What is Rezvoglar (insulin glargine)?

Rezvoglar: A Long-Acting Insulin Analog

Rezvoglar is a long-acting insulin glargine analog used to improve glycemic control in patients with diabetes mellitus, providing consistent basal insulin coverage for approximately 24 hours without pronounced peaks. 1

What is Rezvoglar?

Rezvoglar is a biosimilar insulin glargine product that:

• Is a long-acting human insulin analog produced by recombinant DNA technology
• Is indicated for improving glycemic control in adults and pediatric patients with diabetes mellitus
• Provides relatively constant basal insulin levels for approximately 24 hours without pronounced peaks
• Is administered as a subcutaneous injection once daily at the same time each day
• Is not recommended for treating diabetic ketoacidosis 1

Mechanism of Action

Rezvoglar works through a unique mechanism:

• It has modifications that make it soluble in acidic conditions (pH 4.0) but precipitate in the neutral pH of subcutaneous tissue
• This precipitation delays absorption, creating a depot that slowly releases insulin molecules
• The result is a relatively constant concentration/time profile over 24 hours with no pronounced peak 2, 3

Clinical Benefits

Rezvoglar offers several advantages over traditional NPH insulin:

• Provides more consistent basal insulin coverage without pronounced peaks
• Reduces risk of hypoglycemia, especially nocturnal hypoglycemia
• Moderate-quality evidence shows fewer severe hypoglycemic events (OR 0.65 [95% CI, 0.49 to 0.88]) compared to NPH insulin 4, 2
• Can be administered once daily, improving convenience and potentially adherence
• Achieves equivalent glycemic control to NPH insulin given once or twice daily 5

Dosing and Administration

For insulin-naïve patients with type 2 diabetes:

• Initial dose: 0.1-0.2 units/kg/day or 10 units once daily
• Administer subcutaneously at the same time each day
• Adjust dose based on fasting glucose levels, typically increasing by 2-4 units every 3-7 days until target glucose is achieved
• Monitor for hypoglycemia during dose adjustments 6

For patients already on insulin:

• When switching from once-daily NPH insulin, the initial dose of Rezvoglar is usually the same as the NPH dose
• When switching from twice-daily NPH insulin, the initial Rezvoglar dose is typically reduced by 20-30% from the total daily NPH dose
• Further dose adjustments should be individualized based on glucose response 6

Storage and Handling

• Unopened vials/pens: Store in refrigerator between 36°F to 46°F (2°C to 8°C)
• Opened (in-use) vials/pens: Can be stored at room temperature below 86°F (30°C) for up to 28 days
• Do not freeze; discard if frozen
• Keep away from direct heat and light
• Discard after 28 days of first use, even if insulin remains 1

Important Safety Considerations

• Never share Rezvoglar pens, needles, or syringes between patients due to risk of blood-borne pathogen transmission
• Do not mix Rezvoglar with other insulins due to its acidic pH
• Monitor for hypoglycemia, especially when initiating therapy or changing doses
• Check blood glucose levels regularly as directed by healthcare provider
• Always verify the insulin label before each injection to avoid medication errors 1

Practical Considerations

• Rezvoglar does not treat postprandial hyperglycemia; short-acting insulin at mealtimes may be needed to control glucose surges after meals 2
• In patients with type 2 diabetes, it is often the first insulin introduced when oral medications are insufficient 2
• For patients with highly variable insulin requirements or those requiring large doses, splitting the dose into twice-daily administration may be beneficial 6, 2
• Consider adding GLP-1 receptor agonists to improve glycemic control and reduce insulin requirements when appropriate 6

Rezvoglar represents an important option in diabetes management, offering consistent basal insulin coverage with reduced risk of hypoglycemia compared to traditional NPH insulin, potentially improving both safety and treatment satisfaction for patients with diabetes.