General Information and Indications:
Insulin glargine is used to treat type 1
(insulin-dependent) diabetes (formerly called 'juvenile-onset'). It is also
used to treat people with type 2 (noninsulin-dependent) diabetes (formerly
called 'adult-onset') who need long-acting insulin to control their
diabetes. Insulin glargine is a long-acting, man-made version of human
insulin. Insulin is a hormone made in the pancreas. Insulin helps move sugar
from the blood into other body tissues where it is used for energy. It also
helps the body break down carbohydrates, fats, and proteins from the diet.
In a person with diabetes, the pancreas does not produce enough insulin for
the body's needs, so additional insulin is required. People with diabetes
may gradually develop serious nerve, blood vessel, kidney, and eye problems
if the diabetes is not controlled properly.
Information For Users:
Insulin glargine comes as an injection to inject
subcutaneously (beneath the skin, not into a vein). It is injected once a
day at bedtime. The medication comes in vials (bottles) and also prefilled
containers called cartridges. The amount of insulin glargine you need
depends on diet, other diseases, exercise, and other drugs you are taking
and may change with time. Your doctor will tell you how much you should
take. Follow the directions on your prescription label, ask your doctor or
pharmacist If you have any questions. Take insulin glargine exactly as
directed. Do not take more or less of it or take it more often than directed
by the package label or prescribed by your doctor.
Insulin glargine controls diabetes but does not cure it. It must be taken
regularly. Continue taking insulin glargine even if you feel well. Do not
discontinue taking insulin glargine without informing your doctor.
You do not have to shake the vial or cartridge of insulin glargine before
use. Do not dilute or mix insulin glargine with any other insulin or
solution. The syringe must not have any other medicine or residue in it.
If your insulin glargine comes in cartridges, the medication will already be
inside. You must only use the OptiPen One Insulin Delivery Device with the
cartridges. Before you use the device for the first time, read the written
directions that come with it. Ask your doctor, pharmacist, or nurse to show
you the right way to use this device. Practice while your health care
provider watches.
If your insulin glargine comes in vials, you will have to withdraw (draw up)
the medication into a syringe. Before you do this for the first time, read
the written directions that come with it. Ask your doctor or pharmacist to
show you the right way to withdraw the insulin glargine and to inject the
medication subcutaneously. Practice while your health care provider watches.
If your insulin glargine comes in vials you will need to use syringes.
Always use a syringe that is marked for U-100 insulin products. If you use
the wrong syringe, you may get the wrong dose, and your blood glucose level
may end up being too low or too high.
Plastic syringes are disposable; use a new one for each injection. Used
needles will hurt more and may cause an infection. Never share needles and
syringes. To withdraw insulin glargine into the syringe, follow these steps:
o Wash your hands.
o Hold the vial in your hands to warm the medicine. Look at the medicine in
the vial. Make sure it is clear and colorless. If it is cloudy or has
particles (specks) in it, throw the vial away and get a new one.
o If you are using a new vial, remove the protective cap. Do not remove the
stopper (the rubber inside the cap).
o Wipe the top of the vial with an alcohol swab or cotton dipped in rubbing
alcohol.
o It is easier to withdraw insulin glargine if you first inject air into the
vial. To do this, pull the plunger (the cylinder inside the syringe) back to
the number of insulin glargine units you will have to take. Now your syringe
is filled with the right amount of air. Insert the needle through the rubber
cap and push on the plunger to inject the air into the vial.
o Keep the syringe in the vial and turn both upside down. Hold the syringe
and vial firmly with one hand.
o Make sure the tip of the needle is in the insulin. With your free hand,
pull back on the plunger to withdraw insulin glargine into the syringe, and
measure the correct number of units of insulin glargine.
o Before you take the needle out of the vial, be sure that there are no
bubbles in the syringe. If there are bubbles in the syringe, hold the
syringe straight up and tap the side of the syringe until the bubbles float
to the top. Push the bubbles out with the plunger and draw insulin glargine
back in until you have the correct dose.
o Remove the needle from the vial. Do not let the needle touch anything. You
are now ready to inject.
o If you have trouble seeing the small markings on the syringe, have someone
help you. Also, let your doctor and pharmacist know about this problem. They
can provide syringes that are easier to read, special tools to help you fill
the syringe, or prefilled syringes.
To inject your insulin glargine dose, follow these steps:
o Decide on an injection area, either your abdomen, buttocks, thighs, or
arms.
o Clean the skin at the injection site with an alcohol pad or cotton dipped
in rubbing alcohol.
o Pinch a fold of skin with your fingers at least 3 inches apart and insert
the needle at a 45- to 90-degree angle.
o Then slowly push the plunger of the syringe all the way, making sure you
have injected all the insulin glargine. Leave the needle in the skin for
several seconds.
o Pull the needle straight out and press lightly on the spot where you
injected yourself for several seconds. Do not rub the area.
o Follow the directions given to you for throwing away the needle and
syringe.
Use a different site for each injection, about 1 inch away from the previous
injection but in the same general area (for example, the thigh). Use all
available sites in the same general area before switching to a different
area (for example, the upper arm). Do not use the same injection site more
often than once every month.
