Short answer: Toujeo and Lantus are both insulin glargine, taken once a day. Toujeo holds 300 units/mL and Lantus 100 units/mL.12 In the Toujeo label's 26-week trials against Lantus, A1c drops were similar, but people on Toujeo used 11% to 18% more basal insulin. Unit for unit, Toujeo lowers glucose less, so switching usually needs a higher dose.
| Toujeo (glargine U-300) | Lantus (glargine U-100) | |
|---|---|---|
| Strength and pens | 300 units/mL; SoloStar or Max SoloStar pen1 | 100 units/mL; vial or SoloStar pen2 |
| Approved for | Adults and children 6 and older with diabetes1 | Adults and children with diabetes2 |
| Schedule | Once a day at the same time1 | Once a day at the same time2 |
| Type 2 start, not on insulin | 0.2 units/kg once a day1 | 0.2 units/kg or up to 10 units once a day2 |
| Adult type 1 trial (26 weeks) | A1c change -0.40%1 | A1c change -0.44%1 |
| Adult type 2 trials (26 weeks) | A1c change -0.90%, -0.73%, -1.42%1 | A1c change -0.87%, -0.70%, -1.46%1 |
| Dose used in those trials | 11% to 18% more basal insulin than Lantus1 | The comparison group in those trials1 |
| Boxed warning | None1 | None2 |
The Toujeo label reports open-label, 26-week trials against Lantus in 546 adults and 463 children with type 1 diabetes and 2,474 adults with type 2. A1c and fasting glucose drops with Toujeo were similar to Lantus, each titrated to goal, and Toujeo met the non-inferiority margin in each trial. By the end, people were on a higher Toujeo dose: 11% to 18% more basal insulin across the adult trials.1 The label says no studies have been done to establish Toujeo's heart safety; the ORIGIN outcomes trial was done with Lantus, and the Toujeo label says it is unknown whether its results apply to Toujeo.1
From once-daily Lantus, Toujeo starts at the same unit dose, but the label says to expect a higher daily dose will be needed. Its effect builds over 6 hours and the full effect may take at least 5 days, and dose changes are made no more often than every 3 to 4 days.1 Any insulin change is made with your prescriber and closer glucose checks.
Low blood sugar is the most common side effect of both.12 More detail: Toujeo side effects, Lantus side effects, the Toujeo and Lantus dosing schedules, and the Lantus missed-dose page.