Lantus dosage, forms, and strengths

Lantus is a brand-name insulin glargine injection used to help adults and children with Type 1 diabetes and Type 2 diabetes control high blood sugar (hyperglycemia). Insulin glargine is a long-acting basal insulin, that is, it is used to produce a steady-state concentration of insulin throughout the day with typically only a single injection. All patients with Type 1 diabetes and some with Type 2 diabetes will still need to take short-acting insulin before meals to control spikes in blood sugar levels. Lantus is taken as a self-administered injection often only once per day using the Lantus SoloStar injection pen or a standard syringe and needle.

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Lantus forms and strengths

Lantus can be self-injected or injected by a caregiver using the SoloStar pen injector or an ordinary syringe and needle. 

• Prefilled pen injector: 3 mL at a concentration of 100 units/mL (300 units total)

• Vial: 10 mL vial at a concentration of 100 units/mL (1,000 units total)

Lantus dosage for adults

Lantus is a long-acting basal insulin prescribed to those with Type 1 or Type 2 diabetes to control blood glucose levels. People with Type 1 diabetes do not produce enough insulin whereas people with Type 2 diabetes lose sensitivity to insulin as well as lose the ability to produce insulin as the condition progresses. 

Lantus is intended to produce a constant basal level of insulin throughout the day. For all patients with Type 1 diabetes and some with Type 2 diabetes, Lantus may be part of an insulin regimen that also includes rapid-acting or short-acting insulin injections taken before meals (prandial insulin) to manage spikes in blood sugar levels. Lantus is not used to treat diabetic ketoacidosis, a condition commonly treated with short-acting insulin. Doses will vary depending on each person’s needs, blood glucose levels, physical activities, eating patterns, and overall health.

Source: Epocrates, DailyMed, ADA

Lantus dosage for Type 1 diabetes mellitus

Lantus is a long-acting insulin injection intended to produce a daylong steady-state level of insulin in the body to maintain glycemic control in persons diagnosed with Type 1 diabetes. The active ingredient in Lantus, insulin glargine, is an insulin analog, a synthetic insulin that is slightly different from human insulin.  The changes made to insulin glargine allow it to be slowly released into the body’s fluids from the injection site throughout the day, maintaining a steady level of insulin in the blood for 24 hours.

Doses will vary by person and be based on each patient’s overall insulin requirements. As a general rule, insulin glargine injections will start at one-third of the total daily insulin regimen and could rise to 50% of the total daily insulin. The remaining insulin doses will be taken as rapid- and short-acting insulin injections to manage spikes in blood glucose.

For people being switched to Lantus from other types of insulin therapies such as Toujeo (insulin glargine), NPH insulin, or other long- or intermediate-acting insulins, both Lantus dosages and prandial insulin dosages may need to be adjusted.

• Standard adult dosage for Type 1 diabetes: Doses will vary; recommended dose is 1/3 to 1/2 of the total daily insulin regimen

• Maximum adult dosage for Type 1 diabetes: Not specified

Lantus dosage for Type 2 diabetes mellitus

Lantus can be prescribed as a basal insulin injection in people diagnosed with Type 2 diabetes. In general, treatment guidelines specify insulin treatment for Type 2 diabetes when patients have an A1C of 10% or higher or are experiencing hyperglycemia symptoms. Basal insulins such as Lantus are typically the first insulin treatment used in people with Type 2 diabetes. For Type 2 diabetes, basal insulin injections are intended to suppress the liver’s production of glucose throughout the day as well as reduce blood sugar between meals. People taking Lantus for Type 2 diabetes will continue taking oral antidiabetic medications such as metformin. As their condition progresses, however, they may also need to take prandial (mealtime) insulin, as well.

Doses will start at 0.1 to 0.2 units per kilogram of body weight to a maximum of 10 units per day. Doses will increase by two units every three days until blood sugar targets are reached. Although the manufacturer, Sanofi-Aventis, has not specified a maximum Lantus dosage for Type 2 diabetes, basal insulin has a ceiling above which increased doses do not help control blood sugar. For this reason, treatment guidelines specify a maximum of 0.5 units per kilogram of body weight for basal insulins like Lantus when treating Type 2 diabetes. 

