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Lantus vs Novolog
Introduction
For patients with diabetes, insulin therapy is vital to maintain optimal blood sugar levels. Lantus and Novolog are two types of insulins that help control high blood glucose. Each has a different onset, peak time and duration, but both aim to regulate the body's glucose levels effectively. Lantus (glargine) is considered a long-acting insulin with a relatively constant concentration/time profile over 24 hours with no pronounced peak. On the other hand, Novolog (aspart) falls into the rapid-acting category of insulins; it starts working approximately 15 minutes after injection, peaks about one hour later and continues to work for two to four hours. Both have their places in managing diabetes—Lantus primarily works as a basal insulin providing consistent glucose control throughout the day while Novolog provides rapid relief from high blood sugar at meal times or when correction doses are needed.
Lantus vs Novolog Side By Side
| Attribute | Lantus | Novolog |
|---|---|---|
| Brand Name | Lantus | Novolog |
| Contraindications | Allergic reactions to any of its ingredients, hypokalemia, liver or kidney disease | Allergic reactions to any of its ingredients, hypokalemia |
| Cost | Approximately $300 for a 10 mL vial (100 units/mL) | Around $560 for a package containing five 3-mL pens |
| Generic Name | Insulin Glargine | Insulin Aspart |
| Most Serious Side Effect | Severe hypoglycemia, signs of insulin allergy, low potassium levels | Severe hypoglycemia, signs of an allergic reaction |
| Severe Drug Interactions | Not specified in the text, but typically includes drugs that may affect blood sugar levels or insulin sensitivity | Not specified in the text, but typically includes drugs that may affect blood sugar levels or insulin sensitivity |
| Typical Dose | 0.2 units/kg/day for type 1 diabetes; 10 units/day for type 2 diabetes | 0.1-0.2 units/kg at mealtime or 4–10% of total daily insulin requirement |
What is Lantus?
Insulin glargine (the generic name for Lantus) is a long-acting type of insulin that was first approved by the FDA in 2000. It works by lowering levels of glucose in the blood and is typically prescribed for the treatment of both type 1 and type 2 diabetes. Unlike short-acting insulins, such as Novolog (insulin aspart), it does not need to be taken with meals but instead is usually administered once daily at any time during the day but always at the same time each day. Its action can last up to 24 hours with no peak effect, which results in more steady control of blood sugar levels throughout the day compared to other types of insulin that have peaks and valleys in their effectiveness. This makes Lantus beneficial for people who are looking for all-day sugar control or those who have difficulties managing their blood sugar levels on other forms of insulin therapy.
What conditions is Lantus approved to treat?
Lantus and Novolog are both FDA-approved for the management of diabetes, albeit in different ways:
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Lantus (insulin glargine) is a long-acting insulin used to maintain baseline blood glucose levels throughout the day and night. It's typically administered once daily, at any time during the day.
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Novolog (insulin aspart) is a rapid-acting insulin used to control blood sugar spikes that occur during meals. It's usually taken shortly before or after meals.
How does Lantus help with these illnesses?
Lantus helps to manage diabetes by providing a steady, long-acting supply of insulin. Insulin is a hormone that allows the body's cells to take in glucose from the bloodstream and use it for energy. Lantus achieves its effect by mimicking basal insulin secretion, thus maintaining a constant baseline level of insulin over 24 hours with no peak action. This allows for improved blood sugar control throughout the day and night.
On the other hand, Novolog works differently as it is fast acting; it starts working within minutes after injection and has maximum effects between one to three hours after administration but only lasts about three to five hours total. Its primary function is to control blood sugar levels during meals or snacks, or correct high blood sugar levels.
While both are used in managing diabetes, they have different roles. Lantus provides all-day glucose lowering effects while Novolog is used at mealtimes to prevent spikes in blood glucose levels after eating.
What is Novolog?
NovoLog is a brand name for insulin aspart, which is a rapid-acting insulin analogue that mimics the body's natural response to food by replacing the surge of insulin secretion that occurs after eating. It starts working quicker than regular human insulin due to its specific formulation and it reduces post-meal blood sugar spikes more effectively. NovoLog was first approved by the FDA in 2000.
