, among the advantages of this substitute for the human pancreatic hormone, one can single out its long-term effect, thanks to which you can forget about the obligatory injection of insulin for a whole day.

    Watch the video: What you need to know about insulin Lantus

    Lantus side effects (injection of insulin glargine [rDNA origin]), warnings, use

    • Generic Name: Insulin Glargine [rDNA Origin] Injection
    • Brand Name: Lantus

    Lantus Side Effects Center

    Medical Editor: John P.Cunya, DO, FACOEP

    what moringa oleifera is used for

    What is Lantus?

    Lantus (insulin glargine [rDNA origin]). An injection is an artificial form of a hormone that is produced in the body and is used to treat type 1 (insulin dependent) or type 2 (insulin dependent) diabetes.

    What are the side effects of lantus?

    The most common side effects of Lantus are hypoglycemia or low blood sugar.Symptoms include:

    • Headache,
    • hunger
    • weak spot,
    • sweating
    • tremors,
    • irritability,
    • trouble concentrating,
    • rapid breathing,
    • or fast heartbeat
    • seizures (severe hypoglycemia can be fatal).

    Other common side effects of Lantus include pain, redness, swelling, itching, or thickening of the skin at the injection site.These side effects usually go away in a few days or weeks.

    Dosage for Lantus

    Lantus should be injected subcutaneously (under the skin) once a day at the same time every day. The dose is determined individually and as desired. blood glucose levels.

    What drugs, substances or additives interact with lantus?

    Lantus can interact with albuterol, clonidine, reserpine or beta-blockers. Many other medicines can increase or decrease the effect of insulin glargine in lowering blood sugar levels.Tell your doctor about all prescription and over-the-counter medications and supplements you are taking.

    Lantus during pregnancy and breastfeeding

    Tell your doctor if you are pregnant before using Lantus. Before getting pregnant, talk to your doctor about a blood sugar control plan. Your doctor may change the type of insulin you use during pregnancy. It is not known whether this drug passes into breast milk. Insulin requirements may change during breastfeeding.Talk to your doctor before breastfeeding.

    More Information

    Our Lantus Injection Side Effects Center (insulin glargine [rDNA origin]) provides a comprehensive overview of the available drug information about the potential side effects of this drug.

    This is not a complete list of side effects and they may arise. Ask your doctor about side effects. You can report side effects to the FDA by calling 1-800-FDA-1088.

    Lantus Consumer Information

    Get emergency medical help if you have signs of an insulin allergy: redness or swelling at the injection site, itchy skin rash all over your body, shortness of breath, rapid heart rate, feeling like you might pass out , or swelling of the tongue or throat.

    Call your doctor right away if you have:

    • rapid weight gain, swelling in your feet or ankles;
    • shortness of breath; or
    • low potassium – leg cramps, constipation, irregular heartbeat, fluttering in the chest, increased thirst or urination, numbness or tingling, muscle weakness or a feeling of limp.

    Common side effects may include:

    • low blood sugar;
    • pruritus, mild skin rash; or
    • the thickening or cavity of the skin where you injected the medicine.

    This is not a complete list of side effects and they can occur. Ask your doctor about side effects. You can report side effects to the FDA by calling 1-800-FDA-1088.

    Read all detailed patient monograph for Lantus (insulin glargine injection [rDNA origin])

    Learn More ‘Professional information about Lantus

    ADVERSE EFFECTS

    The following adverse reactions are discussed elsewhere:

    Clinical Trials Experience

    Since are carried out in a wide variety of settings, the frequency of adverse reactions observed in clinical trials of a drug cannot be directly compared with the frequency in clinical trials of another drug and may not reflect the rates observed in practice.

    The data in Table 1 reflect exposure to LANTUS or NPH in 2327 type 1 diabetes patients. Patients with type 1 diabetes had the following characteristics: The mean age was 38.5 years. Fifty-four percent were male, 96.9% were European, 1.8% were black or African American, and 2.7% were Hispanic. The average BMI was 25.1 kg / m².

