Basaglar is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours. Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood.

Basaglar is used to improve blood sugar control in adults and children with diabetes mellitus.

Basaglar, is for use in adults with type 1 or 2 diabetes and in children at least 6 years old with type 1 diabetes (not type 2).

For type 1 diabetes, Basaglar KwikPen is used together with a short-acting insulin given before meals.

Warnings

Never share a Basaglar KwikPen with another person, even if the needle has been changed.

You should not use Basaglar if you are having an episode of hypoglycemia (low blood sugar), or if you are in a state of diabetic ketoacidosis (call your doctor for treatment).

Basaglar is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Never share an injection pen, even if you changed the needle.

Basaglar KwikPen side effects

Get emergency medical help if you have any signs of an allergic reaction to Basaglar: redness or swelling where an injection was given, itchy skin rash over the entire body, trouble breathing, fast heartbeats, feeling like you might pass out, or swelling in your tongue or throat.

Call your doctor at once if you have:

• rapid weight gain, swelling in your feet or ankles;
• shortness of breath; or
• low blood potassium – leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common Basaglar side effects may include:

• low blood sugar;
• swelling, weight gain;
• allergic reaction, itching, rash; or
• thickening or hollowing of the skin where you injected the medicine.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Before taking this medicine

You should not use Basaglar KwikPen if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar) or diabetic ketoacidosis (call your doctor for treatment).

Basaglar KwikPen is not approved for use by anyone younger than 6 years old, and some brands are for use only in adults. Do not use this medicine to treat type 2 diabetes in a child of any age.

To make sure Basaglar is safe for you, tell your doctor if you have:

• liver or kidney disease; or
• heart failure or other heart problems.

Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while you are using insulin may increase your risk of serious heart problems.

Tell your doctor if you are pregnant or breastfeeding.

Follow your doctor’s instructions about using this medicine if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy.

How should I use Basaglar KwikPen?

Use Basaglar exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not use Basaglar in larger or smaller amounts or for longer than recommended.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

The Toujeo brand of insulin glargine contains 3 times as much insulin per milliliter (mL) as the Basaglar brand. There are 300 units of insulin in 1 mL of Toujeo, and 100 units in 1 mL of Basaglar.

If there are any changes in the brand, strength, or type of insulin you use, your dosage needs may change.

Basaglar is injected under the skin. You will be shown how to use injections at home. Do not give yourself Basaglar if you do not understand how to use the injection and properly dispose of used needles and pens.

Basaglar must not be given with an insulin pump, or mixed with other insulins. Do not inject Basaglar into a vein or a muscle.

Do not inject this medicine into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.

Basaglar is usually injected once per day at the same time each day. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and pens.

Your care provider will show you the best places on your body to inject Basaglar. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

Use only the injection pen that comes with Basaglar KwikPen. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe.

Never share an injection pen with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles. Use a puncture-proof “sharps” disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.

Basaglar is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor’s instructions very closely.

Keep Basaglar in its original container protected from heat and light. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) Basaglar KwikPen:

• Refrigerate and use until the expiration date; or
• if stored at room temperature (below 86 degrees Fahrenheit) , use within 28 days.

Storing opened (in use) Basaglar KwikPen:

• Store the injection pen at room temperature (do not refrigerate) and use within 28 days.

Do not use the medicine if it looks cloudy, has changed colors, or has any particles in it. Call your pharmacist for new medicine.

Wear a diabetes medical alert tag (or carry an ID card) in case of emergency. Any medical care provider who treats you should know that you have diabetes.

Do not store an injection pen with the needle attached. Do not reuse a needle or syringe. Place them in a puncture-proof “sharps” container and dispose of it following state or local laws. Keep out of the reach of children and pets.

What happens if I miss a dose?

Call your doctor for instructions if you miss a dose. Do not use more than one dose in a 24-hour period unless your doctor tells you to.

Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . Insulin overdose can cause severe hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizure (convulsions), or loss of consciousness.

What should I avoid while using Basaglar KwikPen?

