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Lantus Onset Peak Duration

Lantus® Can Still Be Your Choice For A Product With Demonstrated Efficacy And Safety

Lantus® Can Still Be Your Choice For A Product With Demonstrated Efficacy And Safety

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 >>

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

Novolog® (insulin Aspart Injection) 100 U/ml Indications And Usage

NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. NovoLog® (insulin aspart injection) 100 U/mL is an insulin analog indicated to improve glycemic control in adults and children with diabetes mellitus. NovoLog® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to NovoLog® or one of its excipients. Never Share a NovoLog® FlexPen, NovoLog® FlexTouch®, PenFill® Cartridge, or PenFill® Cartridge Device Between Patients, even if the needle is changed. Patients using NovoLog® vials must never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens. Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously under close medical supervision and the frequency of blood glucose monitoring should be increased. Hypoglycemia is the most common adverse effect of insulin therapy. The timing of hypoglycemia may reflect the time-action profile of the insulin formulation. Glucose monitoring is re Continue reading >>

Insulin Onset, Peak, Duration

Insulin Onset, Peak, Duration

Section Question Answer Lispro insulin (humalog) onset 15 min before meals Rapid 15 to 30 min Lispro insulin (humalog) peak 1/2 to 2.5 hr Lispro insulin (humalog) duration Short, rapid acting: 3-6.5 hr Aspart insulin (Novolog) onset 5 to 10 min before meals Rapid 10 to 20 min Aspart insulin (Novolog) Peak 1 to 3 hr Aspart insulin (Novolog) duration Short, rapid acting (3 to 5 hr) Regular insulin (Humulin R, Novolin R) 30 min ac. onset 30 to 60 min Regular insulin (Humulin R, Novolin R) peak 1 to 5 hr Regular insulin (Humulin R, Novolin R) Duration Short, slower acting 6-10 hr NPH insulin (Humulin N, Novolin N) two times per day same time onset 1 to 2 hr NPH insulin (Humulin N, Novolin N) peak 6 to 14 hr NPH insulin (Humulin N, Novolin N) duration Intermediate: 16 to 24 hrs Glardine insulin (Lantus) one/day same time onset 70 min Glardine insulin (Lantus peak none Glardine insulin (Lantus) Duration Long (24 hr) memorize Continue reading >>

Long-acting Insulin: How It Works

Long-acting Insulin: How It Works

When you eat, your pancreas releases a hormone called insulin. Insulin moves sugar (glucose) from your blood to your cells for energy or storage. If you take insulin, you may need some at mealtime to help lower your blood sugar after you eat. But even between meals, you need insulin in small amounts to help keep blood sugar stable. This is where long-acting insulin comes in. If you have diabetes, either your pancreas can’t produce enough (or any) insulin, or your cells can’t use it efficiently. To control your blood sugar, you need to replace or supplement the normal function of your pancreas with regular insulin injections. Insulin comes in many types. Each type differs in three ways: onset: how quickly it starts working to lower your blood sugar peak: when its effects on your blood sugar are strongest duration: how long it lowers your blood sugar According to the U.S. Food and Drug Administration (FDA), the five types of insulin are: Rapid-acting insulin: This type starts to work just 15 minutes after you take it. It peaks within 30 to 90 minutes, and its effects last for three to five hours. Short-acting insulin: This type takes about 30 to 60 minutes to become active in your bloodstream. It peaks in two to four hours, and its effects can last for five to eight hours. It is sometimes called regular-acting insulin. Intermediate-acting insulin: The intermediate type takes one to three hours to start working. It peaks in eight hours and works for 12 to 16 hours. Long-acting insulin: This type takes the longest amount of time to start working. The insulin can take up to 4 hours to get into your bloodstream. Pre-mixed: This is a combination of two different types of insulin: one that controls blood sugar at meals and another that controls blood sugar between meals. Lo Continue reading >>

