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Insulin Glargine / Lixisenatide Dosage

Applies to the following strengths: 100 units-33 mcg/mL

The information at is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for Diabetes Type 2

Insulin glargine 100 units/lixisenatide 33 mcg per mL (100/33); dosage is expressed in units

For Patients Inadequately Controlled on Less than 30 units of Basal Insulin or on Lixisenatide:
-Initial dose: 15 units subcutaneously once a day (insulin glargine 15 units/lixisenatide 5 mcg)

For Patients Inadequately Controlled on 30 to 60 units of Basal Insulin or on Lixisenatide:
-Initial dose: 30 units subcutaneously once a day (insulin glargine 30 units/lixisenatide 10 mcg)

Titrate dose in increments of 2 to 4 units weekly based on metabolic needs, blood glucose monitoring results, and glycemic goal until desired fasting plasma glucose is achieved.
-Maintenance dose: 15 to 60 units per day
-Maximum dose: Insulin glargine 60 units/lixisenatide 20 mcg once a day

-Discontinue lixisenatide or basal insulin prior to initiation of this drug.
-Administer subcutaneously once a day within the hour prior to the first meal of the day.
-Alternative antidiabetic products should be used in patients requiring a dose below 15 units or over 60 units per day.
-Product labeling includes a chart that displays units of insulin glargine and micrograms of lixisenatide in each dosage of 100/33.

Use: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus inadequately controlled on basal insulin (less than 60 units per day) or lixisenatide.

Renal Dose Adjustments

Use with caution; frequent glucose monitoring and dose adjustment may be necessary

Liver Dose Adjustments

Use with caution; frequent glucose monitoring and dose adjustment may be necessary

Dose Adjustments

-Initial dosing, dose increments, and maintenance dose should be conservative to avoid hypoglycemic reactions.

Additional titration of dose may be needed with changes in physical activity, meal patterns (macronutrient content or timing of meals), during acute illness, or when used with other medications.

Missed doses:
-If a dose is missed, resume once-daily regimen with next schedule dose; do not administer an extra dose or increase a dose to make up for missed dose.


Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.


Data not available

Other Comments

Administration advice:
-For subcutaneous use only; do not administer IV, IM, or use in an insulin pump
-To avoid medication errors, always check label prior to injection.
-Administer once a day within 1 hour prior to the first meal of the day
-Administer subcutaneously into thigh, upper arm, or abdomen; rotate injection sites within same region to reduce the risk of lipodystropy.
-Do not dilute or mix with any other insulin product or solution
-Do not split dose

Storage requirements:
-Do not use if product has been frozen.
-Protect from light.
-Prior to first opening: Store in refrigerator 36F to 46F (2C to 8C)
-After first opening, store at room temperature (below 86F [30C]); discard 14 days after first opening.

Reconstitution/preparation techniques:
-The pre-filled syringe is for use by 1 person only.
-Use a new needle for each injection, this will insure accurate dosing and prevent contamination and or/infection.
-Consult product labeling for detailed instructions on use.

Compatibility: Do not mix with any other products; do not add to infusion fluids

-This drug has not been studied in patients with a history of pancreatitis; consider other antidiabetic therapies in patients with a history of pancreatitis.
-This drug should not be used in combination with any other product containing lixisenatide or another GLP-1 receptor agonist.
-This drug is not indicated for use in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis.
-This drug has not been studied in patients with gastroparesis and is not recommended in patients with severe gastroparesis.
-This drug has not been studied in combination with prandial insulin.

-Monitor glycemic control; dose adjustments should be based on fasting plasma glucose; patients should self-monitor blood glucose (SMBG) frequently during therapy initiation and as clinically indicated.
-Monitor for hyper and hypoglycemia; the prolonged effect of this insulin may delay recovery from hypoglycemia.
-Monitor serum potassium in patients at risk of hypokalemia
-Monitor for edema or worsening heat failure in patients receiving concomitant PPAR-gamma agonists

Patient advice:
-Patients should be advised to never share pen with another person, even if the needle is changed; patients should understand that sharing needles or syringes with another person carries a risk for transmission of blood-borne pathogens
-Patients should be instructed to always check labels before dosing to prevent mix-ups between this drug and other injectable diabetes medicinal products.
-Patients should be instructed on glucose monitoring, proper injection technique, and the management of hypoglycemia and hyperglycemia.
-Patients should be instructed to check blood sugar prior to driving a car or operating machinery.
-Patients should be instructed to seek medical advice during periods of stress, such as fever, trauma, infection, or surgery as medical management of diabetes may change.
-Patients should be aware of the potential for gastrointestinal reactions and take measures to ensure adequate fluid intake to avoid dehydration and to seek medical advice for persistent and severe events.
-Patients should understand there is a potential risk for pancreatitis; patients should report persistent severe abdominal pain, especially if pain radiates to the back.
-Advise patient to speak to physician or health care professional if pregnant, intend to become pregnant, or are breastfeeding.