If you have type 1 or type 2 diabetes, your doctor might prescribe Toujeo. It’s a prescription diabetes medication used in adults and some children.

To learn more about diabetes and how Toujeo is used, see the “Is Toujeo used for diabetes?” section below.

Toujeo basics

Toujeo contains insulin glargine, which is a type of long-acting insulin. It comes as a liquid solution that you’ll inject under your skin.

Toujeo is a biologic medication that doesn’t currently come in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for non-biologic drugs, biosimilars are made for biologic drugs.)

Read on to learn more about Toujeo’s uses, side effects, and more.

Toujeo comes as two pens: Toujeo SoloStar and Toujeo Max SoloStar. Both forms of the drug contain the same active ingredient, insulin glargine.

The following chart compares these pens:

Toujeo SoloStarToujeo Max SoloStar
Total amount of insulin450 units per pen900 units per pen
Dose increment (smallest possible dose change)1 unit2 units
Maximum dose80 units per injection160 units per injection

If you need to inject more than 20 units of insulin per day, your doctor will likely prescribe Toujeo Max SoloStar.

If your doctor changes your pen from Toujeo SoloStar to Toujeo Max SoloStar, they’ll tell you what dose to inject. You might need to increase or decrease your dose by one unit. (See “How is Toujeo used?” below for more information about how to inject this drug.)

You may wonder if Toujeo is the same as Lantus and other alternatives, such as Basaglar and Semglee. Make sure to talk with your doctor about the drug that’s best for your condition. The chart provides information about how Toujeo compares with some alternatives:

Active ingredientConditions approved forAges approved forDetailed comparison with Toujeo
Toujeoinsulin glarginetype 1 and type 2 diabetesadults and children ages 6 years and older
Lantusinsulin glarginetype 1 and type 2 diabetesadults and children ages 6 years and olderToujeo vs. Lantus
Tresibainsulin degludectype 1 and type 2 diabetesadults and children ages 1 year and olderToujeo vs. Tresiba
Basaglarinsulin glarginetype 1 diabetesadults and children ages 6 years and olderToujeo vs. Basaglar
Levemirinsulin detemirtype 1 and type 2 diabetesadults and children ages 2 years and olderToujeo vs. Levemir

Your doctor will recommend the dosage of Toujeo that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Forms and strength

Toujeo comes as a liquid solution that contains 300 units of insulin glargine per milliliter of solution (units/mL). It comes in a prefilled pen that delivers a specific number of insulin units.

Toujeo SoloStar and Toujeo SoloStar Max

Toujeo is available as two pens: SoloStar and SoloStar Max. Depending on how many units of insulin glargine you need to inject, your doctor will prescribe either the Toujeo SoloStar or Toujeo SoloStar Max pen.

To use either of these pens, you’ll need to attach pen needles. Toujeo doesn’t come in vials. This isn’t how the solution is supplied.

See the “How do Toujeo SoloStar and Toujeo Max SoloStar differ?” section above for details about each type of pen.

Recommended dosage

Your doctor will tell you exactly how many units of Toujeo you’ll inject as a starting dose. This varies depending on whether you have type 1 or type 2 diabetes. Your doctor will also use your blood sugar levels and treatment goals to calculate your dose. And they may adjust your dose over time.

You’ll inject Toujeo once daily at the same time every day. Toujeo doesn’t follow twice daily dosing like some other insulin products.

If you’re already taking a different type of insulin, your doctor will tell you what dose of Toujeo to inject. It may not be the same number of insulin units as your other medication.

Be sure to check the label of your insulin products carefully before injecting. Accidentally mixing up your insulin doses can be dangerous.

Questions about Toujeo’s dosage

  • What if I miss a dose of Toujeo? If you miss a dose of Toujeo, take it as soon as you remember. But if you’re close to taking your next scheduled dose, skip the missed dose. If you’re unsure when to take Toujeo after missing a dose, talk with your doctor or pharmacist. It might help to download a reminder app or set an alarm each day to help you remember to inject Toujeo.
  • Will I need to use Toujeo long term? Diabetes is a long lasting condition, so you might need to take Toujeo long term. To find out how long you’ll need to take Toujeo, talk with your doctor.
  • How long does Toujeo take to work? Toujeo is a long-acting insulin. It takes about 6 hours to start working after injection. Its effects may last for more than 36 hours after injection.

Like most drugs, Toujeo may cause mild or serious side effects. The lists below describe some of the more common side effects of Toujeo. These lists don’t include all possible side effects.

Keep in mind that the side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Toujeo. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Toujeo can cause. To learn about other mild side effects, talk with your doctor or pharmacist or read Toujeo’s prescribing information.

