How long does it take for lantus to start working?

Lantus

Generic Name: insulin glargine (IN su lin GLAR gine)
Brand Names: Lantus, Lantus Solostar Pen

Medically reviewed by Kaci Durbin, MD Last updated on Feb 18, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

What is Lantus?

Lantus (insulin glargine) is a man-made form of a hormone (insulin) that is produced in the body. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Insulin glargine is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours.

Lantus is used to improve blood sugar control in adults and children with diabetes mellitus.

Lantus is used to treat type 1 or type 2 diabetes in adults, and type 1 diabetes children who are at least 6 years old.

Some brands of insulin glargine are for use only in adults. Carefully follow all instructions for the brand of insulin glargine you are using.

Important information

You should not use Lantus if you are having an episode of hypoglycemia (low blood sugar), or if you are in a state of diabetic ketoacidosis.

Never share a Lantus injection pen or cartridge with another person. Sharing injection pens or cartridges can allow disease such as hepatitis or HIV to pass from one person to another.

Not all insulin glargine brands are equal in dosing. Follow your doctor’s instructions when changing from one brand to another. If there are any changes in the brand, strength, or type of insulin you use, your dosage needs may change.

Lantus is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Lantus side effects

Get emergency medical help if you have signs of an allergy reaction to Lantus: redness or swelling where an injection was given, itchy skin rash over the entire body, trouble breathing, fast heartbeats, feeling like you might pass out, or swelling in your tongue or throat.

Call your doctor at once if you have:

  • weight gain, swelling in your hands or feet, feeling short of breath; or

  • signs of low potassium – leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common Lantus side effects may include:

  • low blood sugar;

  • itching, mild skin rash; or

  • thickening or hollowing of the skin where you injected the medicine.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking this medicine

You should not use Lantus if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar).

Lantus is not approved for use by anyone younger than 6 years old, and should not be used to treat type 2 diabetes in a child of any age.

To make sure Lantus is safe for you, tell your doctor if you have:

  • liver or kidney disease; or

  • low levels of potassium in your blood (hypokalemia);

Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while you are using insulin may increase your risk of serious heart problems.

Follow your doctor’s instructions about using Lantus if you are pregnant or breast-feeding a baby. Blood sugar control is very important during pregnancy, and your dose needs may be different during each trimester of pregnancy. Your dose needs may also be different while you are breast-feeding.

How should I use Lantus?

Use Lantus exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

If there are any changes in the brand, strength, or type of insulin you use, your dosage needs may change. The Toujeo brand of insulin glargine contains 3 times as much insulin per milliliter (mL) as the Lantus brand. There are 300 units of insulin in 1 mL of Toujeo, and 100 units in 1 mL of Lantus.

Insulin is injected under the skin. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

Lantus must not be given with an insulin pump, or mixed with other insulins. Do not inject insulin glargine into a vein or a muscle.

Lantus is usually injected once per day at the same time each day. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

Your care provider will show you the best places on your body to inject Lantus. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

If you use an injection pen, use only the injection pen that comes with Lantus. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe.

Never share an injection pen or syringe with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof “sharps” disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.

Lantus is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor’s instructions very closely.

Keep this medicine in its original container protected from heat and light. Do not draw insulin from a vial into a syringe until you are ready to give an injection. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) Lantus:

  • Refrigerate and use until expiration date; or

  • Store at room temperature and use within 28 days.

Storing opened (in use) Lantus:

  • Store the vial in a refrigerator or at room temperature and use within 28 days.

  • Store the injection pen at room temperature (do not refrigerate) and use within 28 days.

Do not store an injection pen with the needle attached.

Do not use the medicine if it looks cloudy, has changed colors, or has any particles in it. Call your pharmacist for new medicine.

Wear a diabetes medical alert tag in case of emergency. Any medical care provider who treats you should know that you have diabetes.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose of Lantus. You should not use more than one dose in a 24-hour period unless your doctor tells you to.

Keep insulin on hand at all times. Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Insulin overdose can cause life-threatening hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizure (convulsions), or loss of consciousness.

What should I avoid while using Lantus?

Do not change the brand of insulin glargine or syringe you are using without first talking to your doctor or pharmacist.

Avoid medication errors by always checking the medicine label before injecting your insulin.

Avoid drinking alcohol. It can cause low blood sugar and may interfere with your diabetes treatment.

What other drugs will affect Lantus?

Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of insulin. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. Tell your doctor about the following medications, which can interact with Lantus:

  • pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin);
  • other anti-diabetic medications;
  • blood pressure medications (including ACE-inhibitors, diuretics or water pills, clonidine, beta-blockers;
  • birth control pills;
  • thyroid medications;
  • anti-depressant medications (especially monoamine oxidase inhibitors or MAOIs, fluoxetine, and others);
  • anti-psychotic medications (including olanzapine, clozapine, and others);
  • certain antibiotics, including sulfa drugs; or
  • corticosteroid medications (such as prednisone);

Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lantus only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 11.03.

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Medical Disclaimer

More about Lantus (insulin glargine)

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Other brands: Basaglar, Toujeo, Toujeo Max SoloStar

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  • Lantus Solostar Pen

Related treatment guides

  • Diabetes, Type 2
  • Diabetes, Type 1

A good way to improve glucose levels is to track the peaks and drops in your glucose, and relate how the peak and action times of your insulins correspond to low or high patterns in your glucose. Identify your glucose patterns (they ARE there!), and work to understand when each of your insulins is active. This allows you adjust your insulin doses or food choices to stop unwanted ups and downs in your readings.

The table below shows the start, peak, and end times for various insulins.

When Does My Insulin Peak and How Long Does It Last?

Action Times for Insulins
Insulin Starts Peaks Ends Low most likely at: Usage
Hum/Nov/Apidra 10–20 m 1.5–2.5 h 4.5–6 h 2–5 h covers meals and lowers high BGs
Regular 30–45 m 2–3.5 h 5–7 h 3–7 h covers meals and lowers high BGs
NPH 1–3 h 4–9 h 14–20 h 4–12 h intermediate peaking and action time
Lantus 1–2 h 6 hr 18–26 h 6–10 h minimal peaking and longer acting background insulin action
Levemir 1–3 h 8–10 18–26 h 8–14 h minimal peaking and longer acting background insulin action
Toujeo 2 h none 36 h varies very flat, long-acting background insulin action
Treshiba 2 h none 42 h varies very flat, long-acting background insulin action

Rapid Insulins

Humalog (lispro), Novolog (aspart), and Apidra (glulisine) insulins cover meals and affect the glucose afterward. Their glucose-lowering activity starts to work about 20 minutes after they are taken, with a gradual rise in activity over the next 1.75 to 2.25 hours, then falling over the next 3 hours. These insulins lower the glucose for 5 hours or a bit longer. Although their “insulin action times” are often quoted as 3-5 hours, the actual duration of insulin action is 5 hours or more. See our article Duration of Insulin Action for more information on this important topic.

These so-called “rapid” insulins are slower than the digestion of most meals where the glucose peaks within an hour and digestion is complete within 2-3 hours. The best-kept secret on stopping post-meal spiking is to take the injection or bolus earlier before the meal and to eat more low glycemic carbs that digest more slowly.

Regular Insulin

The much older Regular insulin has a slightly slower action with a slightly higher risk for nighttime hypoglycemia. It works well for people who take Symlin or who have gastroparesis (delayed digestion). It is also much less expensive at places like Walmart.

Long-Acting Insulins

Though often thought of as being 24-hour insulins, Lantus (glargine) and Levemir (detemir) are actually 18 to 26-hour insulins. About a third of users do not get a full 24 hours of action from these insulins. Those who experience shorter activity times may also notice more peaking in activity and tend to experience lower glucose readings about 6 hours after the injection. A larger peak in activity at 6 to 8 hours is associated with a shorter action time, and vice versa. Anyone who does not take their long-acting insulin at about the same time each day can also experience gaps and stacking of insulin with a single injection a day. Smaller doses of these insulins are also often associated with less than 24 hours of activity.

If Lantus or Levemir “wears out” before the day is done, unexplained highs often occur before or soon after the next dose is given. If one injection is given in the morning, high readings may occur before breakfast due to the lessening activity from the previous dose.

Splitting doses of “24-hour” insulins into two equal doses with half taken in the morning and the other half taken in the evening even out dosing gaps and minimize peaking. After splitting a single dose of Lantus or Levemir, many people find they have better readings.

Both Tujeo (U-300 glargine) and Treshiba (degludec) are the longest-acting insulins (36 hrs or more) and have little or no peak in activity. They provide a very flat and very consistent action from day to day.

