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Lantus - instructions for use, reviews, analogs and forms of release (insulin solution for subcutaneous administration, in the syringe-handle SoloStar, OptSet and OpticKlik) drugs for the treatment of insulin-dependent diabetes mellitus in adults, children and in pregnancy

Lantus - instructions for use, reviews, analogs and forms of release (insulin solution for subcutaneous administration, in the syringe-handle SoloStar, OptSet and OpticKlik) drugs for the treatment of insulin-dependent diabetes mellitus in adults, children and in pregnancy

In this article, you can read the instructions for using the drug Lantus. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Lantus in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Lantus in the presence of existing structural analogues.Use for the treatment of insulin-dependent diabetes mellitus in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

 

Lantus - is an analog of human insulin. It was obtained by the method of recombination of DNA from bacteria of the species Escherichia coli (E. coli) (strains K12). It is characterized by low solubility in a neutral medium. In the formulation of Lantus, it is completely soluble, which is provided by an acidic solution solution for injection (pH = 4). After introduction into the subcutaneous fat, the solution, due to its acidity, enters a neutralization reaction to form micro-precipitates, from which small amounts of insulin glargine are continuously released (the active substance of the Lantus preparation), providing a smooth (without peaks) profile of the concentration-time curve, and long duration of action of the drug.

 

The binding parameters with insulin receptors of insulin glargine and human insulin are very similar. Insulin glargine has a biological effect similar to endogenous insulin.

 

The most important action of insulin is the regulation of glucose metabolism.Insulin and its analogues reduce blood glucose, stimulating glucose consumption by peripheral tissues (especially skeletal muscle and fat tissue), and also inhibiting the formation of glucose in the liver (gluconeogenesis). Insulin inhibits lipolysis in adipocytes and proteolysis while simultaneously enhancing protein synthesis.

 

The increased duration of action of insulin glargine is directly due to the low rate of its absorption, which makes it possible to apply the drug once a day. The onset of action is an average of 1 hour after the administration. The average duration of action is 24 hours, the maximum duration is 29 hours. The nature of the action of insulin and its analogues (for example, insulin glargine) can vary significantly in time in both patients and in the same patient.

 

The duration of action of the drug Lantus is due to its introduction into the subcutaneous fat.

 

Composition

 

Insulin glargine + excipients.

 

Pharmacokinetics

 

A comparative study of the concentrations of insulin glargine and insulin-isophane after subcutaneous administration in blood serum in healthy people and patients with diabetes showed delayed and significantly longer absorption, as well as a lack of peak concentration in insulin glargine compared to insulin-isophane.

 

With the introduction of the drug once a day, the stable average concentration of insulin glargine in the blood is reached after 2-4 days after the first dose.

 

With intravenous administration, the half-life of insulin glargine and human insulin is comparable.

 

In humans, in the subcutaneous fat, insulin glargine is partially cleaved from the carboxyl terminus (C-terminus) of the B chain (beta chain) to form 21A-Gly-insulin and 21A-Gly-des-30B-Thr-insulin. In plasma there are both unchanged insulin glargine, and the products of its cleavage.

 

Indications

  • diabetes, requiring insulin treatment, in adults, adolescents and children older than 6 years;
  • diabetes, requiring insulin treatment, in adults, adolescents and children older than 2 years (for the form SoloStar).

 

Forms of release

 

Solution for subcutaneous administration (cartridges 3 ml in syringe-pens OptiSet and OpticKlik).

 

Solution for subcutaneous administration (cartridges 3 ml in syringe-pens Lantus SoloStar).

 

Instructions for use and usage diagram

 

Lantus Optiset and Optiklik

 

The dose of the drug and the time of day for it are set individually. Lantus is administered subcutaneously once a day, always at the same time. Lantus should be injected into the subcutaneous fat of the abdomen, shoulder or thigh.Place for injection should alternate with each new injection of the drug within the recommended areas for the administration of the drug.

 

The drug can be used as a monotherapy, or in combination with other hypoglycemic drugs.

 

When transferring the patient with insulin long or medium duration of action on Lantus may require adjustment of basal insulin daily dose or variation concomitant antidiabetic therapy (dosage and mode of administration of short-acting insulins or their analogs, as well as doses of oral hypoglycemic agents).

