Once-daily dose at the same time each day

No dosing differences with Lantus® (insulin glargine injection) 100 units/mL for insulin initiation1,2

Type 2 diabetes1 recommended starting dose

0.2 units/kg once daily or up to 10 units once daily

  • Adjustments to the amount and timing of short- or rapid-acting insulins and dosages of any anti-diabetic medications may be necessary

Type 1 diabetes1 recommended starting dose

~1/3 of the total daily insulin requirements

  • Short- or rapid-acting, premeal insulin should be used to satisfy the remainder of the daily insulin requirements
  • BASAGLAR must be used concomitantly with short-acting insulin

SELECT SAFETY INFORMATION
WARNINGS AND PRECAUTIONS
Accidental mix-ups between another insulin glargine product (100 units/mL) and other insulins, particularly rapid-acting insulins, have been reported. To avoid medication errors between BASAGLAR and other insulins, instruct patients to always check the insulin label before each injection.


Other dosing information

  • Inject BASAGLAR subcutaneously once a day, any time of day, at the same time every day
  • Individualize and titrate BASAGLAR dosage based on the metabolic needs, blood glucose monitoring results, and glycemic control goal of the individual
  • Dosage adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), during acute illness, or changes in renal or hepatic function, and should be made under medical supervision with appropriate glucose monitoring

SELECT SAFETY INFORMATION
WARNINGS AND PRECAUTIONS
Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including BASAGLAR. If hypersensitivity reactions occur, discontinue BASAGLAR; treat per standard of care and monitor until symptoms and signs resolve. BASAGLAR is contraindicated in patients who have had hypersensitivity reactions to insulin glargine or one of the excipients.

Titrate BASAGLAR® (insulin glargine injection) 100 units/mL to target FPG levels

Increase dose by 1 unit daily until target FPG level is achieved (≤100mg/dl or FPG based on goal of individual patient)4,10

  • Dose titration of BASAGLAR should be individualized according to patient needs and performed under the guidance of a healthcare professional
  • In the event of hypoglycemia, a dose reduction may be necessary

FPG=fasting plasma glucose

SELECT SAFETY INFORMATION
WARNINGS AND PRECAUTIONS
All insulin products, including BASAGLAR, cause a shift in potassium from the extracellular to intracellular space, possibly leading to hypokalemia. Untreated hypokalemia may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia if indicated.

Transitioning to BASAGLAR® (insulin glargine injection) 100 units/mL

BASAGLAR dosing should be the same as Lantus when transitioning patients from Lantus1

From Lantus® (insulin glargine injection) 100 units/mL

BASAGLAR and Lantus (US-approved) PK properties over a 24-hour period

The dose of BASAGLAR should be the same as Lantus

BASAGLAR and Lantus (US-approved) PK properties over a 24-hour period

The time of day for administration should be determined by the healthcare professional

SELECT SAFETY INFORMATION
WARNINGS AND PRECAUTIONS
Thiazolidinediones (TZDs), which are peroxisome proliferator-activated receptor (PPAR)-gamma agonists, can cause dose-related fluid retention, particularly when used in combination with insulin. Fluid retention may lead to or exacerbate heart failure. 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.

Transitioning from other insulins1

From Toujeo® (insulin glargine injection) 300 units/mL

  • The recommended initial BASAGLAR dosage is 80% of the Toujeo dose that is being discontinued
  • This dosage reduction will lower the likelihood of hypoglycemia

From NPH insulin (twice-daily)

  • The recommended initial BASAGLAR dosage is 80% of the NPH dosage that is being discontinued
  • This dosage reduction will lower the likelihood of hypoglycemia

NPH=Neutral Protamine Hagedorn.

From intermediate- or long-acting insulin other than Lantus

A change in the dose of BASAGLAR may be required and the amount and timing of shorter-acting insulins and doses of any anti-diabetic drugs may need to be adjusted.

Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously and only under close medical supervision, and the frequency of blood glucose monitoring should be increased. For patients with type 2 diabetes, dosage adjustments of concomitant anti-diabetic products may be needed.1

SELECT SAFETY INFORMATION
ADVERSE REACTIONS
Adverse reactions commonly associated with insulin glargine products (5% or greater incidence) are: hypoglycemia, allergic reactions, injection site reaction, lipodystrophy, pruritus, rash, edema, and weight gain.
DRUG INTERACTIONS
Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and close monitoring of blood glucose. The signs and symptoms of hypoglycemia may be blunted when beta-blockers, clonidine, guanethidine, and reserpine are co-administered with BASAGLAR.

