Lantus Insulin

Lantus insulin is long-acting insulin that resembles the insulin made by the human body, except for little change in the insulin protein. It was approved by the FDA in 2000 for use in anyone with type 1 diabetes and only adults with type 2 diabetes. It is formulated in 100 units/mL solution for injection. It is injected once a day into the fat layer under the skin. This insulin is also called insulin glargine.

How Lantus Insulin is Supplied

  • 10ml vial
  • 3ml OptiClik insulin delivery cartridge.
  • 3ml Solostar device

How to Use Lantus Insulin

  • The doctor orders the starting dose and adjusts the dose based on the patient's blood sugar. The usual starting dose is 10 units, but this may vary, depending on the patient's need. The doctor may switch a patient from another kind of insulin to insulin glargine. When the doctor switches a patient from once daily dose of NPH, she usually replaces it with the same dose of insulin glargine. However, when she switches the patient from twice a day NPH dose, she usually starts the patient on 80% of the total daily dose of NPH.
  • The patient should closely check and monitor the finger stick blood sugar about 4 times a day initially. The number of times the patient checks finger-stick blood sugar may decrease as the insulin dose and blood sugar stabilize.
  • Keep the Lantus insulin vial in the refrigerator, open vials that are in use can be kept on room temperature for up to 30 days.
  • Inject the insulin into the fat layer of the upper arm, thighs or abdomen, as instructed by your healthcare personnel.
  • Check the insulin label during each administration to make sure that you have the correct insulin.
  • Rotate the injection site each time to prevent the thickening or thinning of the fat layer where insulin is injected. This change in the fat layer is called lipodystrophy.
  • Inject Lantus insulin once a day at the same time. Choose either mornings or evenings for injection. This is because it works for 24 hours and changing the administration time will affect the dose available in the blood and can result in overdose.
  • Use sterile insulin injection needles.
  • Dispose of the injection needles into secure containers. This protects you and others from needle-stick injury and stops the spread of diseases.
  • In addition to taking glargine, patients with type 1 diabetes should also use short-acting insulin before meals, as ordered by their doctor. This is because glargine releases constantly during the day and does not have peaks to accommodate after meal blood sugar spikes.
  • The doctor may reduce the insulin glargine dose in patients with reduced kidney or liver function. This is because insulin may stay longer in the blood of these patients because of reduced metabolism and clearance.
  • The dose of glargine may need to be adjusted during illness.
  • Do not give glargine to people in diabetic ketoacidosis or metabolic acidosis. IV short acting insulin like regular insulin and Humalog are needed to treat diabetic coma.
  • Do not give to people who are allergic to Lantus.
  • Do not mix glargine with any other insulin preparation.
  • Do not administer glargine by intravenous or IV route.
  • Do not administer glargine with insulin pump.
  • Do not inject into the muscle.
  • Do not repeat administration on the same site.
  • Do not Freeze insulin glargine.
  • Do not change the time of administration from one day to another.

Adverse Reactions Of Lantus Insulin

Adverse reactions of Lantus is the same as other insulin preparations. A major difference is that insulin glagine can cause hypoglycemia for a prolonged period because of its increased length of action.

Adverse Reactions:

  • Hypoglycemia or low blood sugar.
  • Allergic reactions like itch, rash and even anaphylaxis.
  • Upper respiratory infection.
  • Infection.
  • Headache.
  • Weight gain.
  • Peripheral edema
  • Hypertension.

In pregnancy, the doctor may decide to prescribe glargine if the benefit outweighs the potential risk to the baby. The risk to human fetus has not been studied.

Glargine should be carefully dosed in breastfeeding mothers because it is released into breast milk.

Glargine has not been studied in children with type 2 diabetes and those with type 1 diabetes who are less than 6 years of age.

Drug Interactions:

 Oral diabetes medications, ACE inhibitors, salicylates like aspirin, and other medications like fluoxetine, monoamine oxidase inhibitors, propoxyphene, sulfonamide antibiotics and other drugs that lower blood sugar may cause the hypoglycemia in patients using Lantus.

  • Medications that increase blood sugar may cause hyperglycemia in patients who are taking Lantus. Examples of these medications are corticosteroids like prednisone, others are  diuretics, niacin, albuterol, epinephrine, glucagon, isoniazid, thyroid hormones, oral contraceptives, olanzapine, and clozapine.
  • Lantus insulin may also interact with alcohol, clonidine, beta blockers, and lithium and this may either increase or decrease the blood sugar depending on situation.
  • Reserpine , beta blockers and clonidine may reduce the symptoms of hypoglycemia, which could result in untreated hypoglycemia and insulin shock.

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