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When Should Lantus Be Given

Interactive Dosing Calculator

Interactive Dosing Calculator

Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day. Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis. Contraindications Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur. Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening. Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection. Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, treat and monitor until symptoms resolve. A reduction in the Lantus® dose may be re Continue reading >>

Lantus (insulin Glargine)

Lantus (insulin Glargine)

What is it used for? How does it work? Lantus vials, Lantus SoloStar pre-filled pens and Lantus penfill cartridges (for use with ClikSTAR or Autopen 24 pens) contain the active ingredient insulin glargine. They are used to treat diabetes. People with diabetes have a deficiency or absence of a hormone manufactured by the pancreas called insulin. Insulin is the main hormone responsible for the control of sugar (glucose) in the blood. People with type one diabetes need to have injections of insulin to control the amount of glucose in their bloodstream. Insulin injections act as a replacement for natural insulin and allow people with diabetes to achieve normal blood glucose levels. Insulin injections work in the same way as natural insulin, by binding to insulin receptors on cells in the body. Insulin causes cells in the liver, muscle and fat tissue to increase their uptake of glucose from the bloodstream. It also decreases the production of glucose by the liver, and has various other effects that lower the amount of glucose in the blood. Lantus contains a type of insulin called insulin glargine. This is known as a long-acting insulin. When injected under the skin it starts working within two to three hours and produces a steady effect for 25 hours. It is used to help provide background control of blood glucose throughout the day. Insulin glargine is normally used in combination with a short-acting insulin, which is given before meals to control the increasing blood glucose levels after eating. It is important to monitor your blood glucose regularly and adjust your insulin dose as required. Your doctor or diabetic team will explain how to do this. Keeping your blood glucose level as close to normal as possible, and not too high or too low, significantly reduces the risk of Continue reading >>

Lantus

Lantus

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. (lant-us) What is in this leaflet It does not contain all the available information. It does not take the place of talking to your doctor, pharmacist or diabetes educator. All medicines have risks and benefits. Your doctor has weighed the risks of you using Lantus against the benefits they expect it will have for you. If you have any concerns about using this medicine, ask your doctor or pharmacist. What Lantus is used for Lantus is used to reduce high blood sugar (glucose) levels in people with diabetes mellitus. Lantus is a modified insulin that is very similar to human insulin. It is a substitute for the insulin produced by the pancreas. Lantus is a long-acting insulin. Your doctor may tell you to use a rapid-acting human insulin or oral diabetes medication in combination with Lantus. Ask your doctor if you have any questions about why Lantus has been prescribed for you. Before you use Lantus When you must not use Lantus Some of the symptoms of an allergic reaction may include: If you have a lot of hypos discuss appropriate treatment with your doctor. After the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If you use Lantus after the expiry date has passed, it may not work as well. If it has expired or is damaged, return it to your pharmacist for disposal. If the product appears cloudy, discoloured or contains particles, or if the injection pen/cartridge/vial appears damaged. If you are not sure whether you should start using this medicine, talk to your doctor. There is no experience with the use of Lantus in children less than 6 years. Before you start to use Lantus Tell your doctor if you have allergies to any other medicines, foo Continue reading >>

Should Insulin Glargine Be Dosed Once Or Twice Daily?

Should Insulin Glargine Be Dosed Once Or Twice Daily?

Should Insulin Glargine Be Dosed Once or Twice Daily? Insulin glargine (Lantus, sanofi-aventis) claims to have a 24-hour duration of action. Is there any advantage to using it twice daily? If so, what patient population might benefit from twice-daily dosing? Response from Jenny A. Van Amburgh, PharmD, CDE Associate Clinical Professor, School of Pharmacy, Northeastern University, Boston, Massachusetts; Director of the Clinical Pharmacy Team and Residency Director, Harbor Health Services, Inc., Boston, Massachusetts Since its approval in April of 2000, insulin glargine has been used successfully in the treatment of sustained hyperglycemia in patients with type 1 or type 2 diabetes mellitus.[ 1 ] Long-acting insulin formulations such as glargine offer patients a steady, "peakless" 24-hour release of insulin for blood glucose control, in a convenient once-daily dosing schedule. Insulin glargine exerts its therapeutic effects by mimicking the basal secretion of pancreatic insulin to provide around-the-clock coverage for patients with elevated fasting plasma glucose levels. As with other diabetes treatments, the goal of insulin therapy is to prevent both microvascular (eg, retinopathy, neuropathy, nephropathy) and macrovascular (eg, stroke, myocardial infarction) outcomes. Although insulin glargine is US Food and Drug Administration-approved for once-daily dosing, the actual duration of action ranges from 10.8 to more than 24 hours in some patients.[ 1 , 2 ] This fairly wide range suggests that a second dose may be necessary to achieve optimal glycemic control, although this is considered off-label use.[ 3 , 4 ] To further investigate the variability in duration of action, an 8-week, 2-way crossover study was conducted in 20 patients with type 1 diabetes who used insulin asp Continue reading >>