Avoid driving or hazardous activity until you know how Basaglar KwikPen will affect you. Your reactions could be impaired.

Avoid medication errors by always checking the medicine label before injecting your insulin.

Avoid drinking alcohol or using medicines that contain alcohol. It may interfere with your diabetes treatment.

What other drugs will affect Basaglar KwikPen?

Many drugs can affect your blood sugar and may also affect Basaglar. Some medicines can increase or decrease the effects of insulin. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use. Not all possible interactions are listed here.

Baqsimi is used to treat very low blood sugar (severe hypoglycemia) in adults and children aged 1 year and older with diabetes. It is a nasal powder that is administered into the nose, making it easier to administer than traditional injectable glucagon. After giving Baqsimi, the caregiver should call for emergency help.

Baqsimi (glucagon) works by activating liver glucagon receptors, stimulating glycogen breakdown, and releasing glucose from the liver, increasing blood glucose levels. Liver stores of glycogen are necessary for glucagon to produce an antihypoglycemic effect.

Baqsimi gained FDA approval on July 24, 2019. There is no generic.

Side effects

The most common side effects of Baqsimi include:

• nausea
• discomfort in your nose
• watery eyes
• vomiting
• stuffy nose
• redness in your eyes
• headache
• cough
• itchy nose, throat, and eyes
• runny nose
• nose bleed.

Serious side effects and warnings

Baqsimi may cause the following serious side effects:

• High blood pressure. Baqsimi can cause high blood pressure in certain people with tumors in their adrenal glands. Call your doctor at once if you have symptoms of high blood pressure, such as severe headache, blurred vision, and pounding in your neck or ears
• Low blood sugar. Baqsimi can cause certain people with tumors in their pancreas, called insulinomas, to have low blood sugar
• Serious allergic reactions. Call your healthcare provider or get medical help right away if you have a serious allergic reaction, including:
  • rash
  • difficulty breathing
  • low blood pressure
  • hives
  • trouble swallowing
  • feeling dizzy or faint
  • cough
  • swelling of the face, lips, or tongue
  • fast heartbeat.

It is not known if Baqsimi is safe and effective in children under 1 year of age.

These are not all the possible side effects of Baqsimi. For more information, ask your healthcare provider. Call your healthcare provider for medical advice about side effects.

Before taking

You should not use Baqsimi if you are allergic to glucagon, or if you have:

• a tumor of the pancreas (insulinoma); or
• a tumor of the adrenal gland (pheochromocytoma).

Before taking, tell your healthcare provider about all your medical conditions, including if you:

• have adrenal gland problems
• have a tumor in your pancreas
• have not had food or water for a long time (prolonged fasting or starvation)
• have low blood sugar that does not go away (chronic hypoglycemia)
• are pregnant or plan to become pregnant. It is not known if Baqsimi will harm your unborn baby
• are breastfeeding or plan to breastfeed. It is not known if Baqsimi passes into your breast milk. You and your healthcare provider should decide if you can use Baqsimi while breastfeeding.

How should I use Baqsimi?

Read the detailed Instructions for Use that comes with Baqsimi. Use Baqsimi exactly how your healthcare provider tells you to use it.

Make sure your caregiver and those around you know where you keep your Baqsimi and how to use Baqsimi the right way before you need their help.

• Baqsimi contains only 1 dose of medicine and cannot be reused.
• Baqsimi should be given in one side of your nose (nostril), but does not need to be inhaled.
• Baqsimi will work even if you have a cold or are taking cold medicine.
• Act quickly. Having very low blood sugar for a period of time may be harmful.
• After giving Baqsimi, the caregiver should call for emergency medical help right away.

When you can safely swallow food or drink, your caregiver should give you a fast-acting source of sugar (such as a regular soft drink or fruit juice) and a long-acting source of sugar (such as crackers with cheese or peanut butter).

If the person does not respond after 15 minutes, another dose of Baqsimi from a new device may be given, if available, while waiting for emergency services.

Tell your healthcare provider each time you use Baqsimi.

What happens if I miss a dose?

