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Lantus Patient, Information, Instructions - Lantus - Insulin Glargine
Lantus Patient, Information, Instructions - Lantus - Insulin Glargine
INFORMATION FOR PATIENTS
(insulin glargine [Recombinant DNA origin] injection)
Patient Information for the LANTUS Vial
This leaflet tells you about LANTUS (LAN-tus) and about how to use LANTUS in
a vial. At the end of the leaflet is a list of vocabulary words you may find
useful. Read this information carefully before you use LANTUS. Read the information
you get when you refill your LANTUS prescriptions because there may be new information.
This leaflet does not take the place of complete discussions with your health
care professional. If you have questions about LANTUS or about diabetes, talk
with your health care professional.
What is the most important information I should know about LANTUS?
Do not dilute or mix LANTUS with any other insulin or solution. It will
not work as intended, and you may lose blood sugar control, which could be serious.
What is LANTUS?
LANTUS is a long-acting synthetic (man-made) human insulin to treat diabetes.
You need a prescription to get LANTUS. Always be sure the pharmacy gives you
the right insulin. The carton and vial should look like the ones in this picture.
Diabetes is a disease caused when the body cannot produce or use insulin. Insulin
is a hormone produced by the pancreas. Your body needs insulin to turn glucose
(sugar) from food into energy. If your body does not make enough insulin, you
need another source of insulin so you will not have too much sugar in your blood.
That is why you must take insulin injections.
LANTUS is similar to the insulin made by your body. It is used once a day to
lower blood glucose. Like other insulins, you take LANTUS by injecting it in
the fatty layer under the skin (subcutaneously). The dose your health care professional
prescribes helps keep the glucose level in your blood close to normal.
You will be able to tell if LANTUS is working by testing your blood and/or
urine for glucose.
LANTUS contains active and inactive ingredients. The active ingredient is insulin.
It is dissolved in a colorless sterile (germ-free) fluid. The concentration
is 100 units/mL (U-100). Inactive ingredients are zinc, glycerol, m-cresol,
and water for injection.
Insulin injections play an important role in keeping your diabetes in control.
But the way you live your diet, careful monitoring of your glucose levels,
exercise, and planned physical activity all work with your insulin to help
you control your diabetes.
Who should not take LANTUS?
You should not take LANTUS if you are allergic to insulin or any of the inactive
ingredients in LANTUS.
How should I take LANTUS?
Inject LANTUS under your skin once a day at bedtime. You do not need to shake
the vial before use. You should look at the medicine in the vial. If the medicine
is cloudy or has particles in it, throw the vial away and get a new one.
What sort of syringe should I use?
Always use a syringe that is marked for U-100 insulin preparations. If you
use the wrong syringe, you may get the wrong dose and develop a blood glucose
level that is too low or too high.
Use disposable syringes and needles only once. Throw them away properly. Use
a new needle and syringe every time you dose. Never share needles and syringes.
How do I draw the insulin into the syringe?
Do not dilute or mix LANTUS with any other insulin or solution. The syringe
must not contain any other medicine or residue.
Follow these steps:
- Wash your hands.
- Check the insulin to make sure it is clear and colorless. Do not use it
if it is cloudy or if you see particles.
- If you are using a new vial, remove the protective cap. Do not remove the
stopper.
- Wipe the top of the vial with an alcohol swab.
- Draw air into the syringe equal to your insulin dose. Put the needle through
the rubber top of the vial and push the plunger to inject the air into the
vial.
- Leave the syringe in the vial and turn both upside down. Hold the syringe
and vial firmly in one hand.
- Make sure the tip of the needle is in the insulin. With your free hand,
pull the plunger to withdraw the correct dose into the syringe.
- Before you take the needle out of the vial, check the syringe for air bubbles.
If bubbles are in the medicine, hold the syringe straight up and tap the side
of the syringe until the bubbles float to the top. Push the bubbles out with
the plunger and draw insulin back in until you have the correct dose.
- Remove the needle from the vial. Do not let the needle touch anything. You
are now ready to inject.
How do I inject LANTUS?
Do not mix or dilute LANTUS with any other insulin or solution or LANTUS
will not work as intended, and you may lose blood sugar control, which could
be serious. You do not have to shake the vial before use.
Follow these steps:
- Decide on an injection area either upper arm, thigh, or abdomen. Injection
sites within an injection area must be different from one injection to the
next.