Long-acting Insulins

Long-acting Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Drug UPDATES: TRESIBA ®- insulin degludec injection [Drug information / PDF] Click link for the latest monograph Dosing: Click (+) next to Dosage and Administration section (drug info link) Initial U.S. Approval: 2015 Mechanism of Action: The primary activity of insulin, including TRESIBA, is regulation of glucose metabolism. Insulin and its analogs lower blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin also inhibits lipolysis and proteolysis, and enhances protein synthesis. TRESIBA forms multi-hexamers when injected into the subcutaneous tissue resulting in a subcutaneous insulin degludec depot. The protracted time action profile of TRESIBA is predominantly due to delayed absorption of insulin degludec from the subcutaneous tissue to the systemic circulation and to a lesser extent due to binding of insulin-degludec to circulating albumin. INDICATIONS AND USAGE: TRESIBA is indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use TRESIBA is not recommended for the treatment of diabetic ketoacidosis. Dosing: Individualize dose based on type of diabetes, metabolic needs, blood glucose monitoring results and glycemic control goal. Rotate injection sites to reduce the risk of lipodystrophy. Do not dilute or mix with any other insulin or solution. Administer subcutaneously once daily at any time of day. Do NOT perform dose conversion when using the TRESIBA U-100 or U-200 FlexTouch pens. The TRESIBA U-100 and U-200 FlexTouch pens dose window shows the number of insulin units to be delivered and NO conversion is needed. HOW SUPPLIE Continue reading >>

Key Facts About Basaglar: A Less Expensive Long-acting Insulin

Key Facts About Basaglar: A Less Expensive Long-acting Insulin

If you’ve been using a long-acting insulin like Lantus, you might have heard about a friendly competitor called Basaglar which is coming soon to pharmacies. Basaglar is insulin glargine known as a biosimilar (also called a follow-on biologic). Because of the manufacturing process it isn’t considered a generic, but there are no differences from Lantus in regard to safety, purity and potency. To get to know Basaglar better, here are some details you’ll want to be aware of. What is the difference between a biosimilar and a generic? Generic drugs are copies of a brand name drug, and their manufacturing process can be replicated exactly through chemical reactions. Biologics are made using manufacturing processes and living organisms that are unique to each manufacturer. Therefore, it is not really possible to make an exact copy of a biologic. For an in-depth look at the definition of biosimilar, see here. Is Basaglar less expensive than Lantus? The cost of Basaglar is estimated to be about 20% cheaper than Lantus. It is manufactured by Eli Lilly as a KwikPen. Basaglar won’t be sold in a vial form. Will my insurance switch me to Basaglar? In some cases, yes. CVS Health has announced that Basaglar will be on formulary in place of Lantus. Is it really equivalent to Lantus? Yes, the onset, peak and duration of action are almost identical. Will my dose be the same as the insulin I’m currently taking? Your healthcare provider will tell you exactly how to make the switch. In general, Lantus and Basaglar can be interchanged unit for unit. If you were on Levemir, the conversion will also be unit for unit. If you were taking Levemir twice a day, the total number of units will likely be given as one Basaglar injection. If you are switching from Toujeo or NPH, your dose might Continue reading >>

What Is Lantus Insulin Glargine?: Onset, Peak Time And Duration

What Is Lantus Insulin Glargine?: Onset, Peak Time And Duration

What is Lantus Insulin Glargine? Lantus is a long acting insulin that helps blood glucose get into the cells for energy. Lantus is the brand name of insulin glargine. Insulin glargine works by lowering high blood glucose levels in people with diabetes. It replaces the insulin we naturally make. Insulin is a natural hormone that helps our body to convert glucose into energy and store glucose in the form of glycogen for later use. People who are diabetic cannot make enough insulin or use it properly. As a result, glucose cannot be used or stored properly, which leads to a build up of glucose in the bloodstream. Injecting insulin glargine can help lower blood glucose to normal level. This medication is used to treat type 2 diabetes in adults and type 1 diabetes in adults and children who have reached the age of 6 years. Lantus onset, peak time and duration Lantus or insulin glargine refers to a man made hormone that is naturally produced in the body. This medication is used to treat both type 1 and type 2 diabetes. Lantus onset refers to how quickly insulin glargine starts to work in the body. As a long acting insulin, the medication onset is about one and a half hours and can last up to 24 hours. The drug peak refers to how long it takes before this medication achieves the maximum effects in the body. The lantus peak is 6 hours. Insulin glargine is a part of a treatment program that includes diet, exercise, weight control and testing your blood glucose. Make sure you follow the program as it is instructed by your doctor Storage Lantus should be stored in its original container and kept away from heat and light. You are not supposed to freeze this medication. In case of frozen lantus, you should throw it away. Ask your doctor how to properly dispose the medication. Do not Continue reading >>

