1. Toujeo (insulin glargine) is a prescription medication. It’s not available in a generic form.
  2. Toujeo comes as a self-injectable solution.
  3. Toujeo is used to control high blood sugar (hyperglycemia) in people with type 1 and type 2 diabetes.

  • Low blood sugar warning: You may have mild or severe low blood sugar (hypoglycemia) while you’re taking Toujeo. Severe low blood sugar can be dangerous. It can harm your heart or brain, cause unconsciousness or seizures, or even be fatal. Low blood sugar can happen very quickly and come on without symptoms. It’s important to check your blood sugar as often as your doctor recommends. Symptoms of low blood sugar can include:
    • hunger
    • nervousness
    • shakiness
    • sweating
    • chills
    • clamminess
    • dizziness
    • fast heart rate
    • lightheadedness
    • sleepiness
    • confusion
    • blurred vision
    • headache
    • feeling confused or not like yourself, and irritability
  • Thiazolidinediones warning: Taking diabetes pills called thiazolidinediones (TZDs) with Toujeo may cause heart failure. Tell your doctor if you have any new or worsening symptoms of heart failure, such as shortness of breath, swelling of your ankles or feet, and sudden weight gain. Your doctor may adjust your TZD dosage if you have these symptoms.
  • Infection warning: You should never share insulin vials, syringes, or prefilled pens with other people. Sharing or reusing needles or syringes with another person puts you and others at risk of various infections.
  • Low potassium levels warning: All insulin products can decrease the amount of potassium in the blood. Low potassium blood levels may increase your risk of irregular heartbeat. To prevent this, your doctor will check your potassium blood levels before you start taking this drug.

Toujeo is a prescription drug that comes as a self-injectable solution.

Toujeo contains the drug insulin glargine, which is not available in a generic version. Insulin glargine is also available as the brand-name medications Lantus and Basaglar.

Toujeo is a long-acting insulin. If you have type 1 diabetes, it must be used in combination with short- or rapid-acting insulin. If you have type 2 diabetes, this drug may be used alone or with other medications.

Why it’s used

Toujeo is used to reduce blood sugar levels in adults and children with type 1 diabetes. It’s also used to reduce blood sugar levels in adults with type 2 diabetes.

How it works

Toujeo belongs to a drug class called long-acting insulins. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Toujeo works by controlling how sugar is used and stored in your body. It increases the amount of sugar your muscles use, helps to store sugar in fat, and stops your liver from making sugar. It also stops fat and protein from being broken down, and helps your body make protein.

In people without diabetes, these functions are performed by insulin produced in the body.

But if you have type 1 diabetes, your pancreas cannot make insulin. And if you have type 2 diabetes, your pancreas may not make enough insulin, or your body can’t use the insulin that your body makes. Toujeo replaces part of the insulin your body needs.

Toujeo may cause drowsiness. It can also cause other side effects.

More common side effects

The more common side effects that can occur with Toujeo include:

  • Low blood sugar. Symptoms may include:
    • hunger
    • nervousness
    • shakiness
    • sweating
    • chills
    • clamminess
    • dizziness
    • fast heart rate
    • lightheadedness
    • sleepiness
    • confusion
    • blurred vision
    • headache
    • feeling confused or not like yourself, and irritability
  • Unexplained weight gain
  • Swelling (edema) in your arms, legs, feet, or ankles
  • Reactions at the injection site. Symptoms may include:
    • a small indent in your skin (lipoatrophy)
    • an increase or decrease in fatty tissue under the skin from using an injection site too often
    • red, swollen, burning, or itchy skin

These effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

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:

  • Breathing problems
  • Allergic reactions. Symptoms can include:
    • skin rash
    • itching or hives
    • swelling of your face, lips, or tongue
  • Very low blood sugar (hypoglycemia). Symptoms can include:
    • anxiety
    • confusion
    • dizziness
    • increased hunger
    • unusual weakness or tiredness
    • sweating
    • shakiness
    • low body temperature
    • irritability
    • headache
    • blurred vision
    • fast heart rate
    • loss of consciousness

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Toujeo can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with Toujeo are listed below.

