Tresiba vs. Lantus: 6 Differences Between These Long-Acting Insulins

For many people living with diabetes, insulin therapy is a vital part of managing their blood glucose (sugar) levels. Among the many insulin options available, Lantus (insulin glargine) and Tresiba (insulin degludec) are two long-acting insulins your prescriber may consider.

Tresiba and Lantus are both designed to provide a consistent amount of insulin to manage your blood glucose levels throughout the day. But there are some key differences between them  — from how long their effects last to how their injection pens work. We cover six of these differences below.

1. Tresiba’s effects can last longer compared to Lantus

Tresiba and Lantus contain two different insulins. Tresiba contains insulin degludec, while Lantus contains insulin glargine. One of the main differences between these insulins is how long their effects last in the body. Compared to Lantus, Tresiba’s effects last longer.

Tresiba and Lantus are both usually injected once a day. But after injecting Tresiba, its effects last for up to 42 hours. And because of how long it lasts, Tresiba is sometimes called an ultra-long-acting insulin. Lantus lasts for about 24 hours, so it should be injected at the same time each day to keep insulin levels consistent.

Tresiba can be a good option for adults who may need more flexibility in their dosing schedule. This is because Tresiba allows for day-to-day adjustments, as long as there are at least 8 hours between doses. In other words, you don’t have to inject Tresiba at the same time each day. However, children should receive their Tresiba dose at the same time every day.

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2. There are differences between Tresiba and Lantus injection pens

Tresiba and Lantus both come in multidose vials and injection pens. But Tresiba comes in a FlexTouch pen, while Lantus comes in a SoloStar pen. There are a few key differences between these injection pens that can make one a better choice for you.

The Tresiba FlexTouch pen can be a good option for people with hand dexterity problems. After you dial up your dose, all you need to do is press the dose button to inject the insulin. The pen will also click when the insulin dose is delivered. But you’ll still need to keep the pen in place for 6 seconds to ensure you get the full dose.

The Lantus SoloStar pen has a dose button that extends as you dial up your dose. When injecting your dose, the dose selector turns as the insulin is pushed out of the pen. Pressing the button at an angle or not applying enough pressure, which may be difficult for some people, can prevent you from getting your full dose. Unlike Tresiba, the Lantus pen doesn’t click when the dose dial hits zero.

3. Tresiba also comes in a high-concentration form

Tresiba and Lantus pens both come in U-100 concentrations — 100 units of insulin in each mL of liquid. Each U-100 pen can deliver up to 80 units of insulin per dose. But Tresiba also comes in a high-concentration form (called U-200), which contains twice as much insulin per mL. Each U-200 pen delivers up to 160 units per dose.

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If you need higher insulin doses, Tresiba U-200 can be a more convenient option compared to Lantus. That’s because with Lantus pens, doses exceeding 80 units need to be given as two separate injections. Doses up to 160 units can be delivered in a single shot with Tresiba U-200.

Toujeo, which contains the same insulin as Lantus, comes in high-concentration forms. Read more about how Toujeo and Lantus compare.

4. Tresiba may have a lower risk of hypoglycemia compared to Lantus

Hypoglycemia (low blood glucose) can happen with all types of insulin. But research suggests that Tresiba may have a lower risk of hypoglycemia compared to Lantus. It may also have a lower risk of low blood glucose levels at night (called nocturnal hypoglycemia). This can make Tresiba a good option for people at higher risk of hypoglycemia, such as older adults.

5. Tresiba pens and vials last longer compared to Lantus

If you’re prescribed insulin, you’ll receive instructions for how to store it properly. There are a few differences in how Tresiba and Lantus pens and vials should be stored, including how long they last once opened. 

Compared to Lantus, Tresiba pens and vials last twice as long. So depending on your insulin dose, you may not need to refill your Tresiba prescription as often.

Here’s how Tresiba and Lantus storage requirements compare.

6. Lantus has biosimilars available, while Tresiba does not

Tresiba and Lantus are considered biologics — medications that come from living sources rather than chemicals. Instead of having lower-cost generics, biologics have biosimilars. Biosimilars are highly similar (but not identical) biologics that provide a similar benefit, often at a lower cost. Lantus has biosimilars, but Tresiba does not.

Semglee (insulin glargine-yfgn) and Rezvoglar (insulin glargine-aglr) are both FDA-approved Lantus biosimilars. They’re also considered interchangeable with Lantus, so you can switch between products without issues.

Tresiba doesn’t currently have any FDA-approved biosimilars. But an unbranded version called insulin degludec is available. This insulin is identical to Tresiba, but without the brand name on the label.

Similar to generics, biosimilars and unbranded biologics can help you save money on your prescription. Depending on your insurance coverage, these options may cost less than Tresiba or Lantus. There are also other ways to save on Lantus and Tresiba, such as copay savings cards and patient assistance programs.

Can you switch from Lantus to Tresiba (or vice versa)?

Yes. It’s possible to switch from Lantus to Tresiba (or vice versa). Your prescriber will tell you how to do this safely. They may have you start with a slightly lower insulin dose when switching between products to decrease the risk of hypoglycemia. From there, your insulin dose may be adjusted based on how you respond.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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