Since Baqsimi is used as needed, it does not have a daily dosing schedule.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

Overdose symptoms may include nausea, vomiting, constipation, rapid pulse, or increased blood pressure (severe headache, blurred vision, pounding in your neck or ears).

What should I avoid while using Baqsimi?

Do not take by mouth. Nasal medicine is for use only in the nose.

Avoid drinking alcohol. It can lower your blood sugar.

What other drugs will affect Baqsimi?

Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of medicines used to treat diabetes. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all medicines you start or stop using.

• There are many types of medicines used to treat diabetes.
• The medicine that is best for you depends on what type of diabetes you have, how well it is controlled, if you have other health conditions and your lifestyle.
• Diabetes medicines aim to keep your blood glucose levels within a healthy range, so you feel well and to reduce your chances of complications.
• Your doctor can help you monitor your diabetes and recommend the right treatment for you.

How is insulin used to treat diabetes?

Insulin is a hormone that helps move glucose from your blood into the cells of your body, where it can be used for energy.

People with type 1 diabetes produce little or no insulin, so they need lifelong insulin replacement. Some people with type 2 diabetes, and some women with gestational diabetes (diabetes during pregnancy), also need to use insulin.

What non-insulin treatments are available to treat diabetes?

Non-insulin medicines can be used to lower blood glucose levels and are often used to treat type 2 diabetes.

Most people with type 2 diabetes are able at first to manage their condition through:

• healthy eating
• regular physical activity
• and maintaining a healthy weight

Over time, your diabetes may progress. When this happens, you may need medicines to control your blood glucose levels and prevent long-term complications.

There are many types of diabetes medicines. They all work in different ways and have different benefits and side effects.

Metformin

Most people with type 2 diabetes start treatment with metformin. This is a medicine that reduces the amount of glucose released into your blood, and increases the amount taken up by your cells.

Sulphonylureas

Sulphonylureas stimulate the pancreas to produce more insulin. Sometimes, a sulfonylurea is prescribed for people with type 2 diabetes as an alternative to metformin. However, it is usually used in addition to metformin, if diet, exercise and metformin alone do not control your diabetes adequately.

Both metformin and sulphonylureas have been used for many years. They are known to successfully reduce the complications of diabetes.

Other medicines

Other, newer medicines for type 2 diabetes include:

• glitazones — help the body to use insulin more effectively
• acarbose — prevents the carbohydrate you eat from being broken down into glucose
• GLP-1 analogues — increase the amount of insulin in the blood and are usually given as an injection
• SGLT2 inhibitors — increase the amount of glucose excreted in urine and are usually used in combination with other diabetes medicines
• DPP-4 inhibitors — also known as ‘gliptins’, increase your body’s own insulin secretion and decrease the activity of the hormone glucagon, to lower your blood glucose levels

Your doctor will recommend the best medicine or combination of medicines for you, depending on your individual circumstances.

Will I take the same diabetes medicines for life?

Over time, your diabetes can change, meaning your medicines may need to change too. For example, you may need to increase the dose, switch medicines or add more medicines.

Regardless of the type of diabetes you have, it’s important you continue to monitor your blood glucose levels over time. This is to make sure your diabetes remains well managed and your blood glucose levels stay within your target range.

Make sure you have regular check-ups with your doctor. Most people with diabetes should see their doctor every 3 – 6 months. Your doctor will help you monitor your diabetes and recommend the right treatment for you.

What should I do if I take too much or the wrong type of medicine?

If you have taken too much or the wrong type of diabetes medicine, it’s important that you contact your doctor or diabetes nurse or educator for advice.

If your doctor or diabetes nurse or educator is not available.

Taking too much diabetes medicine can cause your blood glucose level to drop too low. This is known as hypoglycaemia (‘hypo’) and can lead to a serious situation if not addressed.

• If you think you may have taken too much diabetes medicine and you self-monitor your blood glucose at home, test your blood glucose levelas soon as possible. If you don’t routinely self-monitor your glucose levels, contact your doctor or seek other medical advice straight away.
• If you find that your blood glucose level is low, you will need to address this straight away.