As Novolog is not a long-acting basal insulin, it does not maintain baseline levels of glucose throughout the day and night like Lantus (insulin glargine). Its quick action on high blood sugar means its side-effect profile can be different from that of long-acting insulins - specifically, there might be an increased risk for hypoglycemia or low blood sugar if meals are skipped or delayed after dosing. The effects of fast acting analogues like NovoLog can be beneficial for controlling mealtime blood sugars, especially in patients who need more precise control over their post-meal glucose levels.
What conditions is Novolog approved to treat?
Novolog is a rapid-acting insulin analog that has been approved for use in the US for the treatment of both type 1 and type 2 diabetes. It's designed to help control blood sugar levels during meal times, making it beneficial for people who need assistance with post-meal spikes. Key uses include:
- Type 1 Diabetes Mellitus
- Type 2 Diabetes Mellitus
How does Novolog help with these illnesses?
Insulin is a hormone that plays an essential role in regulating blood sugar levels, enabling the body's cells to take in glucose and use it for energy. Novolog, known as insulin aspart, functions similarly to naturally produced insulin but has a faster onset of action than Lantus (insulin glargine). This makes Novolog particularly effective at controlling blood sugar levels during meals. It starts working approximately 15 minutes after injection and generally lasts for 3-5 hours. Because of its rapid effect, it is often used in conjunction with a long-acting insulin like Lantus. While both are important tools in diabetes management, if post-meal spikes in blood glucose are problematic despite using a long-acting insulin such as Lantus, the addition of Novolog might be beneficial.
How effective are both Lantus and Novolog?
Both Lantus (insulin glargine) and Novolog (insulin aspart) are insulin analogs with established histories of success in managing blood sugar levels in both type 1 and type 2 diabetes, but they have different roles within a treatment regimen. They were initially approved by the FDA only three years apart. As Lantus is a long-acting insulin and Novolog is rapid-acting, they may be prescribed under different circumstances depending on the patient's specific needs.
The effectiveness of Lantus and Novolog was directly studied in numerous clinical trials over the past two decades; both drugs exhibited excellent efficacy in controlling blood glucose levels, with promising safety profiles. In these studies, various metrics used to measure glycemic control showed no significant difference between patients receiving either medication when used appropriately within their respective roles.
A review of meta-analysis reports on long-acting insulins demonstrated that it effectively controls fasting plasma glucose starting from the first day of treatment, its side effect profile is favorable over other many other forms of insulin, especially regarding hypoglycemia episodes during night time. Further research has shown that Lantus became one of the most widely prescribed basal insulins worldwide due to its lower risk for nocturnal hypoglycemia while maintaining good glycemic control compared to NPH (Neutral Protamine Hagedorn) Insulin.
On the other hand, a review indicated that Novolog seems to be more effective than Regular Human Insulin at postprandial glucose control due to its faster onset action which closely mimics physiological insulin secretion after meals. Nonetheless, Rapid acting analogues like Novolog are usually considered an addition to basal insulins or oral antidiabetic agents unless contraindicated instead of being standalone therapy for people with Type 2 Diabetes.
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At what dose is Lantus typically prescribed?
Dosages of Lantus, a long-acting insulin, vary between individuals but typically start from 0.2 units/kg/day for adults and children with type 1 diabetes. It's usually taken once daily at the same time each day. For those with type 2 diabetes, the starting dose could be higher (10 units/day) depending on their needs. Dosage may need to be adjusted over time based on blood glucose control response.
In contrast, Novolog is a fast-acting insulin administered just before meals; its dosage also varies greatly among individuals and depends on factors such as blood glucose levels and carbohydrate intake. Both Lantus and Novolog dosages should always be tailored by healthcare providers to meet individual patient needs.
At what dose is Novolog typically prescribed?
Novolog treatment is typically initiated based on an individual's mealtime insulin needs. The dosage can be adjusted with a typical starting dose of 0.1-0.2 units/kg at each meal time, or about 4–10% of total daily insulin requirement. Doses should then be tailored as needed to achieve optimal blood glucose control. Novolog can also replace other mealtime insulins and the switch can usually be done unit for unit; however, more frequent blood glucose monitoring may be necessary during the transition period and in the first few weeks thereafter.