 

When transferring a patient from a two-fold administration of insulin-isophane to a single administration of Lantus, the daily dose of basal insulin should be reduced by 20-30% in the first weeks of treatment in order to reduce the risk of hypoglycemia in the night and early morning hours. During this period, a decrease in the dose of Lantus should be compensated for by an increase in short-acting insulin doses followed by an individual correction of the dosing regimen.

 

As with the use of other analogues of human insulin,receiving high doses of drugs due to the presence of antibodies to human insulin, when going to Lantus, an increase in the response to insulin administration may be observed. During the transition to Lantus and in the first weeks after it requires careful monitoring of blood glucose and, if necessary, correction of the insulin dosage regimen.

 

In the case of an improvement in the regulation of metabolism and the consequent increase in sensitivity to insulin, further correction of the dosing regimen may become necessary. Correction of the dose may also be required, for example, with a change in the patient's body weight, lifestyle, time of day for drug administration, or when other circumstances contribute to an increase in predisposition to hypo- or hyperglycaemia.

 

The drug should not be administered iv. In / in the introduction of the usual dose, intended for SC administration, can cause the development of severe hypoglycemia.

 

Before the introduction, it must be ensured that the syringes do not contain the remains of other medicinal products.

 

Rules of use and handling of the drug

 

Pre-filled Optic syringe pens

 

Before use, inspect the cartridge inside the syringe pen. It should only be used if the solution is clear, colorless, contains no visible solid particles and resembles water in a consistency. Empty Optic syringes are not intended for reuse and must be destroyed.

 

To prevent infection, the pre-filled syringe pen is intended for use by only one patient and can not be transferred to another person.

 

Handling of syringe-handle OptiSet

 

Always use a new needle every time you use it. Use only needles that are suitable for the OptiSet syringe.

 

Always give a safety test before each injection.

 

If a new OptiSet pen is used, the readiness check should be performed using 8 units preset by the manufacturer.

 

The dose selector can only be rotated in one direction.

 

Never turn the dose selector (dose change) after pressing the injection pushbutton.

 

If the injection is made by another person, then he needs to take extra care to avoid accidentally injuring the needle and infecting the infectious disease.

 

Never use a damaged OptiSet syringe, or if it is suspected to be defective.

 

It is necessary to have a spare syringe-handle OptiSet in case of loss or damage used.

 

Insulin testing

 

After removing the cap from the syringe pen, check the labeling on the insulin tank to make sure it contains the proper insulin. You should also check the appearance of insulin: the insulin solution should be clear, colorless, free of visible solids and have a consistency similar to water. Do not use the OptiSet pen if the insulin solution is cloudy, colored, or contains foreign particles.

 

Attaching the needle

 

After removing the cap, you should carefully and tightly connect the needle to the syringe pen.

 

Checking the availability of the syringe pen for use

 

Before each injection, it is necessary to check the readiness of the syringe pen for use.

 

For a new and unused syringe pen, the dose indicator should stand on the figure 8, as was previously set by the manufacturer.

 

If a syringe pen is used, the dispenser should be rotated until the dose indicator stops at 2. The dispenser will rotate in only one direction.

 

Pull out the fully-actuated button to dial the dose. Never rotate the dose selector after the start button is pulled out.

 

The outer and inner needle caps must be removed. Save the outer cap to remove the used needle.

 

Holding the syringe handle with the needle pointing upwards, gently tap with your finger on the insulin reservoir so that the air bubbles rise up towards the needle.

 

Then press the start button as far as it will go.

 

If a drop of insulin is released from the tip of the needle, the syringe-pen and the needle function correctly.

 

If a drop of insulin is not displayed at the tip of the needle, repeat the readiness check of the syringe pen until the insulin appears on the tip of the needle.

 

Selecting an insulin dose

 

A dose of 2 units up to 40 units can be set in increments of 2 units. If a dose exceeding 40 units is required, it must be administered in two or more injections. Make sure you have enough insulin for the right dose.