• Standard adult dosage for Type 2 diabetes: 0.2–0.5 units/kg subcutaneous injection taken once per day at the same time each day

• Maximum adult dosage for Type 2 diabetes: Not specified, but there are concerns with efficacy in doses exceeding 0.5 units/kg subcutaneous injection taken once per day 

Lantus dosage for children

The FDA has approved Lantus in children as young as 6 years of age to treat Type 1 diabetes. Healthcare providers may, however, prescribe Lantus off-label to treat children and adolescents with Type 2 diabetes or newborns diagnosed with transient neonatal diabetes mellitus. As with adults, Lantus doses are ultimately based on fasting blood sugar levels. Each dose of Lantus is injected subcutaneously once daily at the same time every day.

• Standard dosage for children ages 6 and older: Doses will vary; recommended dose is 30% to 50% of the total daily insulin regimen

• Maximum dosage for children ages 6 and older: Not specified

Source: Epocrates, Prescriber’s Digital Reference

Lantus dosage restrictions

In general, Lantus dosages are primarily determined by fasting blood glucose levels or a percentage of total daily insulin requirements. There are very few dosage restrictions. People with hepatic impairment or kidney dysfunction may be given lower doses, but precise dosage adjustments have not been specified.

Contraindications include hypersensitivity to insulin glargine or any of the inactive ingredients in the injection. Anyone experiencing low blood sugar or symptoms of hypoglycemia will not be able to take a Lantus injection. People with low blood potassium (hypokalemia) should be cautious about taking Lantus because it may further lower potassium levels.

Lantus dosage for pets

Insulin products are commonly used to treat diabetes in dogs and cats. The most common insulin products used are the fast-acting insulin lispro as well as basal insulins (intermediate- or long-acting insulins) such as insulin glargine, isophane insulin (NPH), protamine zinc insulin (PZI), insulin detemir, and, specifically for veterinary use, porcine zinc insulin. Veterinarians will probably not prescribe brand-name insulin glargine such as Lantus or Toujeo, but a veterinary generic. Using a standard syringe and needle, injections are given subcutaneously once per day at the same time every day. Doses will vary based on the animal’s needs and blood glucose levels.

How to take Lantus

Lantus is taken as a subcutaneous injection once daily. Patients or caregivers can use the Lantus SoloStar prefilled pen or use a standard syringe and needle.

• Take this medicine as prescribed. The prescribing healthcare provider will tell you the exact dose and when to take the medicine.

• Lantus is usually taken only once per day. The dose(s) should be taken at the same time(s) of day each day.

• This medicine will come with illustrated instructions for use. Please read and follow these instructions each time an injection is administered.

• People who are blind or have vision problems should have the dose drawn/selectedby a caregiver.

• Do not share injection pens or needles with other people.

• Do not reuse needles. Attach a new needle before each injection.

• Lantus is never to be used in insulin pumps.

Preparing the injection

• If the medicine is being stored in a refrigerator, remove the vial or pen injector one to two hours before the scheduled injection.

• Inspect the injection pen before giving an injection. 

  • Check first to make sure that the injection pen or vial contains the right insulin. 

  • Check for any damage. If the pen appears damaged, do not use it. 

  • Check the medicine. The medicine should appear clear, colorless, and free from particles. If not, do not use the injector pen or the medicine in the vial.

• With the pen, attach the needle following the instructions for use. Keep the needle straight when attaching it to the pen.

  • Perform a safety check as outlined in the instructions for use. Failure to do so may mean injecting the wrong dose. 

  • Select the dose. Make sure the dose selector is set to “0” before setting the dose. The dose can be set from 1 to 80 units. If a dose larger than 80 units is required, you will need to complete two injections.

• With the vial, use only the syringe and needles approved for this medicine. If you are unsure, ask a pharmacist for the correct needle to use. Draw up the dose as instructed.