NPH

The old NPH (Neutral Protamine Hagedorn) insulin has a shorter action with more peaking than Lantus or Levemir. This can be useful at times. For example, if a teen or young adult has a Dawn Phenomenon or someone with Type 2 diabetes sees their glucose rise in the early morning hours due to release of more free fatty acids during sleep, NPH can be taken at bedtime to provide the extra insulin needed during the late morning hours. Bedtime NPH can be combined with an injection of Lantus or Levemir at breakfast to cover the daytime hours.
A bedtime dose of NPH can also be combined with two daytime injections of NPH before breakfast and lunch to reduce the number of injections required in a day. For those who use a syringe, NPH can also be combined with the rapid insulin taken for a meal into a single injection. Like Regular insulin, NPH is much less expensive. If cost is a concern, try splitting the current dose of Lantus or Levemir into 3 equal injections of NPH each day. Most people find this provides very stable basal insulin action once the total dose is dialed in, along with any increase in the bedtime dose that may be needed to offset a Dawn Phenomenon or Type 2 diabetes.

  • There is no risk to nursing infants from insulin taken by the mother. However, your insulin dose may need to be decreased during breastfeeding. Discuss this with your doctor.
  • Side effects

    Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

    Very common (affect more than 1 in 10 people)

    • Low blood glucose level (hypoglycaemia) – see warning section above.

    Common (affect between 1 in 10 and 1 in 100 people)

    • Redness, swelling or itching at the injection site.
    • Skin thickening or pitting (lipohypertrophy) if injection given too frequently into the same site.

    Uncommon (affect between 1 in 100 and 1 in 1000 people)

    • Loss of fatty tissue (lipoatrophy) if injection given too frequently into the same site.

    Rare (affect between 1 in 1000 and 1 in 10,000 people)

    • Allergic reaction (hypersensitivity), such as skin rash or itching, hives, chest tightness, shortness of breath or severe allergic reactions such as anaphylaxis.
    • Visual disturbances.
    • Excessive fluid retention in the body tissues, resulting in swelling (oedema).

    Very rare (affect less than 1 in 10,000 people)

    • Pain in the muscles (myalgia).
    • Change in taste sensation.

    The side effects listed above may not include all of the side effects reported by the medicine’s manufacturer.

    For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

    How can this medicine affect other medicines?

    Insulin itself doesn’t affect other medicines. However, it is important to be aware that many medicines can affect blood glucose levels and can therefore change your insulin requirements. For this reason, people with diabetes should always seek advice from their doctor or pharmacist before taking any new medicines or stopping existing ones.

    The following medicines may decrease blood sugar levels. If you start treatment with any of these your insulin dose may therefore need decreasing:

    • ACE inhibitors, eg captopril (these can sometimes cause unpredictable drops in blood sugar)
    • anabolic steroids, eg testosterone, nandrolone, stanozolol
    • antidiabetic medicines taken by mouth
    • disopyramide
    • fibrates, eg gemfibrozil
    • fluoxetine
    • MAOI antidepressants, eg phenelzine
    • octreotide
    • large doses of salicylates, eg aspirin (small pain relieving doses do not normally have this effect).

    Beta-blockers, eg propranolol (including eye drops containing beta-blockers) can mask some of the signs of low blood sugar, such as increased heart rate and tremor. They also prolong episodes of low blood sugar and impair recovery back to normal glucose levels.

    The following medicines may increase blood glucose levels. If you start treatment with any of these your insulin dose may therefore need increasing:

    • some antipsychotic medicines, eg chlorpromazine, olanzapine
    • corticosteroids, eg hydrocortisone, prednisolone
    • danazol
    • diuretics, especially thiazide diuretics, eg bendroflumethiazide
    • isoniazid
    • lithium
    • protease inhibitors, eg ritonavir
    • somatropin (human growth hormone).

    Oestrogens and progestogens, such as those contained in oral contraceptives, may affect blood sugar levels, and women taking these may need small adjustments up or down in their insulin dose.

    How do I store Lantus?

    • Pre-filled pens: Unused pre-filled pens should be stored in a refrigerator at 2-8°C. Do not freeze. Keep the pen in the outer carton to protect from light. Once in use, the pens should be kept out of the fridge, below 25°C. They can be used for up to 28 days. The pen cap must be put back on the pen after each injection in order to protect from light. The pens should not be stored with the needle attached and should not be kept in the fridge once in use.
    • Cartridges: Before use, cartridges should be stored in a refrigerator at 2-8°C. Do not freeze. Keep the cartridges in the outer carton to protect from light. Once in use, the pen with the inserted cartridge should be kept out of the fridge, below 25°C. It can be used for up to 28 days. The pen cap must be put back on the pen after each injection in order to protect from light. The pen should not be stored with the needle attached.
    • Vials: Before use, vials should be stored in a refrigerator at 2-8°C. Do not freeze. Keep the vial in the outer carton in order to protect from light. Once in use, the vial should be kept out of the fridge, below 25°C. It can be used for up to 28 days. Again, keep it in the outer carton to protect it from light.