Drugs that increase the risk of hypoglycemia

These medications should be used with caution with Toujeo. Using them with Toujeo may increase your risk of very low blood sugar. Examples of these drugs include:

  • other medications for diabetes
  • pentamidine
  • pramlintide
  • somatostatin analogs

Oral medications for diabetes

These medications should be used with caution with Toujeo. Using them with Toujeo may increase your risk of water retention and heart problems, such as heart failure. Examples of these drugs include:

  • pioglitazone
  • rosiglitazone

Injectable medication for diabetes

Taking exenatide with Toujeo can increase your risk of low blood sugar. If you need to take these drugs together, your doctor may reduce your dosage of Toujeo.

Blood pressure and heart drugs

Different types of blood pressure drugs can affect you differently while you use Toujeo.

Beta-blockers

These drugs change how your body manages blood sugar. Taking them with Toujeo can cause high or low blood sugar. They may also mask your symptoms of low blood sugar. Your doctor will watch you closely if you use these drugs with Toujeo. Examples of these drugs include:

  • acebutolol
  • atenolol
  • bisoprolol
  • metoprolol
  • nadolol
  • nebivolol
  • propranolol

Angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists

These drugs may make you more sensitive to Toujeo. This may raise your risk of low blood sugar. If you’re taking these drugs with Toujeo, you should be monitored closely for blood sugar control. Examples of these drugs include:

  • benazepril
  • captopril
  • enalapril
  • fosinopril
  • lisinopril
  • quinapril
  • ramipril
  • candesartan
  • eprosartan
  • irbesartan
  • losartan
  • telmisartan
  • valsartan

Other types of blood pressure drugs

These drugs may mask the signs and symptoms of low blood sugar. If you’re taking these drugs with Toujeo, your doctor should monitor you closely.

  • clonidine
  • guanethidine
  • reserpine

Irregular heart rate medication

Taking disopyramide with Toujeo may increase the blood sugar-lowering effect of Toujeo. This may raise your risk of low blood sugar. If you need to use these drugs together, your doctor may decrease your dosage of Toujeo.

Medications that lower your cholesterol

Taking fibrates with Toujeo may increase its blood sugar-lowering effects. This may raise your risk of low blood sugar. If you need to take these drugs with Toujeo, your doctor may decrease your Toujeo dosage.

Taking niacin with Toujeo may decrease the blood sugar-lowering effect of Toujeo. This may raise your risk of high blood sugar. If you need to take this drug with Toujeo, your doctor may increase your Toujeo dosage.

Drugs to treat depression

Taking these drugs with Toujeo may increase its blood sugar-lowering effect. This may raise your risk of low blood sugar. If you need to take these drugs with Toujeo, your doctor may decrease your Toujeo dosage. Examples of these drugs include:

  • fluoxetine
  • monoamine oxidase inhibitors (MAOIs)

Pain medications

Taking pain drugs called salicylates with Toujeo may increase its blood sugar-lowering effect. This may raise your risk of low blood sugar. If you need to take these drugs with Toujeo, your doctor may decrease your Toujeo dosage. Examples of these drugs include:

  • aspirin
  • bismuth subsalicylate

Sulfonamide antibiotics

Taking these drugs with Toujeo may increase its blood sugar-lowering effect. This may raise your risk of low blood sugar. If you need to take these drugs with Toujeo, your doctor may decrease your Toujeo dosage. Examples of these drugs include:

  • sulfamethoxazole

Blood thinner medication

Taking pentoxifylline with Toujeo may increase the blood sugar-lowering effect of Toujeo. This may raise your risk of low blood sugar. If you need to take this drug with Toujeo, your doctor may decrease your Toujeo dosage.

Drugs used to treat inflammation

Taking corticosteroids with Toujeo may decrease its blood sugar-lowering effect. This may raise your risk of high blood sugar. If you need to take this drug with Toujeo, your doctor may increase your Toujeo dosage.