Types Of Insulin For Diabetes Treatment

Types Of Insulin For Diabetes Treatment

Many forms of insulin treat diabetes. They're grouped by how fast they start to work and how long their effects last. The types of insulin include: Rapid-acting Short-acting Intermediate-acting Long-acting Pre-mixed What Type of Insulin Is Best for My Diabetes? Your doctor will work with you to prescribe the type of insulin that's best for you and your diabetes. Making that choice will depend on many things, including: How you respond to insulin. (How long it takes the body to absorb it and how long it remains active varies from person to person.) Lifestyle choices. The type of food you eat, how much alcohol you drink, or how much exercise you get will all affect how your body uses insulin. Your willingness to give yourself multiple injections per day Your age Your goals for managing your blood sugar Afrezza, a rapid-acting inhaled insulin, is FDA-approved for use before meals for both type 1 and type 2 diabetes. The drug peaks in your blood in about 15-20 minutes and it clears your body in 2-3 hours. It must be used along with long-acting insulin in people with type 1 diabetes. The chart below lists the types of injectable insulin with details about onset (the length of time before insulin reaches the bloodstream and begins to lower blood sugar), peak (the time period when it best lowers blood sugar) and duration (how long insulin continues to work). These three things may vary. The final column offers some insight into the "coverage" provided by the different insulin types in relation to mealtime. Type of Insulin & Brand Names Onset Peak Duration Role in Blood Sugar Management Rapid-Acting Lispro (Humalog) 15-30 min. 30-90 min 3-5 hours Rapid-acting insulin covers insulin needs for meals eaten at the same time as the injection. This type of insulin is often used with Continue reading >>

Comparison Of Insulin Therapies

Comparison Of Insulin Therapies

BACKGROUND: Insulin is a common therapy in the treatment of diabetes mellitus type 1 and 2. With the advent of intermediate-acting and long-acting insulin products, basal insulin therapy has become a common practice usually utilized to reduce the number of injections needed to administer or in combination with a short-acting insulin product in the basal–bolus insulin regimens. The original insulins created to have longer durations of action were the NPH insulins which utilized a crystalline complex between the insulin and protamine.2 In more recent years, newer basal insulins such as Levemir and Lantus have come onto the market which do not rely on the use of protamine-insulin complexes and also claim to last longer (possibly up to single dose a day administration) with no peak activity. The lack of peak activity promises to reduce hypoglycemia risk and to provide a more basal-like dosing.1,3 The original insulins used as bolus insulin therapy were isolated from either animal or human sources. Today, the standard of isolated insulin therapies is regular human insulin. Like the long acting insulin products, recent years have seen the emergence of rapid acting insulin analogues. These rapid insulins promise to have higher efficacy and safety due to rapid onset (for meal time administration) and shorter duration of action.1,4,5 While the newer insulin products claim to have benefits of duration of action and less risk of hypoglycemia, they come at a higher cost than the regular human insulin and NPH insulin products. The average patient admitted to hospice care usually does not have insulin therapy related to the terminal diagnosis — with some obvious exceptions such as pancreatic cancer. The following is an analysis of the benefits and claimed convenience of the newer Continue reading >>

Typically, Flexible Insulin Therapy (fit) Involves Multiple Daily Injections Of Insulin:

Typically, Flexible Insulin Therapy (fit) Involves Multiple Daily Injections Of Insulin:

