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This document presents crucial safety information related to the use of Lantus (insulin glargine). It is essential to understand the potential risks and take necessary precautions. Please review the following details and consult with your healthcare provider for any questions or concerns.

• Risk of Serious Infections: Do not share Lantus pens, syringes, or needles with others to prevent the transmission of serious infections, such as HIV and hepatitis B.

• Blood Sugar Level Fluctuations: Alterations in your insulin regimen, including changes in injection sites or switching to a Lantus biosimilar, can impact insulin efficacy, leading to high or low blood sugar levels. Repeated injections into areas with lipodystrophy (e.g., pitting or thickened skin) can also elevate blood sugar levels.

• Hypoglycemia (Dangerously Low Blood Sugar Levels): Using Lantus alone or with other blood sugar-lowering medications can cause hypoglycemia, which can be life-threatening if untreated. Factors increasing this risk include dietary and exercise changes, alcohol consumption, concurrent diabetes medications, liver or kidney issues, and improper use of Lantus.

• Hypokalemia (Low Blood Potassium Levels): Lantus may lead to low potassium levels, especially if taken with medications that also reduce potassium, such as loop diuretics. Regular blood tests may be necessary to monitor potassium levels, and your healthcare provider might prescribe medication to maintain safe potassium levels. Seek immediate medical attention if you experience symptoms like weakness, muscle cramps, or constipation.

• Fluid Retention and Heart Failure: Combining Lantus with glitazones (e.g., Actos) can cause fluid retention, exacerbating heart failure and causing symptoms such as difficulty breathing, swelling, and fatigue. Exercise caution if you have heart failure.

• Severe Allergic Reactions: Although rare, Lantus can cause serious allergic reactions, including anaphylaxis. Seek emergency medical assistance if you notice swelling of the lips, face, tongue, rash, or difficulty breathing.

Contraindications: Lantus should not be used if you are experiencing low blood sugar (hypoglycemia). Always consult your healthcare provider before starting this medication if any contraindications apply to you.

When taking this medication, you may experience some common side effects. These include reactions at the injection site such as pain, redness, or irritation, as well as weight gain. Upper respiratory tract infections, swelling of the hands or feet, high blood pressure, flu-like symptoms, sinus infections, bronchitis, cataracts, joint pain, back pain, and headaches are also possible. Some individuals might experience urinary tract infections, diarrhea, depression, or pain in the hands and feet. Although these side effects are generally mild, it's important to consult your healthcare provider if they persist or worsen.

More serious side effects, although less common, require immediate medical attention. These include severely low blood sugar levels, which can manifest as sudden sweating, shaking, a fast heartbeat, hunger, blurred vision, dizziness, or tingling in the hands and feet. It's crucial to manage low blood sugar by having glucose tablets or quickly consuming a sugary food or drink. Severely low potassium levels can also occur, leading to symptoms such as muscle cramps, weakness, or an irregular heartbeat.

A rare but serious allergic reaction may occur, presenting with symptoms like rash, itching, swelling of the face, tongue, or throat, severe dizziness, or difficulty breathing. If you notice any such symptoms, seek urgent medical care. Always discuss any other unusual side effects with your healthcare provider to ensure your safety and well-being.

Interactions between Lantus (insulin glargine) and other medications require careful consideration. It's important to inform your doctor and pharmacist about all medications and supplements you're taking, including prescription, over-the-counter, vitamins, and herbal products. This helps in identifying potential interactions.

For instance, beta-blockers like metoprolol, Propranolol, and certain eye drops such as Timolol, might mask the fast or pounding heartbeat that usually signals low blood sugar. However, other symptoms of low blood sugar, such as dizziness, hunger, or sweating, remain unaffected. This means you should closely monitor your blood sugar levels and report any symptoms of high or low blood sugar to your doctor. Adjustments to your diabetes medication, diet, or exercise routine might be necessary.

Additionally, Lantus may interact with a wide range of other medicines. Some of these drugs are usually not recommended to be used with Lantus but may be necessary in certain situations. If so, your doctor might adjust the dosage or frequency of one or both medications. These include several antibiotics like Ciprofloxacin and medications such as Liraglutide and Metoclopramide.

There are also medications that might increase the risk of side effects when used with Lantus. These include various beta-blockers like Atenolol and propranolol, and other drugs such as dulaglutide and Linezolid. In these cases, your doctor may again adjust how often you take each medication or their dosages to ensure the most effective treatment while minimizing side effects.

Always consult with your healthcare provider before starting, stopping, or changing any medication to ensure safe and effective management of your health. Regularly check your blood sugar levels as advised and communicate the results with your healthcare provider.