George’s doctor prescribed the Lantus Solostar pen. He knows that Lantus is insulin. He is panicking because he thinks he has been having insulin-dependent. He is fearful that he is going to have side effects from Lantus. He is concerned that the Lantus price is expensive. He is trying to also find a Lantus coupon to help save money. He even asked if there is a generic Lantus. More importantly, he is trying to find true answers about his new insulin.
Let’s answer George’s questions.
Table of Contents
What is Lantus?
Lantus (Insulin glargine) is a long-acting insulin. It is slow-release insulin. For example, if George takes 24 units of Lantus, 1 unit of insulin will be released to his bloodstream every hour in the next 24 hours.
How does Lantus work?
Insulin acts on target tissues to regulate the metabolism of carbohydrates, protein, and fats. Target organs for insulin include the liver, skeletal muscle, and adipose tissue.
Within the liver, Lantus Solostar insulin helps the liver pick up the glucose. It also prevents glucose from going into the bloodstream. Without Lantus glucose continue to rise in the bloodstream. That explains why morning blood sugars are high after awakening without consuming any food for 8 to 10 hours.
Why do I need Lantus?
We use basal insulins such as Lantus pen, Basaglar pen, Levemir, Tresiba or Toujeo. We use them if adequate blood sugar control is not adequate after a step-wise trial of other meds. These meds could be metformin and or other noninsulin oral or injectable anti-diabetic medications.
On the other hand, if HbA1c ≥10%, blood glucose is ≥300 mg/dL, or if a patient is symptomatic, basal insulin may be needed earlier than later. Diabetes symptoms can include excessive urination, excessive thirst. So, if George’s blood sugars are very high and he is symptomatic, the Lantus Solostar pen can be initial therapy. Generic Lantus is not available however Basaglar may be cheaper. Lantus coupon is typically available in doctor offices or through Lantus website.
Insulin requirements vary dramatically between patients and dictates frequent monitoring and close medical supervision. Remote glucose monitoring can be extremely useful when patients are on insulin. This approach will definitely help reduce the side effects of Lantus on Geroge and keep him safe.
How do type I diabetic patients take Lantus?
For patients with type 1 diabetes insulin glargine must be used along with rapid- or short-acting insulins. We call this multiple daily injection regimens.
Typically, basal insulin requirement such as Lantus is between 30 to 40% of the total daily dose for patients with type 1 diabetes. Severe Lantus solostar side effects can occur with inappropriate use.
What is a typical Lantus dose should be in patients with type 2 diabetes?
The dose requirement will change from person to person. The normal dose for Lantus Maximally 0.4 to 0.5 units/kg/day. However, we sometimes consider conservative initial doses of 0.1 to 0.2 units/kg/day to avoid the potential for hypoglycemia (low blood sugar).
Higher initial doses may be necessary for patients who are obese or sedentary. To avoid Lantus side effects please discuss your toes with your diabetes doctor or endocrinologist.
How often should I take Lantus?
Now George has his medication and thankfully he found a Lantus coupon. Yet, he forgot his doctor’s instructions and wants to know how to take Lantus. It is a once a day medication. Occasionally dividing the dose into 2 may be beneficial for certain patients.
How to adjust for Lantus dosage?
Dosage must be titrated to achieve glucose control and avoid hypoglycemia (low blood sugar). We adjust the dose to maintain premeal and bedtime glucose in the target range. Since combinations of agents are frequently used, dosage adjustment must address the individual specifically.
Moreover, the insulin itself or other medication regimens that most directly influences the blood glucose should be kept in mind. To minimize hypoglycemia risk, we titrate basal insulin once or twice weekly. Very slow titration such as 1 unit daily is also appropriate in certain patients.
What happens if low blood sugar happens on Lantus?
If low blood sugar happens on the Lantus Solostar pen and if there is no clear reason for hypoglycemia( exercise, not eating for a long time), we recommend decreasing dose by 10% to 20%. If severe low blood sugar happens (hypoglycemia) we reduce dose by 20% to 40%. Severe low blood sugar means requiring assistance from another person or blood glucose <40 mg/dL.
Remember low blood sugar is the most common Lantus side effect. Regardless of the basal insulin you use this could be Lantus, generic glargine basaglar etc. you still will need to be very careful.
I am going for a procedure our surgery should I take my Lantus Solostar pen?
On the morning of surgery or procedure, take 60% to 80% of the usual dose of long-acting insulin (Lantus Solostar pen, Levemir, Tresiba, Toujeo)
What if my doctor is changing my insulin to Lantus or changing my Lantus to another insulin?
If you are on NPH insulin, converting from once-daily NPH insulin to Lantus is easy as conversion as exact same dose. So if you are on 20 units of NPH daily you can take Lantus 20 units.
