Drug & supplement interaction

Fasting + Insulin Glargine Recombinant

Insulin Glargine Recombinant brand name: Toujeo Solostar.

Moderate Interaction
The bottom line Moderate

Insulin Glargine Recombinant falls into 2 drug categories that Fasting can interact with; the most serious is rated moderate. Fasting might increase the risk of hypoglycemia if used with antidiabetes drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Fasting and Insulin Glargine Recombinant

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Fasting interacts with whole categories of medication. Insulin Glargine Recombinant falls into 2 of those categories, so it can interact with Fasting in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

ANTIDIABETES DRUGS

1 of 2

Why this applies to Insulin Glargine Recombinant

Insulin Glargine Recombinant falls under ANTIDIABETES DRUGS — the group Fasting interacts with.

Fasting might increase the risk of hypoglycemia if used with antidiabetes drugs.
Hypoglycemic events have been reported during intermittent fasting, including in patients using antidiabetes drugs. The risk of having a hypoglycemic event is largest for patients taking insulin or sulfonylureas. The risk of hypoglycemic events seems to be lower for patients taking other antidiabetes drugs such as glucagon-like peptide-1 receptor agonist (GLP- 1RA), metformin, thiazolidinediones, dipeptidyl peptidase-4 inhibitors (DPP4 inhibitors), and sodium-glucose cotransporter-2 (SGLT2) inhibitors. Advise patients to monitor glucose levels closely. Dose or time adjustments may be necessary.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing with Toujeo (insulin glargine): it's a long-acting insulin that keeps lowering your blood sugar steadily over about 24 hours, whether or not you eat. When you fast, you take in little or no carbohydrate, but that background insulin keeps working. That mismatch is exactly what can push your sugar too low, which we call hypoglycemia.

Watch for shakiness, sweating, dizziness, confusion, a racing heart, or feeling suddenly weak. Insulin is one of the strongest blood sugar lowering medications, so this is worth taking seriously. The good news is the evidence is moderate and this is manageable. Please don't change your insulin dose on your own. Talk with your doctor or pharmacist first, check your glucose more often, and they may adjust your dose or timing.

References
  1. Carter S, Clifton PM, Keogh JB. Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with Type 2 diabetes: A randomized noninferiority trial. JAMA Netw Open. 2018;1(3):e180756. PubMed
  2. Cioffi I, Evangelista A, Ponzo V, et al. Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials. J Transl Med. 2018;16(1):371. PubMed
  3. Chowdhury A, Khan H, Lasker SS, Chowdhury TA. Fasting outcomes in people with diabetes and chronic kidney disease in East London during Ramadan 2018: The East London diabetes in Ramadan survey. Diabetes Res Clin Pract. 2019;152:166-170. PubMed
  4. Grajower MM, Horne BD. Clinical management of intermittent fasting in patients with diabetes mellitus. Nutrients. 2019;11(4):873. PubMed
  5. Ibrahim M, Davies MJ, Ahmad E, et al. Recommendations for management of diabetes during Ramadan: update 2020, applying the principles of the ADA/EASD consensus. BMJ Open Diabetes Res Care. 2020;8(1):e001248. PubMed
  6. Wang X, Li Q, Liu Y, Jiang H, Chen W. Intermittent fasting versus continuous energy-restricted diet for patients with type 2 diabetes mellitus and metabolic syndrome for glycemic control: A systematic review and meta-analysis of randomized controlled tria
Moderate

INSULIN

2 of 2
Fasting might increase the risk of hypoglycemia if used with insulin.
Hypoglycemic events have been reported during intermittent fasting. The risk of a hypoglycemic event seems to be highest in patients using insulin or sulfonylureas. Patients with type 2 diabetes and other comorbidities, or those with type 1 diabetes, should be strongly advised to avoid fasting while taking insulin. For patients taking insulin who insist on fasting, advise these patients to monitor glucose levels closely. Dose or time adjustments may be necessary.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to keep in mind: Toujeo (insulin glargine) is a long-acting insulin that quietly works in the background all day to lower your blood sugar. When you fast, you're not taking in carbs to balance that out, so your sugar can drift lower than usual. Put those two together and the risk of hypoglycemia goes up.