 

The scale of the residual insulin on a transparent container for insulin shows how much, approximately, of the insulin remains in the syringe-handle OptiSet.This scale can not be used to take a dose of insulin.

 

If the black piston is at the beginning of the color strip, then there are approximately 40 units of insulin.

 

If the black piston is at the end of a colored strip, then there are about 20 units of insulin.

 

The dose selector should be rotated until the arrow-dose indicator indicates the desired dose.

 

Insulin Dose Fence

 

The injection button must be pulled to the limit to fill the insulin pen.

 

It should be checked whether the correct dosage is taken. The button is shifted according to the amount of insulin left in the insulin container.

 

The start button allows you to check which dose is dialed. During the test, the start button must be kept under tension. The last visible wide line on the start button shows the amount of insulin taken. When the start button is held, only the upper part of this wide line is visible.

 

Introduction of insulin

 

Specially trained personnel should explain the technique of injection to the patient.

 

The needle is injected subcutaneously. Press the injection button to the limit.The click will stop when the injection pushbutton is depressed. Then press the injection button for 10 seconds before pulling the needle out of the skin. This will ensure the introduction of the entire dose of insulin.

 

Removing the needle

 

After each injection, the needle should be removed from the syringe-pen and discarded. This will prevent infection, as well as leakage of insulin, air intake and possible blockage of the needle. Needles can not be reused.

 

After this, put back the cap for the syringe pen.

 

Cartridges

 

Cartridges should be used together with the Optipen Pro1 syringe pen, and in accordance with the recommendations given by the device manufacturer.

 

Instructions for using the OptiPen Pro1 syringe for installing the cartridge, connecting the needle and performing insulin injection should be carried out exactly. Inspect the cartridge before use. It should only be used if the solution is clear, colorless, and contains no visible solid particles. Before installing the cartridge in the syringe pen, the cartridge should be at room temperature for 1-2 hours.Before carrying out the injection, remove air bubbles from the cartridge. It is necessary to strictly follow the instructions. Empty cartridges are not used again. If the OptiPen Pro1 syringe pen is damaged, you can not use it.

 

If the syringe pen is faulty, if necessary, insulin can be injected into the patient by typing the solution from the cartridge into a plastic syringe (suitable for insulin at a concentration of 100 IU / ml).

 

To prevent infection with a reusable pen, only one person should use it.

 

OptiKlik cartridge system

 

The Optiklik cartridge system is a glass cartridge containing 3 ml of the glargine insulin solution, which is placed in a transparent plastic container with an attached piston mechanism.

 

The Optiklik cartridge system should be used together with the Optiklik syringe in accordance with the instruction manual attached to it.

 

It is necessary to follow exactly all the recommendations contained in the instruction for installing the cartridge system in the Optiklik syringe, connecting the needle and performing the injection.

 

If the OpticClip syringe is damaged, replace it with a new one.

 

Before installing the cartridge system in the syringe handle Optiklik, it should be at room temperature for 1-2 hours. Before installation, the cartridge system should be inspected. It should only be used if the solution is clear, colorless, and contains no visible solid particles. Before carrying out the injection, remove the air bubbles from the cartridge system (as well as when using a pen syringe). Empty cartridge systems are not reused.

 

If the syringe pen is defective, then, if necessary, insulin can be administered to the patient by typing the solution from the cartridge into a plastic syringe (suitable for insulin at a concentration of 100 IU / ml).

 

To prevent infection with a reusable pen, only one person should use it.

 

Lantus SoloStar

 

Lantus SoloStar should be administered subcutaneously once a day at any time of the day, but every day at the same time.

 

In patients with type 2 diabetes, Lantus SoloStar can be used both as monotherapy and in combination with other hypoglycemic drugs. Target values ​​of blood glucose concentration, as well as dose and time of administration or intake of hypoglycemic drugs should be determined and adjusted individually.

 

Dose adjustment may also be required, for example, with a change in the patient's body weight, lifestyle, changes in the time of administration of the insulin dose, or in other conditions that may increase the predisposition to hypo- or hyperglycaemia. Any changes in the dose of insulin should be conducted with caution and under medical supervision.

