Proven A1C Efficacy1
Lantus® is a once-daily, long-acting insulin that provides 24-hour basal coverage
with no pronounced peak.1 Lantus® can provide effective glycemic
control in diabetes patients as part of an overall diabetes treatment plan, which
includes diet, exercise, and other diabetes medications.
In type 2 diabetes cases, basal insulin therapy is typically initiated after lifestyle
changes and OADs fail to yield the glycemic goal set by a patient's healthcare professional.2
Adding Lantus® to an oral regimen has been shown to be effective at improving
and sustaining glycemic control.2,3
The clinical efficacy of Lantus® has been evaluated in patients with type 1
and type 2 diabetes mellitus in several large, randomized, multicenter trials.
How Lantus® Works:
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Lantus® is a recombinant human insulin analog that works as a parenteral
blood glucose-lowering agent. Lantus® differs from human insulin
in that the physiochemical properties have been modified, shifting the isoelectric
point and producing a solution that is completely soluble at a pH of approximately
4.1
The amino acid asparagine at position A21 is replaced by glycine, and two arginines
are added to the C-terminus of the B-chain. These changes shift the isoelectric
point, producing a solution that is completely soluble at a pH of 4. When injected
into the subcutaneous tissue, the acidic solution is neutralized. This leads to
the formation of microprecipitates, or stabilized aggregates, from which small amounts
of Lantus® are slowly released. The slow dissolution of free hexamers results
in the lack of a pronounced peak and longer duration of action, which allows Lantus® to be dosed once daily.
When injected into the neutral pH environment of the subcutaneous tissue, the acidic
solution microprecipitates, slowly releasing insulin. This accounts for the lack
of a pronounced peak and longer duration of action, which allows Lantus® to be dosed once daily at the same
time each day.1
The mechanics of sustained release
Lantus® is metabolized at the injection site and in the systemic circulation
to two main active metabolites, designated M1 and M2. M1 and M2 are very close in
structure and function to human insulin, but have slightly weaker interactions with
the insulin and IGF-1 receptors than human insulin. Both Lantus® and its active
metabolites have been detected in systemic circulation.1
The activity of Lantus® results in a relatively constant concentration/time
profile over 24 hours with no pronounced peak.
- Lantus® is completely soluble at a pH of 4 prior to injection
- Microprecipitation occurs upon injection into pH-neutral tissue, forming a depot
that slowly releases small amounts of Lantus® throughout 24 hours
- The time course of action of insulins, including Lantus®, may vary between individuals
and within the same individual
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.
Important Safety Information for Lantus® (insulin glargine [rDNA origin] injection)
Contraindications
Lantus® is contraindicated in patients hypersensitive to insulin glargine or
one of its excipients.
Warnings and Precautions
Monitor blood glucose in all patients treated with insulin. Insulin regimens should
be modified 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. Insulin devices
and needles must not be shared between patients.
Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®,
and may be life-threatening.
Severe life-threatening, generalized allergy, including anaphylaxis, can occur.
A reduction in the Lantus® dose may be required in patients with renal or hepatic
impairment.
Drug Interactions
Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and
close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients
taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and reserpine).
Adverse Reactions
Other adverse reactions commonly associated with Lantus® are injection site
reaction, lipodystrophy, pruritus, and rash.
Important Safety Information for Lantus®
SoloSTAR®
Lantus® SoloSTAR® is a disposable prefilled insulin pen. To help ensure
an accurate dose each time, patients should follow all steps in the Instruction
Leaflet accompanying the pen; otherwise they may not get the correct amount of insulin,
which may affect their blood glucose.
Indications and Usage for Lantus® (insulin glargine [rDNA origin] injection)
Lantus® is a long-acting insulin analog indicated to improve glycemic control
in adults and children (6 years and older) 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.
Important Limitations of Use: Lantus® is not recommended for the treatment of
diabetic ketoacidosis. Use intravenous short-acting insulin instead.
Lantus® SoloSTAR® is a disposable prefilled insulin pen.
Please click
here for Full Prescribing Information for Lantus®.
References:
- Lantus® Prescribing Information. April 2010.
- Gerstein HC, Yale J-F, Harris SB, et al. Diabetic Med. 2006;23(7):736-742.
- Blickle, J-F, Hancu N, Piletic M, et al. Diabetes Obes Metab. 2009;11(4):379-386.