Malaysia - English - NPRA (National Pharmaceutical Regulatory Agency, Bahagian Regulatori Farmasi Negara)

fresenius medical care malaysia sdn bhd - calcium chloride dihydrate ph. eur.; magnesium chloride hexahydrate pheur; glucose monohydrate, ph eur; sodium chloride (nacl); sodium lactate solution (50%) -

Malaysia - English - NPRA (National Pharmaceutical Regulatory Agency, Bahagian Regulatori Farmasi Negara)

fresenius medical care malaysia sdn bhd - sodium chloride (nacl); calcium chloride dihydrate ph. eur.; magnesium chloride hexahydrate pheur; glucose monohydrate, ph eur; sodium lactate solution (50%) -

Malaysia - English - NPRA (National Pharmaceutical Regulatory Agency, Bahagian Regulatori Farmasi Negara)

fresenius medical care malaysia sdn bhd - sodium chloride (nacl); calcium chloride dihydrate ph. eur.; magnesium chloride hexahydrate pheur; glucose monohydrate, ph eur; sodium lactate solution (50%) -

Malaysia - English - NPRA (National Pharmaceutical Regulatory Agency, Bahagian Regulatori Farmasi Negara)

fresenius medical care malaysia sdn bhd - calcium chloride dihydrate ph. eur.; magnesium chloride hexahydrate pheur; glucose monohydrate, ph eur; sodium chloride (nacl); sodium lactate (50%) -

Malaysia - English - NPRA (National Pharmaceutical Regulatory Agency, Bahagian Regulatori Farmasi Negara)

fresenius medical care malaysia sdn bhd - magnesium chloride hexahydrate pheur; sodium lactate solution (50%); glucose monohydrate, ph eur; sodium chloride (nacl); calcium chloride dihydrate ph. eur. -

Malaysia - English - NPRA (National Pharmaceutical Regulatory Agency, Bahagian Regulatori Farmasi Negara)

fresenius medical care malaysia sdn bhd - sodium chloride ph eur; calcium chloride dihydrate ph. eur.; magnesium chloride hexahydrate pheur; glucose monohydrate, ph eur; sodium lactate solution (50%) -

United States - English - NLM (National Library of Medicine)