Special
precautions:
o Inform your doctor or pharmacist if you have
allergy to insulin or any other medications.
o Inform your doctor and pharmacist what prescription and nonprescription
medications you are taking, especially acetazolamide (Diamox); AIDS
antiviral medications; albuterol (Proventil, Ventolin); allergy or cold
medications; angiotensin-converting enzyme inhibitors (ACE inhibitors) such
as captopril (Capoten), enalapril (Vasotec), or lisinopril (Prinivil,
Zestril); antibiotics; antipsychotics such as fluphenazine (Prolixin),
mesoridazine (Serentil), or thioridazine (Mellaril); beta-blockers such as
propranolol (Inderal); calcitonin (Calcimar); chloroquine (Aralen);
chlorpromazine (Thorazine); clofibrate (Atromid-S); clonidine (Catapres);
corticosteroids such as dexamethasone (Decadron), methylprednisolone (Medrol),
or prednisone (Deltasone, Orasone); danazol (Danocrine); disopyramide (Norpace);
diuretics ('water pills'); epinephrine; estrogens; fenofibrate (TriCor);
fluoxetine (Prozac, Sarafem); gemfibrozil (Lopid); guanethidine (Ismelin);
isoniazid (INH); lithium (Eskalith, Lithobid); mebendazole (Vermox);
medications that contain alcohol or sugar; morphine (MS Contin, others);
niacin; nicotine; octreotide (Sandostatin); oral contraceptives (birth
control pills); oral medications for diabetes; pentamidine (Pentam);
phenelzine (Nardil); phenytoin (Dilantin); prochlorperazine (Compazine);
promethazine (Phenergan); propoxyphene (Darvon); reserpine (Serpalan,
others); salicylates such as aspirin, diflunisal (Dolobid), or salsalate (Disalcid);
somatropin (human growth hormone); sulfa drugs; sulfinpyrazone (Anturane);
terbutaline (Brethine, Bricanyl); thyroid medications; tranylcypromine (Parnate);
trimeprazine (Temaril); and vitamins or herbal products.
o inform your doctor if you are breast-feeding thyroid, liver, or kidney
disease.
o Inform your doctor if you are pregnant, plan to become pregnant, or are
breast-feeding. If you become pregnant while taking insulin glargine, call
your doctor.
o if you are having surgery, including dental surgery, Inform your doctor or
dentist that you are taking insulin glargine.
o Inform your doctor if you have fever, infection, injury, or illness with
vomiting or diarrhea. These may affect your blood sugar level.
Be sure to follow all exercise and dietary recommendations made by your
doctor or dietitian. It is important to eat a healthful diet. Do not start a
diet or an exercise program without informing your doctor. Your insulin dose
may need to be changed.
To monitor the effectiveness of insulin
glargine, measure the amount of sugar (glucose) in your blood or urine (when
blood sugar is above a certain high level, you will have sugar in your
urine). For measuring the amount of glucose in your blood, you can use a
blood glucose meter. For the urine measurements, you will need special paper
tapes, tablets, or plastic strips that change color depending on how much
sugar is present. Your doctor also may ask you to test your urine for
ketones (substances present when diabetes is not under control). Follow your
doctor's recommendations for testing your urine and blood and for recording
the results. If your blood sugar is high or if sugar or ketones are present
in your urine, call your doctor.
Your dose of insulin glargine may need to be changed when you are ill
(especially with fever, vomiting, or diarrhea), have emotional changes or
stress, gain or lose weight, or change the amount of food you eat or amount
of exercise you do. If any of these things happen, call your doctor.
See your dentist twice yearly; see your eye doctor regularly; get your blood
pressure checked regularly.
If you travel across time zones, ask your doctor how to time your
injections. When you travel, take extra insulin and supplies with you.
Keep yourself and your clothes clean. Wash cuts, scrapes, and other wounds
quickly, and do not let them get infected. Wear medical alert identification
(a bracelet or tag) that says you have diabetes.
Possible Adverse
Effects:
You should know the symptoms of low and high
blood sugar and what to do if you have them.
Eat or drink a food or beverage with sugar in it, such as hard candy or
fruit juice, and call your doctor without delay if you have any of the
symptoms of hypoglycemia (low blood sugar):
o shakiness
o lightheadedness or dizziness
o sweating
o confusion
o nervousness or irritability
o sudden changes in behavior or mood
o headache
o numbness or tingling around the mouth
o weakness
o pale skin
o sudden hunger
o clumsy or jerky movements
o seizures
call your doctor without delay if you have any of the following symptoms of
hyperglycemia (high blood sugar):
o extreme thirst
o frequent urination
o extreme hunger
o weakness
o blurred vision (Impaired vision)
If high blood sugar is not treated, a serious, life-threatening condition
called diabetic ketoacidosis could develop. call your doctor without delay
if you have any of the these symptoms:
o dry mouth
o upset stomach and vomiting
o shortness of breath
o breath that smells fruity
o decreased consciousness
Insulin glargine can cause side effects. Inform your doctor if any of the
following symptoms are severe or do not go away:
o redness, swelling, pain, and itching at the injection site
o changes in the feel of your skin, skin thickening (fat build-up), or a
little depression in the skin (fat breakdown)
If you have any of the following symptoms, call your doctor without delay:
o exaggerated sunburn
o difficulty speaking or moving
o skin rash or hives (Urticaria) all over the body
o itching or redness
o swelling of hands or feet
o difficulty swallowing
o wheezing (problem with breathing)
o fast pulse
o low blood pressure
Brand Name(s):
o Lantus® |