Insulin Glargine (rdna Origin) Injection

Insulin Glargine (rdna Origin) Injection

Insulin glargine is used to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). It is also used to treat people with type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood) who need insulin to control their diabetes. In people with type 1 diabetes, insulin glargine must be used with another type of insulin (a short-acting insulin). In people with type 2 diabetes, insulin glargine also may be used with another type of insulin or with oral medication(s) for diabetes. Insulin glargine is a long-acting, manmade version of human insulin. Insulin glargine works by replacing the insulin that is normally produced by the body and by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Insulin glargine comes as a solution (liquid) to inject subcutaneously (under the Continue reading >>

Lantus (insulin Glargine) Side Effects

Lantus (insulin Glargine) Side Effects

What Is Lantus (Insulin Glargine)? Lantus is the brand name of insulin glargine, a long-acting insulin used to treat adults and children with type 1 diabetes mellitus and adults with type 2 diabetes mellitus to control high blood sugar. Lantus replaces the insulin that your body no longer produces. Insulin is a natural substance that allows your body to convert dietary sugar into energy and helps store energy for later use. In type 2 diabetes mellitus, your body does not produce enough insulin, or the insulin produced is not used properly, causing a rise in blood sugar. Like other types of insulin, Lantus is used to normalize blood sugar levels. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual dysfunction. Proper control of diabetes has also been shown to reduce your risk of a heart attack or stroke. Lantus is meant to be used alongside a proper diet and exercise program recommended by your doctor. Lantus is manufactured by Sanofi-Aventis. It was approved for use by the Food and Drug Administration (FDA) in 2000 as the first long-acting human insulin administered once a day with a 24-hour sugar-lowering effect. Lantus Warnings You will be taught how to properly inject this medication since that is the only way to use it. Do not inject cold insulin because this can be painful. Always wash your hands before measuring and injecting insulin. Lantus is always clear and colorless; look for cloudy solution or clumps in the container before injecting it. Do not use Lantus to treat diabetic ketoacidosis. A short-acting insulin is used to treat this condition. It is recommended that you take a diabetes education program to learn more about diabetes and how to manage it. Other medical problems may affect the use of this Continue reading >>

Pharmacokinetics And Pharmacodynamics Of Insulin Glargine Given In The Evening As Compared With In The Morning In Type 2 Diabetes

Pharmacokinetics And Pharmacodynamics Of Insulin Glargine Given In The Evening As Compared With In The Morning In Type 2 Diabetes

