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Toujeo vs Apidra
Introduction
For patients with diabetes, either type 1 or type 2, certain drugs that assist in managing and controlling the body's glucose levels can help prevent complications. Toujeo and Apidra are two such insulin medications prescribed for this purpose. Both of these insulins play a crucial role in blood sugar management but they do so differently. Toujeo is a long-acting insulin analog meant to provide all-day sugar level control with once-daily dosing, releasing slowly over time to ensure steady concentrations of insulin throughout the day and night. On the other hand, Apidra is classified as a rapid-acting insulin analog which works quickly to manage blood sugar spikes that occur after meals. The onset of action in Apidra is quicker than Toujeo but it doesn't last as long - it's primarily used around meal times for immediate response.
Toujeo vs Apidra Side By Side
| Attribute | Toujeo | Apidra |
|---|---|---|
| Brand Name | Toujeo | Apidra |
| Contraindications | Should not be used if there has been an allergic reaction to any type of insulin in the past. Requires careful monitoring due to potential fluctuations in glucose levels. | Should not be used if there has been an allergic reaction to any type of insulin in the past. Regular blood glucose monitoring is essential. |
| Cost | Around $400 for 1 box (5 pens, 3ml each) of 300 units/ml | Around $280 for a vial (10 ml) of 100 units/ml |
| Generic Name | Insulin Glargine | Insulin Glulisine |
| Most Serious Side Effect | Symptoms of low blood sugar (hypoglycemia), allergic reactions, cardiovascular reactions due to hypokalemia, sodium imbalance, symptoms indicating nervous system issues, toxic reactions such as swelling at injection site. | Signs of allergic reaction or severe skin reaction, hypoglycemia, hyperglycemia, changes in vision, rapid weight gain, swelling in hands and feet. |
| Severe Drug Interactions | Not explicitly mentioned, but interactions that affect glucose levels or insulin action could be significant. | Not explicitly mentioned, but interactions that affect glucose levels or insulin action could be significant. |
| Typical Dose | 0.2–0.4 units/kg/day | Individualized based on the patient's blood glucose level, up to three times a day before meals. |
What is Toujeo?
Insulin glargine (the generic name for Toujeo) was a significant advancement in long-acting insulin therapy compared to the prior class of insulins. Insulin glargine was first approved by the FDA in 2000 and is designed to provide all-day sugar control. It works by releasing insulin slowly and steadily, effectively "maintaining" blood sugar levels throughout the day and night. Toujeo is prescribed for both type 1 and type 2 diabetes.
On the other hand, Apidra (or insulin glulisine), a fast-acting form of insulin, acts much more quickly but its effects wear off sooner. It's used primarily to control blood sugar during meals or when it rises due to stress or illness. Unlike Toujeo which tries to maintain a steady level of glucose control, Apidra aims at quick reduction of high blood sugars with its primary mechanism being rapid absorption into the bloodstream after injection.
Both these medications serve unique purposes in diabetes management but have different influences on how they manage glucose levels leading them having slightly different side effect profiles related to hypoglycemia risks.
What conditions is Toujeo approved to treat?
Toujeo is approved for the management of various forms of diabetes:
- Type 1 Diabetes Mellitus (also known as juvenile diabetes or insulin-dependent diabetes)
- Type 2 Diabetes Mellitus (commonly referred to as non-insulin dependent diabetes)
Apidra, on the other hand, is also used in the treatment of:
- Type 1 Diabetes Mellitus
- Type 2 Diabetes Mellitus Both help control high blood sugar levels, but their duration and onset of action differ.
How does Toujeo help with these illnesses?
Toujeo helps to manage diabetes by providing a steady and constant supply of insulin throughout the day. It does this through its formulation as a long-acting insulin analog, which means it is absorbed into the bloodstream slower over time compared to regular insulins. Insulin is a hormone that regulates the amount of glucose in blood, allowing cells in our body to take up glucose and use it for energy. For individuals with diabetes who have challenges maintaining their blood sugar levels, Toujeo can provide them with more consistent control over their glucose levels than short-acting or immediate-release insulins like Apidra. Therefore, by providing a steady supply of insulin, Toujeo can limit the negative effects of high blood sugars and help patients better manage their condition throughout both day and night.
What is Apidra?
Apidra, a brand name for insulin glulisine, is a rapid-acting insulin analog that helps manage blood sugar levels in individuals with diabetes. It begins to work more quickly than regular human insulin does by mimicking the body's natural response to eating meals and thus helping regulate post-meal spikes in blood glucose levels. Apidra was first approved by the FDA in 2004 and differs from other insulins due to its faster onset of action.
Unlike long-acting insulins like Toujeo (a branded form of Insulin Glargine), which provide a steady level of background insulin over 24 hours, Apidra acts within approximately 15 minutes after injection and peaks at around one hour later. Therefore, it's typically used just before or even after meals to control spikes in blood sugar that occur after eating.
This fast-action profile means that it doesn't cause prolonged hypoglycemia (low blood sugar) as some longer acting insulins can. However, all types of insulin carry the risk of causing low blood sugar if not balanced correctly with food intake and physical activity.
What conditions is Apidra approved to treat?
