Start with Toujeo® and titrate toward glycemic control
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The starting dose of Toujeo is based on prior treatment.
Titrate Toujeo no more frequently than every 3 to 4 days to reduce the risk of hypoglycemia.
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For example purposes only.
Pens per year
Toujeo Max SoloStar® (U-300)NDC: 0024-5871-02
Tresiba® Flex-Touch® (U-200)NDC: 0169-2550-13
Lantus® SoloStar (U-100)
(insulin glargine injection 100 units/mL)NDC: 0088-2219-05
A safety test should be performed before each injection. The total volume does not account for safety tests or pen priming.
For illustrative purposes only. This is not an exhaustive list of all basal insulin pens on the market. The comparison of these pens does not support an evaluation of safety or efficacy between products.
- Toujeo should be injected subcutaneously once a day at the same time each day
- Toujeo Max SoloStar delivers doses in 2-unit increments. Starting doses are rounded down to the nearest even whole unit
- Toujeo Max SoloStar is recommended for patients who require at least 20 units of basal insulin per day
- Ensure patients have a separate prescription for pen needles
- For dosing information for patients with type 1 diabetes, please see the full Prescribing Information
More or less stringent goals may be appropriate for individual patients.
- In clinical trials, patients who started on, or changed to, Toujeo required a higher dose than patients controlled with Lantus
- Monitor glucose frequently in the first few weeks of therapy
- The dosage of other antidiabetic drugs may need to be adjusted when starting Toujeo to minimize the risk of hypoglycemia. View additional dosing information in the full Prescribing Information
How dosing is calculated
An algorithm calculates the total insulin units based on the customized titration schedule. It serves as an example of how titration may occur in clinical practice. To help avoid overestimating the number of units required, the algorithm accounts for titration for the first 30 days only. From Day 31 onward, the daily units included in the calculations remain at the titrated dose.
Ensure patients have a prescription for Toujeo as well as a second separate prescription for pen needles.
Toujeo is a long-acting human insulin analog indicated to improve glycemic control in adults and pediatric patients 6 years and older with diabetes mellitus. Limitations of Use: Toujeo is not recommended for the treatment of diabetic ketoacidosis.
Important Safety Information
Important Safety Information for Toujeo U-300 (insulin glargine) injection
Important Safety Information
Toujeo is contraindicated during episodes of hypoglycemia and in patients hypersensitive to insulin glargine or any of the excipients in Toujeo.
Warnings and Precautions
Toujeo contains the same active ingredient, insulin glargine, as Lantus. The concentration of insulin glargine in Toujeo is 300 units per mL (U-300).
Insulin pens and needles must never be shared between patients. Do NOT reuse needles.
Monitor blood glucose in all patients treated with insulin. Modify insulin regimens only under medical supervision. Changes in insulin regimen, strength, manufacturer, type, injection site or method of administration may result in the need for a change in insulin dose or an adjustment in concomitant oral antidiabetic treatment. Changes in insulin regimen may result in hyperglycemia or hypoglycemia. Dosage adjustments are recommended to lower the risk of hypoglycemia when switching patients to Toujeo from another insulin therapy.
Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis may result in hyperglycemia; sudden change in the injection site (to unaffected area) has been reported to result in hypoglycemia. Advise patients to rotate injection site to unaffected areas and closely monitor for hypoglycemia.
Unit for unit, patients started on, or switched to, Toujeo required a higher dose than patients controlled with Lantus. When switching from another basal insulin to Toujeo, patients experienced higher average fasting plasma glucose levels in the first few weeks of therapy until titrated to their individualized fasting plasma glucose targets. Higher doses were required in titrate-to-target studies to achieve glucose control similar to Lantus.
Hypoglycemia is the most common adverse reaction in patients treated with Toujeo and may be life-threatening. The long-acting effect of Toujeo may delay recovery from hypoglycemia compared to shorter-acting insulins.
Medication errors that may lead to hypoglycemia, such as accidental mix-ups between insulin products, have been reported. Patients should be instructed to always verify the insulin label before each injection.
Do not dilute or mix Toujeo with any other insulin or solution. If mixed or diluted, the solution may become cloudy, and the onset of action/time to peak effect may be altered in an unpredictable manner. Do not administer Toujeo via an insulin pump or intravenously because severe hypoglycemia can occur.
Severe, life-threatening, generalized allergy, including anaphylaxis, can occur. Discontinue Toujeo, monitor, and treat if indicated.
A reduction in the Toujeo dose may be required in patients with renal or hepatic impairment.
All insulins, including Toujeo, can lead to life-threatening hypokalemia. Untreated hypokalemia may cause respiratory paralysis, ventricular arrhythmia, and death. Closely monitor potassium levels in patients at risk of hypokalemia and treat if indicated.
Fluid retention, which may lead to or exacerbate heart failure, can occur with concomitant use of thiazolidinediones (TZDs) with insulin. These patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of TZD must be considered.
Certain drugs may affect glucose metabolism, requiring insulin dosage adjustment and close monitoring of blood glucose. The signs of hypoglycemia may be reduced in patients taking anti-adrenergic drugs (e.g., beta-blockers, clonidine, guanethidine, and reserpine).
Adverse reactions commonly associated with Toujeo include hypoglycemia, hypersensitivity reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, and weight gain.
Important Safety Information for Toujeo U-300 (insulin glargine) injection SoloStar and Toujeo Max SoloStar
Toujeo SoloStar and Toujeo Max SoloStar are single-patient-use prefilled insulin pens. To help ensure an accurate dose each time, patients should follow all steps in the Instruction Leaflet accompanying their pen; otherwise, they may not get the correct amount of insulin, which may affect their blood glucose levels. It is especially important to perform a safety test when a patient is using a new pen for the first time.
Do not withdraw Toujeo from the SoloStar and Max SoloStar single-patient-use prefilled pens with a syringe.
NPH, neutral protamine Hagedorn.
1. Toujeo Prescribing Information. 2. Tresiba Prescribing Information. 3. Lantus Prescribing Information. 4. Levemir Prescribing Information. 5. Basaglar Prescribing Information. 6. Semglee Prescribing Information.