Abasaglar (previously Abasria) (Insulin Glargine Solution for injection) 3.64 mg

Abasaglar is indicated for basal insulin therapy in adult patients with diabetes. It is used to maintain steady glucose levels when combined with mealtime insulin or oral agents.

• Type 1 diabetes mellitus requiring basal insulin support.
• Type 2 diabetes mellitus inadequately controlled with oral antidiabetic drugs alone.
• Adjunct therapy with rapid‑acting insulin for a basal‑bolus regimen.
• Use during pregnancy only when benefits outweigh potential risks, as determined by a clinician.
• Switching from other long‑acting insulin analogs when a comparable basal profile is desired.

• Insulin glargine is a recombinant human insulin analog engineered with a substitution at position A21 and an addition of two arginine residues to the C‑terminus of the B‑chain. These structural changes shift the molecule’s isoelectric point, causing it to precipitate slowly after subcutaneous injection. The gradual release provides a relatively constant activation of insulin receptors, promoting cellular glucose uptake, inhibiting hepatic gluconeogenesis, and reducing lipolysis over a 24‑hour period.

Adverse reactions to Abasaglar may occur, ranging from mild injection‑site events to rare systemic complications.

Common

• Mild hypoglycemia, presenting as shakiness, sweating, or dizziness, often when meals are delayed or carbohydrate intake is reduced.
• Localized redness, swelling, itching, or bruising at the injection site.
• Small, temporary increase in body weight due to fluid retention.
• Development of lipodystrophy (lumpy or indented skin) at repeated injection sites.

Serious

• Severe hypoglycemia with neuroglycopenic symptoms such as confusion, seizures, or loss of consciousness.
• Allergic reactions including urticaria, angioedema, or anaphylactic shock.
• Peripheral edema or worsening of pre‑existing heart failure.
• Persistent hyperglycemia suggesting possible insulin resistance or dosing error.

Before initiating Abasaglar, clinicians should evaluate patient history and monitor specific conditions to minimize risks.

• Assess for hypoglycemia unawareness or frequent low glucose episodes.
• Review renal or hepatic impairment, as clearance may be altered.
• Use caution in patients with cardiovascular disease or edema.
• Adjust dose when switching from other basal insulins to avoid over‑ or under‑insulinisation.
• Educate patients on proper injection technique and rotation of sites.
• Monitor pregnancy status; insulin requirements may change during gestation.
• Conduct regular blood glucose and HbA1c assessments to guide therapy.

Abasaglar can interact with other medicines, affecting glucose control or insulin action.

Avoid

• Concurrent use of other long‑acting insulin analogs without dose adjustment.
• High‑dose beta‑blockers that may mask hypoglycemia symptoms.

Use with caution

• Oral antidiabetic agents (e.g., sulfonylureas, meglitinides) that increase hypoglycemia risk.
• Corticosteroids, which may raise blood glucose and require insulin dose increase.
• Thiazide diuretics, potentially causing fluid retention and edema.
• ACE inhibitors or ARBs, which may affect renal function and insulin clearance.
• Alcohol, especially in excess, as it can potentiate hypoglycemia.