Insulin Glargine and Lixisenatide (Subcutaneous)

Overview

Type 2 diabetes, a condition also referred to as diabetes mellitus or sugar diabetes, can be effectively managed by taking the combination of insulin glargine and lixisenatide. This long-acting medication is active over a 24-hour period and helps to keep blood sugar levels as close as possible to typical levels. As there is no cure for type 2 diabetes, managing the symptoms of the condition, typically out-of-range blood sugar levels, is the desired result of these medications.

Patients that suffer from type 2 diabetes may not produce enough insulin, or the insulin that their body does produce is not utilized properly. This medication is typically for use in patients for whom changes in their diet and level of exercise are insufficient measures to keep their blood sugar levels in a healthy range.

Your doctor will likely advise that you follow a special meal plan that will also help to keep your blood sugar in safe levels. It is important to follow this plan as closely as possible and to also incorporate any suggested to your exercise habits and overall level of activity. Many physicians recommend that type 2 diabetes patients undergo counseling with their families and caregivers to go over the necessary lifestyle changes that come with treating type 2 diabetes.

It is also helpful to have a strong support network when making these changes, and your doctor will want to help provide that for you. If you have any questions about meal and food preparation or daily exercise routines, your healthcare team can work with you to find an effective regimen for you.

Type 2 diabetes and its treatment with insulin glargine and lixisenatide can cause incidences of low blood sugar, which in some cases can lead to fainting. Patients are encouraged to carry a small snack with them at all times, or a beverage such as a fruit juice, that can help to quickly restore their blood sugar levels to safe levels.

It is also recommended that patients wear an identification bracelet or another emblem that clearly states that they are diabetic as this can provide emergency medical responders with valuable information. Identification cards that list all of the patients current medications and their dosage are also helpful to carry on one's person.

Conditions Treated

Type Of Medicine

  • Insulin

Side Effects

Similar to most medications, insulin glargine and lixisenatide can cause unwanted side effects in addition to its prescribed results. Patients should familiarize themselves with the potentially serious symptoms as they may be a sign of a more serious issue and require immediate medical advice and attention. Other symptoms that are less serious often occur as the body adjusts to the introduction of the insulin glargine and lixisenatide. If you experience any significant side effects or the symptoms become worse or linger longer than a few days, it is always best practice to consult with your doctor for further advice.

It is important to check with your doctor immediately if you experience any of the following side effects as they can be a sign of a more serious problem:

An unknown incidence of occurrence:

  • Abdominal or stomach pain
  • Unexplained weight loss
  • Bloating
  • Tightness in the chest
  • Chills
  • Stupor
  • Cold, clammy skin
  • Rapid weight gain
  • Confusion
  • Pains in the stomach, side, or abdomen
  • Convulsions
  • Noisy breathing
  • Coughing
  • Nausea or vomiting
  • Difficulty swallowing
  • Muscle pain or cramps
  • Dizziness, faintness, or lightheadedness
  • Lightheadedness
  • Fast heartbeat
  • Irregular heartbeat
  • Fever
  • Increased urination
  • Fruit-like breath odor
  • Increased hunger
  • Hives, itching, or rash
  • Constipation
  • Increased thirst
  • Headaches
  • Indigestion
  • Flushed, dry skin
  • Irritability
  • Yellow eyes or skin
  • Lethargy
  • Fast, weak pulse
  • Loss of appetite
  • Dry mouth
  • Muscle twitching
  • Dizziness
  • Nightmares
  • Decreased urine output
  • Numbness or tingling in the hands, feet, or lips
  • Cool, pale skin
  • Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Hostility
  • Slurred speech
  • Coma
  • Sweating
  • Cold sweats
  • Troubled breathing
  • Blurred vision
  • Unusual tiredness or weakness
  • Agitation
  • Large, hive-like swelling of the face, eyelids, lips

In addition to negative reactions to insulin glargine and lixisenatide that require immediate medical attention, there are other symptoms that can be a temporary reaction as your body adjusts to the introduction of this medication. If you experience any of the following side effects, they should go away on their own after a few days. If they linger for a more substantial period of time or become worse, it is advised that you check with your doctor for further medical advice:

More likely:

