What is the maximum dose of Lantus (insulin glargine) per injection?

Maximum Dose of Lantus (Insulin Glargine) Per Injection

There is no specified maximum dose of Lantus (insulin glargine) per injection, as dosing should be based on individual patient needs and insulin requirements.

Dosing Considerations for Lantus

• Lantus (insulin glargine) is a long-acting basal insulin analog designed to provide relatively constant, peakless insulin levels over approximately 24 hours 1
• It is typically administered as a once-daily subcutaneous injection to provide basal glycemic control in adults and children with diabetes 2
• The dose is individualized based on the patient's metabolic needs, blood glucose monitoring results, and glycemic control goals 2

Administration Recommendations

• Lantus can be administered at any time of day, but should be given at the same time each day for consistent glycemic control 3
• It can be administered either in the morning or at bedtime with similar efficacy and safety profiles 3
• In obese, insulin-resistant patients, it may be beneficial to administer insulin glargine in two separate injections due to the high volumes required 1

Practical Considerations

• For patients with type 2 diabetes initiating insulin therapy, a common starting dose is 0.15 units/kg/day 4
• Dose adjustments are typically made based on fasting blood glucose levels and HbA1c targets 4
• A simplified dose calculation formula suggested for patients starting glargine is: optimal daily dose = starting dose (0.15 × weight in kg) + incremental dose (baseline HbA1c - target HbA1c + 2) 4

Special Populations

• Lower starting doses may be appropriate for:
  • Patients with retinopathy (0.120 units/kg/day) 4
  • Patients with eGFR <60 mL/min/1.73 m² (0.114 units/kg/day) 4
  • Women (0.135 units/kg/day) 4
  • Patients taking sulfonylureas (0.132 units/kg/day) 4

Clinical Monitoring

• The American Diabetes Association recommends assessing efficacy and safety at least monthly for the first 3 months and at least quarterly thereafter 5
• Increased frequency of blood glucose monitoring is advised during changes to insulin regimen 5

Important Considerations

• Lantus should not be mixed or diluted with any other insulin or solution as this may alter its action profile 2
• In clinical practice, high doses of insulin glargine can be administered safely when needed, with the primary limiting factor being the volume of injection rather than a specific maximum dose 1
• For patients requiring very large doses, splitting the total daily dose into two injections may improve both comfort and absorption 1