INSULIN GLARGINE
(in'su-lin glar'geen)
Lantus
Classifications: hormones & synthetic substitutes; antidiabetic agent; insulin
Prototype: Insulin Injection
Pregnancy Category: C
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100 U/mL injection; 3 mL cartridge
A recombinant human insulin analog with a long duration of action. Enhances transmembrane passage of glucose across cell membranes.
Lowers blood glucose levels over an extended period of time by stimulating peripheral glucose uptake especially in muscle
and fat tissue. In addition, insulin inhibits hepatic glucose production.
Bedtime dosing of adults and children with type 1 diabetes, or adults with type 2 diabetes.
Prior hypersensitivity to insulin glargine; hypoglycemia.
Renal and hepatic impairment; pregnancy (category C), lactation; safety and efficacy in children <6 y of age are not established.
Type 1 Diabetes
Adult/Child: SC If not taking insulin, give 10 U at same time each day (usually at bedtime) once daily; if taking NPH or ultralente insulin once daily, give same dose at same time each day (usually at bedtime); if taking NPH insulin twice daily, give 80%
of total daily dose at same time each day (usually at bedtime)
Type 2 Diabetes
Adult: SC If already taking oral hypoglycemic drugs, start with 10 U at same time each day (usually at bedtime) once daily and adjust
according to patient's needs
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Subcutaneous
- Do not give this product IV.
- Give at same time each day (usually at bedtime) and do not mix with any other insulin product.
- Store in refrigerator at 2°–8° C (36°–46° F), may store at room temperature, 15°–30°
C (59°–86° F). Discard opened refrigerated vials after 28 d and unrefrigerated vials after 14 d. Do not expose
to excessive heat or sunlight, and do not freeze.
Body as a Whole: Allergic reactions. Endocrine: Hypoglycemia, hypokalemia. Skin: Injection site reaction, lipodystrophy, pruritus, rash.
Drug: oral antidiabetic agents, ace inhibitors, disopyramide, fluoxetine, mao inhibitors, propoxyphene, salicylates, sulfonamide antibiotics, octreotide may enhance hypoglycemia; corticosteroids, niacin, danazol, diuretics, sympathomimetic agents, phenothiazines, thyroid hormones, estrogens, progestogens, isoniazid, somatropin may decrease hypoglycemic effects; beta-blockers, clonidine, lithium, alcohol may either potentiate or weaken effects of insulin; pentamidine may cause hypoglycemia followed by hyperglycemia. Herbal: Garlic, ginseng may potentiate hypoglycemic effects.
Absorption: Slowly absorbed from SC injection site. Duration: 10.4–24 h. Metabolism: Metabolized primarily in liver to active metabolites.
Assessment & Drug Effects
- Monitor for S&S of hypoglycemia (see Appendix F), especially after changes in insulin dose or type.
- Lab tests: Monitor fasting blood glucose and HbA1C periodically.
- Withhold drug and notify physician if patient is hypokalemic.
Patient & Family Education
- Do not inject into areas with redness, swelling, itching, or dimpling.
- Absorption patterns for this drug are not dependent on the injection site.
- Ingest some form of sugar (e.g., orange juice, dissolved table sugar, honey) if symptoms of hypoglycemia develop; and seek
medical assistance.
- Check blood sugar as prescribed; notify physician of fasting blood glucose <80 and >120 mg/dL.
- Notify the physician of any of the following: fever, infection, trauma, diarrhea, nausea, or vomiting. Dosage adjustment may
be needed.
- Do not take any other medication unless approved by physician.
- Do not breast feed while taking this drug without consulting physician.
1%)
Canadian drug name; 
Prototype drug