winthrop u.s. - insulin glargine (unii: 2zm8cx04rz) (insulin glargine - unii:2zm8cx04rz) - insulin glargine is indicated to improve glycemic control in adult and pediatric patients with diabetes mellitus. limitations of use insulin glargine is not recommended for the treatment of diabetic ketoacidosis. insulin glargine is contraindicated: - during episodes of hypoglycemia [see warnings and precautions (5.3)] - in patients with hypersensitivity to insulin glargine or any of the excipients in insulin glargine [see warnings and precautions (5.5)] risk summary published studies with use of insulin glargine during pregnancy have not reported a clear association with insulin glargine and adverse developmental outcomes (see data) . there are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy (see clinical considerations) . rats and rabbits were exposed to insulin glargine in animal reproduction studies during organogenesis, respectively 50 times and 10 times the human subcutaneous dosage of 0.2 units/kg/day. overall, the effects of insulin glargine did not generally differ from those observed with regular human insulin (see data) . in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. the estimated background risk of major birth defects is 6% to 10% in women with pregestational diabetes with a peri-conceptional hba1c >7 and has been reported to be as high as 20% to 25% in women with a peri-conceptional hba1c >10. the estimated background risk of miscarriage for the indicated population is unknown. clinical considerations disease-associated maternal and/or embryo-fetal risk hypoglycemia and hyperglycemia occur more frequently during pregnancy in patients with pre-gestational diabetes. poorly controlled diabetes in pregnancy increases the maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications. poorly controlled diabetes increases the fetal risk for major birth defects, stillbirth, and macrosomia-related morbidity. data human data published data do not report a clear association with insulin glargine and major birth defects, miscarriage, or adverse maternal or fetal outcomes when insulin glargine is used during pregnancy. however, these studies cannot definitely establish the absence of any risk because of methodological limitations including small sample size and some lacking comparator groups. animal data subcutaneous reproduction and teratology studies have been performed with insulin glargine and regular human insulin in rats and himalayan rabbits. insulin glargine was given to female rats before mating, during mating, and throughout pregnancy at doses up to 0.36 mg/kg/day, which is approximately 50 times the recommended human subcutaneous starting dosage of 0.2 units/kg/day (0.007 mg/kg/day), on a mg/kg basis. in rabbits, doses of 0.072 mg/kg/day, which is approximately 10 times the recommended human subcutaneous starting dosage of 0.2 units/kg/day on a mg/kg basis, were administered during organogenesis. the effects of insulin glargine did not generally differ from those observed with regular human insulin in rats or rabbits. however, in rabbits, five fetuses from two litters of the high-dose group exhibited dilation of the cerebral ventricles. fertility and early embryonic development appeared normal. risk summary there are either no or only limited data on the presence of insulin glargine in human milk, the effects on breastfed infant, or the effects on milk production. endogenous insulin is present in human milk. the developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for insulin glargine, and any potential adverse effects on the breastfed child from insulin glargine or from the underlying maternal condition. the safety and effectiveness of insulin glargine to improve glycemic control in pediatric patients with diabetes mellitus have been established. use of insulin glargine for this indication is supported by evidence from an adequate and well-controlled study (study d) in 174 insulin glargine-treated pediatric patients aged 6 to 15 years with type 1 diabetes mellitus, and from adequate and well-controlled studies of insulin glargine in adults with diabetes mellitus [see clinical pharmacology (12.3), clinical studies (14.2)] . in the pediatric clinical study, pediatric patients with type 1 diabetes had a higher incidence of severe symptomatic hypoglycemia compared to the adults in studies with type 1 diabetes [see adverse reactions (6.1)] . of the total number of subjects in controlled clinical studies of patients with type 1 and type 2 diabetes who were treated with insulin glargine, 15% (n=316) were ≥65 years of age and 2% (n=42) were ≥75 years of age. no overall differences in safety or effectiveness of insulin glargine have been observed between patients 65 years of age and older and younger adult patients. nevertheless, caution should be exercised when insulin glargine is administered to geriatric patients. in geriatric patients with diabetes, the initial dosing, dosage increments, and maintenance dosage should be conservative to avoid hypoglycemic reactions. hypoglycemia may be difficult to recognize in geriatric patients. the effect of kidney impairment on the pharmacokinetics of insulin glargine has not been studied. some studies with human insulin have shown increased circulating levels of insulin in patients with kidney failure. frequent glucose monitoring and dosage adjustment may be necessary for insulin glargine in patients with kidney impairment [see warnings and precautions (5.3)]. the effect of hepatic impairment on the pharmacokinetics of insulin glargine has not been studied. frequent glucose monitoring and dosage adjustment may be necessary for insulin glargine in patients with hepatic impairment [see warnings and precautions (5.3)]. these instructions for use contain information on how to inject insulin glargine using the vial. read these instructions for use before you start taking insulin glargine and each time you get a new insulin glargine vial. there may be new information. this information does not take the place of talking to your healthcare provider about your medical condition or your treatment. do not share your insulin glargine syringes with other people, even if the needle has been changed. you may give other people a serious infection, or get a serious infection from them. supplies needed to give your injection: - an insulin glargine 10 ml vial - a u-100 insulin syringe and needle - 2 alcohol swabs - 1 sharps container for throwing away used needles and syringes. see "disposing of used needles and syringes" at the end of these instructions. preparing to inject insulin glargine: - wash your hands with soap and water or clean your hands with alcohol. - check the insulin glargine label to make sure you are taking the right type of insulin. this is especially important if you use more than 1 type of insulin. - check the insulin glargine in the vial to make sure it is clear and colorless. do not use insulin glargine if it is colored or cloudy, or if you see particles in the solution. - do not use insulin glargine after the expiration date stamped on the label or 28 days after you first use it. - always use a syringe that is marked for u-100 insulin . if you use a syringe other than a u-100 insulin syringe, you may get the wrong dose of insulin glargine. - always use a new syringe and a new needle for each injection to help prevent infections and prevent blocked needles. step 1: if you are using a new insulin glargine vial, remove the protective cap. do not remove the stopper. step 2: wipe the top of the vial with an alcohol swab. you do not have to