Toujeo is a brand-name prescription medication. It’s FDA-approved to treat type 1 or type 2 diabetes in adults and children ages 6 years and older.

Toujeo contains insulin glargine, which is a long-acting insulin. This drug is given as a subcutaneous injection (an injection under your skin). It’s available in the following two prefilled pens:

  • Toujeo SoloStar. This pen contains 450 units of insulin glargine in 1.5 mL of solution. It can give up to 80 units of insulin glargine in a single injection.
  • Toujeo Max SoloStar. This pen contains 900 units of insulin glargine in 3 mL of solution. It can give up to 160 units of insulin glargine in a single injection.

Effectiveness

Clinical studies tested Toujeo in adults with type 1 or type 2 diabetes. The studies showed that after 26 weeks of treatment, Toujeo lowered their:

A clinical study also tested Toujeo in children ages 6 years or older with type 1 diabetes. The study found that after 26 weeks of treatment, Toujeo lowered their:

  • fasting blood sugar levels by about 10 mg/dL
  • A1C levels by about 0.4%

Toujeo is not used to treat diabetic ketoacidosis. For more information on Toujeo’s effectiveness and how it’s used, see the section below called “Toujeo uses.”

* Fasting blood sugar is measured after you’ve fasted for a certain time. The American Diabetes Association (ADA) recommends a fasting blood sugar level of 80 mg/dL to 130 mg/dL for most adults.
† A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The ADA recommends an A1C goal of less than 7.0% for most adults.

Toujeo is a brand-name biologic drug. It contains a long-acting form of insulin called insulin glargine. Toujeo is not currently available in biosimilar form.

Biologic drugs, such as Toujeo, are made from living cells. This means they can’t be copied exactly. So rather than generic forms, biologics are sometimes available as biosimilars. Biosimilars are considered as safe and effective as their parent drugs, and they are often less expensive.

Insulin glargine (Toujeo’s active ingredient) is also available as the brand-name drugs Lantus, Basaglar, Semglee (insulin glargine-yfgn),* and Rezvoglar (insulin glargine-aglr).* However, Toujeo contains a higher concentration of insulin glargine than these other versions.

For more information about Toujeo and other versions of insulin glargine, talk with your doctor. They can provide details about your treatment options. You can also see the “Toujeo vs. Lantus and Basaglar” section below for details.

* The reason “-yfgn” and “-aglr” appear at the end of these drugs’ names is to show that the drug is distinct from similar medications that may be created in the future.

Toujeo comes inside prefilled pens. There are two forms of Toujeo pens, which are described below:

  • Toujeo SoloStar. This prefilled pen contains 450 units of insulin glargine in 1.5 mL of solution. It can give up to 80 units of insulin glargine in a single injection.
  • Toujeo Max SoloStar. This prefilled pen contains 900 units of insulin glargine in 3 mL of solution. It can give up to 160 units of insulin glargine in a single injection.

With either pen, your doctor will likely start you on a low dosage and adjust it over time to reach the dosage that’s right for you. Be sure to take the dosage your doctor prescribes. And don’t inject more or less Toujeo than your doctor prescribes.

Toujeo, Lantus, and Basaglar are all brand-name drugs that contain a long-acting insulin. Specifically, each of these medications contains the same ingredient, insulin glargine. And they all come in prefilled pens.

While Toujeo, Lantus, and Basaglar contain the same active drug, the main difference between them is that Toujeo is more concentrated than either Lantus or Basaglar.

There are 300 units of insulin glargine in each milliliter (mL) of Toujeo. However, there are only 100 units of insulin glargine in each mL of Lantus and Basaglar. This means that your doctor will need to adjust your dosage if they switch you from Lantus or Basaglar to Toujeo (or vice-versa).

For comparison information about Toujeo with other drugs, see the “Toujeo vs. Tresiba” and “Toujeo vs. Levemir” sections below.

Uses

Toujeo is FDA-approved to improve blood sugar management in adults with type 1 or type 2 diabetes. And it’s also approved for these uses in children ages 6 years or older.

Lantus and Basaglar are approved to improve blood sugar management in adults with type 1 or type 2 diabetes. These drugs are also approved for use in children ages 6 years or older with type 1 diabetes.

Drug forms and administration

Toujeo, Lantus, and Basaglar are each given as an injection under the skin (subcutaneous injection). They’re usually given once daily.

Side effects and risks

Toujeo, Lantus, and Basaglar all contain the same long-acting insulin ingredient, insulin glargine. Therefore, these medications can cause similar common and serious side effects.

For information on possible side effects of Toujeo, see the section below called “Toujeo side effects.”

