💊 Insulin glargine (Basaglar Kwikpen)

🏷️ Brand names & manufacturers

Basaglar Kwikpen🏭 Eli Lilly and CompanyDailyMed

Toujeo🏭 Sanofi-Aventis U.S. LLCDailyMed

Lantus Solostar🏭 sanofi-aventis U.S. LLCDailyMed

Insulin Glargine U-300 Max🏭 Sanofi-Aventis U.S. LLCDailyMed

✅ What it is used for

• Improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus
• Improve glycemic control in adults with type 2 diabetes mellitus
• Not recommended for the treatment of diabetic ketoacidosis

🧪 Active ingredient

The active substance is insulin glargine, a long-acting human insulin analog. It lowers blood glucose by stimulating glucose uptake in skeletal muscle and fat and by inhibiting glucose production in the liver.

🌿 Benefits

• Provides sustained glucose lowering over 24 hours with no pronounced peak
• Can be injected once daily
• Helps improve blood sugar control

📝 How to use

• Your doctor or pharmacist sets the dose based on your metabolic needs and blood glucose monitoring; do not change it on your own
• Inject subcutaneously once daily, at any time of day but at the same time every day
• Inject into the abdomen, thigh, or upper arm (deltoid) and rotate injection sites within the same region to reduce the risk of lipodystrophy and localized cutaneous amyloidosis
• Do not inject into areas of lipodystrophy or localized cutaneous amyloidosis
• Inspect the pen before use: the solution must be clear, colorless, and free of visible particles
• Do not dilute or mix with any other insulin or solution
• Do not give intravenously or via an insulin pump
• In type 1 diabetes, it must be used together with a short-acting insulin
• Never share a pen between people, even if the needle is changed
• Use with caution if you have visual impairment and rely on audible clicks to dial your dose
• Check your blood glucose more often when your insulin regimen changes

💊 Dosage forms

• Injection 100 units/mL (U-100), clear and colorless solution
• 3 mL single-patient-use BASAGLAR KwikPen
• 3 mL single-patient-use BASAGLAR Tempo Pen

🔄 Drug interactions

• Drugs that may increase the risk of hypoglycemia: other antidiabetic agents, ACE inhibitors, angiotensin II receptor blockers, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics
• Drugs that may decrease the blood glucose lowering effect: atypical antipsychotics (e.g., olanzapine, clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens, protease inhibitors, somatropin, sympathomimetics (e.g., albuterol, epinephrine, terbutaline), and thyroid hormones
• Drugs that may increase or decrease the effect: alcohol, beta-blockers, clonidine, and lithium salts; pentamidine may cause hypoglycemia, sometimes followed by hyperglycemia
• Drugs that may blunt signs of hypoglycemia: beta-blockers, clonidine, guanethidine, and reserpine
• Dose adjustment and more frequent glucose monitoring may be needed with these drugs; consult your doctor

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👨‍⚕️ For healthcare professionals

Mechanism of action

Long-acting human insulin analog produced by recombinant DNA technology in E. coli (K12). It regulates glucose metabolism by stimulating peripheral glucose uptake (especially skeletal muscle and fat) and inhibiting hepatic glucose production; it also inhibits lipolysis and proteolysis and enhances protein synthesis. Pharmacodynamics: median time to maximum effect approximately 12 hours, with sustained glucose lowering over 24 hours and no pronounced peak.

Labeled dosing

Dosage is individualized and adjusted by the physician based on metabolic needs, glucose monitoring results, and glycemic goals. Administered subcutaneously once daily at the same time each day. Type 1 diabetes: starting dose approximately one-third of total daily insulin requirements, with short- or rapid-acting pre-meal insulin for the remainder. Type 2 diabetes: starting dose 0.2 units/kg or up to 10 units once daily. When changing from another insulin glargine 100 units/mL product, use the same dose; from once-daily insulin glargine 300 units/mL, the initial dose is 80% of that dose. Pens dial in 1-unit increments, maximum 80 units per injection.

• Not indicated for treatment of diabetic ketoacidosis
• Do not administer intravenously or via insulin pump; do not dilute or mix
• Dose adjustments may be needed with changes in physical activity, meal patterns, acute illness, or renal/hepatic function
• Increase glucose monitoring frequency when converting from another insulin regimen and during the initial weeks
• Common adverse reactions (≥5%): hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, weight gain
• To report suspected adverse reactions: Eli Lilly at 1-800-LillyRx or FDA at 1-800-FDA-1088

🎓 Key points for students

• Long-acting insulin analog: asparagine at A21 replaced by glycine, plus two arginines added to the C-terminus of the B-chain
• Empirical formula C267H404N72O78S6; molecular weight approximately 6.063 kDa
• Solution pH is approximately 4; it is a clear solution that must not be mixed with other insulins
• Slow, prolonged absorption with no pronounced peak and glucose lowering over 24 hours
• Contraindications: episodes of hypoglycemia and hypersensitivity
• Key warnings: hypokalemia and heart failure with thiazolidinediones
• Know the interactions: drugs that raise hypoglycemia risk, drugs that blunt its effect, and beta-blockers that mask hypoglycemia symptoms