Apidra is an insulin analog that the FDA has approved for the management of high blood sugar levels in adults and children with:
- Type 1 diabetes, where the body does not produce enough insulin.
- Type 2 diabetes, a condition where the body does not effectively use produced insulin.
How does Apidra help with these illnesses?
Insulin is a hormone that plays crucial roles in the body's metabolism, affecting how our cells absorb and use glucose for energy. When insulin levels are insufficient or not effectively used by the body, this leads to high blood sugar levels, characteristic of diabetes. Apidra works as a fast-acting insulin analog, meaning it has been slightly modified from regular human insulin to quickly lower blood sugar after meals. Its rapid onset and short duration of action set it apart from other insulins like Toujeo. This makes Apidra particularly useful for controlling spikes in blood sugar associated with meals, as it begins working within 15 minutes and its effects last approximately 4 hours. Despite each having its unique benefits depending on individual patient needs and lifestyles, choosing between them would depend on one's specific needs such as mealtime control (which is where Apidra shines) versus sustained all-day control offered by long-acting insulins like Toujeo.
How effective are both Toujeo and Apidra?
Both insulin glargine (Toujeo) and insulin glulisine (Apidra) are effective at controlling blood sugar levels in patients with diabetes, and were approved by the FDA within a few years of each other. Since they have different onsets of action and durations, they may be prescribed under varying circumstances. The effectiveness of Toujeo and Apidra in managing blood glucose levels was directly studied in several clinical trials; both drugs demonstrated efficacy in maintaining good glycemic control with promising safety profiles.
A 2004 review highlighted that Toujeo provides steady long-lasting coverage for up to 24 hours after injection, making it suitable as a basal insulin. It is often administered once daily, usually at bedtime. Beyond simply controlling fasting plasma glucose levels, Toujeo also appears to reduce nocturnal hypoglycemia - an important consideration for individuals who struggle with nighttime lows.
On the other hand, Apidra is a rapid-acting insulin analog used primarily to control post-meal spikes in blood sugar levels. A 2016 meta-analysis indicated that Apidra begins working faster than regular human insulin and may help lower HbA1C (a measure of long-term glucose control) more effectively when combined with basal insulins like Toujeo or Lantus.
While both insulins play crucial roles in diabetes management, their usage involves careful individualized assessments based on each patient's lifestyle habits such as meal patterns and physical activity level. They can also be co-prescribed together: Toujeo providing consistent baseline coverage throughout the day while Apidra targeting mealtime peaks.
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At what dose is Toujeo typically prescribed?
Injectable dosages of Toujeo, a long-acting insulin, range from 0.2–0.4 units/kg/day. The specific dose will be determined by your doctor based on your individual needs and response to therapy. Children and adolescents may also use Toujeo; the starting dosage should be individualized under a healthcare professional's guidance. On the other hand, Apidra is a fast-acting insulin that can be used in patients over 4 years old with type 1 diabetes and adults with type 2 diabetes at mealtime or within 15 minutes before a meal. Dosage adjustment is usually necessary if switching between these two types of insulin due to their differing pharmacokinetics.
At what dose is Apidra typically prescribed?
Apidra treatment typically begins with an individualized dosage based on the patient's blood glucose level. The dose can be adjusted to achieve optimal control, and it may be necessary to administer it up to three times a day before meals. The maximum daily dose varies depending on the person's insulin needs, which are usually between 0.5–1 unit/kg/day. It is injected under the skin (subcutaneously), and its effects begin in approximately 20 minutes after injection. If there is no response or insufficient glucose control following initial dosing, adjustments should be made under medical supervision after careful monitoring of blood glucose levels.
What are the most common side effects for Toujeo?
Common side effects that may occur when using Toujeo and Apidra include:
- Hypoglycemia (low blood sugar) which can cause symptoms such as dizziness, confusion, anxiety, and trembling
- Allergic reactions including itching, rash or swelling at the injection site
- Weight gain
- Upper respiratory tract infection symptoms like coughing or a sore throat
- Headache
- Back pain
- Flu-like symptoms (such as fever, chills)
- Nausea These are not all the possible side effects of these insulin medications. If you experience other side effects that concern you while taking either drug, promptly consult your healthcare provider.
Are there any potential serious side effects for Toujeo?
While both Toujeo and Apidra are insulins used to manage blood sugar levels in individuals with diabetes, they do have different side effects. Here's what you need to know:
- Symptoms of low blood sugar (hypoglycemia): sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar.
- Signs of an allergic reaction: rash; itching/swelling (especially of the face/tongue/throat); severe dizziness; trouble breathing. This is not a complete list of possible side effects.
- Cardiovascular reactions like palpitations, tachycardia may occur due to hypokalemia
- Sodium imbalance can lead to symptoms such as feeling restless or weak; having muscle cramps or spasms; experiencing nausea and vomiting. -Symptoms that indicate something might be wrong with your nervous system: Trouble moving your muscles smoothly and normally, extreme exhaustion leading up fainting spells -Toxic reactions such as swelling at injection site may also occur.
If any serious symptoms arise while using either medication it's essential you seek medical advice immediately.