Toujeo contains a long-acting insulin called insulin glargine. There are many different types of insulin, which are classified by how fast they work or how long they work. The table below shows examples of different types of insulins, including the type in Toujeo.

Insulin nameClassificationHow fast does it work?How long does it last?
insulin glargine U-300 (Toujeo)long-actingup to 6 hoursup to 36 hours
insulin glargine U-100 (Lantus, Basaglar)long-acting1 to 2 hours20 to 24 hours
insulin detemir (Levemir)long-acting1 to 2 hours6 to 24 hours
insulin degludec (Tresiba)long-acting1 hourup to 42 hours
insulin NPH (Humulin N, Novolin N)intermediate-acting1 to 2 hours10 to 24 hours
regular insulin (Humulin R, Novolin R)short-acting30 to 60 minutes6 to 10 hours
insulin aspart (NovoLog)rapid-acting and short-acting10 to 30 minutes3 to 5 hours
insulin glulisine (Apidra)rapid-acting and short-acting10 to 30 minutes3 to 5 hours
insulin lispro (Humalog)rapid-acting and short-acting15 to 30 minutes3 to 5 hours

Note: This is not a complete list of insulin treatments that are currently available.

Toujeo and Tresiba are both long-acting insulin products, but they contain different forms of insulin. Toujeo contains insulin glargine, and Tresiba contains insulin degludec.

Below is a summary of how Toujeo and Tresiba compare.

Uses

Toujeo is FDA-approved to control blood sugar levels in adults and children ages 6 years and older with type 1 or type 2 diabetes.

Tresiba is FDA-approved to control blood sugar in adults and children ages 1 year and older with type 1 or type 2 diabetes.

Drug forms and administration

Toujeo and Tresiba are both available as a prefilled pen that’s used to deliver insulin using an injection under the skin (subcutaneous injection).

Side effects and risks

Toujeo and Tresiba both contain a long-acting insulin ingredient. Therefore, the side effects that they cause are very similar.

More common side effects of Toujeo and Tresiba include:

  • respiratory infections, such as the common cold, flu, and bronchitis
  • low blood sugar level (hypoglycemia)
  • fluid retention with swelling of the arms or legs
  • weight gain
  • pain, rash, swelling, and itchiness at the injection sites
  • skin thickening or pits at the injection sites

Other common side effects that have been reported in people using Tresiba include headache and diarrhea.

Serious side effects that can occur in people using Toujeo or Tresiba may include:

  • severe low blood sugar (hypoglycemia)
  • low potassium level (hypokalemia)
  • severe allergic reaction

Although both Toujeo and Tresiba can cause hypoglycemia, Toujeo may have a lower risk of this condition. In one study, Toujeo had a lower risk of hypoglycemia than Tresiba when these medications were first started and dosages were being increased.

In another study, low blood sugar levels at night were less common in people taking Toujeo compared to Tresiba. And in yet another study, the risk of severe low blood sugar and nighttime low blood sugar was lower in people taking Toujeo compared to those taking Tresiba.

Effectiveness

Toujeo and Tresiba have been directly compared in several clinical studies. Overall, they were found to be very similar in effectiveness.

In a 2018 study in people with type 2 diabetes, Toujeo and Tresiba worked about equally well for decreasing hemoglobin A1c (A1C)* after 24 weeks of treatment.

Another 2018 study in people with type 2 diabetes also found that Toujeo and Tresiba worked about equally well for lowering blood sugar levels. And there were similar results in yet another 2018 study.

One study evaluated switching people with type 2 diabetes from a long-acting insulin such as Lantus or Levemir, to Toujeo or Tresiba. In this study, making the switch improved A1C about equally well in people who switched to Toujeo as people who switched to Tresiba.

Some research found a difference between the performance of the two drugs. A 2018 analysis of studies found that Toujeo may cause more stable blood sugar levels throughout the day compared to Tresiba.

* A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The American Diabetes Association (ADA) recommends an A1C goal of less than 7.0% for most adults.

Costs

Toujeo and Tresiba are brand-name medications. Neither drug is available in a biosimilar form. (As with generics, biosimilars tend to cost less than brand-name drugs.)

Toujeo may cost less than Tresiba. The actual amount you pay for either drug will depend on your insurance plan, your location, and the pharmacy you use.

You may also wonder how Toujeo compares with Levemir.

Toujeo and Levemir are both long-acting insulin products, but they contain different forms of insulin. Toujeo contains insulin glargine, and Levemir contains insulin detemir.

Uses

Toujeo is FDA-approved to manage blood sugar levels in adults and children ages 6 years and older with type 1 or type 2 diabetes.

Levemir is FDA-approved to manage blood sugar in adults and children ages 2 years and older with type 1 diabetes. It’s also approved for use in adults with type 2 diabetes.

