Lantus Dosage/Direction for Use

Insulin glargine (Lantus) contains insulin glargine, an insulin analogue, and has a prolonged duration of action.
Insulin glargine (Lantus) should be administered once daily at any time but at the same time each day.
The dose regimen (dose and timing) should be individually adjusted. In patients with type 2 diabetes mellitus, Insulin glargine (Lantus) can also be given together with orally active antidiabetic medicinal products.
The potency of this medicinal product is stated in units. These units are exclusive to Insulin glargine (Lantus) and are not the same as IU or the units used to express the potency of other insulin analogues (see Pharmacology: Pharmacodynamics under Actions).
Special population: Elderly population (≥65 years old): In the elderly, progressive deterioration of renal function may lead to a steady decrease in insulin requirements.
Renal impairment: In patients with renal impairment, insulin requirements may be diminished due to reduced insulin metabolism.
Hepatic impairment: In patients with hepatic impairment, insulin requirements may be diminished due to reduced capacity for gluconeogenesis and reduced insulin metabolism.
Paediatric population: Adolescents and children aged 2 years and older patients: Safety and efficacy of Insulin Glargine (Lantus) have been established in adolescents and children aged 2 years and older (see Pharmacology: Pharmacodynamics under Actions). The dose regimen (dose and timing) should be individually adjusted.
Children below 2 years of age: The safety and efficacy of Insulin Glargine (Lantus) have not been established. No data are available.
Switch from other insulins to Insulin Glargine (Lantus): When switching from a treatment regimen with an intermediate or long- acting insulin to a regimen with Insulin Glargine (Lantus), a change of the dose of the basal insulin may be required and the concomitant antidiabetic treatment may need to be adjusted (dose and timing of additional regular insulins or fast-acting insulin analogues or the dose of oral antidiabetic medicinal products).
Switch from twice daily NPH insulin to Insulin Glargine (Lantus): To reduce the risk of nocturnal and early morning hypoglycaemia, patients who are changing their basal insulin regimen from a twice daily NPH insulin to a once daily regimen with Insulin Glargine (Lantus) should reduce their daily dose of basal insulin by 20-30% during the first weeks of treatment. Switch from insulin glargine 300 units/ml to Insulin Glargine (Lantus) Insulin Glargine (Lantus) and Insulin Glargine 300 Units/mL (Toujeo) are not bioequivalent and are not directly interchangeable. To reduce the risk of hypoglycemia, patients who are changing their basal insulin regimen from an insulin regimen with once daily Insulin Glargine 300 Units/ml to a once daily regimen with Insulin Glargine (Lantus) should reduce their dose by approximately 20%.
During the first weeks the reduction should, at least partially, be compensated by an increase in mealtime insulin, after this period the regimen should be adjusted individually.
Close metabolic monitoring is recommended during the switch and in the initial weeks thereafter.
With improved metabolic control and resulting increase in insulin sensitivity a further adjustment in dose regimen may become necessary. Dose adjustment may also be required, for example, if the patient's weight or life- style changes, change of timing of insulin dose or other circumstances arise that increase susceptibility to hypo- or hyperglycaemia (see Precautions). Patients with high insulin doses because of antibodies to human insulin may experience an improved insulin response with Insulin Glargine (Lantus).
Method of administration: Insulin Glargine (Lantus) is administered subcutaneously.
Insulin Glargine (Lantus) should not be administered intravenously. The prolonged duration of action of Insulin Glargine (Lantus) is dependent on its injection into subcutaneous tissue. Intravenous administration of the usual subcutaneous dose could result in severe hypoglycaemia.
There are no clinically relevant differences in serum insulin or glucose levels after abdominal, deltoid or thigh administration of Insulin Glargine (Lantus). Injection sites must be rotated within a given injection area from one injection to the next. Insulin Glargine (Lantus) must not be mixed with any other insulin or diluted. Mixing or diluting can change its time/action profile and mixing can cause precipitation.
For further details on handling, see Special Precautions for Disposal and Other Handling under Cautions for Usage.