Generic Name and Formulations:
Insulin glargine (recombinant) 100 Units/mL; inj; contains m-cresol.
Type 1 diabetes (in adults and children) and type 2 diabetes (in adults) when basal (long-acting) insulin is needed. Limitation of use: not for treating ketoacidosis.
Give once daily at same time each day; SC inj only. Onset 1.1hrs, no pronounced peak, duration 24hrs or longer. <6yrs: not recommended. ≥6yrs: individualize; monitor and adjust as needed. Switching from once-daily NPH or ultralente insulin: initial dose should be the same on a unit-for-unit basis. Switching from twice-daily NPH: reduce initial insulin glargine dose by 20% from previous total NPH dose. Insulin-naive, type 2 diabetics on oral antidiabetic: initially 10 Units; range 2–100 Units.
Instruct patients on diet, exercise, blood or urine testing, proper administration of insulin, change in species of origin, type or purity of insulin, and management of hypoglycemia. Dosage increase may be required during infection, illness, stress, trauma, and pregnancy. Dosage decrease may be needed with renal or hepatic dysfunction. Pregnancy (Cat.C). Nursing mothers.
Do not mix or dilute with other insulins. Potentiated by oral antidiabetic agents, pramlintide, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, propoxyphene, salicylates, somatostatin analog, sulfonamide antibiotics. Antagonized by corticosteroids, isoniazid, niacin, danazol, diuretics, phenothiazines, sympathomimetics, somatropin, thyroid hormones, estrogens, progestogens, atypical antipsychotics, protease inhibitors. Concomitant thiazolidinediones (TZDs) may cause fluid retention and heart failure; consider dose reduction or discontinue TZDs. Variable effects with β-blockers, clonidine, lithium salts, alcohol, pentamidine.
Pain, other inj site reactions, pruritus, rash, hypoglycemia, lipodystrophy, edema, weight gain.
Vials (10mL)—1; Lantus SoloStar pen (3mL)—5 (prefilled, disposable inj device)