However, if you are on twice-daily NPH insulin when you changed to Lantus pen once a day initial dose should be 80% of the total daily dose of NPH. In this case 20% reduction is necessary.
On the other hand, if you are changing from Toujeo to Lantus Solostar pen or basaglar consider 20% reduction in your insulin dose.
In case you are going from once a day Lantus to once-daily Toujeo or once-daily Basaglar initial dose will be the same however, generally my patients need a higher daily dosage of Toujeo to achieve the same level of glycemic control as with Lantus.
If you are changing between Lantus Solostar pen and Tresiba no dose adjustment is necessary.
I have a kidney problem. Can I take Lantus?
There are no dosage adjustments provided in the manufacturer’s labeling. Lantus Solostar insulin requirements will be less in patients with kidney disease in most cases. So, remote glucose monitoring and immediate doing adjustments are very important for these patients.
I have a liver problem can I take Lantus?
There are no dosage adjustments provided in the manufacturer’s labeling. Lantus Solostar insulin requirements will be less in patients with liver disease in most cases. So, remote glucose monitoring and immediate doing adjustments are very important for these patients.
Can kids use a Lantus Solostar pen?
Yes, most of the time patients with type 1 diabetes mellitus will need Lantus as part of their treatment regimen unless they are on insulin pump. More careful dosing and titration may be necessary for younger patients in the pediatric population.
Where can I inject Lantus pen?
Lantus can be injected in the abdomen, behind upper arms and on the outer thigh area as well as upper buttocks.
Lantus side effects:
Lantus Solostar pen can increase the blood volume and increased blood pressure and swelling. Also, occasionally depression is reported due to the use of Lantus Solostar pen.
As we discussed low blood sugar (hypoglycemia) is the most common side effect. This can be severe as well.
Occasionally diarrhea can happen as well as urinary tract infections while on the Lantus Solostar pen.
Moreover, local injection site reactions can happen. That is a relatively common Lantus side effect.
Who should not take Lantus?
Anyone who has hypersensitivity to insulin glargine (Lantus Solostar, basaglar, Toujeo) or any component of the formulation.
If someone is having low blood sugars definitely Lantus should not be used at that moment.
In addition, hypokalemia( low blood potassium) may happen. Insulin (especially IV insulin) causes a shift of potassium from the blood into the cells producing hypokalemia. If left untreated, low potassium may result in respiratory paralysis, ventricular arrhythmia, and even death.
I had bariatric surgery. Why still need Lantus?
Most of the time type II diabetic patients do not need insulin after gastric bypass surgery. However, gastric sleeve and some other gastric band type of surgeries may not be enough to stop insulin totally.
Patients who are on pioglitazone and have heart failure should not take Lantus. They should stop pioglitazone first.
I am on other medications for diabetes. Do they interact with Lantus?
Definitely. That is why you will need the attention of a diabetes specialist or endocrinologist to make sure that Lantus does not cause problems in your diabetes care or other problems that are not diabetes-related.
I am pregnant. Can I use Lantus pen?
Poorly controlled diabetes during pregnancy can cause an increased risk of adverse maternal and fetal outcomes,. This includes diabetic ketoacidosis, preeclampsia, spontaneous abortion. In addition, preterm delivery, delivery complications, major birth defects, stillbirth, and macrosomia can also occur. Although Lantus is not approved for patients with pregnancy most doctors will use a Lantus, Levemir, Toujeo, Tresiba interchangeably. Sometimes these agents including Lantus Solostar pen may be appropriate during gestational diabetes.
Can breastfeeding moms use the Lantus Solostar pen?
According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.
Can I come off Lantus if I change my diet?
This is possible. With the help of diabetes coaches and diabetes doctors who are closely following you will help you achieve the weight loss and exercise goals and will take you off of Lantus. That is possible if type 2 diabetes is not very advanced. This is not possible for patients with type 1 diabetes. We utilize individualized medical nutrition therapy based on ADA recommendations is an integral part of therapy.
How expensive it is Lantus?
1 pen of Lantus can cost around $80-$90. That box has 5 pens. A box of Lantus can cost $400-$500. Without the co-pay cards/Lantus coupons or insurance it can be hard to afford the Lantus Solostar pen.
How can sugarMDs help with my Lantus?
At SugarMDs we are proud that we identify appropriate and correct patients for any medication. Lantus Solostar pen may not be for everyone. Most of the time we can actually take people off Lantus and use medications that are not insulin.
If Lantus is really necessary we can help Lantus become less expensive by using Lantus co-pay cards. We can also use generic Lantus (glargine) to help save money. More importantly, we can help you identify the correct dose. We will make sure that Lantus will not interact with other medications. And we will make sure that we titrate you carefully to prevent low blood sugars and weight gain due to the Lantus Solostar pen.