Short answer: Both contain insulin glargine, injected once a day.12 Soliqua 100/33 adds lixisenatide, a GLP-1 receptor agonist, and is for adults with type 2 diabetes at 15 to 60 units a day. Lantus is insulin glargine alone, for adults and children with diabetes. In a Soliqua label trial, nausea was 9.6% on Soliqua vs 3.6% on insulin glargine alone. Neither has a boxed warning.
| Soliqua 100/33 | Lantus | |
|---|---|---|
| What is in it | Insulin glargine 100 units and lixisenatide 33 mcg per mL1 | Insulin glargine 100 units per mL2 |
| Approved for | Adults with type 2 diabetes1 | Adults and children with diabetes2 |
| When injected | Once daily, within the hour before the first meal of the day1 | Once daily at any time of day, but the same time every day2 |
| Starting dose | 15 units, or 30 units for people on 30 to 60 units of basal insulin1 | Type 1: about one-third of total daily insulin. Type 2 without insulin: 0.2 units/kg or up to 10 units2 |
| Dose range | 15 to 60 units a day; changed by 2 to 4 units each week1 | Set for each person by blood sugar results2 |
| Study A (Soliqua label) | Nausea 9.6%, vomiting 3.2%1 | Insulin glargine alone: nausea 3.6%, vomiting 1.5%1 |
| Other common side effects | Pooled trials: nausea 10.0%, nasopharyngitis 7.0%, diarrhea 7.0%1 | Type 2 vs NPH insulin: upper respiratory infection 11.4% vs 13.3%, infection 10.4% vs 11.6%2 |
| Missed dose | Resume with the next scheduled dose; no extra or larger dose1 | No instruction in the label2 |
| Boxed warning | None1 | None2 |
Study A in the Soliqua label compared Soliqua with lixisenatide alone and with insulin glargine alone. Nausea was 9.6% on Soliqua, 24% on lixisenatide and 3.6% on insulin glargine; vomiting was 3.2%, 6.4% and 1.5%. Stomach and gut reactions were more frequent at the start of Soliqua treatment.1 The label names insulin glargine as the comparator, not the Lantus brand.
Both list low blood sugar as the most common reaction, plus allergic reactions, low potassium, medication mix-ups, never sharing pens, and heart failure risk with thiazolidinediones such as pioglitazone.12 Soliqua adds the GLP-1 warnings: pancreatitis, kidney injury from fluid loss, severe stomach reactions, gallbladder disease and breathing in stomach contents under anesthesia. More than 60 units a day can mean too much lixisenatide, and Soliqua is not used with other GLP-1 receptor agonists. People on basal insulin or a GLP-1 stop it before starting Soliqua.1
Which, if either, fits is for your prescriber. More detail: Soliqua side effects, Lantus side effects, the Soliqua and Lantus dosing schedules, the Soliqua and Lantus missed-dose pages, Soliqua vs Xultophy: how do the two insulin and GLP-1 pens differ? and Toujeo vs Lantus: how do the two insulin glargine strengths differ?.