 

Lantus SoloStar is not an insulin of choice for the treatment of diabetic ketoacidosis. In this case, preference should be given to / in the introduction of short-acting insulin. In treatment regimens that include injections of basal and prandial insulin, 40-60% of the daily insulin dose in the form of insulin glargine is usually administered to meet the need for basal insulin.

 

In patients with type 2 diabetes mellitus who take hypoglycemic drugs for oral administration, the combination therapy begins with a dose of 10 mg of glargine 10 times a day and then the treatment regimen is adjusted individually.

 

In all patients with diabetes it is recommended to monitor the concentration of glucose in the blood.

 

Transition from treatment with other hypoglycemic drugs to Lantus SoloStar

 

When transferring a patient from a treatment regimen using insulin of medium duration or a prolonged effect on the treatment regimen using the drug Lantus SoloStar, it may be necessary to correct the amount (doses) and time of administration of short-acting insulin or its analog during the day or change the doses of oral hypoglycemic drugs.

 

When transferring patients from a single day during the day of insulin-isophane administration to once-daily administration of Lantus SoloStar, the initial doses of insulin usually do not change (that is, the amount of ED of Lantus SoloStar per day equal to the amount of ME insulin isophane per day) is applied.

 

When transferring patients from twice daily insulin-isophane administration to a single injection of Lantus SoloStar before bedtime in order to reduce the risk of hypoglycaemia during the night and early morning hours, the initial daily dose of insulin glargine is usually reduced by 20% (compared with the daily dose of insulin- isophane), and then it is adjusted depending on the patient's reaction.

 

Lantus SoloStar should not be mixed with other insulin preparations or diluted.It is necessary to make sure that the syringes do not contain the remains of other medicines. When mixing or diluting, the profile of insulin glargine can change in time.

 

When switching from human insulin to Lantus SoloStar and during the first weeks after it, careful metabolic monitoring (monitoring of glucose concentration in the blood) is recommended under medical supervision, with correction, if necessary, of an insulin dosage regimen. As with other human insulin analogues, this is especially true for patients who, due to their antibodies to human insulin, require the use of high doses of human insulin. In such patients, with insulin glargine, a significant improvement in the response to insulin administration can be observed.

 

With the improvement of metabolic control and the resulting increase in the sensitivity of tissues to insulin, it may be necessary to correct the dosage regimen of insulin.

 

Mixing and dilution

 

The preparation Lantus SoloStar should not be mixed with other insulins.Mixing can change the time / effect ratio of Lantus SoloStar and also lead to precipitation.

 

Special patient groups

 

The drug Lantus SoloStar can be used in children older than 2 years. Use in children under 2 years of age has not been studied.

 

In elderly patients with diabetes mellitus, the use of moderate initial doses is recommended, their slow increase and the use of moderate maintenance doses.

 

Mode of application

 

The drug Lantus SoloStar is injected in the form of SC injections. The preparation Lantus SoloStar is not intended for intravenous administration.

 

The long duration of the action of insulin glargine is observed only when it is introduced into the subcutaneous fat. In / in the administration of a usual subcutaneous dose can cause severe hypoglycemia. Lantus SoloStar should be injected into the subcutaneous fat of the abdomen, shoulders or thighs. The injection sites should alternate with each new injection within the recommended areas for the administration of the drug. As with other types of insulin, the degree of absorption, and therefore the onset and duration of its action, can change under the influence of physical activity and other changes in the patient's condition.

 

Lantus SoloStar is a clear solution, not a suspension.Therefore, no resuspension is required before use. If the Lantus SoloStar syringe fails, insulin glargine can be removed from the cartridge in a syringe (suitable for 100 IU / ml insulin) and injected.

 

Rules for the use and handling of a pre-filled SoloStar pen

 

Before the first use, the syringe pen should be held at room temperature for 1-2 hours.

 

Before use, inspect the cartridge inside the syringe pen. It should only be used if the solution is clear, colorless, contains no visible solid particles and resembles water in a consistency.

 

Empty SoloStar pen need not be reused and must be destroyed.

 

To prevent infection, a pre-filled syringe pen should only be used by one patient and not transferred to another person.

