Toujeo

DM in adults, adolescents & childn from 6 yr.

SC Individualized dose. Administer once daily, at any time during the day, preferably at the same time every day. Type 1 DM Once daily w/ meal-time insulin. Type 2 DM Initially 0.2 U/kg once daily followed by individual dose adjustments.

Hypersensitivity.

Not intended for IV & via insulin infusion pump. Not to inj into areas of lipodystrophy or localized cutaneous amyloidosis. Not for treatment of diabetic ketoacidosis. Discontinue pioglitazone if any deterioration in cardiac symptoms occurs. Potential risk of delayed insulin absorption & worsened glycemic control following inj. Hypoglycemia & as it develops gradually; glycemic control is markedly improved; transfer from animal to human insulin; presence of autonomic neuropathy. May cause insulin Abs. Possibility of recurrent, unrecognised (especially nocturnal) episodes of hypoglycemia if normal or decreased values for glycated Hb occurs. Patients w/ significant stenoses of coronary arteries or of blood vessels supplying brain (risk of cardiac or cerebral complications) & proliferative retinopathy, particularly if not treated w/ photocoagulation (risk of transient amaurosis following hypoglycemia); long history of diabetes; suffering from psychiatric illness; receiving concurrent treatment w/ other drugs. Instruct patients on appropriate diabetes self-management skills including glucose monitoring, proper inj technique, & hypo-/hyperglycemia management; handling special situations eg, inadequate or skipped insulin dose, inadvertent administration of increased insulin dose, inadequate food intake or skipped meals. Perform continuous rotation of inj site (abdomen, thigh or deltoid) to reduce risk of developing lipodystrophy & localized cutaneous amyloidosis. Consider blood glucose monitoring after change in inj site & dose adjustment of antidiabetics. Close monitoring on factors increasing susceptibility to hypoglycemia eg, change in inj area; increased insulin sensitivity (eg, by removal of stress factors); unaccustomed, increased, or prolonged physical exercise; intercurrent illness (eg, vomiting, diarrhoea); inadequate food intake; alcohol consumption; certain uncompensated endocrine disorders; concomitant treatment w/ certain medications. Correct hypoglycemia by immediate carbohydrate intake. Intensified metabolic monitoring in patients w/ intercurrent illness. Perform urine tests for ketones. Switching between treatment & insulin glargine 100 U/mL, & other insulins. Cases of cardiac failure in combination w/ pioglitazone especially in patients w/ risk factors for development of cardiac failure. Observe for signs & symptoms of heart failure, wt gain & oedema in combination w/ pioglitazone. May affect ability to drive & use machines. Renal & severe hepatic impairment. Maintain good metabolic control throughout pregnancy in patients w/ pre-existing or gestational diabetes. May decrease insulin requirements during 1st trimester & increase during 2nd & 3rd trimester of pregnancy. Adjust insulin dose & diet during lactation. Childn <6 yr. Progressive deterioration of renal function may lead to steady decrease in insulin requirements in elderly.

Hypoglycemia; temporary visual impairment, diabetic retinopathy; lipodystrophy & lipohypertrophy, localized cutaneous amyloidosis at inj site; local allergy at inj site eg, redness, pain, itching, hives, swelling or inflammation. Generalised skin reactions, angioedema, bronchospasm, hypotension & anaphylactic shock.

Increased blood glucose lowering effect & susceptibility to hypoglycemia w/ antihyperglycemics, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, propoxyphene, salicylates, sulfonamides. Reduced blood glucose lowering effect w/ corticosteroids, danazol, diazoxide, diuretics, sympathomimetics (eg, epinephrine, salbutamol, terbutaline), glucagon, INH, phenothiazine derivatives, somatropin, thyroid hormones, estrogens & progestogens (eg, OCs), PIs & atypical antipsychotics (eg, olanzapine & clozapine). Either potentiated or weakened blood glucose lowering effect w/ β-blockers, clonidine, lithium salts & alcohol. Hypo-/hyperglycemia w/ pentamidine. Reduced or absence of adrenergic counter-regulation signs w/ sympatholytics eg, β-blockers, clonidine, guanethidine & reserpine.

Insulin Preparations

A10AE04 - insulin glargine ; Belongs to the class of long-acting insulins and analogues for injection. Used in the treatment of diabetes.

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