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Insulin Degludec Dosage

Applies to the following strength(s): 200 units/mL ; 100 units/mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Diabetes Type 1

Dose should be individualized based on clinical response; this basal insulin should be used in regimens with short or rapid-acting insulin

Insulin-naive patients:
Initial dose: One-third to one-half the total daily insulin requirement subcutaneously once a day.
-The initial total daily insulin requirement in insulin naive patients is generally 0.2 to 0.4 units of insulin per kilogram of body weight.

Current insulin users:
Initiate at the same total daily dose of current long or intermediate-acting insulin subcutaneously once a day.

Comments:
-Adjust dosage according to metabolic needs, blood glucose measurements, and glycemic goals; dose increases should occur no sooner than every 3 to 4 days.
-When changing treatment regimens, the dose and frequency of short-acting insulin may need to be adjusted.
-To minimize hypoglycemia, closely monitor blood glucose, especially with changing regimens.

Use: To improve glycemic control in patients with diabetes mellitus.

Usual Adult Dose for Diabetes Type 2

Initial dose: 10 units subcutaneously once a day

Current insulin users:
Initiate at the same total daily dose of current long or intermediate-acting insulin subcutaneously once a day.

Comments:
-Adjust dosage according to metabolic needs, blood glucose measurements, and glycemic goals; dose increases should occur no sooner than every 3 to 4 days.
-When changing treatment regimens, the dose and frequency of short-acting insulin or other anti-diabetic medications may need to be adjusted.
-To minimize hypoglycemia, closely monitor blood glucose, especially with changing regimens.

Use: To improve glycemic control in patients with diabetes mellitus.

Renal Dose Adjustments

Use caution; glucose-monitoring should be intensified and the insulin dose adjusted on an individual basis.

Liver Dose Adjustments

Use caution; glucose-monitoring should be intensified and the insulin dose adjusted on an individual basis.

Dose Adjustments

Elderly: Glucose-monitoring should be intensified in patients 65 years or older.

-Daily insulin requirements may be higher during illness, stress, pregnancy, in obese patients, trauma, during concurrent use with medications having hyperglycemic effects, or after surgery
-Daily insulin requirements may be lower with exercise, weight loss, calorie restricted diets, or during concurrent use of medications having hypoglycemic effects.

Dosage adjustments may be required when the brand, type, or species of insulin is changed; oral antidiabetic treatment may need to be adjusted as well.

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-Always check insulin labels before administration.
-Never share an insulin pen between patients, even if the needle is changed; do not reuse or share needles or syringes between patients as this presents a risk for transmission of blood-borne pathogens.

-Administer subcutaneously once a day at any time of the day, preferably at the same time every day; injections can be in the thigh, upper arm, or abdominal wall. Rotate sites in order to reduce the risk of lipodystrophy.
-Do not administer IV or IM or use in insulin infusion pumps
-The dose counter shows the number of units regardless of strength; no dose conversion should be done when transferring a patient to a new strength.
-Do not transfer this insulin from the insulin pen into an insulin syringe for administration; the markings on the insulin syringe will not measure the dose correctly.
-Ensure patients have been educated as to proper injection technique.
-Only use this insulin if the solution appears clear and colorless.

Dosing time flexibility:
-On certain occasions, insulin degludec can allow for flexibility in dosing intervals; however, a minimum of 8 hours between doses should be maintained.
-If a patient forgets a dose they should be advised to take it upon discovery and then resume with their normal once daily dosing.

Preparation and Instructions for Use: The manufacturer product information should be consulted.

Storage requirements:
-Store in the refrigerator at 36F to 46F (2C to 8C)) prior to first use.
-Do not freeze, if frozen do not use.
-After opening, do not refrigerate. Store below 86F (30C).
-Pens may be used for a maximum of 8 weeks after opening.
-Keep the cap on the pen to protect from light.

Compatibility:
-Do not dilute or mix with any other insulin products or solutions

General:
-Not recommended for the treatment of diabetic ketoacidosis.
-Insulin requirements may be altered during stress, major illness, or with changes in exercise, meal patterns, or coadministered drugs.
-Hypoglycemia is the most common adverse reaction of insulin therapy; the timing generally reflects the time-action profile of the administered insulin.

Monitoring:
-Blood glucose monitoring is essential for patients receiving insulin therapy.
-Urine ketone testing is recommended for patients with type I diabetes if they develop symptoms of colds, influenza, nausea, vomiting, or other illnesses, polyuria, or if blood glucose levels are unexpectedly high or inconsistent.
-Glycosylated hemoglobin measurements are recommended every 3 months.

Patient advice:
-Patients should be advised to never share an insulin pen with another person, even if the needle is changed; patients should understand that sharing needles or syringes with another person carries a risk for transmission of blood-borne pathogens.
-Patients should be reminded to always check insulin labels before injection, especially if using more than 1 type of insulin.
-Patients should be instructed on glucose monitoring, proper injection technique, and the management of hypoglycemia and hyperglycemia.
-Patients should be instructed on how to handle situations which may affect their insulin requirements.
-Patients should check blood sugar prior to driving a car or operating machinery.
-Advise patient to speak to physician or health care professional if pregnant or if they intend to become pregnant.

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