- Use alcohol to clean the skin where you are going to inject.
- Pinch the skin and hold it. Stick the needle in the way your doctor, nurse,
or diabetes educator showed you.
- Slowly push in the plunger of the syringe all the way, making sure you have
injected all the insulin. Leave the needle in the skin for several seconds.
- Pull the needle straight out and gently press on the spot where you injected
yourself for several seconds. Do not rub the area.
- Follow your health care professional's instructions for throwing away the
needle and syringe.
If your blood glucose reading is high or low, or if your urine tests show glucose,
tell your health care professional so the dose can be adjusted.
What can affect how much insulin I need?
Illness. Illness may change how much insulin you need. It is a good
idea to think ahead and make a "sick day" plan with your health care professional
so you will be ready when this happens. Be sure to test your blood and urine
often and call your health care professional if you are sick.
Pregnancy and nursing. If you are pregnant or nursing, or if you plan
to get pregnant, talk with your health care professional before you take LANTUS.
Your diabetes may be harder to control when you are pregnant. It is important
for you to monitor your glucose closer than usual during this time.
Medicines. Other medicines can change the way insulin works. Therefore,
tell your health care professional about all other medicines you are taking.
Your insulin dosage may need to be changed by your health care professional.
Do not change your medicine doses yourself.
For example, your body may need more insulin if you take birth control, thyroid,
decongestant, or diet pills. Your body may need less insulin if you are taking
antidepressants, antidiabetic pills, or ACE inhibitors (used to lower blood
pressure and for certain heart conditions).
Exercise. Exercise may change the way your body uses insulin. Be sure
to check with your health care professional before you start an exercise program.
Travel. If you travel across time zones, talk with your health care
professional about how to time your injections. When you travel, wear your medical
alert identification. Take extra insulin and supplies with you.
What if I want to drink alcohol?
Before you drink alcohol, talk to your health care professional about its effect
on diabetes.
What are the possible side effects of insulins?
- Allergic reactions:
In rare cases, a patient may be allergic to an insulin product. Severe insulin
allergies may be life-threatening. If you think you are having an allergic
reaction, get medical help right away. Signs of insulin allergy are:
- a rash all over your body
- shortness of breath
- wheezing (trouble breathing)
- a fast pulse
- sweating
- low blood pressure
- Hypoglycemia:
Hypoglycemia is often called an "insulin reaction" or "low blood sugar." It
may occur when you do not have enough glucose in your blood. Common causes
of hypoglycemia are illness, emotional or physical stress, too much insulin,
too little food or missed meals, and too much exercise.
Some of the symptoms of hypoglycemia are:
- sudden cold sweat
- feeling shaky or nervous
- feeling very tired
- feeling sick to your stomach
- feeling dizzy
- blurry vision
- headache
- confusion
- personality changes
Early warning signs of hypoglycemia may be different or less noticeable in
some people. That is why it is important to check your glucose as you have
been advised by your doctor.
If you have hypoglycemia, your body needs sugar. That is why you should carry
sugar, candy mints, or glucose tablets with you. Learn to recognize the signs
and eat or drink something that has some sugar in it.
Hypoglycemia can be very dangerous. Severe hypoglycemia can cause confusion,
seizures, and loss of consciousness. Someone with hypoglycemia who cannot
take sugar by mouth needs medical help fast. Without immediate medical help,
serious reactions or even death could occur.
You will have mild hypoglycemia once in a while when a meal is delayed, if
you get sick, or if you are late with your insulin injection. But if hypoglycemia
happens often or is severe, tell your health care professional about it. Also,
if you have trouble recognizing the symptoms of hypoglycemia, talk with your
health care professional.
- Hyperglycemia:
Hyperglycemia occurs when you have too much glucose in your blood. Usually,
it means there is not enough insulin to break down the food you eat into energy
your body can use. Hyperglycemia can be caused by a fever, an infection, stress,
eating more than you should, taking less insulin than prescribed, or it can
be part of the natural progression of diabetes. Routine testing of your blood
or urine will let you know if you have hyperglycemia. If your tests are often
high, tell your health care professional so your dose of medicine can be changed.
If your glucose is often high, you can develop a very serious condition called
diabetic ketoacidosis. Ketoacidosis can be life-threatening. If your blood
tests show high amounts of glucose or your urine tests show high amounts of
glucose or acetone, or if you have signs of ketoacidosis, you need to get
medical help quickly. Do not use LANTUS to treat diabetic ketoacidosis. Signs
of ketoacidosis are:
- sleepiness
- flushed (red) face
- thirst
- loss of appetite
- fruity odor on your breath
Signs of severe ketoacidosis are:
- heavy breathing
- fast pulse
- Possible reactions on the skin at the injection site:
Injecting insulin can cause the following reactions on the skin at the injection
site:
- a little depression in the skin (lipoatrophy)
- skin thickening (lipohypertrophy)
- red, swelling, itchy skin (injection site reaction)
An injection site reaction should clear up in a few days or a few weeks. If
it does not go away and it continues to occur, tell your health care professional.
You can reduce the chance of getting lipoatrophy and lipohypertrophy if you
change the injection site each time. Tell your health care professional if
you have these problems. You may need to learn to inject your insulin a different
way.
How should I store LANTUS?
Store new LANTUS vials in the refrigerator (not the freezer) between 36°F-46°F
(2°C-8°C). Do not freeze LANTUS. If a vial freezes, throw it away.
Once a vial is opened, you can keep it in the refrigerator or as cool as possible
(below 86°F [30°C]). The 10 mL vial is good for 28 days. Keep LANTUS out of
direct heat and light. For example, do not leave it in your car on a summer
day.
VOCABULARY
Glucose A form of sugar that the body uses for fuel. It is made when
food is broken down in the digestive system. Blood carries glucose to the cells.
Hypoglycemia Also called insulin reaction. It means that glucose levels
in the blood are too low.
Hyperglycemia Too much glucose in the blood. Usually testing, not
symptoms, reveals a too-high level.
Insulin A hormone that helps the cells in your body use glucose.
LANTUS A long-acting insulin similar to insulin made by your body.
It is used once a day at bedtime to lower blood glucose.
Lipoatrophy (LIP-o-AT-troe-fee) Loss of fat under the skin. Can be
caused by repeated insulin injections in the same place.
Lipohypertrophy (LIP-o-hi-PER-troe-fee) A lump under the skin caused
by an overgrowth of fat cells. Can be caused by repeated insulin injections
in the same place.
Ketoacidosis (kee-toe-as-ih-DOE-sis) A dangerous condition caused when
the body does not have enough insulin.
Pancreas (PAN-kree-as) A gland near the stomach that produces insulin.
Subcutaneous (sub-ku-TAE-nee-us) The fatty layer under the skin.
ADDITIONAL INFORMATION
DIABETES FORECAST is a national magazine designed especially for patients
with diabetes and their families and is available by subscription from the American
Diabetes Association, National Service Center, 1701 N. Beauregard Street, Alexandria,
Virginia 22311, 1-800-DIABETES (1-800-342-2383).
Another publication, DIABETES COUNTDOWN , is available from the Juvenile
Diabetes Foundation International (JDF), 120 Wall Street, 19th Floor, New York,
New York 10005, 1-800-JDF-CURE (1-800-533-2873). You may also visit the JDF
website at www.jdf.org.
To get more information about diabetes, check with your doctor or diabetes
educator. To get more information about LANTUS, ask your health care professional
or call 1-800-552-3656.
Feb 2001
Package insert circular number: 50056938
Aventis Pharmaceuticals Inc.
Kansas City, MO 64137 USA
LANTUS must only be used if the solution is clear and colorless with no particles
visible. (See DOSAGE AND ADMINISTRATION , Preparation and Handling ) Patients
must be advised that LANTUS must not be diluted or mixed with any other insulin
or solution. (See PRECAUTIONS , General )
Patients should be instructed on self-management procedures including glucose
monitoring, proper injection technique, and hypoglycemia and hyperglycemia management.
Patients must be instructed on handling of special situations such as intercurrent
conditions (illness, stress, or emotional disturbances), an inadequate or skipped
insulin dose, inadvertent administration of an increased insulin dose, inadequate
food intake, or skipped meals. Refer patients to the LANTUS Information for
the Patient circular for additional information.
As with all patients who have diabetes, the ability to concentrate and/or react
may be impaired as a result of hypoglycemia or hyperglycemia.
Patients with diabetes should be advised to inform their doctor if they are
pregnant or are contemplating pregnancy.
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