Semglee

Indications

Semglee is prescribed to enhance glycemic control in both adults and children with type 1 diabetes mellitus, as well as adults with type 2 diabetes mellitus.

Pharmacology

Insulin Glargine, the active component in Semglee, is a sterile solution designed for subcutaneous injection. It is a long-acting, recombinant human insulin analogue, providing blood glucose control for up to 24 hours. By promoting glucose uptake primarily in skeletal muscles and fat, and inhibiting glucose production in the liver, insulin glargine plays a crucial role in glucose metabolism. Additionally, it aids in reducing lipolysis and proteolysis, while enhancing protein synthesis.

Dosage

With its consistent glucose-lowering effect lasting 24 hours, insulin glargine allows for once-daily administration. The potency of insulin glargine is similar to human insulin, and dosage should be tailored to each patient’s response.

• Type 1 Diabetes: Should be used with short-acting insulin.
• Type 2 Diabetes: For patients not currently using insulin, the initial dose is typically 10 units (or 0.2 Units/kg), adjusted based on individual needs.

Blood glucose monitoring is essential. Insulin Glargine should not be administered intravenously, as doing so can lead to severe hypoglycemia.

Conversion from Other Insulin Therapies

Switching to Semglee from other insulin treatments may require adjusting short-acting insulin or oral diabetes medications:

• Transitioning from once-daily NPH insulin: Start with the same dose as NPH.
• Transitioning from twice-daily NPH insulin: Start with 80% of the total NPH dose.

Administration

Administer Semglee subcutaneously once a day, at the same time each day for consistency.

• Cartridge Use: Insert the cartridge correctly into the pen, gently rotate the pen, and ensure the insulin is mixed evenly.
• Vial Use: Follow proper hygiene practices, draw the correct dose, and ensure no air bubbles remain in the syringe.

Choose injection sites like the upper arm, thigh, abdomen, or buttock, rotating sites to avoid tissue damage. Insert the needle at a 45° angle and avoid rubbing the injection area afterward.

Drug Interactions

Certain medications may affect glucose metabolism and may require dose adjustments. For example:

• Drugs that reduce insulin needs: Oral anti-diabetics, ACE inhibitors, fibrates, salicylates, and others.
• Drugs that increase insulin needs: Thiazides, glucocorticoids, thyroid hormones, beta-sympathomimetics, and growth hormones.

Contraindications

Semglee is contraindicated in patients allergic to insulin glargine or any of its components.

Side Effects

Possible side effects include hypoglycemia, allergic reactions, injection site irritation, lipodystrophy, itching, and rash.

Pregnancy & Lactation

Semglee is classified under pregnancy category C. Its use during pregnancy should only be considered if the benefits outweigh the risks. The excretion of insulin glargine in breast milk is unknown, so caution is advised for nursing women.

Precautions & Warnings

• Monitoring and Dose Adjustments: Regular blood glucose monitoring is crucial. Dosage adjustments should only be made under medical supervision.
• Administration Warnings: Do not mix or dilute Semglee with other insulins or solutions, and avoid intravenous use to prevent severe hypoglycemia.
• Renal or Hepatic Impairment: Dose adjustments may be needed.

Overdose

An overdose of Semglee can result in hypoglycemia, which can typically be managed with oral carbohydrates or, in severe cases, parenteral glucose or glucagon injections.

Storage Instructions

Store Semglee in a refrigerator at 2°C to 8°C. Do not freeze, and protect from light.