Lantus

Lantus – insulin гларгин (Insulin glargine), solution for introduction under skin. Hypoglycemic means, analog of insulin of human long action.

Pharmacological action of Lantus

Active ingredient of Lantus, insulin гларгин, a full analog of insulin human, receive at a genetic recombination of a bacterium of Escherichia coli (K12 strain). In the neutral environment solubility low, is completely dissolved in drug Lantus thanks to acid (рН =4) the environment of injection solution.

Introduction to Lantus hypodermic fatty tissue (insulin of a glargin):

• Thanks to acidity of solution, education is promoted by microprecipitated calcium superphosphate which constantly release a small amount of insulin that provides a smooth profile of a pharmacokinetic curve and the prolonged effect of drug;
• Stimulates biological effect and forms bonds with insulin receptors in an organism, relatives in parameters to effect and bonds of endogenous insulin;
• Serves for glucose metabolism regulation, reducing its content in blood due to increase in its consumption by peripheral fabrics, inhibits glucogenesis;
• Strengthens protein synthesis, at the same time suppressing proteolysis and a lipolysis in adipocytes;
• Provides the prolonged Lantus's action (insulin of a glargin) because of the reduced speed of absorption, allowing to enter it once a day. Lantus's action in an hour after hypodermic introduction begins, continues from 24 to 29 hours.

Form of release of Lantus

Lantus – almost colourless, transparent solution for subcutaneous injections, is issued in glass cartridges (3 ml) or bottles (10 ml). Are developed for usability the cartridge Optiklik system and cartridge the syringe handle "Optiset".

Lantus's analogs

Lantus's analog on active active ingredient (insulin гларгин) – Lantus Solo Is old, solution for hypodermic introduction. Lantus's analogs on the influence mechanism, drugs of one pharmacological subgroup – Levemir Penfill, Levemir Flekspen, solutions for hypodermic introduction.

Indications to Lantus's use

According to the instruction Lantus (insulin гларгин) is shown in a case:

• Diabetes mellitus of the I type (insulin-dependent);
• Diabetes mellitus of the II type (non-insulin-dependent) at stages of resistance to influence of peroral hypoglycemic drugs, intercurrent diseases and pregnancy.

Contraindications

According to the instruction Lantus is contraindicated:

• At hypersensitivity to insulin to a glargin or to any of auxiliary components of drug;
• To children under 6 years.

Pregnant women should apply with care, under observation of the doctor.

Lantus route of administration

For Lantus's use according to the instruction it is necessary to follow the following rules strictly:

• To administer the drug in a hypodermic fatty tissue of a hip, shoulder, a front abdominal wall, a buttock strictly in at one time, once a day, daily alternating an injection site;
• The dose and time of introduction are selected individually attending physician, monotherapy or administration of drug in a complex with other medicinal hypoglycemic drugs is allowed;
• Injection solution of Lantus should not be parted or mixed with other insulin drugs;
• It is not necessary to enter Lantus intravenously, the most effective effect of drug is shown at hypodermic introduction;
• Upon transition on Lantus from other insulin drugs it is necessary to control carefully the content in glucose blood the first 2-3 weeks.

On Lantus the attending physician by results of medical examination, taking into account specific features of the patient has to make the scheme of transition from other hypoglycemic drugs. Further the mode of dosing can be adjusted at increase in the sensitivity to insulin caused by metabolism regulation improvement. Correction of the scheme can be required at change of a way of life, social conditions, weight of the patient or at other factors provoking increase in predisposition to hyper - or a hypoglycemia.

Medicinal interaction

Medicinal interaction with a number of drugs can exert impact on glucose metabolism. The following drugs influence Lantus's action according to the instruction:

• The drugs strengthening Lantus's action (insulin of a glargin) – APF inhibitors, peroral hypoglycemic drugs, MAO inhibitors, fluoxetine, fibrata, Disopyramidum, the propoxyhair dryer, пентоксифиллин, sulfanamide drugs and salicylates;
• The drugs weakening Lantus's action (insulin of a glargin) – GKS, diazoxide, даназол, diuretics, gestagena, estrogen, a glucagon, an isoniazid, Somatotropinum, derivatives of a fenotiazin, sympathomimetics (Epinephrinum, тербуталин, salbutamol), inhibitors of proteases, some neuroleptics (clozapine or olanzapine), hormones of a thyroid gland;
• Both strengthen, and beta adrenoblockers, lithium salts, a clonidine, alcohol weaken Lantus's action (insulin of a glargin);
• Instability of amount of glucose in blood with change of a hypoglycemia with a hyperglycemia can cause a concomitant use of Lantus with pentamidine;
• Signs of adrenergic counterregulation can decrease or be absent at reception of sympatholytic drugs – a guanfatsina, a clonidine, Reserpinum and beta adrenoblockers.

Side effects of Lantus

The most frequent side effect of Lantus, according to reviews, is the hypoglycemia arising if the accepted dose of insulin exceeds requirement. The repeating heavy attacks of a hypoglycemia are capable to lead to defeat of TsNS and pose a real threat to the patient's life. The first signs of a hypoglycemia are shown by activation of sympathoadrenal system and expressed by constant feeling of hunger, irritability, plentiful cold sweating, tachycardia. The following stage – the psychoneurological disturbances expressed by faints, the convulsive syndrome obscured by consciousness.

Lantus's action, according to reviews, can is also undesirable to be reflected in organs of sight. Broad range of change of glucose in blood influences turgor of fabrics and index of refraction of an eye crystalline lens, causing a temporary vision disorder. When the indicator of content of glucose long time is normal, development of a diabetic retinopathy stops. In the presence of a proliferative retinopathy if treatment is not carried out by photocoagulation, during the periods of a heavy hypoglycemia, the passing sight loss can develop.

At long use of Lantus, according to reviews, in places of injections the local delay of absorption of drug and a lipodystrophy of fabrics, especially in case of disturbance of the rule about constant change of places of an injection can develop.

In rare instances at patients, according to reviews, Lantus can provoke local (area of introduction) and the general allergic reactions – reddenings, an itch, urticaria, inflammations or hypostases.

Conditions and periods of storage

Lantus it is necessary to store in protected from light, the place, unavailable to children, at a temperature from 2 ° up to 8 °C. A period of validity – 3 years of date on packaging. A period of validity filled Optiset's syringe handles and systems Optiklik – 4 weeks, at T 25 °C, in the dark place.