Drug forms and administration

Both Toujeo and Levemir are given by an injection under the skin (subcutaneous injection). They’re also both usually given once daily.

Side effects and risks

Toujeo and Levemir both contain a long-acting insulin ingredient. Therefore, the side effects that they can cause are very similar.

More common side effects of Toujeo and Levemir include:

  • respiratory infections, such as the common cold, flu, or bronchitis
  • low blood sugar level (hypoglycemia)
  • fluid retention with swelling of the arms or legs
  • weight gain
  • pain, rash, swelling, and itchiness at the injection sites
  • skin thickening or pits at the injection sites

Other common side effects that have been reported in people using Levemir include:

  • headache
  • back pain
  • fever
  • diarrhea
  • nausea
  • vomiting
  • stomach pain

Serious side effects that can occur in people using Toujeo or Levemir may include:

  • severe low blood sugar (hypoglycemia)
  • low potassium level (hypokalemia)
  • severe allergic reaction

Effectiveness

Toujeo and Levemir haven’t been directly compared in clinical studies. However, an indirect comparison found that Toujeo and Levemir may work about equally well for decreasing hemoglobin A1c (A1C).*

* A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The American Diabetes Association (ADA) recommends an A1C goal of less than 7.0% for most adults.

Costs

Toujeo and Levemir are brand-name medications. Neither drug is available in a biosimilar form. (As with generics, biosimilars tend to cost less than brand-name drugs.)

Toujeo may cost less than Levemir. The actual amount you pay for either drug will depend on your insurance plan, your location, and the pharmacy you use.

The Toujeo dosage your doctor prescribes will depend on several factors. These include:

  • the condition you’re using Toujeo to treat
  • your age
  • your weight
  • your diet and level of physical activity
  • whether you’re already taking insulin
  • your blood glucose level goals

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

You can also see this article for more in-depth information about Toujeo’s recommended dosages.

Forms and strengths

Toujeo is available in two different prefilled pens that are used to deliver insulin with an injection under the skin (subcutaneous injection).

Toujeo pens

  • Toujeo SoloStar: This pen contains 450 units of insulin glargine in 1.5 milliliters (mL) of solution. It can give up to 80 units of insulin glargine in a single injection.
  • Toujeo Max SoloStar: This pen contains 900 units of insulin glargine in 3 mL of solution. It can give up to 160 units of insulin glargine in a single injection.

Toujeo pen needles

Pen needles must be attached to either type of pen before each injection. Needles aren’t included with the Toujeo pens, so you’ll need to purchase them separately. The manufacturer of Toujeo recommends using one of the following pen needles:

  • BD Ultra-Fine
  • Ypsomed Clickfine
  • Owen Mumford Unifine Pentips

Dosage for type 1 diabetes

Your dosage of Toujeo for type 1 diabetes will depend on whether you’re starting treatment with insulin for the first time or you’re switching from a different insulin product to Toujeo.

Starting insulin for the first time

When you’re first starting treatment with insulin, your healthcare professional will calculate a total daily insulin requirement for you. This amount is based on how much you weigh. Usually, the total daily insulin requirement is 0.2 to 0.4 units per kilogram (kg) of body weight.

About one-third to one-half of your total daily insulin requirement will be given as Toujeo, once daily. The rest of your total daily insulin requirement will be given as a short-acting insulin. You’ll divide it and take it with each of your daily meals.

For example, for a person who weighs 175 pounds (about 80 kg) and is prescribed a dosage of 0.3 units/kg per day:

  • their total daily insulin dose would be about 24 units each day,
  • their starting dose of Toujeo would be about one-third of their total daily dose, which is around 8 units, and
  • the rest of their total daily insulin requirement, which is 16 units, would be given as a short-acting insulin with daily meals

Your healthcare professional will work with you to manage your blood sugar levels. They’ll monitor these levels and adjust your insulin dosage if needed.

Switching insulin treatment to Toujeo

When you’re switching from another once-daily, long-acting insulin to Toujeo, your starting dosage of Toujeo would likely be the same as your dosage for the other long-acting insulin. After you switch, your healthcare professional will adjust your dosage of Toujeo, if needed. Most people who switch from Lantus to Toujeo need a higher daily dose of Toujeo than Lantus. This may be because the body absorbs Toujeo more slowly than it absorbs Lantus.

When you’re switching from a twice-daily NPH insulin (an intermediate-acting insulin), your Toujeo starting dosage would likely be 80% of your total daily NPH insulin dosage. Your healthcare professional will adjust your dosage of Toujeo if needed.

Dosage for type 2 diabetes

Toujeo dosing for type 2 diabetes depends on whether you’re starting treatment with insulin for the first time or you’re switching from a different insulin product to Toujeo.

