Lantus Vials Insulin Glargine

Lantus Vials Insulin Glargine

Note: Lantus is not approved to treat diabetic ketoacidosis (DKA) which is a common complication among diabetics.

Lantus contains insulin glargine which is a long-acting insulin that is administered through injection under the skin (subcutaneously).

It is typically prescribed to patients in two forms:

• in 10-milliliter vials that contains 100 units of insulin glargine. The vials are used with syringes (not included with medication).
• as a disposable single-patient-use prefilled insulin pen which contain 3 ml solution that has 100 units of insulin per mL.

Lantus Side Effects

Side effects associated with Lantus can range from mild to severe. The side effects listed below do not include all possible side effects.

The Food & Drug Administration (FDA) tracks side effects associated with drugs that are approved which can be tracked through several websites.

Common side effects associated with Lantus include:

• injection site reactions (itchiness, redness, pain, tenderness around injection area)
• lipodystrophy
• rash
• itchy skin
• edema (swelling)
• weight gain
• respiratory injections
• hypoglycemia (low blood sugar levels)

These side effects typically go away after a few days or weeks. If they become more severe you should consult your doctor or pharmacist.

Other common side effects from patients using Lantus include:

• pain
• redness
• swelling
• itching
• thickening of the skin at injection site(s)

These side effects are typically temporary and go away within a few days or weeks.

Lantus may cause serious side effects, such as severe allergic reactions and can even be fatal. If you experience any of the following seek medical attention immediately:

• Full body rash
• Difficulty breathing
• Rapid heartbeat
• Sweating
• Swelling of of the face, tongue, or throat
• Shortness of breath
• Extreme drowsiness, dizziness, or confusion

This is not a complete list of side effects. Other drugs may interact with Lantus. Discuss side effects and risks with your doctor.

Serious Side Effects

Serious side effects associated with Lantus aren’t common but can occur. These side effects & symptoms include:

Hypokalemia (low potassium levels). Symptoms can include:

• abnormal heart rhythm
• fatigue
• weakness
• msucle cramping
• paralysis (loss of movement in a body part)
• respiratory failure

Side Effects in Detail

Allergic Reaction

As with other insulin medications, patients may experience allergic reactions when taking Lantus.

Symptoms of mild allergic reactions include:

• itchiness
• skin rash
• skin flashes (red and warm skin)

Symptoms of severe allergic reactions may include:

• full body rash
• difficulty breathing
• swelling of mouth, throat or tongue
• swelling under the skin (ie eye lids, lips, feet or hands)

If you experience severe allergic reactions when using Lantus, seek medical attention. Call 911 if you feel the symptoms are life-threatening.

Weight Gain

One of the most common side effects with using Lantus as with other insulin medications is weight gain. This is normal when taking insulin since it causes the body to to store sugar to be used as energy later.

From clinical studies it was found that the average weight gain for patients was:

• up to 1.5 lbs between 16-28 weeks in adults who took Lantus and had type 1 diabetes
• up to 4.8 lbs for 28 weeks in children with type 1 diabetes who took Lantus along with regular insulin
• up to 4.4 lbs in adults with type 2 diabetes who took Lantus for 1 year

Speak to your doctor if weight gain is a concern when taking Lantus.

Hypoglycemia

Hypoglycemia (low blood sugar) is the most common side effect when taking Lantus as with taking any insulin.

It is important to identify symptoms of hypoglycemia so you can address the issue before it becomes serious.

Symptoms of mild hypoglycemia include:

• headache
• hunger
• rapid heartbeat
• nervousness
• irritability
• shakiness

If your blood sugar levels remain too low, symptoms may worse and you may require medical attention.

Symptoms of severe hypoglycemia (extremely low blood sugar levels) may incldue:

• headache
• hunger
• drowsiness
• anxiety
• sweating
• seizures
• irritability
• confusion
• coma
• rapid heartbeat
• coma

It’s important to note that when making adjustments to your insulin treatment may result in both hypoglycemia or hyperglycemia. Your doctor may choose to use a new insulin medication, adjust dosage or modify your insulin regimen.

How common is hypoglycemia when using Lantus?

• A 16-week clinical study examined what happens when adults with type 1 diabetes taking lantus. The study found that 6.5% experienced severe hypoglycemia. 10.6% experienced severe hypoglycemia at least once in a 28-week study.
• In a 5-year clinical study that examined adults with type 2 diabetes found that 7.8% had a severe hypoglycemic episode when combining Lantus with regular insulin.
• Another study looked at children with type 1 diabetes with Lantus. Over a 6-month period, 23% of the children experienced severe hypoglycemia.

What to do if you experience hypoglycemia:

If your blood sugar levels drop too low, you need to fix it right away by eating a sugary snack or drink. This can include:

• glucose tablet
• easily digestible carbs
• honey
• hard candy
• sugar

Speak to your doctor if you are experiencing frequent episodes of hypoglycemia. Your doctor may recommend a glucagon emergency kit. Glucagon is a hormone which quickly raises glucose levels and primarily used when a patient loses consciousness.

How to Use Lantus

Lantus is administered subcutaneously (under the skin) once per day. Insulin dosage is determined based on factors such as lifestyle, health and blood glucose levels.

While taking Lantus, blood glucose levels should be tested often and results shared with your doctor. Do not make any adjustments to your insulin or dose requirements without consulting your doctor first.

Do not mix or dilute Lantus with other insulin or solutions as this may cause the insulin to not work as intended or affect blood glucose control which can be serious.

Always check the label on the vial or carton before use to ensure you are using the correct medication.

