Insulin glargine is used on its own or together with other medicines to treat diabetes by keeping the blood sugar under control.
This medicine is meant to be used as part of a complete diabetes care programme that should include exercise, a healthy diet and regular monitoring of blood sugar levels.
Use Insulin glargine exactly as directed by your doctor or according to the instructions on the label. Do not administer more or less than instructed by your doctor as small changes in the amount of this medicine may affect your blood sugar level.
This medicine is to be injected subcutaneously (into the fatty layer under the skin, usually in the thigh, upper arm or abdomen area). Try to administer it at the same time each day.
This medicine is available as a vial, pre-filled injection pen, or as a solution for injection in a cartridge. Make sure you know how to use the specific device you have been given. If you have problems or do not understand the instructions, ask your doctor or pharmacist. Insulin glargine may become ineffective if your insulin pen does not work properly.
How to use the insulin vial:
- Gather all the supplies you will need for injection (e.g. vial, syringe, alcohol swab).
- Wash your hands with soap and water.
- If you are using a new vial, pull off the protective cap of the medicine (on the top of the vial) then you will see a rubber stopper. Wipe the top of the rubber stopper with alcohol swab.
- Roll the vial between your hands in a horizontal (flat) position until the insulin suspension is evenly mixed. Do not shake the vial.
- Remove the needle cover of the syringe recommended by your doctor. Draw air, equal to your required dose, into the syringe by pulling back the plunger.
- Put the vial on a flat surface then insert the needle down the grey rubber stopper.
- Push the plunger of the syringe down to inject the air and keep the needle inside the vial.
- Turn the vial upside down. Slowly pull back the plunger to fill the syringe with your dose.
- Keep the needle inside the vial. Check the syringe for air bubbles. To remove air bubbles, gently tap the syringe with your fingers until the air bubbles rise to the top of the syringe then slowly push the plunger up. Pull the plunger back down to draw back your required dose.
- Remove the needle from the vial and hold it in your hand that will inject the medicine.
- Wipe the selected injection site with alcohol swab and pinch the skin using your other hand. Insert the needle in a way your doctor or nurse showed you. Push the plunger of the syringe as far as it will go to deliver your dose.
- Slowly let go of the skin and gently pull the needle out of the skin. Do not recap the needle.
- Gently press the injection site for several seconds.
- Dispose your used needles and syringes according to your doctor or pharmacist's instructions. Use a new needle and syringe for each injection.
Ensure that you are using the correct type of syringe. Check with your doctor or nurse if you are not sure.
How to use the insulin pre-filled pen:
- Prepare the injection pen as instructed by your doctor or nurse.
- Attach the needle to the injection pen. Ensure that the needle is screwed on securely.
- Dial the correct dose.
- Swab the injection site area with alcohol.
- Hold the injection pen and push the needle into your skin as shown by your doctor or nurse.
- Place your thumb on the injection button and press all the way in then hold it until it stops.
- Continue holding the injection button in that position and when you see "0" in the dose window, slowly count to 5 to get a full dose.
- Withdraw the injection pen from your body.
- Remove the needle from the pen. Never store the injection pen with the needle attached.
- Reset your pen as instructed by your doctor or nurse.
- Throw away the used needle. Recap your pen and store it according to the instructions on the label or as instructed by your doctor or nurse.
- Use a new needle in every administration of this medicine.
If you have been given the solution for injection in a cartridge, you must first insert the cartridge in the provided injection pen before use. Follow the instructions for pre-filled injection pen to use this device.
Remember to rotate the choice of injection site area. Do not inject into the same area all the time. Do not inject near the navel (belly button).
Do not mix this medicine with any other insulin formulation or solution.
Do not share your insulin injection with anyone else.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of your treatment depending on your condition and response to the medication.
Insulin glargine must be administered regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it unless instructed by the doctor. If you suddenly stop using this medicine, it may lead to hyperglycaemia (high blood sugar level).
If you missed a dose of Insulin glargine, administer the dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal injection schedule. Check your blood sugar levels and ask your doctor on how to adjust your insulin doses if needed.
A missed dose may lead to hyperglycaemia (high blood sugar level). If you often forget to inject your medicine, let your doctor and pharmacist know. They can give you advice that can help you remember your dosing schedule.
DO NOT double a dose to make up for a missed dose.
Do not use Insulin glargine if you ever had an allergic reaction (e.g. rashes, breathlessness, swollen eyes) to this medicine or any of its ingredients.
Alert your doctor if you are experiencing episodes of hypoglycaemia (low blood sugar), as this medicine may not be suitable for you.
