Cinoxacin
Severe
Database
Drug interaction classified as: antagonism
Source: DDInter
Drug reference
Insulin Glargine
Long-acting basal insulin analogue · Antidiabetic
Also known as Lantus, Toujeo, Basaglar, Abasaglar, Glaritus, Semglee
START
Once daily SC same time; ~10 units or 0.1–0.2 unit/kg/day, titrate to fasting glucose
TYPICAL MAX
No fixed ceiling — titrate to targets (U-100 vs U-300 not interchangeable unit-for-unit)
STOP IF
Hypoglycaemia (treat first); not for DKA/IV
WATCH
Fasting/overall glucose, hypoglycaemia (esp. renal impairment), correct strength/device, injection-site rotation
CDSCO approvedSchedule HATC A10AE04
KDIGO 2024 + manufacturer label
- ONSET
- 1.5h · basal onset
- PEAK
- 12h · flat/peakless (illustrative midpoint)
- t½
- 12h · effective t½
- DURATION
- 1d · basal duration
EXCRETION
Enzymatic degradation (subcutaneous/hepatic/renal)
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Acceptable in pregnancy when insulin needed — basal analogue commonly used; titrate to tight targets
FDA category + note
Top interactionssee all 12 →
- CinoxacinSevereDatabaseDDInter
- CiprofloxacinSevereDatabaseDDInter
- DelafloxacinSevereDatabaseDDInter
- EnoxacinSevereDatabaseDDInter
Available in India
17 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Recombinant insulin analogue that microprecipitates at subcutaneous neutral pH, dissolving slowly for a flat, ~24-h, peakless basal insulin-receptor agonism — promotes glucose uptake and suppresses hepatic glucose output.
Indications
Type 1 diabetes mellitus (basal component)Type 2 diabetes mellitus requiring basal insulin
Dosing
- Adult
- Once daily SC at the same time; individualised (e.g. start ~0.1–0.2 unit/kg/day or 10 units, titrate to fasting glucose). U-100 and U-300 strengths (do not interchange unit-for-unit).
- Pediatric
- ≥2–6 years (product-dependent); weight-based, specialist.
- Renal adjustment
- Insulin requirement falls in renal impairment — titrate down, monitor glucose.
- Hepatic adjustment
- Requirement may fall; titrate to glucose.
- Geriatric
- Conservative targets; hypoglycaemia/falls risk.
- Max dose
- No fixed ceiling — titrated to glycaemic targets
Pharmacokinetics
Onset
~1.5 h
Peak effect
Relatively peakless
Duration
~24 h (U-100); up to ~36 h (U-300)
Half-life
Effective ~12 h (flat profile)
Bioavailability
SC
Protein binding
Low
Metabolism
Subcutaneous + hepatic/renal degradation to active metabolites (M1)
Excretion
Renal/peripheral degradation
Contraindications
- Hypoglycaemia
- Hypersensitivity to insulin glargine/excipients
- Not for IV use or diabetic ketoacidosis (use short-acting insulin)
Side effects
Common
HypoglycaemiaWeight gainInjection-site reactions/lipohypertrophyPeripheral oedema (initiation)
Serious
- Severe hypoglycaemia (coma/seizure)
- Severe hypokalaemia
- Severe hypersensitivity/anaphylaxis (rare)
Pregnancy & lactation
Pregnancy
Acceptable in pregnancy when insulin needed — basal analogue commonly used; titrate to tight targets
Lactation
Compatible — not orally bioavailable to infant; maternal dose may need adjustment
Drug interactions
Ciprofloxacin
Severe
Database
Drug interaction classified as: antagonism.
Source: DDInter
Delafloxacin
Severe
Database
Clinical effect not specified
Source: DDInter
Enoxacin
Severe
Database
Clinical effect not specified
Source: DDInter
Gatifloxacin
Severe
Database
.
Source: DDInter
Gemifloxacin
Severe
Database
Clinical effect not specified
Source: DDInter
Grepafloxacin
Severe
Database
Clinical effect not specified
Source: DDInter
Levofloxacin
Severe
Database
.
Source: DDInter
Lomefloxacin
Severe
Database
Clinical effect not specified
Source: DDInter
Moxifloxacin
Severe
Database
.
Source: DDInter
Nalidixic Acid
Severe
Database
Clinical effect not specified
Source: DDInter
Norfloxacin
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Gestational diabetes mellitus
FOGSI · Obstetrics & Gynaecology · 2023
Fluid and electrolyte management in diabetes
RSSDI · Endocrinology · 2025
Diabetes management during Ramadan
ADA · Endocrinology · 2025
Glucose monitoring in diabetes
RSSDI · Endocrinology · 2024
Type 2 diabetes in adults
RSSDI · Endocrinology · 2022
Other Long-acting basal insulin analogue drugs
Ask House about Insulin Glargine
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19