  • Muscle aches
  • Body aches or pain
  • Sore throats
  • Ear congestion
  • Stuffy or a runny nose
  • Sneezing
  • Loss of voice
  • Diarrhea

An unknown incidence of occurrence:

  • Bleeding
  • Stinging
  • Burning
  • Scarring
  • Discoloration of the skin
  • Rash
  • Hives, infection
  • Numbness
  • Itching
  • Tenderness, tingling, ulceration, or warmth at the injection site
  • Pain
  • Inflammation
  • Redness
  • Lumps
  • Feeling of pressure
  • Soreness
  • Coldness
  • Swelling
  • Blistering

It is also possible that patients may experience side effects that are not listed here. If you have any symptoms while taking insulin glargine and lixisenatide that last longer than a few days or become worse, it is advisable that you inform your doctor and receive further medical advice.

Dosage

This medication may be given to you at your doctor's office or you may be trained to self-administer the medication at home. If you have any hesitation with injection yourself with this medication, speak with your doctor or another member of your medical team for further guidance and information on possible alternatives.

Prior to injecting the insulin glargine and lixisenatide, you will need to double check the strength, or concentration, as well as the dosage. It is important that this extra check is completed with every injection. The units of insulin that are contained in each milliliter indicate the concentration of the drug, while the number of milliliters that you take equals the dosage amount.

Before you start self-administering insulin glargine and lixisenatide be sure that you understand the following:

  • Proper preparation of the medication
  • How to safely inject the insulin glargine and lixisenatide
  • Safe and appropriate disposal procedures for any needles, syringes, and other injection devices

Alternate the location of the injection each time you administer the drug in order to avoid infection and other complications that can arise from repeated injections in the same location. If you have any questions regarding the best practices to follow when taking this medication and performing the injections, it is always best practice to consult with a member of your medical team to receive adequate information for you to feel comfortable with the process.

Patients are advised to administer the medication at the same time each day in order to keep the necessary level of medication in their system at all times.

The insulin glargine and lixisenatide solution will appear colorless and clear; if it has a thick or cloudy appearance it should not be used and should be disposed of properly.

In addition to this medication, your doctor will likely recommend an adapted meal plan to you. It is important that this plan is closely followed as the foods that you eat can have a significant impact on your blood sugar levels. Additional exercise and activity will also be advised and these changes should be made to your daily routine. In addition to changes in your diet and activity levels, patients will also need to test their blood sugar levels on a regular basis.

The guidelines listed below reflect the typical dosages that are utilized in patients taking insulin glargine and lixisenatide. Your doctor may prescribe a different amount; in such cases, you must always follow the dosage instructions that are prescribed by your physician.

Do not change the way you take insulin glargine and lixisenatide or stop taking it without first consulting with your doctor.

In cases where insulin glargine and lixisenatide is utilized by children, their pediatrician will determine the amount of the dose on a case by case basis.

Patients that are taking insulin glargine and lixisenatide for type 2 diabetes via the injection method:

Your dosage amount will likely vary due to the fluctuations in your daily blood sugar levels, your doctor will determine your target level and prescribe the appropriate dosage level based on that information.

If you forget to take a dosage amount it is important that you check with your pharmacist for further direction. Do not ever take a double dose to make up for one that you may have forgotten about or skipped.

Major Drug Interactions

There are certain other medications that are contraindicated for use with insulin glargine and lixisenatide. Prior to beginning your insulin glargine and lixisenatide course of treatment, it is important that you inform your doctor of your comprehensive medical history including all medications that you are currently taking and of any allergies that you have to medications, foods, animals, cleaning solutions, or other substances. Inform your doctor of any over the counter medications that you take, such as cold and allergy symptom relievers, pain relievers, herbal remedies, and all vitamin and mineral supplements.