 

Before using the SoloStar pen, carefully read the usage information.

 

Before each use, it is necessary to carefully connect a new needle to the syringe pen and conduct a safety test. It is necessary to use only needles compatible with SoloStar.

 

It is necessary to take special precautions to avoid accidents involving the use of a needle and the possibility of transfer of infection.

 

In no case should you use the SoloStar pen when it is damaged or if you are unsure whether it will work properly.

 

You should always have a spare SoloStar pen in case you lose or damage an existing copy of the SoloStar pen.

 

If the SoloStar pen is stored in the refrigerator, it should be taken 1-2 hours before the proposed injection so that the solution takes room temperature. The introduction of chilled insulin is more painful. The used SoloStar pen must be destroyed.

 

The syringe handle SoloStar must be protected from dust and dirt. The outer side of the SoloStar syringe can be cleaned by wiping it with a damp cloth. Do not immerse in liquid, rinse and lubricate the syringe handle of SoloStar, as this can damage it.

 

The syringe-pen SoloStar precisely doses the insulin and is safe in work. It also requires careful handling.Avoid situations in which damage to the SoloStar pen can occur. If you suspect a damage to the existing copy of the SoloStar pen, you should use a new syringe pen.

 

Stage 1. Insulin control

 

It is necessary to check the label on the SoloStar syringe pen in order to make sure that it contains the appropriate insulin. For Lantus, a gray-colored SoloStar pen with a purple button for injection. After removing the cap of the syringe-pen, monitor the appearance of the insulin contained in it: the insulin solution must be transparent, colorless, free of visible solid particles and resemble water in a consistency.

 

Stage 2. Connecting the needle

 

Use only needles that are compatible with the SoloStar pen. For each subsequent injection, a new sterile needle is always used. After removing the cap, the needle must be carefully installed on the syringe handle.

 

Stage 3. Performance of the safety test

 

Before each injection, a safety test must be carried out and make sure that the syringe pen and needle work well and air bubbles are removed.

 

Measure the dose equal to 2 units.

 

The outer and inner needle caps must be removed.

 

With the needle pen up, gently tap the cartridge with the insulin finger so that all air bubbles are directed toward the needle.

 

Fully press the injection injection button.

 

If insulin appears at the tip of the needle, it means that the pen and needle work correctly.

 

If no insulin appears on the tip of the needle, stage 3 can be repeated until insulin appears on the tip of the needle.

 

Stage 4. Dose selection

 

The dose can be set to an accuracy of 1 unit from the minimum dose (1 unit) to the maximum dose (80 units). If it is necessary to enter a dose exceeding 80 units, two or more injections should be given.

 

The dosage window should indicate "0" after the completion of the safety test. After this, the required dose can be set.

 

Stage 5. Dosing Introduction

 

The patient should be informed about the technique of injection by a medical professional.

 

The needle must be inserted under the skin.

 

The injection button must be pressed completely. It is held in this position for another 10 seconds until the needle is removed. Thus, the introduction of a selected dose of insulin is ensured completely.

 

Step 6.Extraction and ejection of a needle

 

In all cases, the needle after each injection should be removed and discarded. This ensures the prevention of contamination and / or infection, air entering the insulin tank and leakage of insulin.

 

When removing and discarding the needle, special precautions must be taken. Observe the recommended safety measures for removing and disposing of needles (for example, the technique of putting the cap on with one hand) in order to reduce the risk of accidents involving the use of the needle, and to prevent infection.

 

After removing the needle, close the SoloStar pen with the cap.

 

Side effect

  • hypoglycemia - develops most often if the dose of insulin exceeds the need for it;
  • "twilight" consciousness or its loss;
  • convulsive syndrome;
  • hunger;
  • irritability;
  • cold sweat;
  • tachycardia;
  • visual impairment;
  • retinopathy;
  • lipodystrophy;
  • dysgeusia;
  • myalgia;
  • edema;
  • allergic reactions of immediate type to insulin (including insulin glargine) or auxiliary components of the drug: generalized skin reactions, angioedema, bronchospasm,arterial hypotension, shock;
  • redness, pain, itching, hives, swelling, or inflammation at the site of injection.

