insulin glargine (Lantus): Drug Side Effects

What is insulin glargine, and how does it work (mechanism of action)?

Insulin glargine is a bioengineered (man-made) injectable form of long-acting insulin that is used to regulate sugar (glucose) levels in type 1 and type 2 diabetes. Individuals with type 1 diabetes do not produce insulin on their own; and individuals with type 2 diabetes do not produce enough insulin, or insulin is not as effective due to insulin resistance.

Insulin glargine works the same way as natural human insulin, but it's action lasts longer. It helps diabetic patients regulate glucose or sugar in the body. Insulin glargine works by promoting movement of sugar from blood into body tissues and also stops sugar production in liver. Insulin glargine is man-made insulin that mimics the actions of human insulin.

The FDA approved insulin glargine in April 2000.

What brand names are available for insulin glargine?

Lantus

Is insulin glargine available as a generic drug?

GENERIC AVAILABLE: No

Do I need a prescription for insulin glargine?

Yes

What are the side effects of insulin glargine?

Common side effects of insulin glargine are:

• Decreased blood sugar and injection site pain
• Water retention in the joints and weight gain

Local allergic reactions that may occur at the injection sites are:

• Rash
• Itching
• Redness
• Irritation

Long term use of insulin glargine can lead to thickening of fat tissues at the injection site.

Severe allergic reactions are:

• Swelling under the skin
• Very low blood pressure
• Bronchospasm (tightening of chest that leads to difficulty breathing)

Individuals should contact a healthcare professional if they experience any of the above reactions.

What is the dosage for insulin glargine?

• The starting dose should be individualized based on the type of diabetes and whether the patient is insulin-naïve.
• Administer subcutaneously once daily at any time of day, but at the same time every day.
• Rotate injection sites within an injection area (abdomen, thigh, or deltoid) to reduce the risk of lipodystrophy.
• Converting from other insulin therapies may require adjustment of timing and dose of Lantus. Closely monitor glucoses especially upon converting to Lantus and during the initial weeks thereafter.

Which drugs or supplements interact with insulin glargine?

There are many drugs that do not directly interfere with insulin glargine, but they may affect glucose breakdown in the body. This necessitates adjustments of insulin glargine doses.

Pramlintide (Symlin), disopyramide (Norpace), fenofibrate (Tricor), fluoxetine (Prozac), and aspirin can increase blood-sugar-lowering effect of insulin glargine.

Other drugs that can decrease the blood-sugar-lowering effect of insulin glargine are:

• Corticosteroids like prednisone (Deltasone) and hydrocortisone (Hytone);
• niacin (Niaspan),
• isoniazid,
• diuretics like hydrochlorothiazide (Microzide) and furosemide (Lasix);
• estrogens and progesterone in oral contraceptives, and
• albuterol (Proventil).

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Is insulin glargine safe to take if I’m pregnant or breastfeeding?

Safe and effective use of insulin glargine is not established for pregnant females.

It is not known whether insulin glargine enters breast milk; therefore, it should be used with caution in females who are breastfeeding.

What else should I know about insulin glargine?

What preparations of insulin glargine are available?

Insulin glargine is available as 100 units/ml. Insulin glargine is supplied in 10 ml vials, 3 ml SoloStar injectable pens, and a 3 ml cartridge system. Insulin glargine is given only by subcutaneous injection.

How should I keep insulin glargine stored?

• Unopened vials, SoloStar pens, and cartridge systems should be refrigerated between 2 C and 8 C (36 F and 46 F).
• Unopened vials, SoloStar pens, and cartridge systems, if refrigerated, are good until the expiration dates.
• Unopened vials, SoloStar pens, and cartridge systems, stored at room temperature, are good for 28 days.
• Opened vials and cartridge systems can be refrigerated or stored at room temperature below 30 C (86 F).
• Cartridge systems inserted into the insulin delivery device and SoloStar pens should be stored only at room temperature below 30 C (86 F).
• Opened vials, SoloStar pens, and cartridge systems are good for 28 days.