Starting insulin for the first time

Your healthcare professional will calculate your Toujeo dosage based on your body weight. The typical starting dose of Toujeo in people with type 2 diabetes is 0.2 units per kilogram (kg) of body weight. This amount is usually taken once daily.

For example, a person weighs 150 pounds (about 68 kg) and their doctor prescribes 0.2 units/kg per day. Their total daily insulin requirement would be about 14 units each day.

If you’re taking other diabetes medications, your healthcare professional may need to adjust the dosage of those medications when you start taking Toujeo.

Your healthcare professional will work with you to manage your blood sugar levels. They’ll monitor these levels and adjust your insulin dosage and the dosage of your other diabetes medications if needed.

Switching insulin treatment to Toujeo

When you’re switching from another once-daily, long-acting insulin to Toujeo, your starting dosage of Toujeo will likely be the same as the other long-acting insulin. After you switch, your healthcare professional will adjust your dosage of Toujeo, if needed. Most people who switch from Lantus to Toujeo need a higher daily dose of Toujeo than Lantus. This may be because the body absorbs Toujeo more slowly than it absorbs Lantus.

When you’re switching from twice-daily NPH insulin, your Toujeo starting dosage would likely be 80% of your total daily NPH insulin dosage. Your healthcare professional will adjust your dosage of Toujeo if needed.

Pediatric dosage

The dosage for children ages 6 years or older is the same as for adults. The typical starting dose is 0.2 units of insulin per kilogram of body weight. And this amount is usually taken once daily.

For example, a child weighs 60 pounds (about 27 kg) and his doctor prescribes 0.2 units/kg a day. The child’s total daily insulin dose would be about 5 units each day.

What if I miss a dose?

What you should do if you miss a dose depends on when you realize that you’ve missed a dose.

If it’s within about 2 hours of your scheduled dose, it should be OK to go ahead and take your Toujeo dose. You should just be aware that you’ll likely need to adjust the timing of your next dose accordingly.

If it’s been more than 2 hours since your scheduled dose, talk with your healthcare professional right away. They can advise you on the best approach to manage your blood sugar levels.

Be sure not to take a double dose to make up for a missed dose. This can cause dangerous side effects, such as hypoglycemia.

It’s a good idea to talk with your doctor in advance about what to do if you miss a dose. They can tell you at what point you should avoid taking the missed dose and instead wait for the next dose.

Will I need to use this drug long term?

Yes. Toujeo is used long term to manage blood sugar levels in people with type 1 and type 2 diabetes.

What should I do if Toujeo isn’t working?

It’s important to remember that it can take up to 5 days for Toujeo to reach its full effect on your blood sugar levels. Therefore, it may not seem like it’s working when you first start taking it.

But if you’ve already taken it for 5 days or longer and it still doesn’t seem to be working, talk with your healthcare professional. They may need to adjust your Toujeo dosage.

Dosing tips

  • Your blood sugar levels should be closely monitored when you’re starting or switching to Toujeo.
  • It may take up to 5 days for Toujeo to have its full effect on lowering your blood sugar levels.
  • Dosage adjustments should only be made every 3 or 4 days.
  • Toujeo shouldn’t be diluted or mixed with any other insulin products.

Toujeo can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Toujeo. This list doesn’t include all possible side effects.

For more information on the possible side effects of Toujeo, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

You can also see this article for details about Toujeo’s potential side effects.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Toujeo, you can do so through MedWatch.

More common side effects

The more common side effects of Toujeo can include:

  • respiratory infections, such as the common cold, flu, or bronchitis
  • cough
  • low blood sugar (hypoglycemia)
  • fluid retention, with swelling of your arms or legs
  • weight gain
  • pain, rash, swelling, or itchiness at the injection sites
  • skin thickening or pits at the injection sites

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

Side effects from starting insulin or changing dosage

When you first start using Toujeo or if your doctor increases your dosage, you may have certain temporary side effects. These can include changes in vision, such as blurriness.

You may also have peripheral neuropathy (nerve damage that causes pain, numbness, or tingling in your hands and feet). These symptoms will likely go away within a few days or a couple of weeks after you start the drug or change your dosage.

Serious side effects

Serious side effects from Toujeo aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

Side effects in children

In clinical studies, common side effects in children ages 6 years or older were similar to those in adults.

If you have questions about side effects of Toujeo that may affect a child using the drug, talk with your doctor.

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on certain side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Toujeo. But it’s not known for sure how often people taking Toujeo have had an allergic reaction to the drug.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have a severe allergic reaction to Toujeo. But call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight gain

Weight gain can occur in some people who use Toujeo. This is a side effect that can happen with all insulin products. How much weight gain occurs with Toujeo isn’t clear.