Mild side effects of Toujeo that have been reported include:

  • the common cold
  • upper airway infection (such as sinus infection)
  • injection site reaction
  • lipodystrophy or localized cutaneous amyloidosis (skin conditions that cause pits, thickening, or lumps in the skin around your injection site)
  • itchiness
  • edema (fluid buildup in the body)
  • rash*
  • mild hypoglycemia (low blood sugar)*
  • weight gain*

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Toujeo can occur, but they aren’t common. If you have serious side effects from Toujeo, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Toujeo that have been reported include:

* For more information about this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects of Toujeo.

Weight gain

When taking insulin, including Toujeo, you might gain weight. Weight gain can occur when you start Toujeo treatment because the drug may cause you to urinate less than you did before.

Diabetes causes you to urinate more often than usual. When your blood sugar is too high, your body gets rid of some excess sugar through your urine. Urinating frequently means you lose more water from your body than usual. This decreases your “water weight.”

When you’re taking Toujeo and your diabetes is well managed, you’ll typically stop urinating as much. This can make you gain weight because your body won’t be getting rid of as much water.

Toujeo can also lead to weight gain because it affects your metabolism. Insulin decreases the breakdown of fats and protein in your body. It also activates the production of certain fats and proteins. This can make you gain weight.

What might help

A healthy diet and regular exercise can help prevent weight gain. This can also help you manage your blood sugar levels.

If you’re concerned about gaining weight, talk with your doctor. They can help you work toward or maintain a weight that’s right for you.

Rash

A rash might appear where you inject Toujeo. A rash may be a symptom of an allergic reaction or an injection site reaction.

Injection site reactions are typically mild and may cause other symptoms, such as redness, pain, and bruising.

If you have a rash on your entire body or most of your body, it might be a symptom of a severe allergic reaction. Other symptoms of an allergic reaction may include trouble breathing, fast heart rate, or sweating. See “Allergic reaction” below for details.

What might help

If you think you’re having an allergic reaction to Toujeo, contact your doctor immediately. Get emergency medical attention if you’re experiencing trouble breathing, a fast heart rate, or sweating that’s unusual or excessive.

An injection site reaction is usually mild and goes away over time. If you have a rash that doesn’t go away with time, talk with your doctor or pharmacist. They may suggest other injection techniques to help prevent rashes at the injection site.

Hypoglycemia

Hypoglycemia (low blood sugar) is the most common side effect of Toujeo. If your blood sugar drops too low, it can be life threatening.

Your doctor will tell you about hypoglycemia symptoms to look out for. Some symptoms include:

  • feeling shaky, nervous, anxious, or irritable
  • sweating
  • headache and confusion
  • feeling dizzy or lightheaded
  • nausea
  • issues with your eyesight
  • balance problems

If your blood sugar becomes very low or stays low for a long time, you may have more serious symptoms. These can include fainting and seizures. Rarely, severe hypoglycemia can cause death.

What might help

To help prevent hypoglycemia, check your medication labels to make sure you inject the correct amount of insulin for each dose. If you’re taking different types of insulin, make sure to take the correct insulin at the correct time. Your doctor will tell you how to monitor your blood sugar levels and manage hypoglycemia if it occurs.

If you have a low blood sugar level, you should eat something sugary. The 15-15 rule is helpful for remembering how much sugar to take: You’ll take 15 grams (g) of sugar and check your blood sugar 15 minutes later.

Examples of 15 g of sugar include:

  • glucose tablets or gels
  • half a cup (4 ounces) of juice or regular (non-diet) soda
  • 1 tablespoon (tbsp) of sugar, honey, or corn syrup
  • hard candies, jelly beans, or gumdrops
Allergic reaction

Some people may have an allergic reaction to Toujeo.

Symptoms of a mild allergic reaction can include:

  • rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include a whole-body rash and swelling under your skin (typically in your eyelids, lips, hands, or feet). They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Toujeo. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Find answers to some commonly asked questions about Toujeo.

Does Toujeo need to be stored in the refrigerator?

Yes, you should store Toujeo 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. Do not store the drug in the freezer.

For pens you’re using for injections, you should let them come to room temperature before using them. They should get to below 86°F (30°C). Once a pen is at room temperature, it should be stored at this temperature. You can keep pens at room temperature for 56 days before you need to discard them.

What’s the duration of action for Toujeo? Is it a fast-acting insulin?

Toujeo starts working about 6 hours after injection. Its effects may last for more than 36 hours.

Toujeo isn’t a fast-acting insulin. Its active ingredient, insulin glargine, is a long-acting insulin.