Low blood sugar can show up as shakiness, sweating, dizziness, confusion, or in serious cases passing out. Because glargine lasts so long, you can't simply skip a dose once it's already in you. The research here is real but modest in quality, so don't panic. Please talk with your doctor or pharmacist before fasting. They may adjust your dose and have you check your sugar more often.

References
  1. Carter S, Clifton PM, Keogh JB. Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with Type 2 diabetes: A randomized noninferiority trial. JAMA Netw Open. 2018;1(3):e180756. PubMed
  2. Cioffi I, Evangelista A, Ponzo V, et al. Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: a systematic review and meta-analysis of randomized controlled trials. J Transl Med. 2018;16(1):371. PubMed
  3. Chowdhury A, Khan H, Lasker SS, Chowdhury TA. Fasting outcomes in people with diabetes and chronic kidney disease in East London during Ramadan 2018: The East London diabetes in Ramadan survey. Diabetes Res Clin Pract. 2019;152:166-170. PubMed
  4. Grajower MM, Horne BD. Clinical management of intermittent fasting in patients with diabetes mellitus. Nutrients. 2019;11(4):873. PubMed
  5. Ibrahim M, Davies MJ, Ahmad E, et al. Recommendations for management of diabetes during Ramadan: update 2020, applying the principles of the ADA/EASD consensus. BMJ Open Diabetes Res Care. 2020;8(1):e001248. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Fasting Also Interacts With Other Medications

Fasting has 2 major, 205 moderate known drug interactions in our database — the Insulin Glargine Recombinant one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Fasting

Covers the 2,830 medications we’ve checked against Fasting. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Insulin Glargine Recombinant

This page covers Fasting only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Insulin Glargine Recombinant page lists 242 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Chelation Therapy Products (major), Siberian Cocklebur (major), Acai (moderate), African Wild Potato (moderate) and Agaricus Mushroom (moderate).

By severity: 2 major · 211 moderate · 29 minor.

From our pharmacist’s overview on the Insulin Glargine Recombinant page

“If you inject insulin glargine (Toujeo Solostar), this list deserves real respect, because all 242 ingredients on it bear on the number you track daily, your blood sugar. Most of the 211 moderate entries add to insulin's glucose-lowering effect and can tip you into hypoglycemia, a dangerous low, while a smaller group pushes sugar upwar…”

Reviewed by 2 · Jul 18, 2026

Open the Insulin Glargine Recombinant interaction page

How much people look this up

Where Fasting and Insulin Glargine Recombinant Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Fasting
Top half

#720 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Insulin Glargine Recombinant
Steady interest

#1,754 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Eating pattern

About Fasting

What is Fasting?

  • Weight loss
  • Blood sugar control
  • Heart health
  • Religious or spiritual practice
  • General wellness and longevity

Fasting means voluntarily going without food (and sometimes drink) for set periods. Some research suggests it may help with weight loss and blood sugar in certain people, but results vary and quality of evidence is mixed. It is not safe for everyone, so check with your doctor or pharmacist before starting—especially if you take medication or have a health condition.

Read the full Fasting monograph & all interactions
Keep checking

Other Drugs & Fasting

Browse every other medication we’ve checked against Fasting — both the ones with a known interaction and the ones without. Select any drug for the full detail.

2Major
205Moderate
0Minor
2,622No known interaction
Major

2 interactions

Moderate

205 interactions

Showing 60 of 205 moderate interactions — see all 205 on the Fasting page.

No interaction 2,622 drugs checked — show the list

We also checked Fasting against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,622 medications checked with no known interaction — see the full Fasting list.

Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Following Fasting While Taking Insulin Glargine Recombinant: Common Questions

Can you follow Fasting while taking Insulin Glargine Recombinant?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Fasting and Insulin Glargine Recombinant?
Insulin Glargine Recombinant belongs to more than one drug category, and Fasting interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Fasting and Insulin Glargine Recombinant interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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