Home Drug Guide Insulin Glargine Recombinant

Drug Guide

Generic Name

Insulin Glargine Recombinant

Brand Names Lantus, Lantus Solostar, Toujeo Solostar, Toujeo Max Solostar

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Long-acting insulin

FDA Approved Indications

Treatment of diabetes mellitus in adults and children to improve glycemic control

Mechanism of Action

Insulin Glargine is a long-acting insulin analog that mimics endogenous basal insulin secretion. It binds to insulin receptors, facilitating cellular uptake of glucose, promoting glycogen synthesis, and inhibiting gluconeogenesis, thereby lowering blood glucose levels over an extended period.

Dosage and Administration

Adult: Dosage individualized based on patient needs; typically administered once daily via subcutaneous injection.

Pediatric: Recommended dosing based on individual requirements; administration is similar to adults.

Geriatric: Dosage adjustments not required solely based on age; monitor renal and hepatic function.

Renal Impairment: No specific adjustment required but monitor closely due to altered pharmacokinetics.

Hepatic Impairment: Use with caution; monitor blood glucose levels closely.

Pharmacokinetics

Absorption: Slow absorption post subcutaneous injection, providing a steady insulin level.

Distribution: Distribution similar to endogenous insulin; binds to insulin receptors.

Metabolism: Metabolized in the liver and kidneys to inactive metabolites.

Excretion: Excreted via renal and hepatic pathways.

Half Life: Approximately 19 hours, providing a flat, 24-hour insulin profile.

Contraindications

Hypersensitivity to insulin glargine or any excipients.

Precautions

Risk of hypoglycemia, especially during initiation or dose adjustment.
Assess for hypoglycemia risk; educate patients on recognition and management.

Adverse Reactions - Common

Hypoglycemia (Common)
Injection site reactions (e.g., redness, swelling) (Common)
Weight gain (Common)

Adverse Reactions - Serious

Severe hypoglycemia (Uncommon)
Anaphylaxis (Rare)

Drug-Drug Interactions

Other antidiabetic agents (increase hypoglycemia risk)
Certain beta-blockers (may mask hypoglycemia symptoms)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood glucose levels regularly, especially during therapy initiation and dose changes.

Diagnoses:

Risk for unstable blood glucose levels
Risk for hypoglycemia

Implementation: Administer subcutaneously at prescribed times; rotate injection sites; educate patient on self-injection and monitoring.

Evaluation: Assess blood glucose control, signs of hypoglycemia or hyperglycemia.

Patient/Family Teaching

Teach proper insulin injection technique.
Explain the importance of blood glucose monitoring.
Discuss recognizing and managing hypoglycemia.
Advise on diet, activity, and adherence to prescribed regimen.

Special Considerations

Black Box Warnings:

Risk of severe hypoglycemia leading to coma or death.

Genetic Factors: N/A

Lab Test Interference: May interfere with certain laboratory tests affecting glucose measurements.

Overdose Management

Signs/Symptoms: Severe hypoglycemia—confusion, seizures, loss of consciousness.

Treatment: Immediate administration of oral glucose if conscious; if unconscious, administer injectable glucagon or dextrose IV; seek emergency medical care.

Storage and Handling

Storage: Unopened vials/stores at 2°C to 8°C (36°F to 46°F). Do not freeze.

Stability: Once opened, store at room temperature (up to 25°C/77°F) for up to 28 days, or as per manufacturer instructions.