Toujeo vs Lantus Solostar - The differences are minute but may be of immense significance in certain patients. Insulin Glargine U-300, available by the brand name of Toujeo is the concentrated form of Insulin Glargine U-100 (Lantus Solostar).
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U-100 means 100 units per ml
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U-300 means 300 units per ml
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U-500 means 500 units per ml.
This means that U-300 is 3 times more concentrated than U-100. Similarly, U-500 is 5 times more concentrated than U-100. The U-300 and U-500 glargine insulins are prepared for those patients who require a higher dose. However, with the change in the concentration of insulin glargine, some of its other properties have also changed.
What are the advantages of Insulin Glargine U-300 over Lantus Solostar ( Glargine U-100)?
The same insulin is present in both Lantus (Glargine U-100) and Toujeo (U-300), hence there is essentially no variation in the chemical formulation. The following, however, are some key distinctions between Toujeo and Lantus.
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Volume of insulin needed to administer is lesser three times than Toujeo.
- This results in very few local side effects.
- Thus, patients on higher doses of insulin are more likely to benefit from Toujeo than Lantus.
- Contrary to that, patients requiring minute doses may be best managed with Lantus insulin.
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Insulin Glargine U-100 needs to be given at a fixed time of the day.
- However, Insulin Glargine U-300 (Toujeo Insulin) may be given 2 - 4 hours earlier or later than the specified time.
- This allows a little flexibility in the timings of insulin injection especially in individuals with a disturbed routine.
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Insulin glargine U-100, like other insulins, when given in higher doses (more than 40 - 60 units) in a single injection may affect its efficacy.
- This is called the bubble effect.
- Therefore, patients whose insulin dose exceeds 40 - 60 units should either split the dose into two as morning and evening doses or should split the insulin and inject it into different sites.
- The "Bubble effect" is not seen with Insulin Glargine U-300 (Toujeo). Patients can, therefore, inject higher doses as a single once-daily injection.
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Toujeo Vs Lantus - Is there any difference in the Prices [Ref]?
- Lantus Solostar injection costs $34.03 per 100 units (per ml)
- Toujeo Solostar injection costs $103.65 per 300 units (per mL)
- If the unit to unit cost is compared;
- 100 units of Lantus insulin cost $34.03 while 100 units of Toujeo costs $34.55
- So per unit difference in the cost is not great.
My experience with Glargine U-300 (Toujeo) and empagliflozin:
This is a 52 years of age patient with type 2 diabetes mellitus weighing 74 kgs. She presented with blood sugars ranging from 170 - 250 mg/dl in the fasting state and 200 - 400 mg in the prandial (Post-meals) state. She was using:
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Tablet Janumet (Sitagliptin and metformin) 50/500 mg twice daily
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Injection Lantus (Glargine U-100) 34 units twice daily.
Her primary concern was uncontrolled blood sugars.
After counseling regarding a 30-minutes exercise and adequate diabetic diet, I changed her medications to:
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Tab. Diampa-M ( Empagliflozin and metformin) to 12.5/1000 mg after breakfast
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Tab. Janumet (Sitagliptin and metformin) 50/1000 mg after dinner, and
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Inj. Toujeo (Glargine U-300 instead of Lantus) 40 units at bedtime.
Her weight dropped to 64 Kgs. She lost 10 kgs over 8 months. her blood sugars remained below 150 mg/dl in the prandial state and less than 120 mg/dl in the fasting state. She was very satisfied with her blood glucose readings.
However, she was unhappy with the weight loss!!
What should I do?
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Should I stop empagliflozin as it may be causing the weight loss?
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Should I reduce the metformin dose?
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Or Should I continue the same treatment and just counsel her about the benefits of weight loss in her case.
- Toujeo Vs Lantus - What is your experience?
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