Typically, flexible insulin therapy (FIT) involves multiple daily injections of insulin: One or two injections of intermediate or long-acting insulin each day. One injection is often taken at supper or bedtime. Another injection may be taken before breakfast. These injections keep a constant, low level of insulin in the bloodstream. (We call this a "basal level" of insulin.) Rapid- or short-acting insulin is taken before every meal. This injection delivers a quick insulin peak (called a "bolus") to cover the carbohydrates in the meal. By injecting fast-acting and long-acting insulin at different times during the day, you can copy the behavior of a healthy pancreas. Chart: Time-Action of Different Insulins Rapid Acting Insulin Brand Name (type) Onset of action Peak of action Duration Humalog® (lispro) 5 to 15 minutes 30 to 60 minutes 3 to 5 hours Novorapid® (aspart) 5 to 15 minutes 30 to 60 minutes 3 to 5 hours Rapid Acting Insulin Brand Name (type) Onset of action Peak of action Duration Humulin® R (Regular) 1 to 2 hours 3 to 5 hours 6 to 8 hours Novolin® R (Regular) 30 minutes 2 to 3 hours 3 to 6 hours Intermediate Insulin Brand Name (type) Onset of action Peak of action Duration Humulin® N (NPH) 2 to 3 hours 8 to 10 hours 12 to 16 hours Novolin® N (NPH) 2 to 4 hours 4 to 12 hours 12 to 18 hours Long Acting Insulin Brand Name (type) Onset of action Peak of action Duration Lantus® (Glargine) 1 hour Almost no peak 24 hours Levemir® (Detemir) 1 hour Almost no peak 24 hours Some people are able to reduce the number of daily injections by combining two types of insulin in one syringe. However, some insulins (such as Lantus), cannot be combined with other insulins. Insulin Doses Initially, your doctor will calculate how many units of insulin you should take throughou Continue reading >>

Humulin N

Humulin N

HUMULIN® N (human insulin [rDNA origin]) isophane) Suspension DESCRIPTION HUMULIN N (human insulin [rDNA origin] isophane) suspension is a human insulin suspension. Human insulin is produced by recombinant DNA technology utilizing a non-pathogenic laboratory strain of Escherichia coli. HUMULIN N is a suspension of crystals produced from combining human insulin and protamine sulfate under appropriate conditions for crystal formation. The amino acid sequence of HUMULIN N is identical to human insulin and has the empirical formula C257H383N65O77S6 with a molecular weight of 5808. HUMULIN N is a sterile white suspension. Each milliliter of HUMULIN N contains 100 units of insulin human, 0.35 mg of protamine sulfate, 16 mg of glycerin, 3.78 mg of dibasic sodium phosphate, 1.6 mg of metacresol, 0.65 mg of phenol, zinc oxide content adjusted to provide 0.025 mg zinc ion, and Water for Injection. The pH is 7.0 to 7.5. Sodium hydroxide and/or hydrochloric acid may be added during manufacture to adjust the pH. Continue reading >>

Insulin Action

Insulin Action

Insulin is a medicine that lowers blood glucose (sugar). There are several types of insulin. Each type of insulin has a certain time period in which it works. In order to understand insulin action, it is helpful to know the onset, peak and duration of the insulin you take. Onset refers to when the insulin starts to work. Peak refers to when the insulin works hardest. Duration refers to how long the insulin works. You are more likely to have a low blood glucose when your insulin is peaking, during periods of increased physical activity or if you are eating less food. If you are having problems with low blood glucose, talk to your healthcare provider about adjusting your insulin. Usual Action Times of Insulin PRODUCT WHEN TO TAKE ONSET PEAK DURATION Rapid-Acting Lispro (Humalog) Aspart (Novolog) Glulisine (Apidra) 0-15 min before meal 10-30 min 30 min - 3 hours 3-5 hours Short-Acting Regular (R) Human 30 min before meal 30-60 min 2-5 hours Up to 12 hours Intermediate-Acting NPH (N) Human Does not need to be given with meal 90 min - 4 hours 4-12 hours Up to 24 hours Long Acting Glargine (Lantus) Detemir (Levemir) Does not need to be given with meal 45 min - 4 hours Minimal Up to 24 hours Continue reading >>