Are reviews available from people who’ve taken Toujeo?

You can browse the manufacturer’s site for reviews from people who’ve taken Toujeo. The website also provides other tools and resources for people taking Toujeo.

What is Toujeo’s shelf life? When does it expire after opening?

Toujeo’s shelf life depends on whether you’ve used the pens or allowed them to come to room temperature. Any unused pens kept in a refrigerator are safe to use until the expiration date on the packaging. But once you warm a Toujeo pen to room temperature, it’ll expire in 56 days.

How does Toujeo work?

Toujeo is a type of long-acting insulin. It works over a long period to help manage blood sugar by allowing cells in your body to take in sugar.

Another important mechanism of action of insulin, such as Toujeo, is blocking your liver from producing sugar. (“Mechanism of action” refers to how a drug works in your body.)

Your doctor or pharmacist can tell you more about how Toujeo works.

Does Toujeo cause joint pain, diarrhea, or weight loss?

No, Toujeo doesn’t cause joint pain, diarrhea, or weight loss. But other diabetes medications might.

Talk with your doctor or pharmacist if you’re having any joint pain, diarrhea, or weight loss. They can help you find out what might be causing this and how to manage it.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current costs without insurance for Toujeo in your area, visit GoodRx.com.

If you have questions about how to pay for your Toujeo prescription, talk with your doctor or pharmacist. You can also visit the manufacturer’s website to see if they have patient assistance options.

You can also check out this article to learn more about saving money on prescriptions.

Do not take more Toujeo than your doctor prescribes. Taking more than this can lead to serious side effects.

How much Toujeo is too much?

Taking any more than your prescribed dose of Toujeo is too much. Your doctor will calculate the dose of Toujeo that you’ll need. The specific amount of Toujeo that is considered too much can vary by individual.

Symptoms of overdose

Symptoms of an overdose can include:

  • hypoglycemia (low blood sugar)
  • hypokalemia (low potassium level)
  • coma
  • seizures
  • damage to the nervous system (brain or spinal cord)

What to do in case you take too much Toujeo

Call your doctor if you think you’ve taken too much Toujeo. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or, go to the nearest emergency room.

Yes, Toujeo is used in adults and children ages 6 years and older with type 1 or type 2 diabetes. With type 1 diabetes, your pancreas doesn’t produce insulin to manage your blood sugar. If you have type 2 diabetes, the insulin that your body produces doesn’t work properly.

Toujeo is a type of long-acting insulin called insulin glargine. Insulin is made in the body by the pancreas. It manages blood sugar by allowing the muscle and fat cells in your body to take in sugar. Once the sugar is in the cells, your blood sugar decreases. Insulin also controls the production of sugar by the liver.

In addition to insulin such as Toujeo, your doctor may recommend other medications or ways of managing your diabetes. Eating a balanced diet and exercising are two examples. But type 2 diabetes can worsen over time, and you’ll likely need medication.

Note: Toujeo isn’t prescribed to treat diabetic ketoacidosis (high levels of ketones in your blood or urine). Your doctor or pharmacist can provide more information about this.

Your doctor will explain how you should take Toujeo. They’ll also explain how much to take and how often. Be sure to follow their instructions.

Injecting Toujeo

You’ll inject Toujeo under your skin once per day, at the same time every day, using a prefilled pen. You’ll attach a needle to the pen before each injection.

Toujeo injection sites

You can inject Toujeo into the belly, thigh, or upper arm. Do not inject Toujeo into the same spot every day. You should rotate injection sites daily. For example, if you inject Toujeo into your belly, you should use either your thigh or upper arm the next day. Or you can inject it into a different part of your belly.

Rotating injection sites lowers your risk of side effects such as lipodystrophy and localized cutaneous amyloidosis. These side effects can cause pits, thickening, or lumps in the skin around your injection site. Rotating sites also lowers your risk of injection site reactions.

Avoid injecting Toujeo into areas of skin that are pitted or thickened or have lumps. Also avoid areas that are tender, bruised, scaly, or hard. And avoid injecting Toujeo under scars or any type of damaged skin.

Taking Toujeo with other drugs

Your doctor might prescribe other diabetes medications along with Toujeo to help manage your blood sugar. This may include other types of insulin.

For type 1 diabetes, insulin is the only medication you’ll typically take. But your doctor might prescribe more than one type of insulin.

Rapid-acting and short-acting insulin products, such as insulin lispro (Humalog) and regular insulin (Humulin R), can be used with Toujeo. Toujeo is a type of long-acting insulin.