In clinical studies of a similar type of insulin (called Lantus), weight gain of up to about 2 pounds occurred over 28 weeks of treatment.

Joint pain

Joint pain isn’t a side effect that has occurred in studies of Toujeo. It has occurred in as much as 14% of people taking Lantus, a very similar type of insulin. Therefore, it might also happen in people who take Toujeo.

Diarrhea

Diarrhea isn’t a side effect that has occurred in studies of Toujeo. It has occurred in as much as 11% of people taking Lantus, a very similar type of insulin. Therefore, it might also happen in people who take Toujeo.

Rash

A rash, including skin discoloration and itching, sometimes occurs around the injection site in people who use Toujeo. It’s not known how often this occurs.

Hypoglycemia

Low blood sugar (hypoglycemia) is one of the most common side effects of all types of insulin, including Toujeo.

In clinical studies of people taking Toujeo, mild hypoglycemia occurred in up to 69 percent of people with type 1 diabetes and up to 37 percent of those with type 2 diabetes.

Severe hypoglycemia occurred in about 5 percent to 7 percent of people with either type of diabetes. The risk of hypoglycemia was greater for people who received Toujeo in combination with other types of insulin.

If you often have low blood sugar levels or have severe hypoglycemia while taking Toujeo, talk with your doctor about changing your dosage.

As with all medications, the cost of Toujeo can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Toujeo, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Toujeo, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Toujeo, or if you need help understanding your insurance coverage, help is available.

A copay card is available that may help lower the cost of Toujeo. To see if you’re eligible to receive a copay card, visit the manufacturer’s website or call 800-633-1610.

If you’re not eligible for Toujeo’s copay card, other programs may offer financial assistance on this medication. For information about these programs, visit Sanofi Patient Connection or call 888-847-4877.

Generic or biosimilar versions

Toujeo is not available in a biosimilar form. Biosimilars are considered as safe and effective as their parent drugs. And, as with generics, biosimilars tend to cost less than brand-name medications.

Below, we describe Toujeo’s expiration date and how to properly store and dispose of this drug.

Expiration

Each Toujeo package has an expiration date listed on the label. Don’t use Toujeo if the expiration date listed on the label has passed. The expiration date helps guarantee that the medication is effective during this time.

The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Toujeo SoloStar and Toujeo Max SoloStar pens also shouldn’t be used if they’ve been kept at room temperature for more than 8 weeks (56 days). (These pens are meant to be stored in the refrigerator. For information about storing Toujeo, see the next section below.)

Storage

Toujeo SoloStar and Toujeo Max SoloStar pens should be refrigerated until you start using them. They shouldn’t be stored with the needle attached.

Refrigeration

Be sure to keep Toujeo SoloStar and Toujeo Max SoloStar pens in the refrigerator, at a temperature of 36°F to 46°F (2°C to 8°C), until you’re ready to use them. (The pens can stay in the refrigerator until the expiration date.) When Toujeo pens are in use, keep them at room temperature (below 86°F or 30°C).

The pens can stay at room temperature for up to 8 weeks. After the pens have been at room temperature for 8 weeks, you should not use them. You should safely dispose of them at that time. And once you take the pens out of the refrigerator for use, don’t put them back in the refrigerator.

Also, do not freeze the pens. If a pen becomes frozen, do not use it. Dispose of it safely.

Shelf life

Each Toujeo package has an expiration date. Toujeo should not be used if it has gone beyond the expiration date.

Disposal

Right after you’ve used a syringe, needle, or autoinjector, dispose of it in an FDA-approved sharps disposal container. This helps prevent others, including children and pets, from taking the drug by accident or harming themselves with the needle. You can buy a sharps container online, or ask your doctor, pharmacist, or health insurance company where to get one.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

The Food and Drug Administration (FDA) approves prescription medications such as Toujeo to treat certain conditions.

Toujeo for diabetes

Toujeo is FDA-approved to manage blood sugar levels in adults with type 1 or type 2 diabetes. It’s also approved for this use in children ages 6 years or older.

When you have type 1 diabetes, your body doesn’t make enough insulin. When you have type 2 diabetes, your body may be resistant to insulin. This means your body doesn’t respond to insulin the way it should. And over time, your body may also stop producing enough insulin. You can learn more about this condition from our diabetes hub.

Toujeo is a form of insulin. It helps improve blood sugar levels in people with either type of diabetes.

It’s important to note that Toujeo is not used to treat diabetic ketoacidosis (high levels of ketones in your body). Your doctor or pharmacist can give you more information about this condition, including symptoms to watch for and how it’s treated.

