Insulin Glargine (Insulin Glargine (recombinant human insulin analog))
Also sold as: Lantus, Basaglar, Optisulin
Pregnancy
Cat B
Lactation
Safe
Schedule
H1
Forms
Subcutaneous injection: 100 IU/mL (pen, vial) +1
Indications
- Type 1 diabetes (basal-bolus)
- Type 2 diabetes (when oral agents fail)
- Gestational diabetes (if needed)
- Diabetic ketoacidosis (acute, with rapid-acting insulin)
Adult Dosing
Type 1 diabetes (basal)
10-15 IU once daily (morning or evening)
Titrate by 2-4 IU every 3-4 days to target fasting glucose
Type 2 diabetes (starting)
10 IU once daily, increase by 2-4 IU every 3-4 days
Target fasting glucose 100-130 mg/dL
Maintenance (Type 1)
Usually 8-16 IU/day basal (depends on individual)
Once daily, long-term
Pediatric Dosing
Frequent glucose monitoring essential; adjust doses weekly
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 60 mL/min | No adjustment |
| CrCl 30-60 mL/min | May need 10-20% dose reduction; monitor glucose closely |
| CrCl < 30 mL/min | May need significant reduction (25-50%); frequent monitoring essential |
Hepatic Adjustment
No adjustment required; monitor glucose.
Pregnancy & Lactation
Pregnancy: Category B
Safe in pregnancy (preferred basal insulin). Maintain tight glycemic control; target fasting <95 mg/dL.
Lactation: Safe
Safe; insulin not absorbed orally so not transferred to infant.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Sulfonylureas, meglitinides, other insulin | Additive hypoglycemic effect | Moderate |
| Corticosteroids, thiazides | May reduce insulin efficacy; increase insulin dose | Moderate |
| Beta-blockers | May mask hypoglycemia symptoms | Moderate |
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Side Effects
Common
- Hypoglycemia (most common)
- Weight gain
- Lipohypertrophy (if same injection site)
- Injection site reactions
Serious / Discontinue If
- Severe hypoglycemia (seizure, coma, death)
- Hypokalemia (during hyperglycemia treatment)
- Diabetic ketoacidosis (if insulin pump fails)
Contraindications
- Hypoglycemia awareness impaired
- Inability to monitor blood glucose
- Hypersensitivity to insulin or additives
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Lantus 100 IU/mL | Sanofi | 1 pen (3mL) ₹2500-3000 |
| Basaglar 100 IU/mL | Eli Lilly | 1 pen ₹1800-2200 |
| Optisulin 100 IU/mL | Biocon | 1 pen ₹1200-1500 |
Monitoring Required
- Fasting blood glucose daily (initial titration)
- HbA1c every 3 months
- Hypoglycemia awareness / episodes
- Injection technique (rotate sites)
- Lipohypertrophy at injection sites
Patient Counseling Points
- Inject subcutaneously (abdomen, thigh, arm) once daily, same time
- Rotate injection sites to prevent lipohypertrophy (fatty lumps)
- Keep cool (2-8°C unopened); room temperature after opening (max 28 days)
- Carry glucose tablets/glucagon for hypoglycemia
- Check blood glucose before meals and bedtime
- Insulin is lifelong for Type 1 diabetes
- Hypoglycemia risk: report confusion, sweating, rapid heartbeat
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EasyClinic auto-flags Insulin Glargine interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Anjali Kumar, MD (Endocrinology), Insulin Management Specialist
Last reviewed: 2026-04-30
References
- BNF — Insulin Glargine
- ADA Insulin Guidelines 2024
- Hypoglycemia Management