Lantus

Lantus is a long-acting insulin that works slowly over about 24 hours. You may have to use Lantus in combination with another type of insulin or with a type of oral diabetes medicine to keep your blood sugar under control.

Lantus injection is available as:

• 10 milliliter (ml) vial (1,000 units/10 ml)
• 3 ml cartridge systems for use only in OptiClik (300 units/3 ml)
• 3 ml SoloStar disposable insulin device (300 Units/3 ml)

The dosage of Lantus is based on your medical condition and your response to treatment. Your doctor will give you very specific instructions on how much Lantus to take daily.

Lantus may be administered any time during the day, but it should be taken at the same time each day. If you are on insulin therapy, it is essential that you monitor your blood glucose levels.

If you have type 1 diabetes, your doctor will prescribe Lantus with short-acting insulin. If you have type 2 diabetes, your doctor may start you on a dose of 10 units daily and then adjust Lantus according to your needs.

Missed Dose of Lantus

It is very important to follow your insulin regimen exactly. Do not miss any doses of insulin. Keep extra supplies of insulin and an extra syringe and needle on hand. Talk to your doctor about what to do if you miss a dose, as treatment varies according to your medical condition.

Lantus is a prescription medication used to treat people with type 1 and type 2 diabetes for the control of high blood sugar. Lantus may be used along with fast-acting insulin or oral medications to control blood sugar.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Follow the instructions given by your doctor about the type or types of insulin you are using. Do not make any changes with your insulin unless you have talked to your doctor. Your insulin needs may change because of illness, stress, other medicines, or changes in diet or activity level. Talk to your doctor about how to adjust your insulin dose.

• You may take Lantus at any time during the day but you must take it at the same time every day.
• Only use Lantus that is clear and colorless. If your Lantus is cloudy or slightly colored, return it to your pharmacy for a replacement.
• Follow your doctor's instructions for testing your blood sugar.
• Inject Lantus under your skin (subcutaneously) in your upper arm, abdomen (stomach area), or thigh (upper leg). Never inject it into a vein or muscle.
• Change (rotate) injection sites within the same body area.

Lantus  10 mL vial (U-100):

• The syringe must be new and must not contain any other medicine.
• Do not mix Lantus with any other type of insulin.

Follow these steps to draw insulin into syringe:

1. Wash your hands with soap and water or with alcohol.

2. Check the insulin to make sure it is clear and colorless. Do not use the insulin after the expiration date stamped on the label, if it is colored or cloudy, or if you see particles in the solution.

3. If you are using a new vial, remove the protective cap. Do not remove the stopper.

4. Wipe the top of the vial with an alcohol swab. You do not have to shake the vial of Lantus before use.

5. Use a new needle and a U-100 syringe every time you give an injection. Use disposable syringes and needles only once. Throw them away properly. Never share needles and syringes.

6. Draw air into the syringe equal to your insulin dose. Put the needle through the rubber top of the vial and push the plunger to inject the air into the vial.

7. Leave the syringe in the vial and turn both upside down. Hold the syringe and vial firmly in one hand.

8. Make sure the tip of the needle is in the insulin. With your free hand, pull the plunger to withdraw the correct dose into the syringe.

9. Before you take the needle out of the vial, check the syringe for air bubbles. If bubbles are in the syringe, hold the syringe straight up and tap the side of the syringe until the bubbles float to the top. Push the bubbles out with the plunger and draw insulin back in until you have the correct dose.

10. Remove the needle from the vial. Do not let the needle touch anything. You are now ready to inject. Inject Lantus under your skin. Take Lantus as prescribed by your doctor.

Follow these steps to inject Lantus:

1. Decide on an injection area - either upper arm, thigh or abdomen. Injection sites within an injection area must be different from one injection to the next.
2. Use alcohol or soap and water to clean the injection site. The injection site should be dry before you inject.
3. Pinch the skin. Stick the needle in the way your healthcare provider showed you. Release the skin.
4. Slowly push in the plunger of the syringe all the way, making sure you have injected all the insulin. Leave the needle in the skin for about 10 seconds.
5. Pull the needle straight out and gently press on the spot where you injected yourself for several seconds. Do not rub the area.
6. Follow your healthcare providers instructions for throwing away the used needle and syringe. Do not recap the used needle. Used needle and syringe 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.

Lantus SoloStar

It is important to read, understand, and follow the step-by-step instructions before using SoloStar disposable insulin pen. Failure to follow the instructions may result in getting too much or too little insulin.

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any 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.

Insulin is injected under the skin. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

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.

Insulin glargine is usually injected once per day at the same time each day. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

Your care provider will show you the best places on your body to inject insulin glargine. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

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.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and 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, blurred vision, headache, and tiredness.

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

Insulin glargine is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

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.

Avoid medication errors by always checking the medicine label before injecting your insulin.

Avoid drinking alcohol. It can cause low blood sugar and may interfere with your diabetes treatment.

Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of insulin. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products.

Many drugs affect glucose metabolism; if such drugs are used concomitantly, insulin glargine dosage adjustment and careful monitoring may be required.1

Specific Drugs1

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.

• Pharmacologic effects comparable to those of insulin human;1 2 stimulates peripheral glucose uptake by tissues (e.g., skeletal muscle, fat), inhibits hepatic glucose production, inhibits lipolysis, inhibits proteolysis, and enhances protein synthesis.1 On molar basis, has approximately the same glucose-lowering effect as insulin human.1

Insulin glargine is a long-acting type of insulin that works slowly, over about 24 hours. Insulin is one of many hormones that help the body turn the food we eat into energy. This is done by using the glucose (sugar) in the blood as quick energy. Also, insulin helps us store energy that we can use later. When you have diabetes mellitus, your body cannot make enough insulin or does not use insulin properly. This causes you to have too much sugar in your blood. Like other types of insulin, insulin glargine is used to keep your blood sugar level close to normal. You may have to use insulin glargine in combination with another type of insulin or with a type of oral diabetes medicine to keep your blood sugar under control.

This medicine is available only with your doctor's prescription.

Lantus is contraindicated

• During episodes of hypoglycemia [see Warnings and Precautions (5.3)].
• In patients with hypersensitivity to Lantus or one of its excipients [see Warnings and Precautions (5.5)].

Excess insulin administration may cause hypoglycemia and hypokalemia [see Warnings and Precautions (5.3, 5.6)]. Mild episodes of hypoglycemia can usually be treated with oral carbohydrates. Adjustments in drug dosage, meal patterns, or exercise may be needed.

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

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Insulin overdose can cause life-threatening hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizure (convulsions), or loss of consciousness.

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.