Inform your doctor if you have the following conditions:
- heart disease
- eye disease related to diabetes
- liver disease
- kidney disease
Insulin glargine is not intended for the treatment of diabetic ketoacidosis (complication of diabetes characterised by high level of blood acid in your body).
Let your doctor know if you are pregnant or breastfeeding.
If you have a present illness (e.g. vomiting, diarrhoea), inform your doctor as these conditions may affect your blood sugar level.
Exercise will also change your insulin requirement. Consult your doctor if you are changing your exercise routine or starting on a new exercise program.
Notify your doctor if you consume large amounts of alcohol or if you are a frequent drinker.
Do not change the brand or type of insulin you are using without first consulting your doctor.
If you are travelling, discuss with your doctor about how to adjust your injection schedule. Carry your insulin in your hand-carry luggage. Do not put insulin in your check-in luggage as it may freeze.
For as long as you are using this medicine, you will need to have routine blood tests (e.g. blood sugar level, electrolyte level, kidney function tests, liver function tests) to check your body's response to the medicine. Your doctor will advise you about how often you need to have these tests.
If you are taking this medicine, you may have been warned about hypoglycaemia (low blood sugar).
How do I know if I am experiencing hypoglycaemia?
Hypoglycaemia is the medical term for low blood sugar. Symptoms of hypoglycaemia include dizziness, tremor, shaky hands, feeling hungry, weak or confused, sweating. These signs are your body's way of warning you that your blood sugar level is low.
It is important to recognise these symptoms and get relief for hypoglycaemia quickly, as the hypoglycaemia may worsen.
What should I do if I am experiencing hypoglycaemia?
Always carry some glucose tablets (also known as dextrose tablets) with you. Take 15 g of glucose tablet at the first sign of hypoglycaemia, wait for 15 minutes, and re-check your blood sugar level. If you are not feeling better or if your blood sugar level is still low (less than 4 mmol/L or 70 mg/dL), take another 15 g of glucose tablet.
If you don't have glucose tablets, you may take any of the following:
- 1/2 cup (120 mL) of juice or regular soda (not diet)
- 1 tablespoon of sugar, honey, or corn syrup
- hard candies, jellybeans, or gumdrops (not sugar-free)
Get medical help should symptoms do not improve after the second serving.
Insulin glargine may cause hypoglycaemia (low blood sugar) which may affect your ability to concentrate and react. If affected, do not drive or take part in any activity in which you need to be alert.
You may also experience thickening and sinking of the skin around the injection area. This can usually be minimised by rotating the injection site.
Other side effects may include any of the following: headache, runny or stuffy nose, sneezing, sore throat, cough, joint pain, back pain, pain in the arms or legs, diarrhoea, itching, rash, pain, redness, and swelling at the injection site.
If you develop rashes, breathlessness, swollen mouth or eyes, stop using Insulin glargine and alert your doctor immediately. These could be signs of an allergic reaction.
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking or using any of these medicines:
- other medicines for diabetes e.g. pramlintide, pioglitazone
- medicines for high blood pressure e.g. metoprolol, guanethidine, reserpine
- water pills or medicines for water retention
- certain antibiotics e.g. sulfamethoxazole
- medicines for depression e.g. fluoxetine
- medicines for mood disorders e.g. clozapine, olanzapine, lithium
- cholesterol-lowering medicines e.g. ciprofibrate
- medicines for asthma e.g. salbutamol, terbutaline
- birth control pills
- certain medicines for HIV infection
- anti-inflammatory medicines
- disopyramide (medicine for irregular heartbeat)
- isoniazid (medicine to treat a lung infection known as tuberculosis or TB)
This list does not include all medicines that may interact with Insulin glargine.
Always notify your doctor or pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
It is important for you to maintain a healthy diet and weight in order to help keep your diabetes under control.
It may be helpful to discuss your diet plan with your doctor or dietitian to manage your weight and blood sugar levels.
If you have not yet opened it, store Insulin glargine in a refrigerator between 2-8°C. Do not allow to freeze. If frozen, this medicine will become ineffective and should not be used.
Once opened, this medicine may be stored at room temperature not exceeding 30°C away from direct light.
Storage recommendations may vary among different preparations. Refer to specific product guidelines.
Do not use Insulin glargine if it has changed colour, has a frosted appearance or if you see lumps floating in the liquid or stuck to the side of the glass. Throw away any unused portion.
Make sure you know how to store your medicine. This medicine may become ineffective if not stored properly. If you have problems or do not understand the instructions, ask your doctor or pharmacist.
Keep away from heat, sunlight, and from the reach of children.
Medicines must not be used past the expiry date.