OBJECTIVE To compare pharmacokinetics (PK) and pharmacodynamics (PD) of insulin glargine in type 2 diabetes mellitus (T2DM) after evening versus morning administration. RESEARCH DESIGN AND METHODS Ten T2DM insulin-treated persons were studied during 24-h euglycemic glucose clamp, after glargine injection (0.4 units/kg s.c.), either in the evening (2200 h) or the morning (1000 h). RESULTS The 24-h glucose infusion rate area under the curve (AUC0–24h) was similar in the evening and morning studies (1,058 ± 571 and 995 ± 691 mg/kg × 24 h, P = 0.503), but the first 12 h (AUC0–12h) was lower with evening versus morning glargine (357 ± 244 vs. 593 ± 374 mg/kg × 12 h, P = 0.004), whereas the opposite occurred for the second 12 h (AUC12–24h 700 ± 396 vs. 403 ± 343 mg/kg × 24 h, P = 0.002). The glucose infusion rate differences were totally accounted for by different rates of endogenous glucose production, not utilization. Plasma insulin and C-peptide levels did not differ in evening versus morning studies. Plasma glucagon levels (AUC0–24h 1,533 ± 656 vs. 1,120 ± 344 ng/L/h, P = 0.027) and lipolysis (free fatty acid AUC0–24h 7.5 ± 1.6 vs. 8.9 ± 1.9 mmol/L/h, P = 0.005; β-OH-butyrate AUC0–24h 6.8 ± 4.7 vs. 17.0 ± 11.9 mmol/L/h, P = 0.005; glycerol, P < 0.020) were overall more suppressed after evening versus morning glargine administration. CONCLUSIONS The PD of insulin glargine differs depending on time of administration. With morning administration insulin activity is greater in the first 0–12 h, while with evening administration the activity is greater in the 12–24 h period following dosing. However, glargine PK and plasma C-peptide levels were similar, as well as glargine PD when analyzed by 24-h clock time independent of the time of administra Continue reading >>

Is There A Maximum Insulin Glargine (lantus) Dose?

Is There A Maximum Insulin Glargine (lantus) Dose?

Is there a maximum insulin glargine (Lantus) single-injection dose? Anecdotally, I have heard that patients receiving more than 50 units should split the dose from daily dosing to twice-daily. What’s the evidence? The question of a maximum insulin glargine dose is not straightforward because it encompasses several issues: How long does insulin glargine last? Does it ever need to be given twice-daily? Is there a difference in efficacy between daily and twice-daily insulin glargine dosing? Can you administer more than 50 units of insulin glargine as one single injection? Pharmacodynamics and Duration of Insulin Glargine In theory, insulin glargine should last a full 24 hours without a significant peak effect. Glargine forms a depot effect because it is only soluble at an acidic pH.1 In the vial (pH 4), the drug is completely soluble. Once injected, the solution is neutralized to biologic pH (7.4), which causes the insulin molecules to precipitate. These microprecipitates slowly dissolve over a 24-hour period. This slow dissolution results in a slower onset and a lack of a peak effect compared to other insulins, as shown below: Efficacy of Daily versus Twice-Daily Lantus Administration Although insulin glargine should last a full 24 hours, there is some evidence that its duration of action may be reduced to 20-23 hours, particularly following injection due to its delayed onset of activity of about 3-5 hours.2 Currently, the best estimate is that 15-30% of type-I diabetics will have pre-injection hyperglycemia and may benefit from twice-daily dosing. The idea of twice-daily dosing was explored in an 8-week, open-label crossover trial of 20 patients with type-I diabetes.2 Patients received either 100% of a pre-determined dose daily (dinner) or 50% twice-daily (breakfast an Continue reading >>

Lantus® Can Still Be Your Choice For A Once-daily Injection

Lantus® Can Still Be Your Choice For A Once-daily Injection

Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day. Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis. Contraindications Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients. Warnings and Precautions Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur. Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening. Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection. Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, treat and monitor until symptoms resolve. A reduction in the Lantus® dose may be re Continue reading >>

Lantus Dosing

Lantus Dosing

Well, I never thought I’d say this, but it’s a great week to be a person with Type 1 diabetes. With all of the bad news surrounding the Type 2 drug Avandia (rosiglitazone), it’s a relief to know I don’t have to worry about it. I recommended you read my colleague Tara’s blog entry (“Type 2 Drug Avandia Linked to Increased Risk of Heart Attacks”) for the full story. That’s one of the first times in my life I’ve referred to someone as a colleague. What can I say? It’s just not a word in my describe-a-friend/coworker vocabulary. While all of the controversy surrounds Avandia, I’m way over in Type 1 land contemplating whether or not to lower my daily dose of Lantus (insulin glargine). I’ve just started a brand new bottle of Lantus and I’ve been taking my normal 15 units in the morning and then eating a rather normal breakfast and lunch, but I’m still going low in the midmorning and early afternoon. This happened Monday after eating Brussels sprouts and whole-wheat pasta for lunch and only taking one unit of rapid-acting NovoLog (insulin aspart) to help out the Lantus. I’ve known for a while that my body is sensitive to insulin, but lately it’s been a little more sensitive than usual. I took 13 units of Lantus yesterday and my blood glucose was 86 mg/dl before lunch. I often wonder how much of an adjustment two units of Lantus is. While I’m very much locked in on an insulin-to-carbohydrate ratio with my NovoLog, it’s a bit tricky to judge how much the longer-lasting insulins affect your blood glucose. Is there a chart for your Lantus dose? I seem to remember something from when I was diagnosed. I wonder what Google will tell me to do. I realize that Lantus doesn’t have a true peak the way some of the other insulins do, but sometimes it su Continue reading >>

