Indications for LANTUS:
Type 1 diabetes (in adults and children) and type 2 diabetes (in adults) when basal (long-acting) insulin is needed.
Limitations of Use:
Not for treating diabetic ketoacidosis.
Adults and Children:
Give by SC inj once daily at same time each day into abdominal area, thigh, or deltoid; rotate inj sites. Onset ~1hr, no pronounced peak, duration ≥24hrs. <6yrs: not established. ≥6yrs: individualize; monitor and adjust as needed. Type 1 diabetes: Initially ⅓ of total daily insulin dose. Give remainder of the total dose as short-acting, premeal insulin. Insulin-naïve with type 2 diabetes: Initially 0.2 Units/kg or up to 10 Units once daily. May need to adjust amount, timing of short- or rapid-acting insulins and doses of any oral antidiabetics. Switching from once-daily Toujeo (insulin glargine 300 Units/mL): reduce initial Lantus dose by 20% of the previous Toujeo dose. Switching from a long- or intermediate-acting insulin regimen: may need to change basal insulin dose; and adjust the amount, timing of the short-acting insulins and doses of any oral antidiabetics. Switching from once-daily NPH: initial Lantus dose should be the same as previous NPH dose. Switching from twice-daily NPH: reduce initial Lantus dose by 20% of the previous total NPH dose.
During episodes of hypoglycemia.
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. Do not reuse or share pens, needles, or syringes between patients, even if the needle is changed. Do not inject into areas of lipodystrophy or localized cutaneous amyloidosis. Increased risk of hyperglycemia or hypoglycemia if changes in physical activity, meal patterns, renal or hepatic function, insulin regimen, administration site, and if acute illness occurs: monitor glucose more frequently and may need to adjust dose. Discontinue if hypersensitivity reactions occur. Monitor potassium levels in patients at risk for hypokalemia (eg, concomitant K+-lowering or K+-sensitive drugs). Pregnancy. 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.
Hypoglycemia, local or systemic allergy, inj site reactions, lipodystrophy, pruritus, rash, edema, weight gain; hypokalemia.
Generic Drug Availability:
Vials (10mL)—1; Lantus SoloStar prefilled pens (3mL)—5