Lantus SoloStar 100 IU/3 ml SC Injection

Lantus SoloStar – Insulin Glargine 100 IU/ml by Sanofi

What is Lantus SoloStar?

Lantus SoloStar is the disposable pre-filled pen format of insulin glargine 100 IU/ml by Sanofi. It is one of the most widely used basal insulins globally and in Bangladesh. The SoloStar pen requires no cartridge loading - simply attach a needle, prime, dial the dose (1-unit increments up to 80 IU), and inject. After subcutaneous injection, glargine's acidic formulation neutralises at physiological pH, forming a subcutaneous microcrystalline depot that releases insulin slowly over ~24 hours with no pronounced peak. This once-daily, peakless profile provides stable overnight and fasting glucose control. Approved for Type 1 and Type 2 diabetes in adults and children aged 6 years and above.

Generic Name and Composition

Each ml contains 100 IU insulin glargine. Glargine is modified at A21 (asparagine to glycine) and B30 (+2 arginine residues). These changes shift the isoelectric point to physiological pH, causing microprecipitation in SC tissue. Gradual dissolution of microcrystals produces a smooth, ~24-hour peakless insulin release - closely mimicking physiological basal insulin secretion.

Indications

• Type 1 diabetes - once-daily basal insulin in basal-bolus regimen
• Type 2 diabetes - once-daily basal insulin with OADs or bolus insulin
• Adults, adolescents, and children aged 6 years and above
• Insulin-naive patients beginning basal insulin therapy

How It Works - Mechanism of Action

Lantus is formulated at pH 4 - soluble in the pen. At SC injection into pH 7.4 tissue, glargine precipitates into stable microcrystals. These dissolve slowly, releasing insulin monomers into capillaries at a constant, peakless rate over ~24 hours. Glargine monomers bind insulin receptors: stimulate GLUT-4-mediated glucose uptake, suppress hepatic gluconeogenesis and glycogenolysis, and promote glycogen and protein synthesis.

Dosage and Administration

Type 2 (insulin-naive): 10 IU once daily at bedtime; titrate by 2 IU every 3 days to fasting BG target. Type 1: Individualised; typically 40-50% of total daily dose as basal. SoloStar pen: Attach needle, prime 2 IU, dial dose, inject SC. Hold needle in skin for 10 seconds after injection. Discard pen after 28 days. Do not mix with any other insulin.

Side Effects

Very common: Hypoglycaemia.

Common: Injection site reactions, lipohypertrophy, peripheral oedema, weight gain.

Uncommon: Lipoatrophy, visual refraction changes at initiation.

Rare: Generalised hypersensitivity, anaphylaxis.

Drug Interactions

Increase hypoglycaemia: OADs, GLP-1 agonists, SGLT-2 inhibitors, ACE inhibitors, MAO inhibitors, salicylates, sulfonamides, alcohol.

Reduce effect: Corticosteroids, glucagon, thyroid hormones, growth hormone, sympathomimetics, danazol, thiazides, protease inhibitors, oral contraceptives.

Mask symptoms: Beta-blockers, clonidine, reserpine.

Contraindications

• Hypersensitivity to insulin glargine or any excipient
• Active hypoglycaemia; IV or IM administration; mixing with other insulins

Pregnancy and Lactation

Pregnancy: Limited data; specialist supervision recommended - consider human insulin (NPH) as alternative. Lactation: No clinically relevant infant absorption via breast milk expected.

Precautions and Warnings

• Never mix Lantus with any other insulin - mixing disrupts microprecipitation and creates unpredictable pharmacokinetics.
• Rotate injection sites within the same region to prevent lipohypertrophy.
• Discard SoloStar pen 28 days after first use, even if insulin remains.
• Do not freeze. Do not expose to direct heat or sunlight.

Overdose

Hypoglycaemia. Mild-moderate: oral glucose or carbohydrates. Severe: IV 20% dextrose or IM glucagon 1 mg. Monitor glucose every 2-4 hours due to ~24-hour duration.

Storage Instructions

• Unopened pen: 2-8 degrees C. Do not freeze.
• In-use pen: Below 30 degrees C. Do not refrigerate. Keep cap on when not in use.
• Discard 28 days after first use.

Frequently Asked Questions

Q1: Is Lantus SoloStar the same as Lantus Penfill?
Both contain insulin glargine 100 IU/ml but differ in delivery format. SoloStar is a disposable pre-filled pen ready to use without any device. Penfill is a 3 ml cartridge that must be loaded into a compatible reusable pen (e.g. ClikSTAR). SoloStar is more convenient; Penfill may offer cost savings for high-frequency users with a reusable device.

Q2: Can Lantus be used in the morning instead of bedtime?
Yes - Lantus can be injected at any fixed time of day (morning or bedtime). Consistency in timing is more important than the specific time. Some patients prefer morning injection to reduce the risk of nocturnal hypoglycaemia; others use bedtime for better fasting glucose control.

Q3: How does Lantus compare to Tresiba (degludec)?
Both are peakless basal insulins. Tresiba has a longer duration (beyond 42 hours) with lower day-to-day variability and clinically demonstrated lower nocturnal hypoglycaemia vs. Lantus U100 in the BEGIN trials. Lantus is more established and widely available; Tresiba offers more flexibility in dosing time.

Q4: Why is Lantus sometimes cloudy?
Lantus is formulated as a clear solution. If your Lantus appears cloudy, has particles, or has changed colour - do not use it. This may indicate temperature damage (freezing or overheating), contamination, or mixing with another insulin. Discard and use a new pen.

Medical Disclaimer: For educational purposes only. Lantus is Rx-only. Consult your diabetologist before changing insulin therapy. DiabetesStore.com.bd is a licensed online pharmacy.