shake the vial of insulin glargine before use. step 3: draw air into the syringe equal to your insulin glargine dose. put the needle through the rubber top of the vial and push the plunger to inject the air into the vial. step 4: leave the syringe in the vial and turn both upside down. hold the syringe and vial firmly in one hand. make sure the tip of the needle is in the insulin glargine solution. with your free hand, pull the plunger to withdraw the correct dose into the syringe. step 5: before you take the needle out of the vial, check the syringe for air bubbles. if bubbles are in the syringe, hold the syringe straight up and tap the side of the syringe until the bubbles float to the top. push the bubbles out with the plunger and draw insulin back in until you have the correct dose. step 6: remove the needle from the vial. do not let the needle touch anything. you are now ready to inject. injecting insulin glargine: - inject your insulin glargine (with a syringe) exactly as your healthcare provider has shown you. - insulin glargine is injected once daily at any time of the day but at the same time every day. step 7: choose your injection site: - insulin glargine is injected under the skin (subcutaneously) of your upper arms, thighs, or stomach area (abdomen). - change (rotate) your injection sites within the area you choose for each dose to reduce your risk of getting lipodystrophy (pits in the skin or thickened skin) and localized cutaneous amyloidosis (skin with lumps) at the injection sites. - do not inject where the skin has pits, is thickened, or has lumps. - do not inject where the skin is tender, bruised, scaly or hard, or into scars or damaged skin. - wipe the skin with an alcohol swab to clean the injection site. let the injection site dry before you inject your dose. step 8: - pinch the skin. - insert the needle under the skin in the way your healthcare provider showed you. - release the skin. - slowly push in the plunger of the syringe all the way, making sure you have injected all the insulin glargine. - leave the needle in the skin for about 10 seconds. step 9: - pull the needle straight out of your skin. - gently press the injection site for several seconds. do not rub the area. - do not recap the used needle. recapping the needle can lead to a needle-stick injury. disposing of used needles and syringes - put your used needles and syringes in a fda-cleared sharps disposal container right away after use. do not throw away (dispose of) loose needles and syringes in your household trash. - if you do not have a fda-cleared sharps container, you may use a household container that is: made of a heavy-duty plastic, can be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out, upright and stable during use, leak resistant, and properly labeled to warn of hazardous waste inside the container. - made of a heavy-duty plastic, - can be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out, - upright and stable during use, - leak resistant, and - properly labeled to warn of hazardous waste inside the container. - when your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. there may be state or local laws about how you should throw away used needles and syringes. for more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the fda's website at: http://www.fda.gov/safesharpsdisposal. - do not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. do not recycle your used sharps disposal container. storing and disposing insulin glargine? unopened (not in-use) insulin glargine vials - store unused insulin glargine vials in the refrigerator from 36°f to 46°f (2°c to 8°c). - do not freeze insulin glargine. - keep insulin glargine away from direct heat and light. - if a vial has been frozen or overheated, throw it away. - unopened vials can be used until the expiration date on the carton and vial label if they have been stored in the refrigerator (they can be stored past 28 days in the refrigerator). - unopened vials should be thrown away after 28 days if they are stored at room temperature. after insulin glargine vials have been opened (in-use) - store in-use (opened) insulin glargine vials in a refrigerator from 36°f to 46°f (2°c to 8°c) or at room temperature below 86°f (30°c) for up to 28 days . - do not freeze insulin glargine. if a vial has been frozen, throw it away. - keep insulin glargine out of direct heat and light. - the insulin glargine vial you are using should be thrown away after 28 days or if the expiration date has passed, even if it still has insulin left in it. this instructions for use has been approved by the u.s. food and drug administration. manufactured by: sanofi-aventis u.s. llc. bridgewater, nj 08807 u.s. license no. 1752 manufactured for: winthrop u.s., a business of sanofi-aventis u.s. llc a sanofi company ©2023 sanofi-aventis u.s. llc revised: june 2023 read these instructions for use before you start taking the insulin glargine solostar pen and each time you get a new insulin glargine solostar pen. there may be new information. this information does not take the place of talking to your healthcare provider about your medical condition or your treatment. do not share your insulin glargine solostar pen with other people, even if the needle has been changed. you may give other people a serious infection, or get a serious infection from them. people who are blind or have vision problems should not use insulin glargine solostar prefilled pen without help from a person trained to use the insulin glargine solostar prefilled pen. insulin glargine solostar is a disposable prefilled pen used to inject insulin glargine. each insulin glargine solostar pen has 300 units of insulin which can be used for multiple injections. you can select doses from 1 to 80 units in steps of 1 unit. the pen plunger moves with each dose. the plunger will only move to the end of the cartridge when 300 units of insulin glargine have been given. important information you need to know before injecting insulin glargine - do not use your pen if it is damaged or if you are not sure that it is working properly. - do not use a syringe to remove insulin glargine from your pen. - do not reuse needles. if you do, you might get the wrong dose of insulin glargine and/or increase the chance of getting an infection. - always perform a safety test (see step 3 ). - always carry a spare pen and spare needles in case they got lost or stop working. - change (rotate) your injection sites within the area you choose for each dose (see "places to inject" ). learn to inject - talk with your healthcare provider about how to inject before using your pen. - ask for help if you have problems handling the pen, for example if you have problems with your sight. - read all these instructions before using your pen. if you do not follow all these instructions, you may get too much or too little insulin. need help? if you have any questions about your pen or about diabetes, ask your healthcare provider, or go to www.winthropus.com or call sanofi-aventis at 1-800-633-1610. extra items you will need - a new sterile needle (see step 2 ). - an alcohol swab. - a puncture-resistant container for used needles and pens. (see "throwing your pen away" ) places to inject - inject your insulin exactly as your healthcare provider has shown you. - inject your insulin under the skin (subcutaneously) of your upper legs (thighs), upper arms, or stomach area (abdomen). - change (rotate) your injection sites within the area you choose for each dose to reduce your risk of getting lipodystrophy (pits in skin or thickened skin) and localized cutaneous amyloidosis (skin with lumps) at the injection sites. - do not inject where the skin has pits, is thickened, or has lumps. - do not inject where the skin is tender, bruised, scaly or hard, or into scars or damaged skin. get to know your pen step 1: check your pen take a new pen out of the refrigerator at least 1 hour before you inject. cold insulin is more painful to inject. 