    The data in Table 2 reflect exposure to LANTUS or NPH in 1563 patients with type 2 diabetes. Patients with type 2 diabetes had the following characteristics: The mean age was 59.3 years.Fifty-eight percent were male, 86.7% were European, 7.8% were black or African American, and 9% were Hispanic. The average BMI was 29.2 kg / m².

    The incidence of adverse events during LANTUS clinical trials in patients with type 1 diabetes mellitus and type 2 diabetes mellitus is shown in the tables below.

    Table 1. Adverse events in pooled clinical trials of up to 28 weeks duration in adults with type 1 diabetes (adverse events with a frequency of> 5%)

    LANTUS,%
    (n = 1257)
    NPH,%
    (n = 1070)
    Upper respiratory tract infection 22.4 23.1
    Infectious disease * 9.4 10.3 23 906 Accidental injury 5.7 6.4
    Headache 5.5 4.7
    * Body system not specified

    phenomena with a frequency of ≥ 5%)

    not specified

    LANTUS,%
    (n = 849)
    NPH,%
    (n = 714)
    Upper respiratory tract infection 11.4 13.3
    Infectious disease * 10.4 11.6
    Retinal vascular disease 5.8 7.4
    906 Body system

    Table 3: Side effects in a 5-year study of adults with type 2 diabetes (adverse events with an incidence of ≥10%) 90 100 90 375

    9061 3

    LANTUS,%
    (n = 514) NPH,%
    (n = 503) Upper respiratory tract infection 29.0 33.6 Peripheral edema

    20.0 22.7 Hypertension 19.6 18.9 Influenza 18.7 19.5 Sinusitis 17.9 Cataract 18.1 15.9 Bronchitis 15.2 14.1 Arthralgia 14.2 16.1 Limb pain 13.0 13.1 Back pain 12.8 12.3616

    Cough 12.1 7.4 Urinary tract infection 10.7 10.1 Diarrhea 10.7 10.3 9.7 Headache 10.3 9.3

    ; 5%)

    LANTUS,%
    (n = 174)
    NPH,%
    (n = 175)
    Infectious disease no * 13.8 17.7
    Upper respiratory tract infection 13.8 16.0
    Pharyngitis 7.5 8.6
    Rhinitis 5.2 5.1
    * Body system not specified
    most observable hypoglycemia 9502 Severe hypoglycemia reaction in patients taking insulin, including LANTUS [see.

    WARNINGS AND PRECAUTIONS ]. Tables 5, 6 and 7 summarize the incidence of severe hypoglycemia in the individual LANTUS clinical trials.Severe symptomatic hypoglycemia was defined as an event with symptoms consistent with hypoglycemia requiring the help of another person and associated either with a blood glucose level below 50 mg / dL (≤ 56 mg / dL in a 5-year trial or ≤ 36 mg / dL in the ORIGIN study) or rapid recovery after oral carbohydrate intake, intravenous glucose, or glucagon.

    Percentage of adult patients treated with LANTUS who experienced severe symptomatic hypoglycemia in the LANTUS clinical trial [see Ref. Clinical studies ] were comparable to the percentage of patients receiving NPH for all treatment regimens (see Tables 5 and 6). In phase 3 pediatric clinical trials, children and adolescents with type 1 diabetes had a higher incidence of severe symptomatic hypoglycemia in the two treatment groups compared to the trials of adults with type 1 diabetes.