Medications that may be prescribed with Toujeo for type 2 diabetes include:

Should I take Toujeo with food?

You can take Toujeo with or without food. Taking Toujeo with or without food doesn’t change how much of the medication your body absorbs.

Questions for your doctor

You may have questions about Toujeo and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions, such as:
    • How will Toujeo affect my body, mood, or lifestyle?
  • Bring someone to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

Some important things to discuss with your doctor when considering treatment with Toujeo include your overall health and any medical conditions you may have.

Tell your doctor if you’re taking other medications. This is important since some drugs can interfere with Toujeo. These and other considerations to discuss with your doctor are described below.

Interactions

Certain vaccines, foods, and other drugs can affect how your medication works. These effects are called interactions.

Toujeo can interact with several types of drugs. These drugs include:

This list does not contain all types of drugs that may interact with Toujeo.

Before taking Toujeo, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, describe any vitamins, herbs, or supplements you take. Your doctor or pharmacist can tell you about any interactions these items may cause with Toujeo.

Warnings

Toujeo may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Toujeo. Factors to consider include those in the list below.

  • Hypoglycemia (low blood sugar). Hypoglycemia can occur when you’re changing from one insulin product to another. Make sure to read your medication labels carefully before injection to ensure you have the right dose. If you have an episode of hypoglycemia, your doctor may adjust your dose of Toujeo. Your doctor will tell you how to recognize symptoms of hypoglycemia and what to do. You can also see “What are Toujeo’s side effects?” above for details.
  • Allergic reaction. If you’ve had an allergic reaction to Toujeo or any of its ingredients, your doctor may not recommend Toujeo as a treatment option. Ask your doctor what other medications are better options for you.
  • Hypokalemia (low potassium level). Hypokalemia is a possible side effect of Toujeo. If you have risk factors for this condition, you may have a higher risk of severe hypokalemia with Toujeo. Risk factors include taking medications that can lower your potassium level, such as furosemide (Lasix) and indapamide. Your doctor may monitor your blood potassium levels more often than usual during Toujeo treatment. If you have severely low potassium, you may have serious breathing problems and an irregular heartbeat. This can be life threatening in severe cases. Make sure to tell your doctor if you have possible symptoms of this condition. They may stop your Toujeo treatment.
  • Heart failure and fluid buildup. If you have heart failure or edema, taking Toujeo with certain other diabetes medications can make your condition worse. This includes drugs called thiazolidinediones, such as pioglitazone (Actos) and rosiglitazone (Avandia). Your doctor will monitor your heart function if you’re taking Toujeo and a thiazolidinedione medication.

Toujeo and alcohol

Alcohol can have different effects on insulin, including insulin glargine, the active ingredient in Toujeo. It can either decrease or increase the effectiveness of insulin.

This means that alcohol could make Toujeo more or less effective for managing your blood sugar. It’s possible for alcohol to cause hypoglycemia during Toujeo treatment, which can be dangerous.

How well Toujeo works if you’re also drinking alcohol depends on a few factors. These include how much alcohol you’ve consumed and how much food you’ve eaten.

Since you can’t predict how alcohol will affect your treatment, talk with your doctor to make sure that alcohol is safe for you to have. Your doctor may need to know how often and how much alcohol you drink. Do not adjust your dose of Toujeo without first talking with your doctor.

Pregnancy and breastfeeding

In studies of Toujeo treatment during pregnancy, the drug was not shown to cause harmful effects on a pregnant person or fetus. But more information is needed to say for sure whether Toujeo does or does not increase the risk of harmful effects when taken during pregnancy.

But it’s important to manage your diabetes during pregnancy to avoid the risk of problems with fetal development (commonly called birth defects).

There’s also not enough information about Toujeo use while breastfeeding. Breast milk contains insulin that’s produced by the body, but it’s unclear if Toujeo passes into breast milk.

If you’re pregnant, breastfeeding, or considering either, talk with your doctor to find out which diabetes medications are best for you. Your doctor can help you weigh the benefits of Toujeo and the possible risks to you and your child.

If you have questions about Toujeo, talk with your doctor or pharmacist. Your doctor can tell you about other treatments you can use for your diabetes. This article with a complete list of diabetes medications might also be helpful.

Some questions to ask your doctor about Toujeo may include:

  • What can I do to lower my dose of Toujeo?
  • How can I minimize any pain while injecting Toujeo?
  • How should I dispose of my empty or expired Toujeo pens?
  • If the liquid in my Toujeo pen is cloudy, what should I do?

You can learn more about the uses of Toujeo by subscribing to the Healthline type 2 diabetes newsletter.

Disclaimer: Healthline 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.