1a check the name and expiration date on the label of your pen. - make sure you have the correct insulin. - do not use your pen after the expiration date. 1b pull off the pen cap. 1c check that the insulin is clear. - do not use the pen if the insulin looks cloudy, colored or contains particles. 1d wipe the rubber seal with an alcohol swab. if you have other injector pens: - making sure you have the correct medicine is especially important if you have other injector pens. step 2: attach a new needle - do not reuse needles. always use a new sterile needle for each injection. this helps stop blocked needles, contamination, and infection. only use needles2 that are compatible for use with insulin glargine solostar, such as bd ultra-fine® . 2a take a new needle and peel off the protective seal. 2b keep the needle straight and screw it onto the pen until fixed. do not over-tighten. 2c pull off the outer needle cap. keep this for later. 2d pull off the inner needle cap and throw away. handling needles - take care when handling needles to prevent needle-stick injury and cross-infection. step 3: do a safety test always do a safety test before each injection to: - check your pen and the needle to make sure they are working properly. - make sure that you get the correct insulin glargine dose. 3a select 2 units by turning the dose selector until the dose pointer is at the 2 mark. 3b press the injection button all the way in. when insulin comes out of the needle tip, your pen is working correctly: if no insulin appears: - you may need to repeat this step up to 3 times before seeing insulin. - if no insulin comes out after the third time, the needle may be blocked. if this happens: – change the needle (see step 6 and step 2 ), – then repeat the safety test (step 3 ). - do not use your pen if there is still no insulin coming out of the needle tip. use a new pen. - do not use a syringe to remove insulin from your pen. if you see air bubbles: - you may see air bubbles in the insulin. this is normal, they will not harm you. step 4: select the dose do not select a dose or press the injection button without a needle attached. this may damage your pen. 4a make sure a needle is attached and the dose is set to "0." 4b turn the dose selector until the dose pointer lines up with your dose. - if you turn past your dose, you can turn back down. - if there are not enough units left in your pen for your dose, the dose selector will stop at the number of units left. - if you cannot select your full prescribed dose, use a new pen or inject the remaining units and use a new pen to complete your dose. how to read the dose window even numbers are shown in line with dose pointer. odd numbers are shown as a line between even numbers. units of insulin glargine in your pen: - your pen contains a total of 300 units of insulin glargine. you can select doses from 1 to 80 units in steps of 1 unit. each pen contains more than 1 dose. - you can see roughly how many units of insulin are left by looking at where the plunger is on the insulin scale. step 5: injecting your insulin glargine dose if you find it hard to press the injection button in, do not force it as this may break your pen. see the section below for help. 5a choose a place to inject as shown in the picture above. 5b push the needle into your skin as shown by your healthcare provider. do not touch the injection button yet. 5c place your thumb on the injection button. then press all the way in and hold. - do not press at an angle. your thumb could block the dose selector from turning. 5d keep the injection button held in and when you see "0" in the dose window, slowly count to 10. - this will make sure you get your full dose. 5e after holding and slowly counting to 10, release the injection button. then remove the needle from your skin. if you find it hard to press the button in: - change the needle (see step 6 and step 2 ) then do a safety test (see step 3 ). - if you still find it hard to press in, get a new pen. - do not use a syringe to remove insulin from your pen. step 6: remove the needle - take care when handling needles to prevent needle-stick injury and cross-infection. - do not put the inner needle cap back on. 6a grip the widest part of the outer needle cap. keep the needle straight and guide it into the outer needle cap. then push firmly on. - the needle can puncture the cap if it is recapped at an angle. 6b grip and squeeze the widest part of the outer needle cap. turn your pen several times with your other hand to remove the needle. - try again if the needle does not come off the first time. 6c throw away the used needle in a puncture-resistant container (see "throwing your pen away" at the end of this instructions for use). 6d put your pen cap back on. - do not put the pen back in the refrigerator. storing the insulin glargine solostar pen before first use - keep new pens in the refrigerator between 36°f to 46°f (2°c to 8°c) . - do not freeze. do not use insulin glargine if it has been frozen. after first use - keep your pen at room temperature below 86°f (30°c) . - keep your pen away from heat or light. - store your pen with the pen cap on. - do not put your pen back in the refrigerator. - do not store your pen with the needle attached. - keep out of the reach of children. - only use your pen for up to 28 days after its first use. throw away the insulin glargine solostar pen you are using after 28 days, even if it still has insulin left in it. caring for your insulin glargine solostar pen handle your pen with care - do not drop your pen or knock it against hard surfaces. - if you think that your pen may be damaged, do not try to fix it. use a new one. protect your pen from dust and dirt - you can clean the outside of your pen by wiping it with a damp cloth (water only). do not soak, wash or lubricate your pen. this may damage it. throwing your pen away - the used insulin glargine solostar pen may be thrown away in your household trash after you have removed the needle. - put the used needle in an fda-cleared sharps disposal container right away after use. do not throw away (dispose of) the used needles in your household trash. - if you do not have a fda-cleared sharps disposal container, you may use a household container that is: – made of a heavy-duty plastic, – can be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out, – upright and stable during use, – leak-resistant, and – properly labeled to warn of hazardous waste inside the container. - when your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. there may be state or local laws about how you should throw away used needles and syringes. for more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the fda's website at: http://www.fda.gov/safesharpsdisposal . - do not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. do not recycle your used sharps disposal container. this instructions for use has been approved by the u.s. food and drug administration. manufactured by: sanofi-aventis u.s. llc u.s. license no. 1752 manufactured for: winthrop u.s., a business of sanofi-aventis u.s. llc bridgewater, nj 08807 a sanofi company ©2023 sanofi-aventis u.s. llc lantus is a registered trademark of sanofi-aventis u.s. llc. revised: june 2023