Asthma drugs

Taking these drugs with Toujeo may decrease its blood sugar-lowering effect. This may raise your risk of high blood sugar. If you need to take these drugs with Toujeo, your doctor may increase your Toujeo dosage. Examples of these drugs include:

  • epinephrine
  • albuterol
  • terbutaline

Medications used to treat infections

Taking these drugs with Toujeo may decrease its blood sugar-lowering effect. This may raise your risk of high blood sugar. If you need to take these drugs with Toujeo, your doctor may increase your Toujeo dosage. Examples of these drugs include:

  • isoniazid
  • pentamidine

Thyroid hormones

Taking these drugs with Toujeo may decrease its blood sugar-lowering effect. This may raise your risk of high blood sugar. If you need to take these drugs with Toujeo, your doctor may increase your Toujeo dosage.

Female hormones

Taking Toujeo with hormones commonly used in birth control may decrease the blood sugar-lowering effect of Toujeo. This may raise your risk of high blood sugar. If you need to take these drugs with Toujeo, your doctor may increase your Toujeo dosage. Examples of these drugs include:

  • estrogen
  • progestogens

Drugs to treat HIV

Taking protease inhibitors with Toujeo may decrease its blood sugar-lowering effect. This may raise your risk of high blood sugar. If you need to take these drugs with Toujeo, your doctor may increase your Toujeo dosage. Examples of these drugs include:

  • atazanavir
  • darunavir
  • fosamprenavir
  • indinavir
  • lopinavir/ritonavir
  • nelfinavir
  • ritonavir

Drugs to treat psychotic disorders

Taking these drugs with Toujeo may decrease its blood sugar-lowering effect. This may raise your risk of high blood sugar. If you need to take these drugs with Toujeo, your doctor may increase your Toujeo dosage. Examples of these drugs include:

  • olanzapine
  • clozapine
  • lithium
  • phenothiazines

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you’re taking.

This drug comes with several warnings.

Allergy warning

Toujeo can cause a severe allergic reaction. Symptoms can include:

  • rash all over your body
  • shortness of breath
  • trouble breathing
  • fast pulse
  • sweating
  • low blood pressure

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t use this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Food interaction warning

The type and amount of food you eat can affect how much Toujeo you need. Tell your doctor if you change your diet. They may need to adjust your dosage of Toujeo.

Alcohol interaction warning

Alcohol may make it more difficult to control your blood sugar while you’re taking Toujeo. Limit the amount of alcohol you drink while taking this drug.

Usage warning

Don’t share Toujeo with others even if they have the same medical condition. It could harm them.

Warnings for people with certain health conditions

For people with liver disease: Your liver may not be able to make glucose and break down Toujeo as well as it should. Your doctor may give you a lower dosage of this medication.

For people with kidney disease: Your kidneys may not be able to eliminate Toujeo from your body as well as they should. Your doctor may give you a lower dosage of this medication.

For people with low blood sugar (hypoglycemia): You need to use Toujeo with caution if you get low blood sugar often. The drug stays in your body for a long time and as a result, it may take longer to treat low blood sugar. Your risk may be higher if you’re 65 years or older or if you don’t eat on schedule.

For people with edema: Toujeo can make your edema (swelling) worse. This drug can cause your body to retain sodium. This can trap fluid in your body tissue, which in turn causes swelling of your hands, feet, arms, and legs.

For people with heart failure: Taking oral diabetes pills called thiazolidinediones (TZDs) with Toujeo can trap fluid in the tissues of your body and cause or worsen heart failure.

Warnings for other groups

For pregnant women: It’s not known if Toujeo is safe to use in pregnant women.

Tell your doctor if you’re pregnant or plan to become pregnant. You should only use Toujeo during pregnancy if the potential benefit justifies the potential risk.

For women who are breastfeeding: It isn’t known if Toujeo passes into breast milk. You and your doctor may need to decide if you’ll use Toujeo or breastfeed. If you do both, your Toujeo dosage may need to be adjusted, and your blood sugar level may be closely monitored.

For seniors: People aged 65 years or older may be more sensitive to Toujeo. This may raise your risk of a low blood sugar reaction. Your doctor may start you on a lower dosage, and increase your dosage slowly.

For children: This drug hasn’t been established as safe and effective for use in children younger than 18 years.

All possible dosages and forms may not be included here. Your dose, form, and how often you use it will depend on:

  • your age
  • the condition being treated
  • the severity of your condition
  • other medical conditions you have
  • how you react to the first dose

Dosage forms and strengths

  • Brand: Toujeo
  • Form: injectable solution
  • Strengths:
    • 300 units per mL in a 1.5-mL prefilled pen (450 units/1.5 mL)
    • 300 units per mL in a 3-mL prefilled pen (900 units/3 mL)

Dosage to improve glucose control in people with type 1 diabetes

Adult dosage (ages 18–64 years)

  • Inject Toujeo once per day, at the same time every day.
  • Your doctor will calculate your starting dosage and any dosage changes based on your needs, blood glucose monitoring results, and treatment goals.
  • If you have type 1 diabetes, the recommended starting dose is about one-third to one-half of your total daily insulin requirements. You should use short-acting insulin to satisfy the remainder of your daily insulin requirements.
  • If you have never received insulin before, in general, your doctor can use a dose of 0.2 to 0.4 units of insulin/kg to calculate your starting total daily insulin dose.
  • If you’re changing from an intermediate- or long-acting insulin to Toujeo, your doctor may need to adjust the amount and timing of your doses of insulin and antidiabetic drugs.

Child dosage (ages 0–17 years)

This drug hasn’t been established as safe and effective for use in children younger than 18 years.

Senior dosage (ages 65 years and older)

  • You should use Toujeo with caution if you’re over 65 years old, because it may be more difficult to spot the signs of low blood sugar. You may also be more sensitive to the effects of insulin.
  • Your doctor may start you with a lower first dosage and increase your dosage more slowly.

Dosage to improve glucose control in people with type 2 diabetes

Adult dosage (ages 18–64 years)

  • Inject Toujeo once per day, at the same time every day.
  • Your doctor will calculate your starting dosage and any dosage changes based on your needs, blood glucose monitoring results, and treatment goals.
  • If you’ve never received insulin before, the recommended initial dose is 0.2 units/kg once daily.
  • If you’re changing from an intermediate- or long-acting insulin to Toujeo, your doctor may need to adjust the amount and timing of your doses of insulin and antidiabetic drugs.

Child dosage (ages 0–17 years)

This drug hasn’t been established as safe and effective in people younger than 18 years.

Senior dosage (ages 65 years and older)

  • You should use Toujeo with caution if you’re over 65 years old, because it may be more difficult to spot the signs of low blood sugar. You may also be more sensitive to the effects of insulin.
  • Your doctor may start you with a lower first dosage and increase your dosage more slowly.

Special dosage considerations

For people with liver disease: Your liver may not be able to make glucose and break down Toujeo as well as it should. Your doctor may prescribe you a lower dosage of this medication.

For people with kidney disease: Your kidneys may not be able to eliminate Toujeo from your body as well as they should. Your doctor may prescribe you a lower dosage of this medication.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

When to call your doctor

  • Tell your doctor if you’re sick, throwing up, or have changed your eating or exercise habits. Your doctor may adjust your Toujeo dosage or check you for complications of diabetes. Tell your doctor before you start any new prescription or over-the-counter medications, herbal products, or supplements.

Toujeo is used for long-term treatment. It comes with serious risks if you don’t use it as prescribed.

If you stop taking the drug or don’t take it at all: You may have high blood sugar, which may lead to serious health effects.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you use too much: If you use too much Toujeo, you may have mild or life-threatening low blood sugar (hypoglycemia). Carry a quick source of sugar with you in case you have symptoms of mild low blood sugar. Follow your low blood sugar treatment plan as prescribed by your doctor. Symptoms of more serious low blood sugar may include:

  • passing out
  • seizures

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 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: It’s important not to miss a dose. Your doctor should discuss a plan for missed doses with you. If you do miss a dose, follow that plan.

How to tell if the drug is working: Your blood sugar level should be lower.

Keep these considerations in mind if your doctor prescribes Toujeo for you.

General

  • You can use Toujeo with or without food.
  • You can use Toujeo at any time during the day, but you should use it at the same time every day.

Storage

It’s important to store Toujeo correctly for it to work as it should.

Unopened vial:

  • Store new (unopened) Toujeo vials in the refrigerator at a temperature between 36°F and 46°F (2°C and 8°C).
  • Toujeo can be stored in the refrigerator until the expiration date on the box or vial.
  • Don’t freeze this medication.
  • Keep this drug out of direct heat and light.
  • If a Toujeo vial has been frozen, left out at high temperatures, or is expired, throw it away even if there is insulin left in it.

Open (in use) vial:

  • Once a Toujeo vial is opened, you can keep it in the refrigerator or at room temperature below 86°F (30°C).
  • Keep this drug away from direct heat and light.
  • An opened vial should be thrown away 28 days after the first use even if it still has insulin left in it.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t harm your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Unopened vials of this medication need to be refrigerated. Use an insulated bag with a cold pack to maintain the temperature when traveling. Opened vials can be refrigerated or kept at room temperature below 86°F (30°C). However, be sure to keep them away from direct heat and light. Follow the storage instructions mentioned on the medication package.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
  • Needles and syringes need to be used to use this medication. Check for special rules about traveling with drugs, needles, and syringes.

Self-management

Your doctor, pharmacist, nurse, or diabetes educator will show you how to:

  • withdraw insulin from the vial
  • attach needles
  • give your Toujeo injection
  • adjust your dosage for activities and illness
  • check your blood sugar
  • spot and treat the symptoms of low and high blood sugar

In addition to Toujeo, you’ll need:

  • needles
  • syringes
  • a safe needle disposal container
  • alcohol swabs
  • lancets to prick your finger to test your blood sugar
  • blood sugar test strips
  • blood glucose monitor

Taking your medication:

  • Inject Toujeo at the same time each day.
  • Use it exactly as prescribed by your doctor.
  • Never mix it in the same syringe with other insulins before injection.
  • Always check the appearance of Toujeo before using it. It should be clear and colorless like water. Don’t use it if it’s cloudy, thickened, colored, or has particles in it.
  • Don’t reuse or share needles or syringes used to inject this medication. Doing so may spread diseases.

Disposing of used needles:

  • Don’t throw out individual needles in trash cans or recycling bins, and never flush them down the toilet.
  • Ask your pharmacist for a safe container for disposing of used needles and syringes.
  • Your community may have a program for disposing used needles and syringes.
  • If disposing the container in the trash, label it “do not recycle.”

Clinical monitoring

Your doctor may do blood tests before and during treatment with Toujeo to make sure it’s still safe for you to use. These tests may include:

  • blood sugar levels
  • glycosylated hemoglobin (A1C) levels (measures your blood sugar control over the last two to three months)
  • liver function test
  • kidney function test
  • blood potassium levels

Your doctor may also do other tests to check for complications of diabetes:

  • eye exam
  • foot exam
  • dental exam
  • tests for nerve damage
  • blood test for cholesterol levels
  • checks of blood pressure and heart rate

Your doctor may need to adjust your dosage of Toujeo based on the following:

  • blood sugar levels
  • kidney function
  • liver function
  • other medications you’re taking
  • your exercise habits
  • your eating habits

Your diet

During treatment with Toujeo:

  • Don’t skip meals.
  • Ask your doctor if you should avoid alcohol.
  • Be careful with over-the-counter (OTC) cough and cold medications. Many OTC products contain sugar or alcohol that can affect your blood sugar.

Hidden costs

In addition to the medication, you’ll need to purchase:

  • needles
  • syringes
  • a safe needle disposal container
  • alcohol swabs
  • lancets to prick your finger to test your blood sugar
  • blood sugar test strips
  • blood glucose monitor

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

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 other 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.