Effectiveness for type 1 diabetes in adults and children

In a clinical study of adults, Toujeo was effective in treating type 1 diabetes.

The 26-week study compared Toujeo with Lantus. Half of the people took Toujeo, while the other half took Lantus. Both groups also took mealtime insulin. (In people with type 1 diabetes, Toujeo and Lantus are always used with a mealtime insulin.)

At the end of this study:

  • fasting blood sugar* was reduced by 17 mg/dL in people taking Toujeo
  • fasting blood sugar reduced by 20 mg/dL in people taking Lantus
  • hemoglobin A1c (A1C)† was reduced by an average of 0.39% in people taking Toujeo
  • A1C was reduced by an average of 0.40% in people taking Lantus

* Fasting blood sugar is measured after you’ve fasted for a certain time. The American Diabetes Association (ADA) recommends a fasting blood sugar level of 80 mg/dL to 130 mg/dL for most adults.
† A1C is a measurement that shows your average blood sugar levels over the past 2 to 3 months. The ADA recommends an A1C goal of less than 7.0% for most adults.

In a 26-week clinical study of children ages 6 years and older, Toujeo was found effective in treating type 1 diabetes. This study compared Toujeo with Lantus. Half of the children took Toujeo, while the other half took Lantus. Both groups also took mealtime insulin.

At the end of this study:

  • fasting blood sugar reduced by 10.4 mg/dL in children taking Toujeo
  • fasting blood sugar reduced by 10.6 mg/dL in children taking Lantus
  • A1C was reduced by an average of 0.39% in children taking Toujeo
  • A1C was reduced by an average of 0.40% in children taking Lantus

Effectiveness for type 2 diabetes in adults

In three clinical studies of adults, Toujeo was effective in treating type 2 diabetes. Each 26-week study compared Toujeo with Lantus. In all three studies, half of the people took Toujeo and half took Lantus. Other medications that the people took varied, as follows:

  • In one study, people taking Toujeo and people taking Lantus also took mealtime insulin and metformin (a diabetes drug that’s taken by mouth) if needed. Before starting Toujeo or Lantus, the people in this study were taking a different basal insulin for their diabetes.
  • In the second study, people taking Toujeo and people taking Lantus also took certain noninsulin diabetes drugs. Before starting Toujeo or Lantus, the people in this study were taking a different basal insulin for their diabetes.
  • In the third study, people taking Toujeo and people taking Lantus also took certain noninsulin diabetes drugs. Before starting the study neither group of people had ever taken a basal insulin. They were all first-time insulin users.

At the end of these studies, people taking Toujeo had their fasting blood sugar lowered by 18 mg/dL to 61 mg/dL. And their A1C was reduced by an average of 0.73% to 1.42%.

In comparison, people taking Lantus had their fasting blood sugar reduced by 22 mg/dL to 68 mg/dL. And their A1C was reduced by an average of 0.70% to 1.46%.

Toujeo for children

Toujeo is FDA-approved for use in children ages 6 years or older with type 1 or type 2 diabetes. It’s not known if the drug is safe or effective for use in younger children.

For information about Toujeo’s effectiveness for diabetes in children, see the sections above under “Toujeo for diabetes”.

Taking too much of this medication can increase your risk for serious side effects.

Overdose symptoms

Symptoms of Toujeo overdose are mainly those related to hypoglycemia (low blood sugar) and hypokalemia (low potassium level). These symptoms can include:

What to do in case of an overdose

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

If you’re having symptoms of hypoglycemia, call for help and eat fast-acting carbohydrates to raise your blood sugar level. Some examples of fast-acting carbohydrates include:

  • 4 ounces of fruit juice
  • 4 ounces of regular (not diet) soda
  • 15 grams of hard candy
  • glucose gel, liquid, powder, or tablets

You should take Toujeo according to your doctor or healthcare professional’s instructions.

Toujeo injection sites

Toujeo injections can be given in the skin of your:

  • upper arms
  • abdomen (at least 2 inches away from your belly button)
  • thighs

Look for a healthy area of skin to inject your doses into. Do not inject the drug into an area that’s discolored, bruised, or has a cut or wound.

Also, it’s important to rotate injection sites each time you take a dose of Toujeo. Doing this helps to prevent your injection sites from getting red, sore, or swollen.

When to take

Toujeo is taken once daily. It should be taken at about the same time each day. Your healthcare professional may recommend taking it in the morning before breakfast or in the evening before dinner.

Taking Toujeo with food

Toujeo doesn’t need to be taken with food or at the time of a meal.

However, people with diabetes need to follow consistent diet, exercise, and insulin schedules, which would include treatment with Toujeo. These schedules may be different for each person. Your healthcare professional can tell you more.