United States - English - NLM (National Library of Medicine)

winthrop u.s, a business of sanofi-aventis u.s. llc - insulin glargine (unii: 2zm8cx04rz) (insulin glargine - unii:2zm8cx04rz) - insulin glargine u-300 is indicated to improve glycemic control in adults and pediatric patients 6 years of age and older with diabetes mellitus. limitations of use: insulin glargine u-300 is not recommended for the treatment of diabetic ketoacidosis. insulin glargine u-300 is contraindicated: - during episodes of hypoglycemia [see warnings and precautions (5.3)] . - in patients with hypersensitivity to insulin glargine or any excipients in insulin glargine u-300 [see warnings and precautions (5.5)] . risk summary published studies with use of insulin glargine during pregnancy have not reported a clear association with insulin glargine and adverse developmental outcomes (see data) . there are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy (see clinical considerations) . rats and rabbits were exposed to insulin glargine in animal reproduction studies during organogenesis, respectively 50 times and 10 times the human subcutaneous dose of 0.2 unit/kg/day. overall, the effects of insulin glargine did not generally differ from those observed with regular human insulin (see data) . in the u.s. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. the estimated background risk of major birth defects is 6% to 10% in women with pregestational diabetes with a peri-conceptional hba1c >7 and has been reported to be as high as 20% to 25% in women with a peri-conceptional hba1c >10. the estimated background risk of miscarriage for the indicated population is unknown. clinical considerations disease-associated maternal and/or embryo/fetal risk hypoglycemia and hyperglycemia occur more frequently during pregnancy in patients with pre-gestational diabetes. poorly controlled diabetes in pregnancy increases the maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications. poorly controlled diabetes increases the fetal risk for major birth defects, stillbirth, and macrosomia-related morbidity. data human data published data do not report a clear association with insulin glargine and major birth defects, miscarriage, or adverse maternal or fetal outcomes when insulin glargine is used during pregnancy. however, these studies cannot definitely establish the absence of any risk because of methodological limitations including small sample size and some lacking comparator groups. animal data subcutaneous reproduction and teratology studies have been performed with insulin glargine and regular human insulin in rats and himalayan rabbits. insulin glargine was given to female rats before mating, during mating, and throughout pregnancy at doses up to 0.36 mg/kg/day, which is approximately 50 times the recommended human subcutaneous starting dosage of 0.2 units/kg/day (0.007 mg/kg/day). in rabbits, doses of 0.072 mg/kg/day, which is approximately 10 times the recommended human subcutaneous starting dosage of 0.2 units/kg/day (0.007 mg/kg/day), were administered during organogenesis. the effects of insulin glargine did not generally differ from those observed with regular human insulin in rats or rabbits. however, in rabbits, five fetuses from two litters of the high-dose group exhibited dilation of the cerebral ventricles. fertility and early embryonic development appeared normal. risk summary there are either no or only limited data on the presence of insulin glargine in human milk, the effects on breastfed infant, or the effects on milk production. endogenous insulin is present in human milk. the developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for insulin glargine u-300, and any potential adverse effects on the breastfed child from insulin glargine u-300 or from the underlying maternal condition. the safety and effectiveness of insulin glargine u-300 to improve glycemic control in pediatric patients 6 years of age and older with diabetes mellitus have been established. the use of insulin glargine u-300 for this indication is supported by evidence from an adequate and well-controlled study in 463 pediatric patients 6 to 17 years of age with type 1 diabetes mellitus [see clinical studies (14.2)] and from studies in adults with diabetes mellitus [see clinical pharmacology (12.3), clinical studies (14.3)] . the safety and effectiveness of insulin glargine u-300 have not been established in pediatric patients less than 6 years of age. in controlled clinical studies, 30 of 304 (9.8%) insulin glargine-treated patients with type 1 diabetes and 327 of 1242 (26.3%) insulin glargine-treated patients with type 2 diabetes were ≥65 years of age, among them 2.0% of the patients with type 1 and 3.0% of the patients with type 2 diabetes were ≥75 years of age. no overall differences in safety or effectiveness of insulin glargine have been observed between patients 65 years of age and older and younger adult patients. nevertheless, caution should be exercised when insulin glargine u-300 is administered to geriatric patients. in geriatric patients with diabetes, the initial dosing, dose increments, and maintenance dosage should be conservative to avoid hypoglycemia [see warnings and precautions (5.3), adverse reactions (6), and clinical studies (14)] . the effect of kidney impairment on the pharmacokinetics of insulin glargine has not been studied. some studies with human insulin have shown increased circulating levels of insulin in patients with kidney failure. frequent glucose monitoring and dose adjustment may be necessary for insulin glargine in patients with kidney impairment [see warnings and precautions (5.3)] . the effect of hepatic impairment on the pharmacokinetics of insulin glargine has not been studied. frequent glucose monitoring and dose adjustment may be necessary for insulin glargine u-300 in patients with hepatic impairment [see warnings and precautions (5.3)] . instructions for use insulin glargine u-300 solostar ® (in-su-lin-glar-gine) (insulin glargine) injection, for subcutaneous use 1.5 ml single-patient-use prefilled pen read this first do not share your insulin glargine u-300 solostar pen with other people, even if the needle has been changed. you may give other people a serious infection, or get a serious infection from them. insulin glargine u-300 contains 300 units/ml of insulin glargine - do not re-use needles. if you do, you might not get your dose (underdosing) or get too much (overdosing) as the needle could block. - do not use a syringe to remove insulin from your pen. if you do, you will get too much insulin. the scale on most syringes is made for u-100 (non-concentrated) insulin only. - the dose selector of your insulin glargine u-300 solostar pen dials by 1 unit. people who are blind or have vision problems should not use the insulin glargine u-300 solostar pen without help from a person trained to use the insulin glargine u-300 solostar pen. important information - do not use your pen if it is damaged or if you are not sure that it is working properly. - always perform a safety test (see step 3 ). - always carry a spare pen and spare needles in case they are lost or stop working. - change (rotate) your injection sites within the area you choose for each dose (see " places to inject" ). learn to inject - talk with your healthcare provider about how to inject, before using your pen. - read all of these instructions before using your pen. if you do not follow all of these instructions, you may get too much or too little insulin. need help? if you have any questions about your pen or about diabetes, ask your healthcare provider, go to www.winthropus.com or call sanofi-aventis at 1-800-633-1610 . extra items you will need: - a new sterile needle (not included with the pen) (see step 2 ). - an alcohol swab. - a puncture-resistant container for used needles and pens (see " throwing your pen away" ). places to inject - inject your insulin exactly as your healthcare provider has shown you. - inject your insulin under the skin (subcutaneously) of your upper legs (thighs), upper arms, or stomach area (abdomen). - change (rotate) your injection sites within the area you choose for each dose to reduce your risk of getting pits or thickening of the skin (lipodystrophy) and lumps in the skin (localized