What are the most common side effects for Apidra?
Apidra, like most insulin medications, can prompt a range of side effects including:
- Hypoglycemia (low blood sugar)
- Weight gain
- Injection site reactions such as redness, swelling or itching
- Allergic reactions that can cause rash or hives
- Fluid retention and heart failure with concomitant use of PPAR-gamma agonists
- Potassium levels may decrease - causing irregular heartbeat. Remember, it is essential to monitor your blood glucose regularly when on Apidra. It's also important to note these side effects are not exhaustive and individuals should consult their healthcare provider for any adverse symptoms they experience while using this medication.
Are there any potential serious side effects for Apidra?
While Apidra is generally considered safe and effective, it's important to be aware of potential adverse effects. These may include:
- Signs of allergic reaction or severe skin reaction: hives, itching, rash, difficulty breathing, swelling in your face or throat
- Hypoglycemia (low blood sugar), which can cause symptoms like dizziness, sweating, confusion and rapid heartbeat
- Hyperglycemia (high blood sugar), characterized by frequent urination, thirst that won't go away and unexplained weight loss
- Changes in vision or blurred vision
- Rapid weight gain with no discernible cause
- Swelling in hands and feet If you are taking Apidra and experience any of these side effects persistently, consult your healthcare provider immediately.
Contraindications for Toujeo and Apidra?
Both Toujeo and Apidra, along with most other insulin medications, can cause hypoglycemia (low blood sugar) in some people. If you notice symptoms of low blood sugar such as dizziness, confusion, sweating or rapid heartbeat, please seek immediate medical attention.
Neither Toujeo nor Apidra should be used if you have had an allergic reaction to any type of insulin in the past. Always tell your physician which medications you are taking; there may be potential interactions between certain medicines and these insulins that could impact their effectiveness or cause side effects. In addition, both drugs require careful monitoring due to potential fluctuations in glucose levels so regular checks are essential for safe use.
How much do Toujeo and Apidra cost?
For the brand-name versions of these drugs:
- The price of 1 box (5 pens, 3ml each) of Toujeo (300 units/ml) averages around $400, which works out to approximately $8-$16/day depending on your dose.
- The price for a vial (10 ml) of Apidra (100 units/ml), averages about $280, working out to roughly $9-$18/day.
Thus, if you are in the higher dosage range for Toujeo (i.e., more than 50 units per day), then brand-name Apidra is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
At present there are no generic versions available for either insulin glargine (Toujeo) or insulin glulisine (Apidra). As such their prices remain relatively high compared to other medications. However, it's essential to consider that while costs can influence decisions about diabetes management and medication choice - effectiveness, side effects profile and personal preference also play key roles in optimal therapeutic decision-making.
Popularity of Toujeo and Apidra
Insulin glargine, sold under the brand name Toujeo among others, is a long-acting insulin used to treat both type 1 and type 2 diabetes. In 2020, around 3.5 million prescriptions for Toujeo were written in the United States alone. It accounts for about 25% of all long-acting insulin prescriptions given out in America and has seen steady growth since its introduction.
On the other hand, insulin glulisine, marketed as Apidra by Sanofi-Aventis, is a rapid-acting form of insulin that's also used to manage blood sugar levels in patients with type 1 and type 2 diabetes. It was prescribed to approximately half a million people across the USA throughout last year which equates to roughly only about 10% of fast-acting insulins prescription share countrywide. Lately Apidra's popularity remained relatively stable with minor fluctuations over the past decade.
Conclusion
Both Toujeo (insulin glargine) and Apidra (insulin glulisine) have well-established histories of use in managing diabetes, backed by many clinical studies indicating their effectiveness over no treatment. In some cases, these insulins may be used together to manage blood sugar levels throughout the day. However, this depends on your healthcare provider's careful evaluation since they work differently and are not interchangeable.
Toujeo is a long-acting insulin that provides steady blood sugar control for about 24 hours while Apidra is a rapid-acting insulin that works within minutes after injection to lower post-meal or sudden increases in blood sugars.
While both drugs are types of insulin and thus do not come in generic form, there can be considerable variation in cost depending on insurance coverage. Both require an adjustment period during which dosage will need fine-tuning based on individual needs and response.
The side effect profiles between the two are similar with hypoglycemia being the most common side effect; however, weight gain is more commonly seen with long-acting insulins like Toujeo than with rapid-acting ones like Apidra. Regardless of type, all patients using insulin should monitor their glucose levels regularly and seek immediate medical help if they experience symptoms of severe low or high blood sugar.
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Refrences
- Lingvay, I., Manghi, F. P., García-Hernández, P., Norwood, P., Lehmann, L., Tarp-Johansen, M. J., … for the DUAL V Investigators. (2016, March 1). Effect of Insulin Glargine Up-titration vs Insulin Degludec/Liraglutide on Glycated Hemoglobin Levels in Patients With Uncontrolled Type 2 Diabetes. Jama. American Medical Association (AMA).http://doi.org/10.1001/jama.2016.1252
- Dunn, C. J., Plosker, G. L., Keating, G. M., McKeage, K., & Scott, L. J. (2003). Insulin Glargine. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200363160-00007