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Toujeo Side Effects

Generic Name: insulin glargine

Note: This page contains side effects data for the generic drug insulin glargine. It is possible that some of the dosage forms included below may not apply to the brand name Toujeo.

For the Consumer

Applies to insulin glargine: subcutaneous solution

As well as its needed effects, insulin glargine (the active ingredient contained in Toujeo) may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking insulin glargine, check with your doctor immediately:

More common:
  • Anxiety
  • behavior change similar to being drunk
  • blurred vision
  • chills
  • cold sweats
  • confusion
  • convulsions (seizures)
  • cool, pale skin
  • difficulty with thinking
  • dizziness or lightheadedness
  • drowsiness
  • excessive hunger
  • fast heartbeat
  • headache
  • nausea
  • nervousness
  • nightmares
  • restless sleep
  • shakiness
  • slurred speech
  • tingling in the hands, feet, lips, or tongue
  • unusual tiredness or weakness
Less common or rare:
  • Fast pulse
  • skin rash or itching over the entire body
  • sweating
  • trouble breathing
Incidence not known:
  • Bloating or swelling of the face, hands, lower legs, or feet
  • cough
  • decreased urine
  • difficulty with swallowing
  • dry mouth
  • hives
  • increased thirst
  • irregular heartbeat
  • muscle pain or cramps
  • numbness or tingling in the hands, feet, or lips
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rapid weight gain
  • vomiting

Minor Side Effects

Some insulin glargine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Fever
  • sore throat
  • stuffy or runny nose
Less common or rare:
  • Depression of the skin at the injection site
  • itching, pain, redness, or swelling at the injection site
  • thickening of the skin at injection site

For Healthcare Professionals

Applies to insulin glargine: subcutaneous solution

General

Adverse reactions associated with insulin glargine (the active ingredient contained in Toujeo) include hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, and weight gain.[Ref]

Metabolic

The ORIGIN (Outcome Reduction with Initial Glargine Intervention) trial, an open-labeled, randomized study comparing insulin glargine (the active ingredient contained in Toujeo) to standard care in persons 50 years or older with abnormal glucose levels (impaired fasting glucose and/or impaired glucose tolerance) or early type 2 diabetes mellitus and established cardiovascular (CV) disease or CV risk factors, found over the course of the 6 year study, severe hypoglycemia occurred in 5.7% of patients receiving insulin glargine compared to 1.9% in the standard care group. The median HbA1c values in the insulin glargine group ranged from 5.9% to 6.4% while the HbA1c values in the standard care group ranged from 6.2% to 6.6%. The incidence for all hypoglycemia was 58% and 26% in the insulin glargine and standard groups, respectively.

Weight gain has been reported with insulin therapy and has been attributed to the anabolic effects of insulin and the decrease in glucosuria. In the ORIGIN trial, the median change in body weight from baseline to the last treatment visit was 2.2 kg greater in the insulin glargine group (+1.4 kg vs -0.8 kg).[Ref]

Very common (10% or more): Hypoglycemia
Frequency not reported: Weight gain[Ref]

Local

Injection site reactions include redness, pain, itching, hives, swelling, or inflammation. In some cases, these reactions may be caused by other factors, such as irritants in skin cleansing agents. In clinical studies, there was a higher incidence of treatment-emergent injection site pain in insulin-glargine treated patients compared to NPH-treated patients (2.7% vs 0.7%).[Ref]

Common (1% to 10%): Injection site reactions, injection site pain[Ref]

Hypersensitivity

Hypersensitivity side effects have included both local and systemic reactions. Anaphylaxis has been reported. Local reactions have presented as erythema, local edema, and pruritus at the injection site. Most minor reactions to insulin at the injection site resolve in a few days to a few weeks.[Ref]

Rare (less than 0.1%): Allergic reactions[Ref]

Cardiovascular

Very common (10% or more): Hypertension (up to 19.6%)
Common (1% to 10%): Peripheral edema[Ref]

Insulin may cause sodium retention and edema, especially as metabolic control is improving. The ORIGIN (Outcome Reduction with Initial Glargine Intervention) trial, an open-labeled, randomized study in persons 50 years or older with abnormal glucose levels (impaired fasting glucose and/or impaired glucose tolerance) or early type 2 diabetes mellitus and established cardiovascular (CV) disease or CV risk factors, found the time to first occurrence of a major adverse cardiovascular event (MACE) and the incidence of MACE to be similar between insulin glargine and standard care (n=12.537).[Ref]

Dermatologic

Postmarketing reports indicate children and adolescents may experience more skin reactions such as rash and urticaria, than adults.[Ref]

Common (1% to 10%): Lipohypertrophy
Uncommon (0.1% to 1%): Lipoatrophy
Postmarketing reports: Rash urticaria[Ref]

Oncologic

Frequency not reported: Cancer occurrence[Ref]

The ORIGIN (Outcome Reduction with Initial Glargine Intervention) trial, an open-labeled, randomized study in persons 50 years or older with abnormal glucose levels (impaired fasting glucose and/or impaired glucose tolerance) or early type 2 diabetes mellitus and established cardiovascular (CV) disease or CV risk factors, comparing insulin glargine to standard care found the overall incidence of all types of cancer combined or death from cancers was similar between treatment groups (n=12,537). In July 2009, The US FDA reported on an ongoing safety review evaluating a possible increased risk of cancer. In February 2011, the FDA in an updated communication reported the evidence was inconclusive and it is not possible to conclude that the use of this insulin increases the risk of cancer.[Ref]

Immunologic

Frequency not reported: Antibody formation[Ref]

As with all therapeutic proteins, the potential for immunogenicity exits. The detection of antibody formation is highly dependent on the sensitivity and specificity of the assay and may be influenced by assay methodology, sample handling and collection, concomitant medications, and underlying disease. The presence of insulin antibodies may increase or decrease the efficacy of insulin and may require dose adjustment.[Ref]

Ocular

Rare (less than 0.1%): Visual impairment, retinopathy[Ref]

Rapid improvement in glucose control has been associated with a transitory, reversible ophthalmologic refraction disorder and worsening of diabetic retinopathy. However, long-term glycemic control decreases the risk.[Ref]

Gastrointestinal

Common (1% to 10%): Gastroenteritis[Ref]

Musculoskeletal

Rare (less than 0.1%): Myalgia[Ref]

Nervous system

Common (1% to 10%): Headache
Very rare (less than 0.01%): Dysgeusia
Frequency not reported: Peripheral neuropathy[Ref]

Rapid improvement in glucose control has been associated with a transitory, reversible acute painful peripheral neuropathy. However, long-term glycemic control decreases the risk.[Ref]

Respiratory

Very common (10% or more): Upper respiratory infection (up to 22.4%)
Common (1% to 10%): Pharyngitis, rhinitis, sinusitis[Ref]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. "Product Information. Lantus (insulin glargine)" Aventis Pharmaceuticals, Swiftwater, PA.

3. Cerner Multum, Inc. "Australian Product Information." O 0

4. "Product Information. Toujeo SoloStar (insulin glargine)." sanofi-aventis, Bridgewater, NJ.

5. FDA. U.S. Food and Drug Administration "FDA Drug Safety Communication: Update to ongoing safety review of Lantus (insulin glargine) and possible risk of cancer. Available from: URL: http://www.fda.gov/Drugs/DrugSafety/ucm239376.htm." ([2011 Jan 12]):

It is possible that some side effects of Toujeo may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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