Larsulin 100 IU/ml Injection

Larsulin 100IU – Insulin Glargine 100 IU/ml Long-Acting Injection (10 ml Vial)

What is Larsulin 100IU?

Larsulin 100IU is a long-acting basal insulin analogue containing insulin glargine 100 IU/ml, available in a 10 ml vial, manufactured by Lars Medico Ltd., Bangladesh. It provides once-daily, peakless, 24-hour background insulin coverage — controlling fasting and inter-meal blood glucose without the pronounced peaks associated with NPH insulin. As a locally manufactured biosimilar to Lantus (Sanofi), Larsulin 100IU offers an affordable, accessible basal insulin option for Bangladeshi patients with Type 1 or Type 2 diabetes requiring basal insulin therapy.

Generic Name and Composition

Each ml contains: 100 IU insulin glargine (rDNA origin). Insulin glargine differs from human insulin by substitution of asparagine at A21 with glycine and addition of two arginines at the B-chain C-terminus. These modifications shift the isoelectric point, making glargine soluble at pH 4 (in the vial) but precipitating at neutral physiological pH after SC injection — forming micro-precipitates that dissolve slowly to produce a flat, peakless 24-hour action profile.

Indications

• Type 1 diabetes — basal component of a basal-bolus insulin regimen
• Type 2 diabetes — once-daily basal insulin to control fasting glucose
• Patients requiring a long-acting, peakless basal insulin analogue
• Patients seeking an affordable locally manufactured alternative to Lantus

How It Works — Mechanism of Action

After SC injection at physiological pH, insulin glargine precipitates into micro-aggregates at the injection site. These dissolve slowly and steadily over 24 hours, releasing insulin monomers into the bloodstream at a constant, low rate. This produces a flat, peakless action profile with no pronounced peaks — mimicking the low-level basal insulin secretion of a healthy pancreas. By suppressing hepatic glucose output and maintaining background glucose uptake, glargine controls fasting and inter-meal blood glucose without causing the nocturnal hypoglycaemia characteristic of NPH insulin.

Dosage and Administration

Administer once daily at the same time each day — evening or bedtime is common, but morning injection is also effective. Starting dose in Type 2 (insulin-naive): 10 IU/day, titrated upward by 2 IU every 3 days until fasting glucose target is met. Use a U-100 insulin syringe. Inject SC into abdomen, thigh, or upper arm. Rotate injection sites. Do not mix Larsulin 100IU with any other insulin in the same syringe — mixing alters the pH and destroys the extended-release property.

Side Effects

Very common: Hypoglycaemia (especially at initiation). Common: Injection site reactions, lipohypertrophy, weight gain. Uncommon: Lipoatrophy, peripheral oedema. Rare: Hypersensitivity, anaphylaxis, visual changes at treatment initiation.

Drug Interactions

Enhance hypoglycaemia: OADs, GLP-1 agonists, SGLT-2 inhibitors, ACE inhibitors, MAO inhibitors, salicylates, alcohol. Reduce effect: Corticosteroids, glucagon, thyroid hormones, sympathomimetics, thiazides, oral contraceptives. Mask symptoms: Beta-blockers, clonidine.

Contraindications

• Active hypoglycaemia
• Hypersensitivity to insulin glargine or any excipient
• Do not use IV — for SC injection only

Pregnancy and Lactation

Pregnancy: Limited data on glargine; many specialists prefer NPH or detemir in pregnancy. Consult obstetrician/endocrinologist. Lactation: Insulin glargine is not expected to pass into breast milk in clinically significant amounts.

Precautions and Warnings

• Larsulin 100IU is a clear, colourless solution — do not use if cloudy, discoloured, or particulate.
• Never mix with other insulins — alters pH and eliminates extended-release action.
• Rotate injection sites — repeated injection at same site causes lipohypertrophy, which reduces absorption and worsens glucose control.
• Do not freeze — freezing destroys the solution. Keep refrigerated until first use.

Overdose

Hypoglycaemia. Mild: oral glucose. Severe: IV dextrose 20–50% or IM glucagon 1 mg. Glargine's 24-hour duration means sustained monitoring is required — prolonged or recurrent hypoglycaemia may necessitate IV glucose infusion for several hours.

Storage Instructions

• Unopened vial: 2–8 degrees C. Do not freeze.
• In-use vial: Below 25 degrees C. Protect from light.
• Discard 28 days after first use.

Frequently Asked Questions

Q1: What is the difference between Larsulin 100IU vial and Larsulin Pen Cartridge?
Both contain identical insulin glargine 100 IU/ml. The 10 ml vial is used with standard U-100 insulin syringes — typically chosen for its lower cost-per-unit and economy of scale. The pen cartridge (3 ml) fits into a reusable insulin pen device for convenient, accurate dosing without syringes. Choice depends on patient preference, pen device availability, and cost considerations.

Q2: Is Larsulin the same as Lantus?
Both contain insulin glargine 100 IU/ml and have the same mechanism of action and pharmacokinetic profile. Lantus is manufactured by Sanofi (France/Germany); Larsulin is manufactured locally by Lars Medico Ltd. (Bangladesh). As a biosimilar, Larsulin undergoes regulatory assessment for equivalence. The clinical effect per unit is the same.

Q3: When should I inject Larsulin 100IU?
Once daily at the same time each day. Bedtime is most common as it controls fasting (morning) glucose — often the initial target in Type 2 diabetes. Some patients prefer morning injection — both are effective. Consistency in timing is more important than which time is chosen.

Q4: Can I mix Larsulin with my mealtime insulin?
No. Never mix insulin glargine with any other insulin. Mixing alters the pH and destroys the micro-precipitate mechanism that gives glargine its 24-hour action. Use separate syringes and separate injection sites if both glargine and a rapid-acting insulin are required.

Medical Disclaimer: For educational purposes only. Larsulin 100IU is Rx-only. Consult your diabetologist before starting or changing insulin therapy. DiabetesStore.com.bd is a licensed online pharmacy in Bangladesh.