For people with type 1 diabetes, their bodies don’t produce enough insulin. People with type 2 diabetes, on the other hand, usually have insulin resistance. This means their body doesn’t respond to insulin the way it should. Over time, people with type 2 diabetes may also stop producing enough insulin.

Toujeo helps improve blood sugar levels in people with either type of diabetes.

How insulin affects blood sugar

Usually, when you eat food, your body releases insulin to help transport glucose (sugar) from your bloodstream into the cells of your body. The cells then turn the glucose into energy.

When your body doesn’t produce enough insulin, or when your body doesn’t respond to insulin the way it should, this causes problems. The cells of your body may not get the glucose they need to work correctly.

Also, you may get too much glucose in your blood. This is called high blood sugar (hyperglycemia). Having too much glucose in your blood can damage your body and organs, including your eyes, heart, nerves, and kidneys.

What Toujeo does

Toujeo is a type of insulin called insulin glargine. It’s a long-acting insulin, which means it works for the whole day (up to 36 hours).

Toujeo is used to partly replace the body’s natural production of insulin, which will help move glucose into your cells. This helps your cells get the sugar they need. It also helps stabilize your blood sugar levels.

Toujeo is often used with other medications. For instance, for type 2 diabetes, it may be used with metformin. And for type 1 diabetes, it may be used with a type of insulin that’s taken with meals.

How long does it take to work?

Toujeo starts working within 6 hours. However, it may take up to 5 days for Toujeo to fully affect your blood sugar levels.

Alcohol should be avoided or consumed cautiously while taking Toujeo. Drinking alcohol can increase or decrease your blood sugar levels.

If you drink alcohol while taking Toujeo, you should monitor your blood sugar levels more closely. Be sure to talk with your doctor about how much alcohol, if any, is safe for you to have.

Toujeo can interact with several other medications. It can also interact with certain supplements.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Toujeo and other medications

Below is a list of medications that can interact with Toujeo. This list doesn’t contain all drugs that may interact with Toujeo.

Before taking Toujeo, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Toujeo and drugs that increase the risk of low blood sugar levels

When taken with Toujeo, some medications can cause low blood sugar levels and increase the risk of hypoglycemia (low blood sugar level). If you take these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change your dosage of Toujeo.

Examples of these medications include:

Toujeo and drugs that increase blood sugar levels

Some medications can increase blood sugar levels in your body. If you take these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change your dosage of Toujeo.

Examples of these medications include:

If taken with Toujeo, an antifungal drug called pentamidine (Pentam) may cause hypoglycemia (low blood sugar) at first, followed by hyperglycemia (high blood sugar).

Toujeo and drugs that may mask symptoms of hypoglycemia

Some medications may mask or reduce certain symptoms of hypoglycemia (low blood sugar). These symptoms include fast heartbeat or feeling shaky. Taking these medications with Toujeo may make it difficult for you to feel if you have a low blood sugar level.

If you have to take these drugs with Toujeo, talk with your doctor about other symptoms of hypoglycemia to watch for. This can help you act quickly to treat episodes of hypoglycemia.

Examples of these drugs include:

  • metoprolol (Toprol XL)
  • nadolol (Corgard)
  • atenolol (Tenormin)
  • clonidine (Catapres)
  • lithium salts

Toujeo and herbs and supplements

When taken with Toujeo, some herbs and supplements might increase your risk for low blood sugar (hypoglycemia). Examples include:

Before taking Toujeo, talk with your doctor about any medical conditions you have. Toujeo may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Kidney or liver disease. People with these conditions have a higher risk for low blood sugar levels (hypoglycemia) while taking Toujeo. If you have kidney or liver disease, talk with your doctor about steps you can take to prevent low blood sugar levels.
  • Heart failure. Taking Toujeo along with certain diabetes medications called thiazolidinediones, such as Actos or Avandia, can worsen symptoms of heart failure. If you have heart failure and your symptoms get worse, talk with your doctor. You may need to stop taking thiazolidinediones.

There aren’t any studies of Toujeo use during pregnancy. However, an analysis of studies didn’t find any negative effects from insulin glargine treatment during pregnancy. Insulin glargine is the insulin in Toujeo.

If you’re pregnant or planning to become pregnant, talk with your doctor about the risks and benefits of Toujeo treatment during pregnancy. Your body’s insulin requirements may change during pregnancy, and your doctor may need to adjust your dosage.

It’s not known if Toujeo is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Toujeo.

For more information about taking Toujeo during pregnancy, see the “Toujeo and pregnancy” section above.

Note: Sex and gender exist on spectrums. Use of the term “female” and “male” in this article refers to sex assigned at birth.