 

Contraindications

  • Children under 6 years of age for Lantus Optics and OpticKlik (no clinical application data at present);
  • Children under 2 years old for Lantus SoloStar (lack of clinical data for use);
  • hypersensitivity to the components of the drug.

 

Application in pregnancy and lactation

 

Caution should be used Lantus during pregnancy.

 

For patients with pre-existing or gestational diabetes mellitus, it is important during the entire pregnancy to maintain adequate regulation of the metabolism. In the first trimester of pregnancy, the need for insulin can decrease, in 2 and 3 trimesters - increase. Immediately after delivery, the need for insulin decreases, and the risk of developing hypoglycemia increases. In these conditions, careful monitoring of glucose in the blood is essential.

 

In experimental animal studies, direct or indirect data on embryotoxic or fetotoxic effects of insulin glargine were not obtained.

 

Controlled clinical studies of the safety of the use of Lantus during pregnancy have not been conducted. There are data on the use of Lantus in 100 pregnant women with diabetes mellitus. The course and outcome of pregnancy in these patients did not differ from those in pregnant women with diabetes who received other insulin preparations.

 

Women in the period of breastfeeding may need to adjust the dosage regimen of insulin and diet.

 

Use in children

 

Clinical data for use in children under the age of 6 years is currently not available.

 

Application in elderly patients

 

In elderly patients, a progressive deterioration in kidney function can lead to a persistent decrease in insulin requirements.

 

special instructions

 

Lantus is not a drug of choice for the treatment of diabetic ketoacidosis. In such cases, intravenous insulin administration is recommended.

 

Due to limited experience with Lantus, it was not possible to evaluate its efficacy and safety in the treatment of patients with impaired liver function or patients with moderate or severe renal insufficiency.

 

In patients with impaired renal function, the need for insulin may decrease in connection with the weakening of the processes of its elimination. In elderly patients, a progressive deterioration in kidney function can lead to a persistent decrease in insulin requirements.

 

In patients with severe hepatic insufficiency, the need for insulin can be lowered due to a decrease in the ability to gluconeogenesis and biotransformation of insulin.

 

In case of ineffective control over the level of glucose in the blood, as well as in the presence of a tendency to develop hypoglycemic or hyperglycemia, before proceeding with correction of the dosing regimen, it is necessary to check the accuracy of compliance with the prescribed treatment regimen, the injection site and the technique of literally conducting SC injections , considering all the factors affecting this.

 

Hypoglycaemia

 

The time of development of hypoglycemia depends on the profile of the action of the insulin used and can, therefore, change with a change in the treatment regimen. Due to an increase in the time of insulin administration of a prolonged action in the application of Lantus, one should expect a lower probability of developing nocturnal hypoglycemia, whereas in the early morning hours this probability is higher.When hypoglycemia occurs in patients receiving Lantus, the possibility of slowing the release from the state of hypoglycemia in connection with the prolonged action of insulin glargine should be considered.

 

Patients in whom episodes of hypoglycemia may have a particular clinical significance, incl. in patients with severe stenosis of the coronary arteries or the vessels of the brain (risk of cardiac and cerebral hypoglycemia complications), as well as in patients with proliferative retinopathy, particularly if they do not receive treatment photocoagulation (risk of transient loss of vision due to hypoglycemia), you should take special precautions and carefully monitor the content of glucose in the blood.

 

Patients should be warned about conditions in which symptoms-precursors of hypoglycemia may decrease, become less pronounced or absent in certain risk groups, which include:

  • patients who have significantly improved blood glucose regulation;
  • patients who develop hypoglycemia gradually;
  • patients of advanced age;
  • patients with neuropathy;
  • patients with long-term diabetes mellitus;
  • patients suffering from mental disorders;
  • patients transferred from insulin of animal origin to human insulin;
  • patients receiving concomitant medication with other medications.

 

Such situations can lead to the development of severe hypoglycemia (with possible loss of consciousness) before the patient realizes that he is developing hypoglycemia.

 

In case normal or reduced parameters of glycated hemoglobin are noted, it is necessary to consider the possibility of developing recurrent unrecognized episodes of hypoglycemia (especially at night).