cutaneous amyloidosis) at the injection sites. - do not inject where the skin has pits, is thickened, or has lumps. do not inject where the skin is tender, bruised, scaly or hard, or into scars or damaged skin. - do not inject where the skin is tender, bruised, scaly or hard, or into scars or damaged skin. get to know your pen step 1: check your pen take a new pen out of the refrigerator at least 1 hour before you inject. cold insulin is more painful to inject. - check the name and expiration date on the label of your pen. make sure you have the correct insulin. do not use your pen after the expiration date printed on the label. - make sure you have the correct insulin. - do not use your pen after the expiration date printed on the label. - pull off the pen cap. - check that the insulin is clear. do not use the pen if the insulin looks cloudy, colored or contains particles. - do not use the pen if the insulin looks cloudy, colored or contains particles. - wipe the rubber seal with an alcohol swab. if you have other injector pens - making sure you have the correct medicine is especially important if you have other injector pens. step 2: attach a new needle - do not re-use needles. always use a new sterile needle for each injection. this helps stop blocked needles, contamination and infection. - always use needles 2from bd (such as bd ultra-fine ® ), ypsomed (such as clickfine ® ), or owen mumford (such as unifine ® pentips ® ). - take a new needle and peel off the protective seal. - keep the needle straight and screw it onto the pen until fixed. do not over-tighten. - pull off the outer needle cap. keep this for later. - pull off the inner needle cap and throw away. handling needles - be careful when you are handling needles to help prevent accidental needle-stick injury. you may give other people a serious infection, or get a serious infection from them. step 3: do a safety test always do a safety test before each injection to: - check your pen and the needle to make sure they are working properly. - make sure that you get the correct insulin dose. if the pen is new, you must perform safety tests before you use the pen for the first time until you see insulin coming out of the needle tip. if you see insulin coming out of the needle tip, the pen is ready to use. if you do not see insulin coming out before taking your dose, you could get an underdose or no insulin at all. this could cause high blood sugar. - select 3 units by turning the dose selector until the dose pointer is at the mark between 2 and 4. - press the injection button all the way in. when insulin comes out of the needle tip, your pen is working correctly. - when insulin comes out of the needle tip, your pen is working correctly. if no insulin appears: - you may need to repeat this step up to 3 times before seeing insulin. - if no insulin comes out after the third time, the needle may be blocked. if this happens: change the needle (see step 6 and step 2 ), then repeat the safety test (see step 3 ). - change the needle (see step 6 and step 2 ), - then repeat the safety test (see step 3 ). - do not use your pen if there is still no insulin coming out of the needle tip. use a new pen. - do not use a syringe to remove insulin from your pen. if you see air bubbles - you may see air bubbles in the insulin. this is normal, they will not harm you. step 4: select the dose - do not select a dose or press the injection button without a needle attached. this may damage your pen. - insulin glargine u-300 solostar is made to deliver the number of insulin units that your healthcare provider prescribed. you do not need to do any dose calculations . - the dose selector of your insulin glargine u-300 solostar pen dials by 1 unit. - make sure a needle is attached and the dose is set to "0." - turn the dose selector until the dose pointer lines up with your dose. set the dose by turning the dose selector to a line in the dose window. each line equals 1 unit. the dose selector clicks as you turn it. always check the number in the dose window to make sure you dialed the correct dose. do not dial your dose by counting the clicks. you may dial the wrong dose. this may lead to you getting too much insulin or not enough insulin. if you turn past your dose, you can turn back down. if there are not enough units left in your pen for your dose, the dose selector will stop at the number of units left. if you cannot select your full prescribed dose, split the dose into 2 injections or use a new pen. if you use a new pen, perform a safety test (see step 3 ). - set the dose by turning the dose selector to a line in the dose window. each line equals 1 unit. - the dose selector clicks as you turn it. - always check the number in the dose window to make sure you dialed the correct dose. - do not dial your dose by counting the clicks. you may dial the wrong dose. this may lead to you getting too much insulin or not enough insulin. - if you turn past your dose, you can turn back down. - if there are not enough units left in your pen for your dose, the dose selector will stop at the number of units left. - if you cannot select your full prescribed dose, split the dose into 2 injections or use a new pen. if you use a new pen, perform a safety test (see step 3 ). how to read the dose window the dose selector dials by 1 unit. even numbers are shown in line with the dose pointer: odd numbers are shown as a line between even numbers: units of insulin in your pen - your pen contains a total of 450 units of insulin. you can select doses from 1 to 80 units. each pen contains more than 1 dose. - you can see roughly how many units of insulin are left by looking at where the plunger is on the insulin scale. step 5: inject your dose if you find it hard to press the injection button in, do not force it as this may break your pen. see the section below for help. - choose a place to inject as shown in the picture labeled "places to inject." the site you choose for the injection should be clean and dry. if your skin is dirty, clean it as instructed by your healthcare provider. - the site you choose for the injection should be clean and dry. - if your skin is dirty, clean it as instructed by your healthcare provider. - push the needle into your skin as shown by your healthcare provider. do not touch the injection button yet. - do not touch the injection button yet. - place your thumb on the injection button. then press all the way in and hold. do not press at an angle. your thumb could block the dose selector from turning. - do not press at an angle. your thumb could block the dose selector from turning. - keep the injection button held in and when you see "0" in the dose window, slowly count to 5. this will make sure you get your full dose. - this will make sure you get your full dose. - after holding and slowly counting to 5, release the injection button. then remove the needle from your skin. if you find it hard to press the injection button in: - change the needle (see step 6and step 2) then do a safety test (see step 3). - if you still find it hard to press in, get a new pen. - do not use a syringe to remove insulin from your pen. step 6: remove the needle - take care when handling needles to prevent needle injury and cross-infection. - do not put the inner needle cap back on. - grip the widest part of the outer needle cap. keep the needle straight and guide it into the outer needle cap. then push firmly on. the needle can puncture the cap if it is recapped at an angle. - the needle can puncture the cap if it is recapped at an angle. - grip and squeeze the widest part of the outer needle cap. turn your pen several times with your other hand to remove the needle. try again if the needle does not come off the first time. - try again if the needle does not come off the first time. - throw away the used needle in a puncture-resistant container (see " throwing your pen away" at the end of this instructions for use). - put the pen cap back on. do not put the pen back in the refrigerator. - do not put the pen back in the refrigerator. use by - only use your pen for up to 56 days after its first use. how to store your pen before first use - keep new pens in the refrigerator between 36°f and 46°f (2°c and 8°c). - do not freeze. throw away your pen if it has been frozen (see " throwing your pen away "). after first use - keep your pen at room temperature up to 86°f (30°c) . - protect your pen from direct heat and light. - do not put your pen back in the refrigerator. - do not store your pen with the needle attached. - store your pen with the pen cap on. - keep insulin glargine u-300 solostar pens and needles out of the reach of children. how to care for your pen handle your pen with care - do not drop your pen or knock it against hard surfaces. - if you think that your pen may be damaged, do not try to fix it. use a new one. protect your pen from dust and dirt - you can clean the outside of your pen by wiping it with a damp cloth (water only). do not soak, wash or lubricate your pen. this may damage it. throwing your pen away - the used insulin glargine u-300 solostar pen may be thrown away in your household trash after you have removed the needle. - put the used needle in a fda-cleared sharps disposal container right away after use. do not throw away (dispose of) needles in your household trash. - if you do not have a fda-cleared sharps disposal container, you may use a household container that is: made of a heavy-duty plastic, can be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out, upright and stable during use, leak-resistant, and properly labeled to warn of hazardous waste inside the container. - made of a heavy-duty plastic, - can be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out, - upright and stable during use, - leak-resistant, and - properly labeled to warn of hazardous waste inside the container. - when your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. there may be state or local laws about how you should throw away used needles and syringes. for more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the fda's website at: http://www.fda.gov/safesharpsdisposal. - do not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. do not recycle your used sharps disposal container. manufactured by: sanofi-aventis u.s. llc bridgewater, nj 08807 u.s. license no. 1752 manufactured for: winthrop u.s., a business of sanofi-aventis u.s. llc bridgewater, nj 08807 a sanofi company ©2022 sanofi-aventis u.s. llc this instructions for use has been approved by the u.s. food and drug administration. revised: august 2022 instructions for use insulin glargine u-300 max solostar ® (in-su-lin-glar-gine) (insulin glargine) injection, for subcutaneous use 3 ml single-patient-use prefilled pen read this first do not share your insulin glargine u-300 max solostar pen with other people, even if the needle has been changed. you may give other people a serious infection, or get a serious infection from them. insulin glargine u-300 contains 300 units/ml of insulin glargine - do not re-use needles. if you do, you might not get your dose (underdosing) or get too much (overdosing) as the needle could block. - do not use a syringe to remove insulin from your pen. if you do, you will get too much insulin. the scale on most syringes is made for u-100 (non-concentrated) insulin only. - the dose selector of your insulin glargine u-300 max solostar pen dials by 2 units . people who are blind or have vision problems should not use the insulin glargine u-300 max solostar pen without help from a person trained to use the insulin glargine u-300 max solostar pen. important information - do not use your pen if it is damaged or if you are not sure that it is working properly. - always perform a safety test (see step 3 ). - always carry a spare pen and spare needles in case they are lost or stop working. - change (rotate) your injection sites within the area you choose for each dose (see " places to inject" ). learn to inject - talk with your healthcare provider about how to inject, before using your pen. - read all of these instructions before using your pen. if you do not follow all of these instructions, you may get too much or too little insulin. need help? if you have any questions about your pen or about diabetes, ask your healthcare provider, go to www.winthropus.com or call sanofi-aventis at 1-800-633-1610 . extra items you will need: - a new sterile needle (not included with the pen) (see step 2 ). - an alcohol swab. - a puncture-resistant container for used needles and pens (see " throwing your pen away" ). places to inject - inject your insulin exactly as your healthcare provider has shown you. - inject your insulin under the skin (subcutaneously) of your upper legs (thighs), upper arms, or stomach area (abdomen). - change (rotate) your injection sites within the area you choose for each dose to reduce your risk of getting pits or thickening of the skin (lipodystrophy) and lumps in the skin (localized cutaneous amyloidosis) at the injection sites. - do not inject where the skin has pits, is thickened, or has lumps. do not inject where the skin is tender, bruised, scaly or hard, or into scars or damaged skin. - do not inject where the skin is tender, bruised, scaly or hard, or into scars or damaged skin. get to know your pen step 1: check your pen take a new pen out of the refrigerator at least 1 hour before you inject. cold insulin is more painful to inject. - check the name and expiration date on the label of your pen. make sure you have the correct insulin. do not use your pen after the expiration date printed on the label. - make sure you have the correct insulin. - do not use your pen after the expiration date printed on the label. - pull off the pen cap. - check that the insulin is clear. do not use the pen if the insulin looks cloudy, colored or contains particles. - do not use the pen if the insulin looks cloudy, colored or contains particles. - wipe the rubber seal with an alcohol swab. if you have other injector pens - making sure you have the correct medicine is especially important if you have other injector pens. step 2: attach a new needle - do not re-use needles. always use a new sterile needle for each injection. this helps stop blocked needles, contamination and infection. - always use needles 3from bd (such as bd ultra-fine ® ), ypsomed (such as clickfine ® ), or owen mumford (such as unifine ® pentips ® ) that are 8 mm long or shorter. - take a new needle and peel off the protective seal. - keep the needle straight and screw it onto the pen until fixed. do not over-tighten. - pull off the outer needle cap. keep this for later. - pull off the inner needle cap and throw away. handling needles - be careful when you are handling needles to help prevent accidental needle-stick injury. you may give other people a serious infection, or get a serious infection from them. step 3: do a safety test always do a safety test before each injection to: - check your pen and the needle to make sure they are working properly. - make sure that you get the correct insulin dose. if the pen is new, you must perform safety tests before you use the pen for the first time until you see insulin coming out of the needle tip. if you see insulin coming out of the needle tip, the pen is ready to use. if you do not see insulin coming out before taking your dose, you could get an underdose or no insulin at all. this could cause high blood sugar. - select 4 units by turning the dose selector until the dose pointer is at the 4 mark. - press the injection button all the way in. when insulin comes out of the needle tip, your pen is working correctly. - when insulin comes out of the needle tip, your pen is working correctly. if no insulin appears: - you may need to repeat this step up to 6 times before seeing insulin. - if no insulin comes out after the sixth time, the needle may be blocked. if this happens: change the needle (see step 6 and step 2 ), then repeat the safety test (see step 3 ). - change the needle (see step 6 and step 2 ), - then repeat the safety test (see step 3 ). - do not use your pen if there is still no insulin coming out of the needle tip. use a new pen. - do not use a syringe to remove insulin from your pen. if you see air bubbles - you may see air bubbles in the insulin. this is normal, they will not harm you. step 4: select the dose - do not select a dose or press the injection button without a needle attached. this may damage your pen. - insulin glargine u-300 max solostar is made to deliver the number of insulin units that your healthcare provider