Pharm

Insulin Glargine U-300

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Insulin Glargine U-300, Toujeo, Toujeo Max Solostar

  • See Also
  1. Insulin
  2. Insulin Glargine
  3. Insulin Dosing
  • Indications
  1. Similar indications to standard Insulin Glargine concentration (100 units/ml)
    1. Promoted as a longer acting Lantus (closer to 24 hour duration) at several fold higher cost
    2. However, in practice, U-300 likely adds little benefit over standard Insulin Glargine
  2. Type 1 Diabetes Mellitus
    1. Basal insulin for those not using an Insulin Pump (or for emergency use when Insulin Pump fails)
  3. Type 2 Diabetes Mellitus with Insulin Resistance refractory to non-Insulin therapy
  • Medications
  1. Toujeo Solostar pen
    1. Toujeo contains 80 units/injection (450 u/pen)
    2. Toujeo Max contains 160 units/injection (900 u/pen)
    3. Both contain the same 3x GlargineInsulin concentration of Lantus)
  • Pharmacokinetics
  1. Onset: 6 hours
  2. Duration: 24 to 36 hours
  3. Released in 2015 (curiously as Lantus becomes generic)
    1. Promoted as a longer acting Lantus (closer to 24 hour duration)
    2. However, more expensive ($500/month if 60 u/day); contrast with NPH at 10% of cost
  • Dosing
  1. See Insulin Dosing
  2. See Insulin Dosing in Type I Diabetes
  3. See Insulin Dosing in Type II Diabetes
  4. Insulin Glargine U-300 is injected subcutaneously
  5. Do not adjust Toujeo dose more often than every 3-4 days
  6. Insulin Naive Starting Dose in Type 2 Diabetes Mellitus: 0.2 units/kg SQ daily
  7. Transitioning from other agents
    1. From Lantus, Basaglar daily
      1. Dose Toujeo at 110% of Lantus dose
    2. From Lantus twice daily
      1. Dose Toujeo at 100% of the Lantus dose
    3. From Detemir or NPH twice daily
      1. Dose Toujeo at 80% of total daily Basal insulin dose
  8. Transitioning to other agents
    1. To Lantus or Basaglar
      1. Dose Lantus or Basaglar at 80% of Toujeo dose to start, then titrate up
  • Adverse Effects
  1. See Insulin
  • Safety
  1. Insulin is considered safe in pregnancy and Lactation
  • References
  1. (2018) Presc Lett 25(8)
  2. Riddle (2014) Diabetes Care 37(10):2755-62 +PMID:25078900 [PubMed]