 

Patient compliance with the dosing regimen, diet and diet, proper use of insulin, and control of the onset of hypoglycemia symptoms contribute to a significant reduction in the risk of hypoglycemia. In the presence of factors that increase the predisposition to hypoglycemia, a particularly careful observation is necessary, since may need to adjust the dose of insulin. These factors include:

  • change the place of insulin administration;
  • increased sensitivity to insulin (eg, when stress factors are eliminated);
  • unusual, increased or prolonged physical activity;
  • intercurrent diseases, accompanied by vomiting, diarrhea;
  • violation of diet and diet;
  • missed food intake;
  • alcohol consumption;
  • Some uncompensated endocrine disorders (eg, hypothyroidism, adenohypophysis deficiency or adrenal cortex);
  • concomitant medication with some other medicines.

 

Intercurrent diseases

 

When intercurrent diseases require more intensive monitoring of blood glucose. In many cases, the analysis of the presence of ketone bodies in the urine is shown, and often a correction of the insulin dosage regimen is required. The need for insulin often increases. Patients with type 1 diabetes should continue to regularly consume at least a small amount of carbohydrates, even when eating only in small amounts or when food is not available, and when vomiting. These patients should never completely stop the introduction of insulin.

 

Drug Interactions

 

Oral hypoglycemic agents, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAO inhibitors, pentoxifylline, dextropropoxyphene,salicylates and Sulfanilamide antimicrobial agents can enhance the hypoglycemic action of insulin and increase the predisposition to the development of hypoglycemia. With these combinations, you may need to adjust the dose of insulin glargine.

 

Glucocorticosteroids (GCS), danazol, diazoxide, diuretics, glucagon, isoniazid, estrogens, gestagens, phenothiazine derivatives, somatotropin, sympathomimetics (eg epinephrine, salbutamol, terbutaline), thyroid hormones, protease inhibitors, some antipsychotics (eg olanzapine or clozapine ) can reduce the hypoglycemic action of insulin. With these combinations, you may need to adjust the dose of insulin glargine.

 

With simultaneous application of Lantus with beta-blockers, clonidine, lithium salts, ethanol (alcohol), both strengthening and weakening of hypoglycemic action of insulin are possible. Pentamidine, when combined with insulin, can cause hypoglycemia, which is sometimes replaced by hyperglycemia.

 

With simultaneous use with drugs that have a sympatholytic effect,such as beta-blockers, clonidine, guanfacine, and reserpine, there may be a decrease or absence of signs of adrenergic counterregulation (activation of the sympathetic nervous system) in the development of hypoglycemia.

 

Pharmaceutical interaction

 

Lantus should not be mixed with other insulin preparations, with any other medicines or diluted. When mixing or diluting, the profile of its action over time can change, in addition, mixing with other insulins can cause precipitation.

 

Analogues of the medicinal product Lantus

 

Structural analogs for the active substance:

  • Insulin glargine;
  • Lantus SoloStar.

 

Analogues on the curative effect (agents for the treatment of insulin-dependent diabetes mellitus):

  • Actrapid;
  • Anistat;
  • Apidra;
  • B Insulin;
  • Berselsulin;
  • Biosulin;
  • Gliiformin;
  • Glukobay;
  • Depo insulin C;
  • Dibikor;
  • Isofan Insulin World Cup;
  • Iletin;
  • Insulin Isophanycum;
  • Insulin Lente;
  • Insulin Maxyrapid B;
  • Insulin is a soluble neutral;
  • Insulin Semilente;
  • Insulin Ultralente;
  • Insulin Long;
  • Insulin Ultralong;
  • Insuman;
  • Inutral;
  • Comb-insulin C;
  • Levemir Penfill;
  • Levemir FlexPen;
  • Metformin;
  • Mixtard;
  • Monosuansulin MK;
  • Monotard;
  • NovoMiks;
  • NovoRapid;
  • Pensulin;
  • Protafan;
  • Rinsulin;
  • Stylamine;
  • Torvacard;
  • Trakor;
  • Ultradard;
  • Humalog;
  • Humulin;
  • Cigapan;
  • Erbisol.

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