prescribed. you do not need to do any dose calculations . - the dose selector of your insulin glargine u-300 max solostar pen dials by 2 units and can only dial even doses of insulin. - make sure a needle is attached and the dose is set to "0." - turn the dose selector until the dose pointer lines up with your dose. set the dose by turning the dose selector to a line in the dose window. each line equals 2 units. the dose selector clicks as you turn it. always check the number in the dose window to make sure you dialed the correct dose. do not dial your dose by counting the clicks. you may dial the wrong dose. this may lead to you getting too much insulin or not enough insulin. if you turn past your dose, you can turn back down. if there are not enough units left in your pen for your dose, the dose selector will stop at the number of units left. if you cannot select your full prescribed dose, split the dose into 2 injections or use a new pen. if you use a new pen, perform a safety test (see step 3 ). - set the dose by turning the dose selector to a line in the dose window. each line equals 2 units. - the dose selector clicks as you turn it. - always check the number in the dose window to make sure you dialed the correct dose. - do not dial your dose by counting the clicks. you may dial the wrong dose. this may lead to you getting too much insulin or not enough insulin. - if you turn past your dose, you can turn back down. - if there are not enough units left in your pen for your dose, the dose selector will stop at the number of units left. - if you cannot select your full prescribed dose, split the dose into 2 injections or use a new pen. if you use a new pen, perform a safety test (see step 3 ). how to read the dose window the dose selector dials by 2 units. each line in the dose window is an even number. units of insulin in your pen - your pen contains a total of 900 units of insulin. you can select doses from 2 to 160 units. the dose is adjusted by 2 units at a time. each pen contains more than 1 dose. - you can see roughly how many units of insulin are left by looking at where the plunger is on the insulin scale. step 5: inject your dose if you find it hard to press the injection button in, do not force it as this may break your pen. see the section below for help. - choose a place to inject as shown in the picture labeled "places to inject." the site you choose for the injection should be clean and dry. if your skin is dirty, clean it as instructed by your healthcare provider. - the site you choose for the injection should be clean and dry. - if your skin is dirty, clean it as instructed by your healthcare provider. - push the needle into your skin as shown by your healthcare provider. do not touch the injection button yet. - do not touch the injection button yet. - place your thumb on the injection button. then press all the way in and hold. do not press at an angle. your thumb could block the dose selector from turning. - do not press at an angle. your thumb could block the dose selector from turning. - keep the injection button held in and when you see "0" in the dose window, slowly count to 5. this will make sure you get your full dose. - this will make sure you get your full dose. - after holding and slowly counting to 5, release the injection button. then remove the needle from your skin. if you find it hard to press the injection button in: - change the needle (see step 6 and step 2 ) then do a safety test (see step 3 ). - if you still find it hard to press in, get a new pen. - do not use a syringe to remove insulin from your pen. step 6: remove the needle - take care when handling needles to prevent needle injury and cross-infection. - do not put the inner needle cap back on. - grip the widest part of the outer needle cap. keep the needle straight and guide it into the outer needle cap. then push firmly on. the needle can puncture the cap if it is recapped at an angle. - the needle can puncture the cap if it is recapped at an angle. - grip and squeeze the widest part of the outer needle cap. turn your pen several times with your other hand to remove the needle. try again if the needle does not come off the first time. - try again if the needle does not come off the first time. - throw away the used needle in a puncture-resistant container (see " throwing your pen away" at the end of this instructions for use). - put the pen cap back on. do not put the pen back in the refrigerator. - do not put the pen back in the refrigerator. use by - only use your pen for up to 56 days after its first use. how to store your pen before first use - keep new pens in the refrigerator between 36°f and 46°f (2°c and 8°c) . - do not freeze. throw away your pen if it has been frozen (see " throwing your pen away" ). after first use - keep your pen at room temperature up to 86°f (30°c) . - protect your pen from direct heat and light. - do not put your pen back in the refrigerator. - do not store your pen with the needle attached. - store your pen with the pen cap on. - keep insulin glargine u-300 max solostar pens and needles out of the reach of children. how to care for your pen handle your pen with care - do not drop your pen or knock it against hard surfaces. - if you think that your pen may be damaged, do not try to fix it. use a new one. protect your pen from dust and dirt - you can clean the outside of your pen by wiping it with a damp cloth (water only). do not soak, wash or lubricate your pen. this may damage it. throwing your pen away - the used insulin glargine u-300 max solostar pen may be thrown away in your household trash after you have removed the needle. - put the used needle in a fda-cleared sharps disposal container right away after use. do not throw away (dispose of) needles in your household trash. - if you do not have a fda-cleared sharps disposal container, you may use a household container that is: made of a heavy-duty plastic, can be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out, upright and stable during use, leak-resistant, and properly labeled to warn of hazardous waste inside the container. - made of a heavy-duty plastic, - can be closed with a tight-fitting, puncture-resistant lid, without sharps being able to come out, - upright and stable during use, - leak-resistant, and - properly labeled to warn of hazardous waste inside the container. - when your sharps disposal container is almost full, you will need to follow your community guidelines for the right way to dispose of your sharps disposal container. there may be state or local laws about how you should throw away used needles and syringes. for more information about safe sharps disposal, and for specific information about sharps disposal in the state that you live in, go to the fda's website at: http://www.fda.gov/safesharpsdisposal. - do not dispose of your used sharps disposal container in your household trash unless your community guidelines permit this. do not recycle your used sharps disposal container. manufactured by: sanofi-aventis u.s. llc bridgewater, nj 08807 u.s. license no. 1752 manufactured for: winthrop u.s., a business of sanofi-aventis u.s. llc bridgewater, nj 08807 a sanofi company ©2022 sanofi-aventis u.s. llc this instructions for use has been approved by the u.s. food and drug administration. revised: august 2022

United States - English - NLM (National Library of Medicine)

sanofi-aventis deutschland gmbh - insulin glargine (unii: 2zm8cx04rz) (insulin glargine - unii:2zm8cx04rz) - insulin glargine is indicated to improve glycemic control in adults and pediatric patients with type 1 diabetes mellitus and in adults with type 2 diabetes mellitus. limitations of use insulin glargine is not recommended for the treatment of diabetic ketoacidosis. insulin glargine is contraindicated: - during episodes of hypoglycemia [see warnings and precautions (5.3)] - in patients with hypersensitivity to insulin glargine or one of its excipients [see warnings and precautions (5.5)] risk summary published studies with use of insulin glargine during pregnancy have not reported a clear association with insulin glargine and adverse developmental outcomes [see data] . there are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy [see clinical considerations] . rats and rabbits were exposed to insulin g