Toujeo® is a long-acting human insulin analog indicated to improve glycemic control in adults with diabetes mellitus.
What is Toujeo?
- Toujeo (insulin glargine) is a man-made form of a hormone that is produced in the body. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Insulin glargine is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours.
- The Toujeo SoloStar injection pen is used to improve blood sugar control in adults with diabetes mellitus.
- Toujeo is used to treat type 1 diabetes or type 2 diabetes in adults.
- It is not known if Toujeo is safe and effective in children.
- Toujeo SoloStar contains 3 times as much insulin per milliliter (mL) as regular insulin.
- You should not use Toujeo if you are having an episode of hypoglycemia (low blood sugar), or if you are in a state of diabetic ketoacidosis.
- Never share a Toujeo SoloStar injection pen with another person, even if the needle has been changed.
- Sharing injection pens can allow disease such as hepatitis or HIV to pass from one person to another.
- Toujeo is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.
Before taking this medicine
You should not use Toujeo if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar).
To make sure Toujeo is safe for you, tell your doctor if you have:
- liver or kidney disease;
- low levels of potassium in your blood (hypokalemia); or
- diabetic ketoacidosis (call your doctor for treatment).
Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while you are using Toujeo may increase your risk of serious heart problems.
Follow your doctor's instructions about using insulin if you are pregnant or breast-feeding a baby. Blood sugar control is very important during pregnancy, and your dose needs may be different during each trimester of pregnancy. Your dose needs may also be different while you are breast-feeding.
How should I use Toujeo?
- Use Toujeo exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
- Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
- The Toujeo brand of insulin glargine contains 3 times as much insulin per milliliter (mL) as the Lantus or Basaglar brands. There are 300 units of insulin in 1 mL of Toujeo, and 100 units in 1 mL of Lantus or Basaglar.
- If there are any changes in the brand, strength, or type of insulin you use, your dosage needs may change.
- Insulin is injected under the skin. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and injection pens.
- Toujeo must not be given with an insulin pump, or mixed with other insulins. Do not inject insulin glargine into a vein or a muscle.
- Toujeo is usually injected once per day at the same time each day. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and injection pens.
- Your care provider will show you the best places on your body to inject Toujeo. Use a different place each time you give an injection. Do not inject into the same place two times in a row.
- Use only the SoloStar injection pen that comes with Toujeo. Attach a new needle before each use. Do not transfer the insulin from the SoloStar pen into a syringe.
- Never share an injection pen with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.
- Use a disposable needle only once. Follow any state or local laws about throwing away used needles and injection pens. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.
Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.
Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.
Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.
Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.
Toujeo is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
Keep this medicine in its original container protected from heat and light. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.
Storing unopened (not in use) Toujeo SoloStar pens:
- Refrigerate and use until expiration date.
Storing opened (in use) Toujeo SoloStar pens:
- Store the injection pen at room temperature (do not refrigerate) and use within 42 days.
- Do not store a Toujeo SoloStar injection pen with the needle attached.
Do not use the medicine if it looks cloudy, has changed colors, or has any particles in it. Call your pharmacist for new medicine.
Wear a diabetes medical alert tag in case of emergency. Any medical care provider who treats you should know that you have diabetes.
What happens if I miss a dose?
- Call your doctor for instructions if you miss a dose of Toujeo. You should not use more than one dose in a 24-hour period unless your doctor tells you to.
- Keep insulin on hand at all times. Get your prescription refilled before you run out of medicine completely.
What happens if I overdose?
- Seek emergency medical attention. Insulin overdose can cause life-threatening hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizure (convulsions), or loss of consciousness.
What should I avoid while using Toujeo?
- Do not change the brand of insulin glargine you are using without first talking to your doctor or pharmacist.
- Avoid medication errors by always checking the medicine label before injecting your insulin.
- Avoid drinking alcohol. It can cause low blood sugar and may interfere with your diabetes treatment.
Toujeo side effects
Get emergency medical help if you have signs of an allergy reaction to Toujeo: redness or swelling where an injection was given, itchy skin rash over the entire body, trouble breathing, fast heartbeats, feeling like you might pass out, or swelling in your tongue or throat.
Call your doctor at once if you have:
- fluid retention - weight gain, swelling in your hands or feet, feeling short of breath; or
- low potassium - leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.
Common Toujeo side effects may include:
- low blood sugar;
- itching, mild skin rash; or
- thickening or hollowing of the skin where you injected the medicine.
What other drugs will affect Toujeo?
- Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of insulin. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products.
Along with its needed effects, insulin glargine (the active ingredient contained in Toujeo) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking insulin glargine:
- More common
- behavior change similar to being drunk
- blurred vision
- cold sweats
- convulsions (seizures)
- cool, pale skin
- difficulty with thinking
- dizziness or lightheadedness
- excessive hunger
- fast heartbeat
- restless sleep
- slurred speech
- tingling in the hands, feet, lips, or tongue
- unusual tiredness or weakness
Less common or rare
- Fast pulse
- skin rash or itching over the entire body
- trouble breathing
Incidence not known
- Bloating or swelling of the face, hands, lower legs, or feet
- decreased urine
- difficulty with swallowing
- dry mouth
- increased thirst
- irregular heartbeat
- muscle pain or cramps
- numbness or tingling in the hands, feet, or lips
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- rapid weight gain
Some side effects of insulin glargine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- sore throat
- stuffy or runny nose
Less common or rare
- Depression of the skin at the injection site
- itching, pain, redness, or swelling at the injection site
- thickening of the skin at injection site