Insulin Glargine

Insulin Glargine

Pronunciation (IN soo lin GLAR jeen) Index Terms Glargine Insulin Dosage Forms Excipient information presented when available (limited, particularly for generics); consult specific product labeling. Solution, Subcutaneous: Lantus: 100 units/mL (10 mL) [contains metacresol] Solution Pen-injector, Subcutaneous: Basaglar KwikPen: 100 units/mL (3 mL) [contains metacresol] Lantus SoloStar: 100 units/mL (3 mL) [contains metacresol] Toujeo SoloStar: 300 units/mL (1.5 mL) [contains metacresol] Brand Names: U.S. Basaglar KwikPen Lantus Lantus SoloStar Toujeo SoloStar Pharmacologic Category Insulin, Long-Acting Pharmacology Insulin acts via specific membrane-bound receptors on target tissues to regulate metabolism of carbohydrate, protein, and fats. Target organs for insulin include the liver, skeletal muscle, and adipose tissue. Within the liver, insulin stimulates hepatic glycogen synthesis. Insulin promotes hepatic synthesis of fatty acids, which are released into the circulation as lipoproteins. Skeletal muscle effects of insulin include increased protein synthesis and increased glycogen synthesis. Within adipose tissue, insulin stimulates the processing of circulating lipoproteins to provide free fatty acids, facilitating triglyceride synthesis and storage by adipocytes; also directly inhibits the hydrolysis of triglycerides. In addition, insulin stimulates the cellular uptake of amino acids and increases cellular permeability to several ions, including potassium, magnesium, and phosphate. By activating sodium-potassium ATPases, insulin promotes the intracellular movement of potassium. Normally secreted by the pancreas, insulin products are manufactured for pharmacologic use through recombinant DNA technology using either E. coli or Saccharomyces cerevisiae. Insulin glargine Continue reading >>

Types Of Insulin

Types Of Insulin

Topic Overview Insulin is used to treat people who have diabetes. Each type of insulin acts over a specific amount of time. The amount of time can be affected by exercise, diet, illness, some medicines, stress, the dose, how you take it, or where you inject it. Insulin strength is usually U-100 (or 100 units of insulin in one millilitre of fluid). Short-acting (regular) insulin is also available in U-500. This is five times more concentrated than U-100 regular insulin. Long-acting insulin (glargine) is also available in U-300. This is three times more concentrated than U-100 long-acting insulin. Be sure to check the concentration of your insulin so you take the right amount. Insulin is made by different companies. Make sure you use the same type of insulin consistently. Types of insulinfootnote 1 Type Examples Appearance When it starts to work (onset) The time of greatest effect (peak) How long it lasts (duration) Rapid-acting Apidra (insulin glulisine) Clear 10-15 minutes 1-1.5 hours 3-5 hours Humalog (insulin lispro) Clear 10-15 minutes 1-2 hours 3.5-4.75 hours NovoRapid (insulin aspart) Clear 10-15 minutes 1-1.5 hours 3-5 hours Short-acting Humulin R, Novolin ge Toronto (insulin regular) Clear 30 minutes 2-3 hours 6.5 hours Intermediate-acting Humulin N, Novolin ge NPH(insulin NPH) Cloudy 1-3 hours 5-8 hours Up to 18 hours Long-acting Lantus (insulin glargine) Clear 1.5 hours Does not apply Up to 24 hours Levemir (insulin detemir) Clear 1.5 hours Does not apply 16 to 24 hours Toujeo (insulin glargine U-300) Clear Up to 6 hours Does not apply Up to 30 hours Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal. Rapid-acting insulin acts most like insulin that is produced by Continue reading >>

In This Pharmacokinetics/pharmacodynamics Study, Toujeo® Demonstrated A Glucose-lowering Effect That Lasted Up To 36 Hours1

In This Pharmacokinetics/pharmacodynamics Study, Toujeo® Demonstrated A Glucose-lowering Effect That Lasted Up To 36 Hours1

Toujeo® is a long-acting human insulin analog indicated to improve glycemic control in adults with diabetes mellitus. Limitations of Use: Toujeo® is not recommended for treating diabetic ketoacidosis. Contraindications Toujeo® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or any of its excipients. Warnings and Precautions Toujeo® contains the same active ingredient, insulin glargine, as Lantus®. The concentration of insulin glargine in Toujeo® is 300 Units per mL. Insulin pens and needles must never be shared between patients. Do NOT reuse needles. Monitor blood glucose in all patients treated with insulin. Modify insulin regimens 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. Changes in insulin regimen may result in hyperglycemia or hypoglycemia. Unit for unit, patients started on, or changed to, Toujeo® required a higher dose than patients controlled with Lantus®. When changing from another basal insulin to Toujeo®, patients experienced higher average fasting plasma glucose levels in the first few weeks of therapy until titrated to their individualized fasting plasma glucose targets. Higher doses were required in titrate-to-target studies to achieve glucose control similar to Lantus®. Hypoglycemia is the most common adverse reaction of insulin therapy, including Toujeo®, 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 bef Continue reading >>

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