    Make sure all medicines are kept out of the reach of children and avoid exposing them to excessive heat or direct sunlight.

    Other medicines containing the same active ingredient

    There are currently no other products available in the UK that contain this kind of insulin (insulin glargine).

    There are many other forms of insulin available; you can read about these here.

    Last updated 11.04.2012

    HOST (NANCY MEYER) AKA SANDY

    OPENING

    Hello. My name is Sandy, and I’d like to welcome you to the Guide to Administering Lantus® Using the Lantus® SoloSTAR® Pen demonstration video.

    This video will provide you with some basic information about Lantus® and teach you the proper technique for injecting Lantus® with the Lantus® SoloSTAR® pen.

    But before we begin, let’s review some important safety information for Lantus®.

    ISI

    Indications and Usage for Lantus®

    Lantus® is a long-acting insulin analog indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. Lantus® should be administered once a day at the same time every day.

    Important Limitations of Use: Lantus® is not recommended for the treatment of diabetic ketoacidosis.

    Contraindications

    Lantus® is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or one of its excipients.

    Warnings and Precautions

    Insulin pens, needles, or syringes must never be shared between patients. Do NOT reuse needles.

    Monitor blood glucose in all patients treated with insulin. Modify insulin regimen cautiously and only under medical supervision. Changes in insulin strength, manufacturer, type, or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment.

    Do not dilute or mix Lantus® with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Lantus® via an insulin pump or intravenously because severe hypoglycemia can occur.

    Hypoglycemia is the most common adverse reaction of insulin therapy, including Lantus®, and may be life-threatening.

    Medication errors, such as accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. Patients should be instructed to always verify the insulin label before each injection.

    Severe life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Lantus®, monitor and treat if indicated.

    A reduction in the Lantus® dose may be required in patients with renal or hepatic impairment.

    As with all insulins, Lantus® use can lead to life-threatening hypokalemia. Untreated hypokalemia may cause respiratory paralysis, ventricular arrhythmia, and death. Closely monitor potassium levels in patients at risk of hypokalemia and treat if indicated.

    Fluid retention, which may lead to or exacerbate heart failure, can occur with concomitant use of thiazolidinediones (TZDs) with insulin. These patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of TZD must be considered.

    Drug Interactions

    Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and reserpine).

    Adverse Reactions

    Adverse reactions commonly associated with Lantus® include hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema and weight gain.

    Lantus® SoloSTAR® is a disposable prefilled insulin pen. To help ensure an accurate dose each time, patients should follow all steps in the Instruction Leaflet accompanying the pen; otherwise they may not get the correct amount of insulin, which may affect their blood glucose.

    OPENING PART II

    Now that we’ve reviewed the Important Safety Information, I’d like to share a brief description of Lantus®.

    It is administered once daily, subcutaneously at the same time every day. Its slow release and 24-hour duration closely resemble the physiologic constant secretion of endogenous basal insulin that is typically present in patients without diabetes. The dosage of Lantus® must be individualized based on clinical response; frequent monitoring of blood glucose essential. It is important to remember Lantus® must not be diluted or mixed with any other insulin or solution, which may alter the onset of action or time to peak effect in an unpredictable manner.

    Now, I’ll turn things over to Nancy, who will guide you through a demonstration of how to administer Lantus® with the Lantus® SoloSTAR® pen.

    NURSE (JULIA KELLEY) AKA NANCY

    Hello. I’m Nancy, and I’m going to teach you the proper technique for injecting Lantus® with the Lantus® SoloSTAR® pen.

    Let’s begin by reviewing the key components of the Lantus® SoloSTAR® pen.

    The Lantus® SoloSTAR® pen is a prefilled, disposable insulin pen that contains 300 Units of insulin glargine.

    The pen body consists of a rubber seal at the tip, an insulin reservoir, a dose window, the dosage selector, and the injection button.

    The dose can be selected by adjusting the dosage selector dial from 1 to 80 Units.

    The Lantus® SoloSTAR® pen uses disposable, single-use needles that are either pushed or screwed onto threads located at the tip of the pen body.

    Needles are not provided with the Lantus® SoloSTAR® pen.