Injecting a dose of Lantus

• When Lantus is first prescribed, a healthcare professional will demonstrate how to administer an injection and where on the body to make an injection. Make sure these instructions are fully understood before giving injections at home.

• Lantus injections are given in the stomach, thigh, or upper arm. Use a different area of the body for each injection.

• Lantus is administered as a subcutaneous injection, that is, it is injected right below the skin. Do not inject Lantus into a vein or muscles.

• Clean the injection site with an alcohol swab.

• With the pen, insert the needle into the skin, holding the pen straight.

  • Press the injection button with your thumb. The dose indicator will gradually move to “0.”

• With the syringe and needle, pinch the skin and hold it then insert the needle as directed by your healthcare professional. 

  • Slowly push in the plunger of the syringe all the way.

• Keep the needle inserted and count out 10 seconds.

• The injection is finished. Remove the needle from the skin.

• For the pen,  replace the outer cap back on the needle and unscrew the needle from the injector.

• Dispose of the needle, either from the pen or syringe, in a sharps container, sealable hard plastic container, or sealable metal container.

Storing Lantus

• Store unused Lantus pens and unopened vials in a refrigerator (36°F to 46°F). Do not freeze. If the medicine becomes frozen, dispose of the medicine.

• Opened vials can be stored either in a refrigerator or at room temperature (up to 86°F). Used Lantus pens should be stored at room temperature.

• Store this medicine protected from light and out of reach and sight of children.

• Used Lantus pens and opened vials can be used for only 28 days. After 28 days, dispose of any unused medicine.

Lantus dosage FAQs

What happens if I miss a dose of Lantus?

When first prescribed Lantus, a healthcare professional will discuss what to do if a dose is missed. Follow these instructions if a dose of Lantus is forgotten at the scheduled time of day. If you don’t have instructions for a missed dose, call a doctor if a scheduled dose is missed.

How do I stop taking Lantus?

Never stop taking Lantus or any other prescribed insulin product except under the medical supervision of a doctor. Stopping insulin can produce a sudden and dangerous rise in blood glucose levels.

There may be reasons to stop taking Lantus immediately such as allergic reactions or serious side effects. If you notice symptoms of an allergic reaction to Lantus, seek medical help. A doctor may need to take you off Lantus therapy.

Can you overdose on Lantus?

An overdose of insulin glargine can cause low blood sugar (hypoglycemia) and low potassium (hypokalemia). Mild hypoglycemia can be treated with carbohydrates, but severe hypoglycemia is a potentially life-threatening medical emergency. If an overdose of insulin is suspected, call a poison helpline or get emergency medical treatment. Many patients, however, will have an emergency glucagon injection kit to treat hypoglycemia emergencies.

What interacts with Lantus?

When getting an insulin prescription, make sure to keep a list of all prescription drugs, over-the-counter medicine, and supplements being taken and share it with the prescribing healthcare provider. Like other prescription drugs, insulin products have some drug interactions that could cause serious problems. The most significant drug interactions involve antidiabetic drugs called thiazolidinediones (TZDs) which, when combined with insulin, raise the risk of swelling (edema) and heart failure. Drugs such as antipsychotics, oral contraceptives, estrogen hormone treatments, and corticosteroids all increase blood sugar and so work counter to insulin injections. Some drugs such as beta blockers or reserpine will mask episodes of hypoglycemia, a potentially serious side effect of insulin treatment.

Is it safe to take Lantus during pregnancy?

Pregnant women can take Lantus during all stages of pregnancy. Women who are breastfeeding should consult with a healthcare provider. There are no clinical studies on the effects of insulin glargine on milk production or its effects on a nursing infant, so there may be better studied basal insulin products to take while breastfeeding.

Related resources for Lantus dosages:

• Glargine insulin, StatPearls

• Insulin glargine drug summary, Prescriber’s Digital Reference

• Insulin glargine injection, Cleveland Clinic

• Lantus, Epocrates

• Lantus prescribing information, U.S. National Library of Medicine

• Plumb’s Veterinary Drug Handbook, 7th edition

• Practice Guideline Resources, American Diabetes Association