Insulin glargine is a long-acting (basal) insulin: a lab-made insulin that is released slowly from under the skin to cover blood sugar between meals and overnight. It is sold as Lantus, Toujeo (a more concentrated U-300 form), Basaglar and Semglee (insulin glargine-yfgn), and is also part of Soliqua 100/33 with lixisenatide.
Also known as: Lantus, Toujeo, Basaglar, Semglee, insulin glargine-yfgn.
Lantus is U-100 (100 units/mL) in a 10 mL vial and a 3 mL SoloStar pen. Basaglar is U-100 in a 3 mL KwikPen or Tempo Pen (up to 80 units per injection). Semglee is U-100 in a 10 mL vial and a 3 mL pen. Toujeo is U-300 (300 units/mL) in a 1.5 mL SoloStar (450 units, up to 80 units per injection) and a 3 mL Max SoloStar (900 units, 2-unit steps, up to 160 units). Pen dose windows show units, so no conversion is done.
The labels approve insulin glargine to improve blood sugar control in diabetes: Lantus and Semglee in adults and children, Toujeo in adults and children 6 and older, and Basaglar in adults and children with type 1 and adults with type 2 diabetes. None is for treating diabetic ketoacidosis. Label dosing: one injection under the skin once a day at the same time each day, into the belly, thigh or upper arm, rotating sites. In type 1 diabetes the start is about one-third of the total daily insulin (one-third to one-half for Toujeo), with mealtime insulin for the rest. In type 2 diabetes not already on insulin, the start is 0.2 units/kg, or up to 10 units once a day for Lantus, Basaglar and Semglee. Toujeo doses are changed no more often than every 3 to 4 days; unit for unit it lowers glucose less than Lantus, and people switching to it needed higher doses in trials. Glargine is not given into a vein or by insulin pump, and not diluted or mixed with other insulins. None of the labels gives a missed-dose rule.
No glargine label has a boxed warning. Low blood sugar is the most common side effect of every insulin, and severe lows can cause seizures or death. The labels also warn: never share a pen, cartridge or syringe, even with a new needle; changes in insulin type, maker, strength or injection site are made under medical supervision with more glucose checks; insulin mix-ups have happened, so the label is checked before each injection; insulin can lower potassium; and heart failure can worsen when insulin is used with a thiazolidinedione such as pioglitazone. In the Lantus trials against NPH insulin, upper respiratory infection affected 22.4% vs 23.1% in type 1 diabetes, and injection site pain 2.7% vs 0.7%. Full numbers by brand: side effects of Lantus, Toujeo, Basaglar and Semglee; dosing schedules for Lantus, Toujeo, Basaglar and Semglee; missed doses for Lantus, Toujeo, Basaglar and Semglee; storage for Lantus, Toujeo, Basaglar and Semglee. Comparisons: Basaglar vs Lantus, Semglee vs Lantus, Basaglar vs Semglee, Toujeo vs Lantus, Lantus vs Tresiba, Humulin N vs Lantus and Soliqua vs Lantus.
None of the four glargine labels gives a half-life. The Lantus label says blood insulin stays fairly constant over 24 hours with no pronounced peak, unlike NPH insulin; in type 1 diabetes the median time to the end of its effect was 24 hours (range 10.8 to more than 24 hours, the end of the study), versus 14.5 hours for NPH. In the Basaglar study, insulin peaked at a median of 12 hours and fell to baseline by about 24 hours. The Toujeo label says its action builds over 6 hours, insulin peaks at a median of 12 to 16 hours depending on dose, and steady state takes at least 5 days.
Numbers shown are taken from the source above. Half-life varies from person to person.
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