Lantus Solostar Pens (Insulin Glargine)

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Lantus Solostar Pens (Insulin Glargine) Dosage and Side Effects

LANTUS is a recombinant human insulin analogue that is a long-acting blood-glucose-lowering agent administered subcutaneously (under the skin) once a day.

Proper Use of this medication

Dosage:

The dosage of LANTUS should be individualized and determined based on your health professional’s advice in accordance with your needs. You may take LANTUS at any time during the day, but you must take it at the same time every day.

Many factors may affect your usual LANTUS dose, which may include changes in your diet, activity, or work schedule. Follow your health professional’s instructions carefully. Consult your health professional if you notice your insulin requirements changing markedly. Other factors that may affect your dose of insulin or your need to do additional blood/urine testing are:

Illness:

Illness, especially with nausea and vomiting, diarrhea and/or fever, may change how much insulin you need. Even if you are not eating, you will still require insulin. You and your health professional should establish a sick day plan for you to use in case of illness. When you are sick, test your blood/urine frequently and call your health professional as instructed.

Pregnancy:

If you are planning to have a baby, are pregnant, or are nursing a baby, consult your health professional. Good control of diabetes is especially important for you and your unborn baby. Pregnancy may make managing your diabetes more difficult.

Medication:

Always discuss any medications you are taking, prescription or “over-the-counter”, with your health professional. To prevent drug interactions, volunteer the names of everything you are taking even before they ask if there have been any changes. Insulin requirements may be increased in the presence of drugs with hyperglycemic activity, such as oral contraceptives (for example, birth control pills, injections and patches), and hormone replacement therapies, corticosteroids, thyroid replacement therapy, and sympathomimetic agents such as decongestants and diet pills. Insulin requirements may be reduced in the presence of drugs with hypoglycemic activity, such as oral antidiabetic agents, salicylates (for example, aspirin), sulfa antibiotics, blood pressure medications including ACE inhibitors, and certain psychiatric medications including MAO inhibitors or antidepressants and anti-anxiety medications.

Substances such as beta-blockers (medicines used for conditions including blood pressure, heart arrhythmias, palpitations and headache) and alcohol may enhance or weaken the blood-glucose-lowering effect of insulins, and signs of hypoglycemia may be reduced or absent, as well.

Exercise:

If your exercise routine changes, discuss with your health professional the possible need to adjust your insulin regimen. Exercise may lower your body's need for insulin during, and for some time after, the activity. As for all insulins, the rate of absorption, and consequently the onset and duration of action, may be affected by exercise and other variables.

Travel:

Consult your health professional concerning possible adjustments in your insulin schedule if you will be traveling across time zones. You may want to take along extra insulin and supplies whenever you travel.

Overdose:

If you have injected too much LANTUS, your blood sugar level may become too low (hypoglycemia). Check your blood sugar frequently. In general, to prevent hypoglycemia you must eat more food and monitor your blood sugar.

Hypoglycemia may occur as a result of an excess of insulin relative to food intake, energy expenditure or both.

In case of drug overdose, contact a health professional, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.

Missed dose:

If you have missed a dose of LANTUS or if you have not injected enough insulin, your blood sugar l
evel may become too high (hyperglycemia). Check your blood sugar frequently.

Do not take a double dose to make up for a forgotten dose.

Side Effects

Severe hypoglycemia may require the assistance of another person. Patients who are unable to take sugar orally or who are unconscious may require an injection of glucagon or should be treated with intravenous administration of glucose by medical personnel. Without immediate medical help, serious reactions or even death could occur.

Hyperglycemia can be mild or severe. It can progress to high glucose levels, diabetic ketoacidosis (DKA), and result in unconsciousness and death.

Diabetic ketoacidosis (DKA):

The first symptoms of diabetic ketoacidosis usually come on over a period of hours or days. With ketoacidosis, urine tests show large amounts of glucose and acetone.

Symptoms of diabetic ketoacidosis include:

First symptoms:

  • drowsiness,
  • flushed face,
  • thirst,
  • loss of appetite,
  • fruity smelling breath,
  • rapid, deep breathing,
  • abdominal (stomach area) pain.

Severe symptoms:

  • heavy breathing,
  • rapid pulse.

Prolonged hyperglycemia or diabetic ketoacidosis can lead to:

  • nausea,
  • vomiting,
  • dehydration,
  • loss of consciousness,
  • death.

Severe or continuing hyperglycemia or DKA requires prompt evaluation and treatment by your health professional. LANTUS should not be used to treat DKA, and the persons treating you should be advised you are taking a long-acting insulin and about your regimen.

Allergic reactions:

In rare cases, a patient may be allergic to an insulin product. Severe insulin allergies may be life-threatening. If you think you are having an allergic reaction, seek medical help immediately.

Signs of insulin allergy include:

  • a rash all over your body,
  • shortness of breath,
  • wheezing (trouble breathing),
  • a fast pulse,
  • sweating,
  • low blood pressure.

Possible reactions on the skin at the injection site:

Injecting insulin can cause the following reactions on the skin at the injection site:

  • a little depression in the skin (lipoatrophy),
  • skin thickening (lipohypertrophy),
  • redness, swelling, or itching at injection site.

In some instances, these reactions may be related to factors other than insulin, such as irritants in the skin cleansing agent or poor injection technique. You can reduce the chance of getting an injection site reaction if you change the injection site each time. If you have local injection site reactions, contact your health professional.

This is not a complete list of side effects. For any unexpected effects while taking LANTUS, contact your health professional.

Warnings and Precautions

Serious Warnings and Precautions

  • Hypoglycemia is the most common adverse effect of insulin, including LANTUS.
  • Glucose monitoring is recommended for all patients with diabetes.
  • Uncorrected hypoglycemic or hyperglycemic reactions can cause loss of consciousness, coma, or death.
  • Any change of insulin should be made cautiously and only under medical supervision.
  • LANTUS is not intended for intravenous or intramuscular administration.
  • LANTUS must not be mixed with any other insulin or diluted with any other solution because it might not work as intended.
  • This insulin product shall not be used if it is not water-clear and colourless or if it has formed a deposit of solid particles on the wall of the vial or cartridge.

Concomitant oral antidiabetic treatment may need to be adjusted.

The use of thiazolidinediones (such as rosiglitazone and pioglitazone), alone or in combination with other antidiabetic agents (including insulin), has been associated with heart failure and swelling of the lower extremities. Please contact your physician immediately if you develop symptoms of shortness of breath, fatigue, exercise intolerance, or swelling of the lower extremities while you are on these agents.

Accidental mix-ups between insulin glargine and other insulins, particularly short-acting insulins, have been reported. To avoid medication errors between insulin glargine and other insulins, check your insulin labels before every injection.

Hypokalemia (low potassium) is a possible side effect with all insulins. You might be more at risk if you are using potassium lowering drugs or losing potassium through other means (e.g. diarrhea). Symptoms of hypokalemia may include: Fatigue, muscle weakness or spasms, constipation, tingling or numbness, feeling of skipped heart beats or palpitations.

If you have diabetic retinopathy (condition affecting the retina of the eye) and you have a marked change in blood glucose levels, the retinopathy may temporary get worse. Ask your doctor about this.

BEFORE you use LANTUS talk to your health professional if:

  • You are planning to have a baby, are pregnant, or are nursing a baby;
  • You are taking any medication.

Interactions with this medication

Other medicines, including non-prescription medicines, and dietary supplements (such as vitamins) can change the way insulin works. Your dose of insulin or other medications may need to be changed in consultation with your health professional. 

Other related products

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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