as red biohazard containers), hard plastic containers (such as detergent bottles), or metal
containers (such as an empty coffee can). Such containers should be sealed and disposed of
properly.
What can affect how much insulin I need?
Illness. Illness may change how much insulin you need. It is a good idea to think ahead and make
a ″sick day″ plan with your healthcare provider in advance so you will be ready when this happens.
Be sure to test your blood sugar more often and call your healthcare provider if you are sick.
Medicines. Many medicines can affect your insulin needs. Other medicines, including prescription
and non-prescription medicines, vitamins, and herbal supplements, can change the way insulin works.
You may need a different dose of insulin when you are taking certain other medicines. Know all the
medicines you take, including prescription and non-prescription medicines, vitamins, and herbal
supplements. You may want to keep a list of the medicines you take. You can show this list to your
healthcare provider anytime you get a new medicine or refill. Your healthcare provider will tell you if
your insulin dose needs to be changed.
Meals. The amount of food you eat can affect your insulin needs. If you eat less food, skip meals, or
eat more food than usual, you may need a different dose of insulin. Talk to your healthcare provider
if you change your diet so that you know how to adjust your LANTUS and other insulin doses.
Alcohol. Alcohol, including beer and wine, may affect the way LANTUS works and affect your blood
sugar levels. Talk to your healthcare provider about drinking alcohol.
Exercise or Activity level. Exercise or activity level may change the way your body uses insulin. Check
with your healthcare provider before you start an exercise program because your dose may need to
be changed.
Travel. If you travel across time zones, talk with your healthcare provider about how to time your
injections. When you travel, wear your medical alert identification. Take extra insulin and supplies with
you.
Pregnancy or nursing. The effects of LANTUS on an unborn child or on a nursing baby are unknown.
Therefore, tell your healthcare provider if you are planning to have a baby, are pregnant, or nursing
a baby. Good control of diabetes is especially important during pregnancy and nursing.
What are the possible side effects of LANTUS and other insulins?
Insulins, including LANTUS, can cause hypoglycemia (low blood sugar), hyperglycemia (high blood
sugar), allergy, and skin reactions.
Hypoglycemia (low blood sugar):
Hypoglycemia is often called an ″insulin reaction″ or ″low blood sugar″. It may happen when you do
not have enough sugar in your blood. Common causes of hypoglycemia are illness, emotional or
physical stress, too much insulin, too little food or missed meals, and too much exercise or activity.
Early warning signs of hypoglycemia may be different, less noticeable or not noticeable at all in some
people. That is why it is important to check your blood sugar as you have been advised by your
healthcare provider.
Hypoglycemia can happen with:
• Taking too much insulin. This can happen when too much insulin is injected.
• Not enough carbohydrate (sugar or starch) intake. This can happen if a meal or snack is
missed or delayed.
• Vomiting or diarrhea that decreases the amount of sugar absorbed by your body.
• Intake of alcohol.
• Medicines that affect insulin. Be sure to discuss all your medicines with your healthcare provider.
Do not start any new medicines until you know how they may affect your insulin dose.
• Medical conditions that can affect your blood sugar levels or insulin. These conditions
include diseases of the adrenal glands, the pituitary, the thyroid gland, the liver, and the kidney.
• Too much glucose use by the body. This can happen if you exercise too much or have a fever.
• Injecting insulin the wrong way or in the wrong injection area.
Hypoglycemia can be mild to severe. Its onset may be rapid. Some patients have few or no warning
symptoms, including:
• patients with diabetes for a long time
• patients with diabetic neuropathy (nerve problems)
• or patients using certain medicines for high blood pressure or heart problems.
Hypoglycemia may reduce your ability to drive a car or use mechanical equipment and you may risk
injury to yourself or others.
Severe hypoglycemia can be dangerous and can cause temporary or permanent harm to your heart
or brain. It may cause unconsciousness, seizures, or death.
Symptoms of hypoglycemia may include:
• anxiety, irritability, restlessness, trouble concentrating, personality changes, mood changes, or
other abnormal behavior
• tingling in your hands, feet, lips, or tongue
• dizziness, light-headedness, or drowsiness
• nightmares or trouble sleeping
• headache
• blurred vision
• slurred speech
• palpitations (fast heart beat)
• sweating
• tremor (shaking)
• unsteady gait (walking).
If you have hypoglycemia often or it is hard for you to know if you have the symptoms of hypoglycemia,
talk to your healthcare provider.
Mild to moderate hypoglycemia is treated by eating or drinking carbohydrates, such as fruit juice,
raisins, sugar candies, milk or glucose tablets. Talk to your healthcare provider about the amount of
carbohydrates you should eat to treat mild to moderate hypoglycemia.