Only use Lantus if it appears clear and colorless.

Injecting Lantus with a vial and syringe

Before you get started:

• Wash your hands
• Ensure insulin is clear and colorless. Do not use and discard if solution is cloudy or you see particles.
• Do not dilute or mix insulin with other insulin or solutions as they may affect how it works and you may lose blood sugar control.
• Do not share syringes, needles and pens with others. Always use a new syringe and do not reuse needles.
• Relax

STEP 1: Prepare the dose

• Remove the cap — If you are using a new vial, remove the protective cap. Do not
  remove the stopper.
• Sterilize the top — Wipe the top of the vial with an alcohol swab.
• Inject air into the vial—Draw air into the syringe that is equal to your insulin dose.
• Put the needle through the rubber top of the vial and push the plunger to inject the air into the vial.
• Draw up the dose — Leave the syringe in the vial and turn both upside down. Hold the syringe and vial firmly in one hand. Make sure the tip of the needle is in the insulin. With your free hand, pull the plunger to withdraw the correct dose into the syringe.

STEP 2: Remove air bubbles

• Check for bubbles — Before you take the needle out of the vial, check the syringe for air bubbles.
• Tap to release — If bubbles are in the medicine, hold the syringe straight up and tap the side of the syringe until the bubbles float to the top.
• Eject the air — Push the bubbles out with the plunger and draw insulin back in until you have the correct dose.
• Remove the needle — Remove the needle from the vial. Do not let the needle touch anything. You’re now ready to inject.

STEP 3: Choose an injection area

• Pick your spot — Decide on an injection area: either upper arm, thigh, or abdomen. Injection sites within an injection area must be different from one  injection to the next.
• Clean your skin — Use rubbing alcohol to clean the skin where you are going to inject. Alcohol can sometimes sting if it’s not completely dry when you inject, so wait a few seconds for it to evaporate or pat the area dry with a sterile cotton ball.
• Pinch a fold of skin — Pinch the skin and hold it. Insert the needle the way your healthcare professional showed you.

STEP 4: Complete the injection

• Administer insulin— Slowly push in the plunger of the syringe all the way, making sure you have injected all the insulin. Leave the needle in the skin for 10 seconds.
• Apply light pressure — Pull the needle straight out and gently press on the spot where you injected yourself for several seconds. Don’t rub the area.
• Discard materials safely — Follow your healthcare professional’s instructions for throwing away the needle and syringe

Be Syringe Savvy

To ensure you get the correct dose of insulin, always use a U-100 insulin syringe. Your pharmacist will make sure you use the correct syringe when using Lantus. If you have trouble seeing the lines on the syringe, your pharmacist may recommend using a magnifying device.

Storage

The integrity of this medication depends on several factors including how you and where you store it.

Storing unopened vials

Unopened Lantus vials should be stored in a refrigerator until the expiration date found on the label or carton. You can also store medication at room temperature for up to 28 days but will need to be discarded after 28 days.

Storing opened vials

Once the Lantus vial has been used, you can store it at room temperature or inside a refrigerator for up to 28 days.

Warnings & Precautions

Lantus insulin should not be used to treat diabetic ketoacidosis.

Do not use during episodes of low blood sugar.

Do not use if you are allergic to insulin or any of the ingredients contained in Lantus.

Do not share needles, syringes or pens with others as this can lead to spreading infections and blood pathogens. Do not reuse needles.

Inform your doctor if you have any existing medication conditions, including: kidney or liver problems; if you are pregnant, breast feeding or planning on pregnancy.

If you are pregnant or breastfeeding your doctor may provide a treatment plan based on your current stage of pregnancy and blood sugar levels. They may also choose to switch insulin during pregnancy or breastfeeding. It is unknown whether insulin passes through breast milk. Consult your doctor if you going to breast feed.

Rotate injection sites to avoid skin complications such as amyloidosis (skin with lumps) lipodystrophy (pitted or thickened skin) at the site of injection. Do not use the same spot if it is lumpy, pitted, thickened, hard, bruised, scaly, tender, scarred or damaged.

Heart failure may occur if you are taking insulin with other medications such as TZDs (thiazolidinediones), even if you have no history of heart complications. If you already have heart problems, the combination of Lantus and TZD’s may worsen your heart condition. Your doctor may choose to modify or stop treatment. Inform your doctor if you experience new or worsening symptoms related to heart failure such as: swelling of ankles and feet, shortness of breath or sudden weight gain.

Let your doctor know if you are taking other medications, over-the-counter drugs, vitamins, minerals and herbal supplements.

Do not use if solution contains particles.

Do not drive or operate heavy machinery while using Lantus unless you know how it affects you. Speak to your doctor if it is safe for you to drive or use heavy machinery while using Lantus.

Do not drink alcohol or consume medication that contains alcohol when using Lantus. Alcohol can have serious complications when taking insulin.

Drug Interactions

Other drugs may affect blood sugar levels and the effectiveness of the Lantus medication.

Inform your doctor if you are taking any of the following medications which can interact with Lantus:

Medications, Substances or Supplements known to interact with Lantus:

• albuterol
• clonidine
• reserpine
• pioglitazone or rosiglitazone
• other anti-diabetic medications
• blood pressure medications
• beta-blockers
• birth control pills
• thyroid medications
• anti-depressant medications
• anti-psychotic medications
• certain antibiotics
• corticosteroid medications

Other medications, over-the-counter drugs, vitamins, minerals and supplements may interact with insulin glargine and affect blood glucose levels. It’s important to inform your doctor if you are taking these.