Lantus Side Effects

Lantus Side Effects

Generic Name: insulin glargine (IN su lin GLAR gine) Brand Names: Basaglar KwikPen, Lantus, Lantus Solostar Pen, Toujeo SoloStar What is Lantus? Lantus (insulin glargine) is a man-made form of a hormone that is produced in the body. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Insulin glargine is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours. Lantus is used to improve blood sugar control in adults and children with diabetes mellitus. Lantus is used to treat type 1 or type 2 diabetes in adults, and type 1 diabetes children who are at least 6 years old. Some brands of insulin glargine are for use only in adults. Carefully follow all instructions for the brand of insulin glargine you are using. Important information You should not use Lantus if you are having an episode of hypoglycemia (low blood sugar), or if you are in a state of diabetic ketoacidosis. Never share a Lantus injection pen or cartridge with another person. Sharing injection pens or cartridges can allow disease such as hepatitis or HIV to pass from one person to another. Lantus is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels. Before taking this medicine You should not use Lantus if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar). Lantus is not approved for use by anyone younger than 6 years old, and should not be used to treat type 2 diabetes in a child of any age. To make sure Lantus is safe for you, tell your docto Continue reading >>

What Are The Possible Side Effects Of Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?

What Are The Possible Side Effects Of Insulin Glargine (lantus, Lantus Opticlik Cartridge, Lantus Solostar Pen)?

LANTUS® (insulin glargine) Injection DESCRIPTION LANTUS (insulin glargine injection) is a sterile solution of insulin glargine for subcutaneous use. Insulin glargine is a recombinant human insulin analog that is a long-acting, parenteral blood-glucose-lowering agent [see CLINICAL PHARMACOLOGY]. Insulin glargine has low aqueous solubility at neutral pH. At pH 4 insulin glargine is completely soluble. After injection into the subcutaneous tissue, the acidic solution is neutralized, leading to formation of microprecipitates from which small amounts of insulin glargine are slowly released, resulting in a relatively constant concentration/time profile over 24 hours with no pronounced peak. This profile allows oncedaily dosing as a basal insulin. LANTUS is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of Escherichia coli (K12) as the production organism. Insulin glargine differs from human insulin in that the amino acid asparagine at position A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain. Chemically, insulin glargine is 21A-Gly-30Ba-L-Arg-3030b-L-Arg-human insulin and has the empirical formula C267H404N72O78S6 and a molecular weight of 6063. Insulin glargine has the following structural formula: LANTUS consists of insulin glargine dissolved in a clear aqueous fluid. Each milliliter of LANTUS (insulin glargine injection) contains 100 Units (3.6378 mg) insulin glargine. The 10 mL vial presentation contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg m-cresol, 20 mg glycerol 85%, 20 mcg polysorbate 20, and water for injection. The 3 mL prefilled pen presentation contains the following inactive ingredients per mL: 30 mcg zinc, 2.7 mg m-cresol, 20 mg glycerol 85%, and water for inje Continue reading >>

Lantus (insulin Glargine) Not Only For Bedtime?

Lantus (insulin Glargine) Not Only For Bedtime?