    Table 5: Severe Symptomatic Hypoglycemia in Patients with Type 1 Diabetes

    Study A Type 1 Diabetes Adults 28 weeks Combined with conventional insulin Study B Type 1 Diabetes Adults 28 weeks Combined with normal insulin Study C Type 1 Diabetes Adults, 16 weeks In combination with insulin lispro Study D Type 1 diabetes in pediatrics, 26 weeks In combination with conventional insulin
    LANTHUS
    N = 292
    NPH
    N = 293
    LANTUS
    N = 264
    NPH
    N = 270
    LANTUS
    N = 310
    NPH
    N = 309
    LANTUS
    N = 174
    patients N = 17527 10.6 15.0 8.7 10.4 6.5 5.2 23.0 28.6

    Table 6: Severe symptomatic hypoglycemia in patients with type 2 diabetes

    NPH

    , 7

    Study E Type 2 Diabetes Adults, 52 weeks Combined with oral medication Study F Type 2 Diabetes Adults, 28 weeks Combined with regular insulin Study G Type 2 Diabetes Adults 5 years Combined with regular insulin
    LANTUS
    N = 289
    NPH
    N = 281
    LANTUS
    N = 259
    NPH
    N = 259
    LANTUS
    N = 513
    1.1 0.4 2.3 7.8 11.9

    Table 7 shows the proportion of patients with severe symptomatic hypoglycemia in the Lantus and Standard Care groups in the ORIGIN study [see. Clinical studies ].

    Table 7: Severe symptomatic hypoglycemia in the ORIGIN study

    ORIGIN Study Average follow-up: 6.2 years.
    LANTUS
    N = 6231
    Standard care
    N = 6273
    Percentage of patients 5.6 1.8
    and edema, especially if previously poor metabolic control has been improved by increased insulin therapy.

    Lipodystrophy

    Subcutaneous insulin, including LANTUS, has resulted in lipoatrophy (skin depression) or lipohypertrophy (tissue enlargement or thickening) in some patients [see. DOSAGE AND ADMINISTRATION ].

    Insulin delivery and increased glucose control

    An increase or rapid improvement in glucose control has been associated with transient reversible ophthalmic refractive disorder, worsening diabetic retinopathy, and acute painful peripheral neuropathy. However, prolonged glycemic control reduces the risk of diabetic retinopathy and neuropathy.

    Weight gain

    Weight gain has occurred with the use of several insulin therapies, including LANTUS, and has been attributed to the anabolic effects of insulin and a decrease in glucosuria.

    Allergic reactions

    Local allergy

    As with any insulin therapy, patients taking LANTUS may experience injection site reactions including redness, pain, itching, hives, swelling and inflammation. In clinical trials involving adult patients, the incidence of treatment-related injection site pain was higher in patients treated with LANTUS (2.7%) than in patients treated with NPH insulin (0.7%).Reported injection site pain did not lead to discontinuation of therapy.

    Systemic allergy

    Severe, life-threatening generalized allergies, including anaphylaxis, generalized skin reactions, angioedema, bronchospasm, hypotension and shock, can occur with any insulin, including LANTUS, and can be life-threatening.

    Immunogenicity

    Like all therapeutic proteins, there is a potential for immunogenicity. All insulin products can cause the formation of insulin antibodies.The presence of such antibodies to insulin can increase or decrease the effectiveness of insulin and may require an adjustment in the insulin dose. In LANTUS phase 3 clinical trials, increases in insulin antibody titers were observed in the NPH and LANTUS insulin treatment groups with a similar frequency.

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    Post-Marketing Experience

    The following adverse reactions have been identified during post-approval use of LANTUS.

    Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship with drug exposure.

    Treatment errors have been reported when other insulins, especially rapid-acting insulins, were accidentally injected in place of LANTUS [see Ref. Patient Information ]. To avoid medication errors between LANTUS and other insulins, patients should be instructed to always check the insulin label before each injection.

    Read all FDA prescribing information for Lantus (insulin glargine injection [rDNA origin])

    Learn More ‘Related Resources for Lantus

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    • Diabetes Insipidus
    • Diabetes Treatment: Medications , Diet and Insulin
    • Types of Insulin for Diabetes

    Concomitant Drugs

    Read Lantus User Reviews »

    Information for Lantus Patients is provided by Cerner Multum, Inc.and Lantus consumer information is provided by First Databank, Inc., used under license and subject to their respective copyrights.

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