Calculating Toujeo Volume for 80 Units Daily
For a patient requiring 80 units of Toujeo (insulin glargine) daily, the prescribed volume would be 0.27 mL, as Toujeo comes in a concentration of 300 units/mL.
Understanding Toujeo Concentration and Calculation
Toujeo is a long-acting basal insulin analog that comes in a concentration of 300 units/mL, which is three times more concentrated than standard U-100 insulin formulations. This higher concentration allows for smaller injection volumes for the same insulin dose.
To calculate the volume needed:
- Toujeo concentration: 300 units/mL
- Required dose: 80 units
- Volume calculation: 80 units ÷ 300 units/mL = 0.267 mL (rounded to 0.27 mL)
Dosing and Administration Considerations
When prescribing Toujeo:
- The insulin is administered subcutaneously once daily at the same time each day
- The SoloStar pen delivers Toujeo in 1-unit increments, with a maximum single dose of 80 units
- The pen should be primed with 3 units before first use to ensure proper functioning
- Injection sites should be rotated to prevent lipodystrophy
Clinical Context
Toujeo provides relatively constant basal insulin levels with no pronounced peak over 24 hours, similar to continuous subcutaneous insulin infusion 1, 2. This pharmacokinetic profile offers several advantages:
- Lower risk of nocturnal hypoglycemia compared to NPH insulin 3, 4
- Once-daily dosing for most patients
- Stable glucose control with less variability
Important Considerations
- Initial dosing for insulin-naïve patients typically starts at 0.1-0.2 units/kg/day (10-20 units for a 100 kg person) 5
- For patients switching from other basal insulins, dose conversion may be needed
- Overbasalization should be monitored for (signs include basal dose >0.5 units/kg, high bedtime-morning glucose differential, hypoglycemia, or high variability) 5
- Toujeo should not be diluted or mixed with any other insulin products
Monitoring and Titration
After initiating Toujeo:
- Adjust dosing based on fasting glucose levels
- Titration is typically done in 2-4 unit increments every 3-4 days until target glucose levels are achieved
- Regular blood glucose monitoring is essential, especially when initiating or changing doses
Remember that while Toujeo provides basal insulin coverage, it does not address postprandial glucose excursions, which may require additional prandial insulin coverage in patients with type 1 diabetes or advanced type 2 diabetes.