Severe hypoglycemia may require the help of another person or emergency medical people. A person
with hypoglycemia who is unable to take foods or liquids with sugar by mouth, or is unconscious needs
medical help fast and will need treatment with a glucagon injection or glucose given intravenously (IV).
Without medical help right away, serious reactions or even death could happen.
Hyperglycemia (high blood sugar):
Hyperglycemia happens when you have too much sugar in your blood. Usually, it means there is not
enough insulin to break down the food you eat into energy your body can use. Hyperglycemia can be
caused by a fever, an infection, stress, eating more than you should, taking less insulin than prescribed,
or it can mean your diabetes is getting worse.
Hyperglycemia can happen with:
• Insufficient (too little) insulin. This can happen from:
- injecting too little or no insulin
- incorrect storage (freezing, excessive heat)
- use after the expiration date.
• Too much carbohydrate intake. This can happen if you eat larger meals, eat more often, or
increase the amount of carbohydrate in your meals.
• Medicines that affect insulin. Be sure to discuss all your medicines with your healthcare provider.
Do not start any new medicines until you know how they may affect your insulin dose.
• Medical conditions that affect insulin. These medical conditions include fevers, infections, heart
attacks, and stress.
• Injecting insulin the wrong way or in the wrong injection area.
Testing your blood or urine often will let you know if you have hyperglycemia. If your tests are often
high, tell your healthcare provider so your dose of insulin can be changed.
Hyperglycemia can be mild or severe. Hyperglycemia can progress to diabetic ketoacidosis (DKA)
or very high glucose levels (hyperosmolar coma) and result in unconsciousness and death.
Although diabetic ketoacidosis occurs most often in patients with type 1 diabetes, it can also happen
in patients with type 2 diabetes who become very sick. Because some patients get few symptoms of
hyperglycemia, it is important to check your blood sugar/urine sugar and ketones regularly.
Symptoms of hyperglycemia include:
• confusion or drowsiness
• increased thirst
• decreased appetite, nausea, or vomiting
• rapid heart rate
• increased urination and dehydration (too little fluid in your body).
Symptoms of DKA also include:
• fruity smelling breath
• fast, deep breathing
• stomach area (abdominal) pain.
Severe or continuing hyperglycemia or DKA needs evaluation and treatment right away by your
healthcare provider.
Do not use LANTUS to treat diabetic ketoacidosis.
Other possible side effects of LANTUS include:
Serious allergic reactions:
Some times severe, life-threatening allergic reactions can happen with insulin. If you think you are
having a severe allergic reaction, get medical help right away. Signs of insulin allergy include:
• rash all over your body
• shortness of breath
• wheezing (trouble breathing)
• fast pulse
• sweating
• low blood pressure.
Reactions at the injection site:
Injecting insulin can cause the following reactions on the skin at the injection site:
• little depression in the skin (lipoatrophy)
• skin thickening (lipohypertrophy)
• red, swelling, itchy skin (injection site reaction).
You can reduce the chance of getting an injection site reaction if you change (rotate) the injection site
each time. An injection site reaction should clear up in a few days or a few weeks. If injection site
reactions do not go away or keep happening, call your healthcare provider.
Tell your healthcare provider if you have any side effects that bother you.
These are not all the side effects of LANTUS. Ask your healthcare provider or pharmacist for more
information.
How should I store LANTUS?
• Unopened vial:
Store new (unopened) LANTUS vials in a refrigerator (not the freezer) between 36°F to 46°F (2°C
to 8°C). Do not freeze LANTUS. Keep LANTUS out of direct heat and light. If a vial has been frozen
or overheated, throw it away.
• Open (In-Use) vial:
Once a vial is opened, you can keep it in a refrigerator or at room temperature (below 86°F [30°C])
but away from direct heat and light. Opened vial, either kept in a refrigerator or at room
temperature, should be discarded 28 days after the first use even if it still contains LANTUS. Do
not leave your insulin in a car on a summer day.
These storage conditions are summarized in the following table:
Not in-use
(unopened)
Not in-use
(unopened)
In-use
(opened)
Refrigerated Room
Temperature
(See Temperature
Below)
10 mL Vial Until expiration date 28 days 28 days
Refrigerated or room
temperature
• Do not use a vial of LANTUS after the expiration date stamped on the label.
• Do not use LANTUS if it is cloudy, colored, or if you see particles.
General Information about LANTUS
• Use LANTUS only to treat your diabetes. Do not give or share LANTUS with another person, even
if they have diabetes also. It may harm them.
• This leaflet summarizes the most important information about LANTUS. If you would like more
information, talk with your healthcare provider. You can ask your doctor or pharmacist for
information about LANTUS that is written for healthcare professionals. For more information about
LANTUS call 1-800-633-1610 or go to website www.lantus.com.
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