What are the most common side effects for Lantus?
Common side effects of Lantus and Novolog, two different types of insulin used in the management of diabetes, vary slightly:
- Hypoglycemia (low blood sugar), which can cause symptoms such as anxiety, nervousness, tremor, and sweating
- Weight gain
- Localized allergic reactions at the injection site (redness or swelling)
- Generalized allergic reactions including rash; these are rare but serious
- Lipodystrophy (changes in fat tissue at the site of injection)
For both medications, hypoglycemia is a key concern. However, it's important to note that everyone responds differently to medication - what works best will depend on individual health status and lifestyle considerations. Always consult your healthcare provider for personalized advice.
Are there any potential serious side effects for Lantus?
While using Lantus or Novolog, it is important to monitor for any serious side effects which may include:
- Signs of insulin allergy: skin rash over the entire body, shortness of breath, fast heartbeat, sweating, or feeling like you might pass out.
- Low potassium levels in the body - muscle weakness or limp feeling; leg cramps; constipation; irregular heartbeats; fluttering in your chest; increased thirst or urination
- Swelling and weight gain
- Shortness of breath (even with mild exertion), swelling in your feet or ankles.
- Rapid weight gain
- Hypoglycemia (low blood sugar) symptoms such as dizziness, confusion, hunger, headache
Severe hypoglycemia can be life-threatening. Symptoms could include seizures and unconsciousness.
Please remember that these are possible side effects and most people do not experience them. However if you notice any unusual changes after starting these medications contact medical assistance immediately.
What are the most common side effects for Novolog?
While the side effects of Novolog can vary from person to person, some of the most commonly reported ones include:
- Low blood sugar (hypoglycemia), which might be accompanied by shakiness, sweating, fast heartbeat and confusion
- Weight gain
- Thicken skin at injection site
- Allergic reactions like rash or itching
- Fluid retention causing swelling in your hands and feet
- Nausea or abdominal pain
- Headache and dizziness
Remember it's important to monitor these symptoms closely as they may require medical attention if they persist.
Are there any potential serious side effects for Novolog?
While Novolog is generally considered safe for most people, there are certain adverse reactions that you should be aware of. Some potential serious side effects include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
- Hypoglycemia (low blood sugar) which may show symptoms like headache, hunger, sweating, irritability, dizziness, nausea and feeling shaky
- Hyperglycemia (high blood sugar) with symptoms including increased thirst or urination
- Rapid weight gain
- Swelling in your hands or feet
- Shortness of breath
If you experience any such side effects after taking Novolog insulin it's important to contact a healthcare professional immediately.
Contraindications for Lantus and Novolog?
Both Lantus and Novolog, like other insulin medications, can cause hypoglycemia (low blood sugar) in some people. If you notice symptoms of low blood sugar such as dizziness, confusion or sweating excessively, seek immediate medical attention.
Neither Lantus nor Novolog should be used if you have had allergic reactions to any of its ingredients. Always inform your physician about any medications you are taking; certain oral diabetes drugs may need to be discontinued or dosage altered when starting on Lantus or Novolog.
Lantus and Novolog shouldn't be taken by those with hypokalemia (low levels of potassium in the blood) without proper medical consultation as these insulins can further decrease potassium levels in the body which might lead to serious heart problems. Furthermore, precautions must also be taken for patients with liver or kidney disease due to potential risk of prolonged hypoglycemic episodes.
How much do Lantus and Novolog cost?
For the brand name versions of these drugs:
- The price of a 10 mL vial (100 units/mL) of Lantus (insulin glargine) is approximately $300, which works out to about $10-$30/day depending on your dose.
- The price for a package containing five 3-mL pens of Novolog (insulin aspart), is around $560. This can work out to anywhere from $18–$56 per day, again dependent on your dosage.
Thus, if you're using more insulin per day (such as over 50 units), then Lantus might be less expensive on a daily treatment basis. However, cost should not be the primary consideration when determining which medication is right for you; effectiveness and how it fits into your lifestyle are also important factors.
