Insulin Glargine 300 units/mL (U-300) is a long-acting, concentrated basal insulin analogue. It is a biosimilar to the originator product, designed to provide a more stable and prolonged pharmacokinetic/pharmacodynamic profile compared to Insulin Glargine 100 units/mL (U-100). It provides a flatter and more extended blood glucose-lowering effect with a duration of action beyond 24 hours, allowing for once-daily subcutaneous administration. It is indicated for the treatment of diabetes mellitus in adults and children.
Adult: Individualized. Typically initiated at 0.2 units/kg or 10 units once daily, adjusted based on glycemic response. When switching from other basal insulins, a dose reduction of ~10-20% may be required initially to minimize hypoglycemia risk.
Note: For subcutaneous injection only. Administer once daily at the same time each day, preferably in the evening. Rotate injection sites (abdomen, thigh, or upper arm) to prevent lipodystrophy. Use a U-100 insulin syringe calibrated for U-300 insulin or a dedicated pen device. Do NOT administer intravenously or intramuscularly. Do NOT mix with other insulins.
Insulin Glargine is a recombinant human insulin analogue where asparagine at position A21 is replaced by glycine and two arginines are added to the C-terminus of the B-chain. This modification shifts the isoelectric point towards a neutral pH, making it less soluble at physiological pH. Upon subcutaneous injection, it forms microprecipitates from which small amounts of insulin glargine are slowly released, resulting in a prolonged, peakless profile.
Pregnancy: Pregnancy Category C. Insulin is the drug of choice for glycemic control in pregnancy. Insulin requirements may decrease in first trimester and increase significantly in second and third trimesters. Close monitoring is essential. Use only if clearly needed.
Driving: Caution advised. Hypoglycemia can impair concentration and reaction time. Patients should check blood glucose before driving and avoid driving if hypoglycemic.
| Oral Hypoglycemic Agents (e.g., Sulfonylureas, Meglitinides) | Additive hypoglycemic effect, increased risk of hypoglycemia | Major |
| Corticosteroids (e.g., Prednisolone, Dexamethasone) | Antagonize insulin effect, leading to hyperglycemia; dose increase may be needed | Major |
| Beta-blockers (e.g., Propranolol) | May mask tachycardia during hypoglycemia and impair counter-regulatory response | Moderate |
| Thiazide Diuretics | May cause hyperglycemia, reducing insulin efficacy | Moderate |
| ACE Inhibitors (e.g., Ramipril) | May enhance insulin sensitivity, increasing hypoglycemia risk | Moderate |
| Alcohol | Potentiates hypoglycemic effect and impairs gluconeogenesis; risk of delayed hypoglycemia | Major |
| Octreotide, Lanreotide | Alters glucose metabolism; may increase or decrease insulin requirement | Moderate |
Same composition (Insulin Glargine (300u/ml)), different brands: