Insulin Glargine (insulin glargine)
Insulin Glargine is a long-acting (basal) recombinant human insulin analog, 100 units/ml (u-100); a 300 units/ml (u-300) version is marketed as toujeo from Sanofi, marketed originally as Lantus. This monograph covers approved indications, mechanism, dosing, side effects, the generic manufacturer landscape and verified list prices.
Overview
Insulin glargine is a long-acting basal insulin - a recombinant human insulin analogue designed to be injected once a day and to release insulin slowly and steadily over roughly 24 hours. It covers the body's background insulin needs between meals and overnight; it does not cover the carbohydrate in a meal, the job of a rapid-acting insulin such as insulin aspart.
The molecule differs from human insulin in two places: two arginine residues are added to the end of the B chain, and the asparagine at position A21 is replaced by glycine. That shifts the isoelectric point to about pH 4, so the analogue is poorly soluble at the pH of body tissue; after subcutaneous injection it precipitates into a small depot and is absorbed slowly, producing a nearly peakless action profile. Sanofi markets it as Lantus (来得时) and a concentrated 300 units/mL version as Toujeo.
It improves glycaemic control in adults and children with diabetes and is explicitly not recommended for treating diabetic ketoacidosis. Doses are individualised: about one-third of the total daily insulin requirement in type 1 diabetes, or 0.2 units/kg (up to 10 units) once daily when starting in type 2 diabetes. Hypoglycaemia is the most common adverse reaction and may be life-threatening, and because it acts for about a day it can delay recovery. Injection site pain occurred in 2.7% of Lantus patients against 0.7% of NPH patients, and lipodystrophy, weight gain, oedema, pruritus and hypokalaemia are also recognised.
Copies of glargine are biosimilars rather than generics - highly similar biologics, not chemically identical products. Semglee, developed by Biocon Biologics with Viatris, was the first FDA-approved biosimilar of Lantus (June 2020) and in July 2021 became the first biosimilar ever granted interchangeable status, allowing pharmacy-level substitution. Eli Lilly's Basaglar (marketed as Abasaglar in some countries) is another approved biosimilar.
Storage is a strict cold chain requirement: unused vials and pens must be kept refrigerated at 2-8 degrees C and must never be frozen, and an in-use pen is kept below 30 degrees C and discarded after 28 days even if insulin remains.
Insulin Glargine price list — Bangladesh
Every DGDA-registered brand of this molecule with its list unit price, including the originator for comparison. Bangladesh is the most transparent reference market for on-patent generics.
| Brand | Manufacturer | Strength | Unit price | ≈ USD | Pack |
|---|---|---|---|---|---|
| Abasaglar | Healthcare Pharmaceuticals Ltd. (Mfg. by: Eli Lilly and Company) | 100 IU/ml SC Injection | — | — | 5's pack: ৳ 4,475.00 |
| Glarine | ACI Limited (Mfg. by: Swiss Made) | 100 IU/ml SC Injection | — | — | 3's pack: ৳ 2,400.00 |
| Insul Glargine | Popular Pharmaceuticals Ltd. | 100 IU/ml SC Injection | — | — | — |
| Insulet GN | Aristopharma Ltd. | 100 IU/ml SC Injection | — | — | — |
| Larsulin | Square Pharmaceuticals PLC | 100 IU/ml SC Injection | — | — | — |
| Mytus | Drug International Ltd. | 100 IU/ml SC Injection | — | — | 3's pack: ৳ 1,800.00 |
| Semglee | Beximco Pharmaceuticals Ltd. (Mfg. by: Mylan Laboratories Ltd.) | 100 IU/ml SC Injection | — | — | 5's pack: ৳ 5,080.00 |
| Toujeo SoloStar | Synovia Pharma PLC. | 300 IU/ml SC Injection | — | — | 3's pack: ৳ 6,915.00 |
| Vibrenta | Incepta Pharmaceuticals Ltd. | 100 IU/ml SC Injection | — | — | — |
| Lantus Originator | Synovia Pharma PLC. | 100 IU/ml SC Injection | — | — | 5's pack: ৳ 4,910.00 |
| Lantus SoloStar Originator | Synovia Pharma PLC. | 100 IU/ml SC Injection | — | — | 5's pack: ৳ 7,750.00 |
Source: MedEx Bangladesh drug registry (list prices of DGDA-registered brands). Unit prices move with pack size, pharmacy and exchange rate — reference only. Original registry page
How it works
Insulin glargine is a slow-release form of insulin. After injection it forms a small depot under the skin that releases insulin steadily over roughly a day, giving a flat, background (basal) level of insulin that keeps blood sugar stable between meals and overnight. It is not used to cover a meal - a rapid-acting insulin is used for that.
Insulin glargine is a long-acting human insulin analog produced by recombinant DNA technology: two arginine residues are added to the C-terminus of the B chain and the asparagine at position A21 is replaced by glycine, which shifts the isoelectric point to about pH 4 and makes the analog less soluble at physiological pH. This causes it to precipitate in the subcutaneous tissue after injection and to be absorbed slowly, giving a nearly peakless, approximately 24-hour glucose-lowering profile. Insulin glargine is partly metabolized at the carboxyl terminus of the B chain in the subcutaneous depot to two active metabolites, M1 (21A-Gly-insulin) and M2 (21A-Gly-des-30B-Thr-insulin), which retain in vitro activity similar to human insulin; unchanged drug and these degradation products also circulate. Like human insulin it promotes cellular glucose uptake (especially in skeletal muscle and fat) and inhibits hepatic glucose production.
Approved indications
- To improve glycemic control in adult and pediatric patients with diabetes mellitus (Lantus, US label)
- Not recommended for the treatment of diabetic ketoacidosis
- The biosimilar Semglee (insulin glargine-yfgn) is approved for the same indications: adults and pediatric patients with type 1 diabetes and adults with type 2 diabetes
Dosage & administration
Individualize the dose. Type 1 diabetes: start at approximately one-third of the total daily insulin requirement, with short-acting pre-meal insulin providing the remainder. Type 2 diabetes not currently treated with insulin: 0.2 units/kg or up to 10 units once daily. Administer subcutaneously into the abdominal area, thigh or deltoid once daily at any time of day but at the same time every day; do not dilute or mix with any other insulin or solution; do not administer intravenously or via an insulin pump; rotate injection sites within the same region.
Dose adjustment
Adjust for changes in physical activity, meal patterns, acute illness, and renal or hepatic function (patients with renal or hepatic impairment may be at higher risk of hypoglycemia); changes to an insulin regimen should be made under close medical supervision with increased glucose monitoring. Switching to Lantus: from once-daily Toujeo (insulin glargine U-300) use 80% of the Toujeo dose; from once-daily NPH use the same dose; from twice-daily NPH use 80% of the total NPH dose. In type 1 diabetes Lantus must be used with a short-acting insulin. The SoloStar pen dials in 1-unit increments and should be used with caution in patients with visual impairment who may rely on audible clicks.
Side effects
Hypoglycemia - the most common adverse reaction, and may be life-threatening; the long-acting effect may delay recovery · Injection site reactions - in clinical studies injection site pain occurred in 2.7% of Lantus patients vs 0.7% of NPH patients · Lipodystrophy and localized cutaneous amyloidosis at injection sites · Pruritus and rash · Peripheral edema (sodium retention and edema, especially after intensified insulin therapy) · Weight gain · Hypokalemia (shift of potassium into cells)
- Allergic reactions, including severe generalized allergy and anaphylaxis
Monitoring
- Blood glucose self-monitoring and HbA1c; increase the frequency of glucose monitoring during any change in insulin strength, manufacturer, type, injection site or method of administration
- Signs and symptoms of hypoglycemia, especially in patients with renal or hepatic impairment or hypoglycemia unawareness
- Potassium levels in patients at risk of hypokalemia (e.g., those on potassium-lowering drugs or drugs sensitive to serum potassium)
- Injection sites for lipodystrophy and localized cutaneous amyloidosis; advise patients to move injection sites to unaffected areas
- Signs and symptoms of heart failure in patients taking a thiazolidinedione (PPAR-gamma agonist) with insulin
Generic and biosimilar landscape
Insulin glargine copies are biosimilars, not generics: they are biologic products shown to be highly similar to Lantus with no clinically meaningful differences in safety, purity and potency, but they are not chemically identical products the way a small-molecule generic is. Semglee (insulin glargine-yfgn), co-developed by Biocon Biologics and Viatris (formerly Mylan), was first approved by the FDA in June 2020 as a biosimilar of Lantus and in July 2021 became the first biosimilar ever granted interchangeable status - meaning it may be substituted for Lantus at the pharmacy counter without the prescriber's intervention, with 12 months of exclusivity before another interchangeable glargine biosimilar could be approved. Semglee has an identical amino acid sequence to Lantus and is approved for the same indications. Even so, switching between insulin products of different brands must be done cautiously and under medical supervision, because changes in insulin strength, manufacturer, type or delivery device can affect glycemic control; the label recommends increased glucose monitoring during any such change and notes that some patients may need different doses.
Who makes it
| Manufacturer | Country | Brand | Strength | Notes |
|---|---|---|---|---|
| Biocon Biologics | India (drug product manufactured at Biocon Sdn. Bhd., Johor, Malaysia) | Semglee (insulin glargine-yfgn); also unbranded insulin glargine-yfgn | 100 IU/mL, 3 mL prefilled pen and vial | First FDA-approved biosimilar of Lantus (June 2020) and the first FDA-approved interchangeable biosimilar (July 2021), allowing pharmacy-level substitution for Lantus; identical am |
| Eli Lilly | United States | Basaglar (insulin glargine); marketed as Abasaglar in some markets | 100 IU/mL 3 mL KwikPen cartridge and prefilled pen | Approved biosimilar of Lantus. In Bangladesh listed as Abasaglar distributed by Healthcare Pharmaceuticals - 3 mL cartridge BDT 895, 3 mL KwikPen BDT 1,350. |
| Gan & Lee Pharmaceuticals | China | Basalin (insulin glargine injection and prefilled pen) | 100 IU/mL | Insulin glargine injection and prefilled pen manufactured with a Malaysian partner received NPRA (Malaysia) registration approval in February 2025; a locally filled insulin glargin |
| Wockhardt | India | Glaritus (insulin glargine) | 100 IU/mL | Biosimilar insulin glargine available in India for type 1 and type 2 diabetes; Reuters reported the launch of Glaritus in India in 2009 as a version of Sanofi's Lantus. Wockhardt i |
| Multiple local manufacturers | Bangladesh | Glarine (ACI Limited), Larsulin (Square Pharmaceuticals), Mytus (Drug International), Vibrenta (Incepta), Insulet GN (Aristopharma), Insul Glargine (Popular Pharmaceuticals) | 100 IU/mL (vials, cartridges, pens) | Locally marketed insulin glargine brands listed with prices on MedEx; ACI's Glarine is noted as Swiss-made. Useful as a low-price benchmark in a South Asian market - several 3 mL v |
| Lannett Company | United States | Langlara (insulin glargine-aldy) | 100 units/mL prefilled pen | FDA-approved interchangeable biosimilar to Lantus, cited in market reporting as further expanding pharmacy substitution options for insulin glargine in the US. |
Availability in Southeast Asia
| Country | Status | Notes |
|---|---|---|
| Malaysia | available / locally manufactured | Biocon Sdn Bhd's insulin manufacturing facility in Johor (Asia's largest integrated insulin facility) is approved by Malaysia's NPRA and is the site that produces biosimilar insulin glargine; the NPRA also granted registration approval to Gan & Lee's insulin glargine injection and prefilled pen in February 2025. |
| Indonesia | available | A locally filled insulin glargine prefilled pen developed by Gan & Lee with an Indonesian partner was approved by the Indonesian Ministry of Health (announced December 2022); biosimilar insulins are described as more affordable than the imported originator. |
| Bangladesh (South Asia benchmark) | available | Lantus, Lantus SoloStar, Toujeo, Abasaglar and Semglee plus at least six local brands are listed with prices on MedEx. Not Southeast Asia; included as a regional price benchmark. |
Price by country
Reference prices by market
| Market | Product | Listed price | Source |
|---|---|---|---|
| Bangladesh | Lantus 100 IU/mL 3 mL cartridge (Synovia Pharma PLC) | BDT 982.00 (5's pack BDT 4,910.00) | medex.com.bd |
| Bangladesh | Lantus SoloStar 100 IU/mL 3 mL pen (Synovia Pharma PLC) | BDT 1,550.00 (5's pack BDT 7,750.00) | medex.com.bd |
| Bangladesh | Semglee 100 IU/mL 3 mL cartridge (Beximco Pharmaceuticals, mfg. Mylan Laboratories Ltd.) | BDT 1,016.00 (5's pack BDT 5,080.00) | medex.com.bd |
| Bangladesh | Abasaglar 100 IU/mL 3 mL cartridge / KwikPen (Healthcare Pharmaceuticals, mfg. Eli Lilly) | BDT 895.00 cartridge (5's BDT 4,475.00); BDT 1,350.00 KwikPen (5's BDT 6,750.00) | medex.com.bd |
| Bangladesh | Toujeo SoloStar 300 IU/mL 1.5 mL (Synovia Pharma PLC) | BDT 2,305.00 (3's pack BDT 6,915.00) | medex.com.bd |
| United States | Unbranded Semglee (insulin glargine-yfgn) | as low as USD 58.04 at certain pharmacies with a GoodRx coupon | goodrx.com |
Frequently asked questions
Is there a biosimilar version of Lantus (insulin glargine)?
Insulin glargine copies are biosimilars, not generics: they are biologic products shown to be highly similar to Lantus with no clinically meaningful differences in safety, purity and potency, but they are not chemically identical products the way a small-molecule generic is. Semglee (insulin glargine-yfgn), co-developed by Biocon Biologics and Viatris (formerly Mylan), was first approved by the FDA in June 2020 as a biosimilar of Lantus and in July 2021 became the first biosimilar ever granted interchangeable status - meaning it may be substituted for Lantus at the pharmacy counter without the prescriber's intervention, with 12 months of exclusivity before another interchangeable glargine biosimilar could be approved. Semglee has an identical amino acid sequence to Lantus and is approved for the same indications. Even so, switching between insulin products of different brands must be done cautiously and under medical supervision, because changes in insulin strength, manufacturer, type or delivery device can affect glycemic control; the label recommends increased glucose monitoring during any such change and notes that some patients may need different doses. Manufacturers supplying insulin glargine generic versions include Biocon Biologics, Eli Lilly, Gan & Lee Pharmaceuticals, Lannett Company, Multiple local manufacturers, Wockhardt. Brands registered in Bangladesh include Abasaglar, Glarine, Insul Glargine, Insulet GN, Lantus, Lantus SoloStar.
What is the difference between a biosimilar and a generic medicine for insulin?
Insulin glargine copies are biosimilars, not generics: they are biologic products shown to be highly similar to Lantus with no clinically meaningful differences in safety, purity and potency, but they are not chemically identical products the way a small-molecule generic is. Semglee (insulin glargine-yfgn), co-developed by Biocon Biologics and Viatris (formerly Mylan), was first approved by the FDA in June 2020 as a biosimilar of Lantus and in July 2021 became the first biosimilar ever granted interchangeable status - meaning it may be substituted for Lantus at the pharmacy counter without the prescriber's intervention, with 12 months of exclusivity before another interchangeable glargine biosimilar could be approved. Semglee has an identical amino acid sequence to Lantus and is approved for the same indications. Even so, switching between insulin products of different brands must be done cautiously and under medical supervision, because changes in insulin strength, manufacturer, type or delivery device can affect glycemic control; the label recommends increased glucose monitoring during any such change and notes that some patients may need different doses. Manufacturers supplying insulin glargine generic versions include Biocon Biologics, Eli Lilly, Gan & Lee Pharmaceuticals, Lannett Company, Multiple local manufacturers, Wockhardt. Brands registered in Bangladesh include Abasaglar, Glarine, Insul Glargine, Insulet GN, Lantus, Lantus SoloStar.
Is Semglee interchangeable with Lantus at the pharmacy?
Insulin Glargine (Long-acting (basal) recombinant human insulin analog, 100 units/mL (U-100); a 300 units/mL (U-300) version is marketed as Toujeo, originally Lantus (来得时); Toujeo / Toujeo Max (U-300) by Sanofi) Insulin glargine is a slow-release form of insulin. After injection it forms a small depot under the skin that releases insulin steadily over roughly a day, giving a flat, background (basal) level of insulin that keeps blood sugar stable between meals and overnight. It is not used to cover a meal - a rapid-acting insulin is used for that. Individualize the dose. Type 1 diabetes: start at approximately one-third of the total daily insulin requirement, with short-acting pre-meal insulin providing the remainder. Type 2 diabetes not currently treated with insulin: 0.2 units/kg or up to 10 units once daily. Administer subcutaneously into the abdominal area, thigh or deltoid once daily at any time of day but at the same time every day; d
How long does insulin glargine last in the body?
Insulin Glargine (Long-acting (basal) recombinant human insulin analog, 100 units/mL (U-100); a 300 units/mL (U-300) version is marketed as Toujeo, originally Lantus (来得时); Toujeo / Toujeo Max (U-300) by Sanofi) Insulin glargine is a slow-release form of insulin. After injection it forms a small depot under the skin that releases insulin steadily over roughly a day, giving a flat, background (basal) level of insulin that keeps blood sugar stable between meals and overnight. It is not used to cover a meal - a rapid-acting insulin is used for that. Individualize the dose. Type 1 diabetes: start at approximately one-third of the total daily insulin requirement, with short-acting pre-meal insulin providing the remainder. Type 2 diabetes not currently treated with insulin: 0.2 units/kg or up to 10 units once daily. Administer subcutaneously into the abdominal area, thigh or deltoid once daily at any time of day but at the same time every day; d
How should insulin glargine be stored before and after first use?
Storage: Dispense in the original sealed carton. Store unused Lantus in a refrigerator between 2 degrees C and 8 degrees C (36-46 degrees F); do not freeze and discard if it has been frozen; protect from direct heat and light. Unopened vials or pens may be used until the expiration date if kept refrigerated. In-use (opened) product: keep at room temperature below 30 degrees C (86 degrees F) away from heat and light, store with the pen cap on, do NOT put an in-use pen back in the refrigerator, do not store with a needle attached, and use for only 28 days after first use before discarding even if insulin remains. For Toujeo (U-300) the in-use period is 56 days at room temperature only, and in-use pens must not be refrigerated. Keep the product in its original packaging and check the expiry date printed on the pack.
What happens if insulin glargine freezes?
Insulin Glargine (Long-acting (basal) recombinant human insulin analog, 100 units/mL (U-100); a 300 units/mL (U-300) version is marketed as Toujeo, originally Lantus (来得时); Toujeo / Toujeo Max (U-300) by Sanofi) Insulin glargine is a slow-release form of insulin. After injection it forms a small depot under the skin that releases insulin steadily over roughly a day, giving a flat, background (basal) level of insulin that keeps blood sugar stable between meals and overnight. It is not used to cover a meal - a rapid-acting insulin is used for that. Individualize the dose. Type 1 diabetes: start at approximately one-third of the total daily insulin requirement, with short-acting pre-meal insulin providing the remainder. Type 2 diabetes not currently treated with insulin: 0.2 units/kg or up to 10 units once daily. Administer subcutaneously into the abdominal area, thigh or deltoid once daily at any time of day but at the same time every day; d
Can insulin glargine be mixed with rapid-acting insulin in the same syringe?
Insulin Glargine (Long-acting (basal) recombinant human insulin analog, 100 units/mL (U-100); a 300 units/mL (U-300) version is marketed as Toujeo, originally Lantus (来得时); Toujeo / Toujeo Max (U-300) by Sanofi) Insulin glargine is a slow-release form of insulin. After injection it forms a small depot under the skin that releases insulin steadily over roughly a day, giving a flat, background (basal) level of insulin that keeps blood sugar stable between meals and overnight. It is not used to cover a meal - a rapid-acting insulin is used for that. Individualize the dose. Type 1 diabetes: start at approximately one-third of the total daily insulin requirement, with short-acting pre-meal insulin providing the remainder. Type 2 diabetes not currently treated with insulin: 0.2 units/kg or up to 10 units once daily. Administer subcutaneously into the abdominal area, thigh or deltoid once daily at any time of day but at the same time every day; d
What is the difference between Lantus and Toujeo?
Insulin Glargine (Long-acting (basal) recombinant human insulin analog, 100 units/mL (U-100); a 300 units/mL (U-300) version is marketed as Toujeo, originally Lantus (来得时); Toujeo / Toujeo Max (U-300) by Sanofi) Insulin glargine is a slow-release form of insulin. After injection it forms a small depot under the skin that releases insulin steadily over roughly a day, giving a flat, background (basal) level of insulin that keeps blood sugar stable between meals and overnight. It is not used to cover a meal - a rapid-acting insulin is used for that. Individualize the dose. Type 1 diabetes: start at approximately one-third of the total daily insulin requirement, with short-acting pre-meal insulin providing the remainder. Type 2 diabetes not currently treated with insulin: 0.2 units/kg or up to 10 units once daily. Administer subcutaneously into the abdominal area, thigh or deltoid once daily at any time of day but at the same time every day; d
What are the most common side effects of insulin glargine?
The most frequently reported side effects of insulin glargine are hypoglycemia - the most common adverse reaction, and may be life-threatening; the long-acting effect may delay recovery, allergic reactions, including severe generalized allergy and anaphylaxis, injection site reactions - in clinical studies injection site pain occurred in 2.7% of lantus patients vs 0.7% of nph patients, lipodystrophy and localized cutaneous amyloidosis at injection sites, pruritus and rash, peripheral edema (sodium retention and edema, especially after intensified insulin therapy), weight gain. Routine monitoring: Blood glucose self-monitoring and HbA1c; increase the frequency of glucose monitoring during any change in insulin strength, manufacturer, type, injection site or method of administration; Signs and symptoms of hypoglycemia, especially in patients with renal or hepatic impairment or hypoglycemia unawareness; Potassium levels in patients at risk of hypokalemia (e.g., those on potassium-lowering drugs or drugs sensitive to serum potassium). Report any new or worsening symptom to your treating physician — most adverse effects are managed by dose reduction rather than stopping treatment.
How do I switch from NPH insulin or Toujeo to insulin glargine 100 units/mL?
Insulin Glargine (Long-acting (basal) recombinant human insulin analog, 100 units/mL (U-100); a 300 units/mL (U-300) version is marketed as Toujeo, originally Lantus (来得时); Toujeo / Toujeo Max (U-300) by Sanofi) Insulin glargine is a slow-release form of insulin. After injection it forms a small depot under the skin that releases insulin steadily over roughly a day, giving a flat, background (basal) level of insulin that keeps blood sugar stable between meals and overnight. It is not used to cover a meal - a rapid-acting insulin is used for that. Individualize the dose. Type 1 diabetes: start at approximately one-third of the total daily insulin requirement, with short-acting pre-meal insulin providing the remainder. Type 2 diabetes not currently treated with insulin: 0.2 units/kg or up to 10 units once daily. Administer subcutaneously into the abdominal area, thigh or deltoid once daily at any time of day but at the same time every day; d
Sources
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/021081s076lbl.pdf
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/206538Orig1s017Lbl.pdf
- https://www.prnewswire.com/news-releases/viatris-inc-and-biocon-biologics-receive-historic-approval-for-first-interchangeable-biosimilar-semglee-insulin-glargine-yfgn-injection-for-the-treatment-of-diabetes-301343915.html
- https://gabionline.net/biosimilars/general/interchangeable-insulin-glargine-biosimilars-available-through-prime-therapeutics-and-walgreens
- https://www.bioconbiologics.com/our-business/global-biosimilars-portfolio/insulin-glargine
- https://www.biocon.com/more/biocon-malaysia
- https://www.ganlee.com/detail/766.html
- https://www.ganlee.com/detail/682.html
- https://www.reuters.com/article/wockhardt-insulin-idINBOM36661820090210
- https://adisinsight.springer.com/drugs/800038655
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3507590
- https://medex.com.bd/generics/614/insulin-glargine/brand-names
- https://www.goodrx.com/lantus/semglee-vs-lantus-diabetes
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