Physicians are pursuing several different possibilities of dosing that deviate from the FDA-approved instructions for Lantus dosing. Lantus is approved only for bedtime dosing. That’s because the pre-approval studies were conducted only using bedtime dosing, therefore the FDA approved the drug that way. But from experience, patients can also use Lantus in the morning. Lantus is a “peakless” insulin…giving steady concentrations throughout the day. But for some patients, it doesn’t last the full 24 hours. Morning dosing might be preferred for these patients. That way, Lantus wears off at night when insulin requirements are lower. Some patients use BID dosing if Lantus doesn’t last all day. Explain that the big advantage to Lantus is once daily dosing. Lantus (insulin glargine) is a recombinant human insulin analog with a duration of action up to 24 hours.1 The microprecipitates that are formed in the subcutaneous tissue after injection slow the absorption of Lantus and provide a relatively constant level of insulin over 24 hours without a pronounced peak.1 This prolonged effect over 24 hours enables it to be administered once daily. Lantus is FDA approved for once-daily subcutaneous administration at bedtime for adults and children six years of age and older with type 1 diabetes mellitus or adults with type 2 diabetes mellitus who require basal (long-acting) insulin for the control of hyperglycemia.1 When changing a patient (child >6 years or adult) from intermediate- or long-acting insulin to Lantus, the amount of short-acting insulin or oral antidiabetic agent may need to be adjusted. In premarketing studies, for patients using once-daily NPH or Ultralente insulin, the initial dose of Lantus was not changed. For patients using twice-daily NPH insulin, the in Continue reading >>

Levemir Vs. Lantus: Similarities And Differences

Levemir Vs. Lantus: Similarities And Differences

Levemir and Lantus are both long-acting injectable insulins that can be used for long-term management of diabetes. Insulin is a hormone that is naturally produced in the body by the pancreas. It helps convert the glucose (sugar) in your bloodstream into energy. This energy is then distributed to cells throughout your body. With diabetes, your pancreas produces little or no insulin or your body is unable to use the insulin correctly. Without insulin, your body can’t use the sugars in your blood and can become starved for energy. The excess sugar in your blood can also damage different parts of your body, including your blood vessels and kidneys. Everyone with type 1 diabetes and many people with type 2 diabetes must use insulin to maintain healthy blood sugar levels. Levemir is a solution of insulin detemir, and Lantus is a solution of insulin glargine. Both are basal insulin formulas. That means that they work slowly to lower your blood sugar levels. They’re both absorbed into your body over a 24-hour period. They keep blood sugar levels lowered for longer than short-acting insulins do. Although the formulations are slightly different, Levemir and Lantus are very similar drugs. There are only a few differences between them. Children and adults can use both Levemir and Lantus. Specifically, Levemir can be used by people who are 2 years or older. Lantus can be used by people who are 6 years or older. Levemir or Lantus can help with daily management of diabetes. However, you may still need to use short-acting insulin to treat spikes in your blood sugar levels and diabetic ketoacidosis (a dangerous buildup of acids in your blood). Learn more: All about diabetic ketoacidosis » Administration Both Levemir and Lantus are given through injection in the same way. You can gi Continue reading >>

When Should I Inject Lantus?

When Should I Inject Lantus?

Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. I was just wondering at what time people inject their Lantus? I've been injecting 18 units of Lantus at 10pm every night. I find that it generally keeps my BS level stable through the night but recently i've been having high BS levels at about 4pm. I've been told that Lantus tends to be less effective after about 18 hours so i'm wondering if this could be the reason for my late afternoon peaks. Does anyone inject in the morning for exactly this reason? I'm worried that if i start doing this then my night time sugars levels will become unstable. Is two injections the answer?? I was always told that Lantus didn't actually drop off, it lasted pretty much the whole day at a constant rate, though I think other people here will probably testify differently. You CAN split your dose into two injections, though in all honesty that rather defeats the point of lantus given that it's not supposed to peak or trough and therefore only need one jab a day. If, however, we assume that lantus does trough, as you suggest, why not put it to good use? Maybe try doing your lantus dose in the morning - that way, when it drops off after 18 hours, it'll be in the middle of the night, when your bg's at it's lowest anyway, so theoretically with lantus you won't go too high, and you'll also prevent night-time hypos too. Obviously though, talk to the relevent medical people first though. For some people Lantus lasts longer/shorter then others, it's really something you can't help. If I were you though, I would continue to take Lantus at 10pm since it helps you though the night and most of the day, but when you bolus for Continue reading >>

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