While the use of insulin glargine and lixisenatide with the following list of drugs is not recommended, it may be the most effective way to treat your type 2 diabetes. If you are currently taking one of the following medications and your doctor prescribes insulin glargine and lixisenatide be sure to discuss any cautionary steps that you may need to take:

  • Acetohexamide
  • Tolbutamide
  • Besifloxacin
  • Thioctic Acid
  • Ciprofloxacin
  • Rufloxacin
  • Dienogest
  • Prulifloxacin
  • Enoxacin
  • Pioglitazone
  • Ethinyl Estradiol
  • Pazufloxacin
  • Etonogestrel
  • Ofloxacin
  • Flumequine
  • Norgestrel
  • Gemifloxacin
  • Norfloxacin
  • Gliclazide
  • Nadifloxacin
  • Glipizide
  • Metreleptin
  • Glyburide
  • Lomefloxacin
  • Levofloxacin
  • Gatifloxacin
  • Liraglutide
  • Levonorgestrel
  • Mestranol
  • Lanreotide
  • Moxifloxacin
  • Gliquidone
  • Norethindrone
  • Glimepiride
  • Norgestimate
  • Gestodene
  • Octreotide
  • Pasireotide
  • Fleroxacin
  • Pefloxacin
  • Ethynodiol
  • Pramlintide
  • Estradiol
  • Rosiglitazone
  • Drospirenone
  • Sparfloxacin
  • Desogestrel
  • Tolazamide
  • Chlorpropamide
  • Balofloxacin
  • Tosufloxacin

Taking insulin glargine and lixisenatide with this next group of medications may increase your chance of experiencing unwanted side effects. If it is determined by your doctor that the combination of insulin glargine and lixisenatide with one of the following medications represents that best course of treatment for you, they may change the dosage or frequency with which you take one or both of the medications:

  • Acebutolol
  • Timolol
  • Albiglutide
  • Selegiline
  • Betaxolol
  • Rasagiline
  • Carteolol
  • Procarbazine
  • Celiprolol
  • Pindolol
  • Esmolol
  • Penbutolol
  • Furazolidone
  • Nialamide
  • Insulin Aspart, Recombinant
  • Nadolol
  • Insulin Degludec
  • Metoprolol
  • Insulin Glargine, Recombinant
  • Methylene Blue
  • Insulin Lispro, Recombinant
  • Linezolid
  • Dulaglutide
  • Levobunolol
  • Labetalol
  • Lixisenatide
  • Iproniazid
  • Metipranolol
  • Insulin Glulisine
  • Moclobemide
  • Insulin Detemir
  • Nebivolol
  • Insulin Bovine
  • Oxprenolol
  • Insulin
  • Phenelzine
  • Exenatide
  • Practolol
  • Isocarboxazid
  • Propranolol
  • Carvedilol
  • Safinamide
  • Bisoprolol
  • Sotalol
  • Atenolol
  • Tranylcypromine

If you use tobacco products or drink alcohol on a regular basis, these habits may affect the way that insulin glargine and lixisenatide works within your symptoms. When discussing your medical history with your doctor prior to starting your insulin glargine and lixisenatide course of treatment, be sure that they are aware of these lifestyle habits. While you are taking insulin glargine and lixisenatide it is important to inform your doctor of any changes to your medical conditions, medications that you are taking, and any changes to your overall health and wellbeing.

Patients that suffer from any of the following medical conditions may have a higher occurrence of unwanted side effects, or the use of insulin glargine and lixisenatide may have a negative effect on their treatment. Inform your doctor of any complications that you experience if you suffer from:

Warnings

Do not share your insulin pen with anyone else. The sharing of any type of injection device can increase the likelihood of contracting HIV/AIDS, hepatitis, and a number of other illnesses that are transmitted via blood.

When you are starting this medication your doctor will likely order some diagnostic tests such as blood or urine tests to monitor the effectiveness of the medication as well as to detect and manage any unwanted side effects.

There are certain instances and substances that can cause unwanted side effects, or even be dangerous when taken with this medication. With that in mind, be sure to follow all medical advice provided by your doctor or another member of your the medical staff that is caring for you. Pay special attention to the following:

  • Alcohol can have a serious impact on your blood sugar level, and its use while taking this medication should be thoroughly discussed with your doctor. It is best to avoid drinking any alcoholic beverages while taking this medication but if you are unable to do that, it is important that you are honest with your doctor about your usage.
  • Make sure to inform your doctor of all of the medications, herbal remedies, and supplements that you are taking. Do not begin taking a new medication without first discussing the impact with your doctor. This is especially true of any over the counter medications, especially those taken for treatment of cold and allergy symptoms.
  • It is important that you, your family, and any caregivers are familiar with your diabetes and its proper treatment. Because you will likely be advised to start a modified meal plan your family should also be counseled to be supportive of the necessary changes that you will need to make for the successful treatment of your diabetes. It is also helpful for your family to encourage you in the lifestyle changes that you will need to make. Adopting a habit of regular family exercise can help to make these changes enjoyable for all.
  • Patients are advised to carry a sufficient amount of medication with them while traveling; in fact, it is advised that additional dosages be taken along in case of any delays that may occur and extend the length of the trip.
  • Be prepared for emergencies that may occur as the result of sudden changes in your blood sugar levels. Patients are encouraged to take all possible steps to avoid losing consciousness. Prior to operating heavy machinery or driving, it is strongly advised that you fully understand how your system reacts to your medication. Do not engage in these activities if you often feel dizzy or lightheaded after taking it.

Patients that are currently being treated for type 2 diabetes are encouraged to:

  • Carry an information card in their wallet that clearly states that they suffer from type 2 diabetes and provides information on all of their medications and how they take them. This information can also be relayed by an identification medallion or bracelet that is worn at all times.
  • Type 2 diabetes patients are encouraged to carry an extra dosage of medication with themselves at all times along with all of the necessary equipment to administer an emergency dose of insulin. It advised that a family member or close friend is also trained to administer your insulin glargine and lixisenatide in case of emergency.
  • If you suffer from low blood sugar and often feel faint or lightheaded, it is a good idea to carry candy or fruit juice with you in order to avoid such symptoms.

Patients and their caregivers should be aware of the signs of low blood sugar:

  • Shakiness
  • Blurred vision
  • Nightmares
  • Confusion
  • Irritability or abnormal behavior
  • Dizziness or lightheadedness
  • Fast heartbeat
  • Excessive hunger
  • Anxiety
  • Headaches
  • Drowsiness
  • Nervousness
  • Difficulty in thinking
  • Restless sleep
  • Cold sweat
  • Slurred speech
  • Behavior change similar to being drunk
  • Tingling in the hands, feet, lips, or tongue

Storage

It is always best to keep all medications in its original packaging. Unused and unopened medicinal pens can be stored in the refrigerator away from direct light. If you have opened one of the injection pens it can be stored for up to two weeks at room temperature. All medications that have not been used in a two-week period should not be used and should be disposed of properly.

Keep this and all medications out of the reach of children and pets.

Patients should not use any medication that is older than two weeks. Do not keep excess or unused medicine in the home. If you are unsure how to properly and safely dispose of excess medication or any of other equipment related to your insulin, confer with your pharmacist for further medical advice.

Summary

Type 2 diabetes, a condition also referred to as diabetes mellitus or sugar diabetes, can be effectively managed by taking the combination of insulin glargine and lixisenatide. This long-acting medication is active over a 24-hour period and helps to keep blood sugar levels as close as possible to typical levels. As there is no cure for type 2 diabetes, managing the symptoms of the condition, typically out-of-range blood sugar levels, is the desired result of these medications.

Patients who suffer from type 2 diabetes may not produce enough insulin, or the insulin that their body does produce is not utilized properly. This medication is utilized in patients for whom changes in their diet and level of exercise are insufficient measures to keep their blood sugar levels in a healthy range.

In addition to taking insulin glargine and lixisenatide, patients will need to make significant changes to their daily lives. These changes include following the suggested meal plan recommended by the healthcare team, increasing their overall activity level, and adding regular exercise to their daily routine. Patients are encouraged to include their family and caregivers in any counseling that they receive to help them achieve these goals.

With the correct medication and changes to diet and activity levels, it is possible to effectively manage the symptoms of type 2 diabetes. Patients are encouraged to work closely with their doctors in order to establish a daily routine that is achievable for them while also being effective in helping to manage their symptoms.

Patients and their caregivers are encouraged to speak with their healthcare providers about possible emergency situations that can arise for type 2 diabetes patients and how to successfully manage them. It is especially important to understand the signs and symptoms of low blood sugar levels and how to prevent them.

While undergoing long-term treatment for type 2 diabetes, patients are encouraged to keep all follow-up appointments with their doctors and to undergo all diagnostic testing as ordered.