    During today’s injection demonstration, I’ll be using the BD AutoShield™ Duo pen needle, the only pen needle that covers the front and back needles, helping to minimize exposure after use. If your facility does not use BD pen needles, please refer to the needle manufacturer’s instructions.

    Now let’s take a look at the components of the AutoShield Duo needle.

    The AutoShield Duo is a 30-gauge, 5 millimeter, very short and thin needle designed as a single-use product. It is the only pen needle that fits every diabetes pen, to get the highest level of protection.

    You’ll see there are colored shields, which help to provide a visual confirmation of safety, on both the front and back ends of the needle.

    The shield is also designed to facilitate 90 degree insertion and to help prevent accidental needle stick injuries. During injection, the shield retracts to allow the needle to penetrate the skin at the appropriate depth and has an auto-lock system to prevent re-use.

    It’s important to note that a sterile, new needle must be used each time you deliver a dose.

    Now that you’re familiar with the key components of the pen and needle, let’s go through the 6 steps for preparing and injecting Lantus® with the Lantus® SoloSTAR® pen.

    After a pen is opened, it can be used for 28 days.

    Check the label on the insulin pen to ensure you are using the correct insulin. Lantus®SoloSTAR® is grey and has a flat, smooth button. It contains a long-acting insulin, Lantus®.

    After removing the pen cap, check the insulin reservoir on the pen. Lantus® should be clear. Don’t use the Lantus® SoloSTAR® pen if the insulin is cloudy, colored, or has particles in it. In addition to verifying that the insulin is correct, you also need to ensure that the pen device is the one labeled and intended for that specific patient.

    You should attach a new needle each time you use the Lantus® SoloSTAR® pen.

    Examine the tamper evident label on the AutoShield Duo. Discard the needle if the label is damaged or missing.

    Peel away the foil tamper evident tab from the pen needle and discard. Do not touch the clear shield at any point prior to the injection.

    Next, swab the rubber seal on the end of the pen with an alcohol swab prior to attaching the pen needle.

    Now, push and twist the pen needle hub onto the Lantus® SoloSTAR® pen in a clockwise direction until you feel resistance. Keep the needle straight as you attach it. Do not over tighten.

    Pull only the outer cover straight off. The needle will remain covered by the clear plastic Outer Shield.

    The next step is performing an air shot also called a safety test. This is necessary immediately before administering injections with Lantus® SoloSTAR® pens to eliminate air bubbles and check that the pen is working correctly.

    To perform the air shot, select a dose of 2 units using the dosage selector dial. Make sure the dosage window is facing you. Pull the needle cover straight off.

    Now hold the pen with the needle pointing upward.

    Tap the insulin reservoir gently so any air bubbles rise toward the needle.

    Keeping the needle pointing upward and using the palmar grip, press the injection button all the way in.

    Check to be sure that insulin comes out of the needle tip. If no insulin comes out, check for air bubbles and repeat the air shot 2 more times to remove them. If still no insulin comes out, the needle may be blocked. Change the needle and try again. If no insulin comes out after changing the needle, the Lantus® SoloSTAR® pen may be damaged and should not be used.

    After the air shot, check to make sure that the dose window shows zero. Also, make sure you’re not holding the pen so that the dose window is upside down. This will ensure that you can properly read the numbers in the dose window. Then select the required dose.

    A dose of 1 to 80 units can be set on the dial. Doses larger than 80 units should be given as 2 or more injections. The dial can be turned in either direction when selecting the dose. Be sure to avoid pushing the injection button while adjusting the dial. The Lantus® SoloSTAR® pen is designed so that the dosage selector cannot be turned past the number of units remaining in the pen. If the amount remaining in the pen is less than the units needed for the patient’s injection, simply inject the partial dose and use a second pen dialed to the number of units needed to complete the dose.

    Now we’re ready to inject the dose. This step involves 2 distinct actions: first insert the needle, then inject the insulin.

    Lantus® may be injected in the abdomen, upper arm, or thigh. Remember to rotate injection sites.

    The abdomen is the preferred injection site for the AutoShield Duo. This location facilitates proper injection technique—such as keeping the pen at the proper 90 degree angle. Be sure to rotate injection sites.

    Make sure to clean the area at the injection site with rubbing alcohol.

    Now comes part 1 of the injection process: inserting the needle. The proper way to hold the pen during the injection is to grip the pen in the palm of your hand using the palmar grip.

    The standard injection technique is to use one continuous motion to insert the needle straight on at a 90 degree angle to the flat skin of the abdomen.