As for generic versions — unfortunately at this time there aren't any "official" generics or biosimilars available for either Lantus or Novolog in many countries including U.S., but there are lower-cost "follow-on" insulins that have been approved by the FDA such as Basaglar for Lantus and Admelog for Novolog:
- A box with five KwikPens each containing three ml prefilled injection pen filled with long acting insulin glargine(Basaglar = follow-on version of lantus) costs about $326 – roughly translating to between $11 - $33/day depending upon your dose.
- Similar pack size(5 x 3ml cartridge pack )of fast acting insulin lispro injection(Admelog= follow-on version of novolog) comes around at an average retail price is about $350 ,which translates into an approximate cost range between
$12 -$35 /day based upon individual’s dosage requirements.
Remember prices may vary significantly based on location, insurance coverage and pharmacy benefits etc.
Popularity of Lantus and Novolog
Insulin glargine, sold under brands like Lantus, was prescribed to approximately 8.3 million people in the USA in 2020. Insulin Glargine accounted for nearly one-third of all long-acting insulin prescriptions and almost a quarter of overall insulin prescriptions in the country. It's a long-acting basal insulin that is typically administered once daily to help control blood sugar levels throughout the day.
On the other hand, Insulin aspart (brand name Novolog) had about 4 million users in 2020 across America. This rapid-acting insulin represents around one-fifth of mealtime or bolus insulins and just over ten percent of total insulin therapy prescriptions. Unlike Lantus, Novolog is used right before meals to combat post-meal blood sugar spikes.
Both are essential components for comprehensive diabetes management but serve different roles within it: while Lantus provides consistent background glucose control, Novolog caters to immediate carbohydrate-induced requirements.
Conclusion
Both Lantus (insulin glargine) and Novolog (insulin aspart) have long-standing records of usage in patients with diabetes, and are backed by numerous clinical studies indicating that they are more effective than previous insulin formulations. In many cases, the insulins may be combined to achieve optimal blood glucose control, but this is subject to careful consideration by a physician due to their different pharmacokinetic profiles. Lantus acts primarily as a basal insulin providing steady coverage throughout the day, whereas Novolog is rapid-acting and used specifically for mealtime coverage.
Both insulins come in pen form which offers convenient dosing especially for individuals on multiple daily injections. However, neither drug has an available generic version so cost can be a concern particularly for those paying out of pocket.
The side effect profile is similar between the two drugs; both being generally well-tolerated but hypoglycemia remains the most common adverse event. Weight gain can also occur when starting insulin therapy or increasing dosage. For both Lantus and Novolog, patients must closely monitor their blood glucose levels before and after meals and at bedtime, adjusting doses as needed based on results and symptoms of hyperglycemia or hypoglycemia.
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Refrences
- Rosenstock, J., Dailey, G., Massi-Benedetti, M., Fritsche, A., Lin, Z., & Salzman, A. (2005, April 1). Reduced Hypoglycemia Risk With Insulin Glargine. Diabetes Care. American Diabetes Association.http://doi.org/10.2337/diacare.28.4.950
- Thisted, H., Johnsen, S. P., & Rungby, J. (2006, July). An Update on the Long‐Acting Insulin Analogue Glargine. Basic & Clinical Pharmacology & Toxicology. Wiley.http://doi.org/10.1111/j.1742-7843.2006.pto_352.x
- Elrishi, M., Jarvis, J., Khunti, K., & Davies, M. (2008, August). Insulin glargine and its role in glycaemic management of Type 2 diabetes. Expert Opinion on Drug Metabolism & Toxicology. Informa Healthcare.http://doi.org/10.1517/17425255.4.8.1099
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- Chapman, T. M., Noble, S., & Goa, K. L. (2003). Spotlight on Insulin Aspart in Type 1 and 2 Diabetes Mellitus*. Treatments in Endocrinology. Springer Science and Business Media LLC.http://doi.org/10.2165/00024677-200302010-00006
- Setter, S. M., Corbett, C. F., Campbell, R. K., & White, J. R. (2000, December). Insulin Aspart: A New Rapid-Acting Insulin Analog. Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1345/aph.19414
- Clements, J. N., & Bello, L. (2016, March 15). Insulin glargine 300 units/mL: A new basal insulin product for diabetes mellitus. American Journal of Health-System Pharmacy. Oxford University Press (OUP).http://doi.org/10.2146/ajhp150174