For females using Toujeo

The manufacturer of Toujeo hasn’t stated that females taking this drug need to use birth control. But keep in mind that if you’re using birth control pills to prevent pregnancy, the pills may interact with Toujeo.

In this case, the birth control pills may decrease Toujeo’s ability to lower your blood sugar level. For more information about this interaction, see the section above called “Toujeo interactions.”

If you’re taking birth control pills, your doctor may increase your dose of Toujeo. And they may recommend that you monitor your blood sugar levels more often than usual.

For males using Toujeo

The manufacturer of Toujeo hasn’t stated that males taking this drug need to use birth control. If you have questions about your birth control needs, talk with your doctor.

Toujeo is considered safe to use during breastfeeding. However, your body’s insulin requirements may change during pregnancy. So, your doctor might change your Toujeo dosage while you’re breastfeeding.

Be sure to talk with your doctor first if you want to breastfeed while taking Toujeo.

Here are answers to some frequently asked questions about Toujeo.

Is Toujeo the same as Lantus?

No. Toujeo isn’t the same as Lantus, but they’re very similar. Both Toujeo and Lantus contain the same long-acting insulin, insulin glargine. But Toujeo contains 300 units per milliliter (mL) of solution, while Lantus contains 100 units per mL of solution.

This means that Toujeo is more concentrated than Lantus. When switching between insulins, your doctor will adjust your dose accordingly.

Is Toujeo a fast-acting insulin?

No, Toujeo isn’t fast-acting. It has a slow onset of about 6 hours. When you first start taking Toujeo, it can take up to 5 days to take full effect on your blood sugar levels.

Toujeo is a long-acting insulin. It can work for up to 36 hours in your body.

When does Toujeo peak?

Toujeo, similar to other long-acting insulins, doesn’t have a peak. It mimics the body’s natural steady release of insulin throughout the day.

How do I switch from another type of insulin to Toujeo?

This depends on the other form of insulin that you’re taking. Talk with your healthcare professional about the best way to switch.

Usually, when switching from another once-daily, long-acting insulin to Toujeo, the starting dosage of Toujeo is the same as the dosage for the other long-acting insulin. If needed, your healthcare professional will work with you to adjust your dosage of Toujeo after your switch.

However, most people who switch from Lantus to Toujeo need a higher daily dose of Toujeo than Lantus. This is probably because your body absorbs Toujeo more slowly than it absorbs Lantus.

When switching from twice-daily NPH insulin, the typical Toujeo starting dosage is 80 percent of the total daily NPH insulin dose. Your healthcare professional will adjust your dosage of Toujeo if needed.

Toujeo burns when I inject it — am I doing something wrong?

When injecting Toujeo, it’s common to feel a small amount of pain, such as a stinging or burning sensation.

One way to decrease this discomfort is to take your Toujeo pen out of the refrigerator at least one hour before giving an injection. The injection hurts more when the solution is cold.

What is Toujeo’s half-life?

Toujeo’s half-life is around 18 to 19 hours. A drug’s half-life refers to the time it takes your body to clear half of a dose from your system.

Most drugs are cleared from the body after about 5 half-lives. So, it should take around 90 to 95 hours (about 4 days) for your body to clear Toujeo from your system.

The following information is provided for clinicians and other healthcare professionals.

Indications

Toujeo (insulin glargine) is indicated to improve blood glucose management in adults and children ages 6 years and older with type 1 or type 2 diabetes.

Administration

Toujeo is administered subcutaneously using a prefilled pen.

Mechanism of action

Toujeo contains insulin glargine U-300. Insulin glargine is a long-acting, or basal, insulin. Insulin glargine, like other insulins, lowers blood glucose by increasing peripheral glucose uptake and decreasing glucose production in the liver. It also inhibits the breakdown of glucose, fat, and proteins.

The insulin glargine U-300 onset of action occurs over a period of 6 hours and has a duration of action of about 36 hours.

Pharmacokinetics and metabolism

The median time to maximum insulin concentration following subcutaneous injection of Toujeo is 12 hours. Steady state concentration occurs within 5 days.

Contraindications

Toujeo should not be used by people who are allergic to insulin glargine or excipients of Toujeo.

Toujeo should not be used during episodes of hypoglycemia.

Storage

Toujeo SoloStar and Toujeo Max SoloStar pens can be refrigerated, at a temperature of 36°F to 46°F (2°C to 8°C), but they should not be frozen. Frozen pens must be discarded.

Once Toujeo is taken out of the refrigerator for use, it should not be placed back in the refrigerator. Toujeo may be stored at room temperature (below 86°F or 30°C) for up to 8 weeks (56 days). After 8 weeks at room temperature, Toujeo pens must be safely discarded.

Toujeo should not be stored with the needle attached.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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