    Be sure to go in at 90 degrees, as a 45 degree angle may result in the needle reemerging from the skin and a needle stick injury

    As you press down, the clear plastic shield retracts, allowing the needle to penetrate into the subcutaneous layer of fat. The needle has fully penetrated the skin when the clear needle shield retracts and the white sleeve is flush with the skin.

    Now that the needle is fully inserted, we move to part 2 of the injection process: injecting the insulin. Maintaining constant pressure against the skin, deliver the dose by pressing the injection button all the way down. The number in the dose window will return to zero as you inject.

    Keeping the injection button pressed, slowly count to 10 before withdrawing the needle from the skin. Waiting 10 seconds is important to make sure you deliver the full dose.

    (Comparative presentation with correct technique showing large amount of insulin on the skin)

    If the needle is removed before the dose is completely delivered, drops of insulin may appear on the patient’s skin.

    (Comparative presentation with correct technique showing needle being pulled out with insulin dripping from needle)

    Insulin may also appear dripping from the needle. If you see drops of insulin on the skin, it’s likely the patient has not received the full dose.

    Once the dose has been delivered, lift the pen away.

    The safety shield will automatically lock into place. The appearance of a red indicator band confirms that it is locked and that the needle cannot be reactivated or used for another patient.

    Press down on the area with a cotton ball or gauze. Do not rub the area.

    Let’s take a closer look at what happens while injecting using this clear injection dome. As we showed earlier, after you swab the injection site, this is a 2 part process: first you insert the needle, then you inject the insulin. Again, you insert the needle straight on at a 90-degree angle to the flat skin of the abdomen. The needle has fully penetrated the skin when the clear needle shield retracts and the white sleeve is flush with the skin. Next, with the needle fully inserted, maintain a constant pressure against the skin and deliver the dose by pressing the injection button all the way down.

    Slowly count to 10 while you keep the injection button pressed before withdrawing the needle from the skin. A full 10 seconds is needed to assure you deliver the full dose.

    As you can see in this demonstration using a clear dome, the insulin is being administered over the full 10 second time span with only a small drop of insulin remaining on the skin. When using a needle with a protective, plastic safety shield, you will be prevented from actually seeing the insulin being administered. The shield is a safety feature to protect you from needle stick injuries.

    To remove the AutoShield Duo, hold it by the clear hub and twist the pen counterclockwise. The orange shield will deploy to protect the pen connection end of the needle. Do not place your fingers on the activated shields.

    Between injections, the Lantus® SoloSTAR® pen should be stored with its cap on and no needle attached. Once it has been used, it should not be refrigerated.

    Finally, safely dispose of the needle in an appropriate sharps container.

    Then with the AutoShield Duo removed, replace the cap on the Lantus® SoloSTAR® pen.

    Return the patient’s individually labeled insulin pen to the patient’s medication storage drawer or the location approved by your facility’s pharmacy. It is important to remember, pens are for single patient use only.

    Remember, each Lantus® SoloSTAR® pen is a multidose pen and can continue to be used for the same patient until the insulin in the pen is gone, or up until 28 days after the pen was first used, whichever comes first.

    That covers the 6 steps for preparing and injecting Lantus® with the Lantus® SoloSTAR® pen.

    Let’s do a quick review: Step 1: Prepare for an injection; Step 2: Attach a new needle; Step 3: Perform an air shot or safety test; Step 4: Select the dose; Step 5: Inject the dose; Step 6: Remove the needle.

    HOST (NANCY MEYER) AKA SANDY VIDEO CLOSING

    Thank you, Nancy.

    Now, let’s go over a few important points to keep in mind. First is delivering a full dose.

    When you get toward the end of the insulin reservoir, there may not be enough insulin for the patient’s daily dose.

    If you can’t turn to the dose you want, don’t force it. The pen prevents selection of doses greater than the amount of insulin left in the reservoir.

    As Nancy mentioned, you can either inject what’s remaining in this Lantus® SoloSTAR® pen and complete the dose with a new pen, or you can use a new pen for the full dose. Please be sure to follow your hospital’s recommendations or policy.

    Next let’s discuss storing the Lantus® SoloSTAR® pen.

    After 28 days, throw away a used pen that still has insulin in it.

    Do not use any pen after the expiration date on the label or individual patient label.

    This concludes our demonstration.

    If you have any questions about the Lantus® SoloSTAR® pen, call 1-800-633-1610 to talk to a Lantus® SoloSTAR® expert.

    Thank you for watching. I hope you found this demonstration helpful and have a better understanding of how to administer Lantus® using the Lantus® SoloSTAR® pen.

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