Begin with the BASAGLAR® (insulin glargine injection) 100 units/mL prefilled KwikPen®

Prefilled BASAGLAR KwikPen®—a similar design to other Lilly KwikPens

BASAGLAR KwikPen® must never be shared between patients, even if the needle is changed. Sharing poses a risk of transmission of blood borne pathogens.1

In patients with type 1 diabetes, BASAGLAR must be used concomitantly with short-acting insulin.1

*Multiple sizes may be used.

†In a study, the 4 mm x 32 G pen needle provided equivalent glycemic control with reduced pain compared to longer and thicker needles (Hirsch LJ, et al. Curr Med Res Opin. 2010;26:1531-1541).

‡Do not freeze or use a KwikPen® that has been frozen.

Indications and Important Safety Information
Indication

BASAGLAR is indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus.

LIMITATION OF USE

BASAGLAR is not recommended for the treatment of diabetic ketoacidosis.

IMPORTANT SAFETY INFORMATION
CONTRAINDICATIONS

BASAGLAR is contraindicated during episodes of hypoglycemia, and in patients with hypersensitivity to insulin glargine or one of its excipients.

WARNINGS AND PRECAUTIONS

BASAGLAR KwikPen® must never be shared between patients, even if the needle is changed. Sharing poses a risk of transmission of blood borne pathogens.

Changes in insulin strength, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. These changes should be made cautiously and only under close medical supervision, and the frequency of blood glucose monitoring should be increased. For patients with type 2 diabetes, dosage adjustments of concomitant anti-diabetic products may be needed.

Hypoglycemia is the most common adverse reaction associated with insulins, including BASAGLAR. Severe hypoglycemia can cause seizures, may be life-threatening, or cause death.

Accidental mix-ups between another insulin glargine product (100 units/mL) and other insulins, particularly rapid-acting insulins, have been reported. To avoid medication errors between BASAGLAR and other insulins, instruct patients to always check the insulin label before each injection.

Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including BASAGLAR. If hypersensitivity reactions occur, discontinue BASAGLAR; treat per standard of care and monitor until symptoms and signs resolve. BASAGLAR is contraindicated in patients who have had hypersensitivity reactions to insulin glargine or one of the excipients.

All insulin products, including BASAGLAR, cause a shift in potassium from the extracellular to intracellular space, possibly leading to hypokalemia. Untreated hypokalemia may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk for hypokalemia if indicated.

Thiazolidinediones (TZDs), which are peroxisome proliferator-activated receptor (PPAR)-gamma agonists, can cause dose-related fluid retention, particularly when used in combination with insulin. Fluid retention may lead to or exacerbate heart failure. 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.

ADVERSE REACTIONS

Adverse reactions commonly associated with insulin glargine products (5% or greater incidence) are: hypoglycemia, allergic reactions, injection site reaction, lipodystrophy, pruritus, rash, edema, and weight gain.

DRUG INTERACTIONS

Certain drugs may affect glucose metabolism, requiring insulin dose adjustment and close monitoring of blood glucose. The signs and symptoms of hypoglycemia may be blunted when beta-blockers, clonidine, guanethidine, and reserpine are co-administered with BASAGLAR.

BV HCP ISI 24JUN2016

For more information, please see Full Prescribing Information, including Patient Information and Instructions for Use.

BASAGLAR and KwikPen® are registered trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates and are available by prescription only.

References
1. BASAGLAR [Prescribing Information]. Indianapolis, IN: Eli Lilly and Company. 2. Lantus [Prescribing Information]. Bridgewater, NJ: sanofi-aventis U.S. LLC; 2015. 3. Linnebjerg H, Lam EC, Seger ME, et al. Diabetes Care. 2015;38:2226-2233. 4. Rosenstock J, Hollander P, Bhargava A, et al. Diabetes Obes Metab. 2015;17:734-741. 5. Data on file, Lilly USA, LLC. BAS20160408A. 6. Data on file, Lilly USA, LLC. BAS20160811B. 7. Blevins TC, Dahl D, Rosenstock J, et al. Diabetes Obes Metab. 2015;17:726-733. 8. Data on file, Lilly USA, LLC. BAS20151103E. 9. Data on file, Lilly USA, LLC. BAS20160811A. 10. Gerstein HC, Yale JF, Harris SB, et al. Diabet Med. 2006;23:736-742. 11. BASAGLAR KwikPen [Instructions for Use]. Indianapolis, IN: Eli Lilly and Company.