Insulin degludec and liraglutide
Generic name: insulin degludec and liraglutide [ IN-su-lin-de-GLOO-dek-and-LIR-a-GLOO-tide ]
Brand name: Xultophy
Dosage form: subcutaneous solution (100 units-3.6 mg/mL)
Drug class: Antidiabetic combinations
What is insulin degludec and liraglutide?
Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Insulin degludec is a long-acting insulin that starts to work several hours after injection and keeps working evenly for 24 hours.
Liraglutide is similar to a hormone that occurs naturally in the body and helps control blood sugar, insulin levels, and digestion.
Insulin degludec and liraglutide is a combination medicine used to lower blood sugar in adults with type 2 diabetes mellitus. insulin degludec and liraglutide should be used together with diet and exercise.
Insulin degludec and liraglutide is usually given when your blood sugar levels have not been well controlled by using other medications.
Insulin degludec and liraglutide is not for people with type 1 diabetes.
Insulin degludec and liraglutide may also be used for purposes not listed in this medication guide.
You should not use this medicine if you have multiple endocrine neoplasia type 2 (tumors in your glands), a personal or family history of medullary thyroid cancer, insulin-dependent diabetes, or if you are having an episode of low blood sugar or diabetic ketoacidosis.
In animal studies, liraglutide caused thyroid tumors or thyroid cancer. It is not known whether these effects would occur in people.
Call your doctor at once if you have signs of a thyroid tumor, such as swelling or a lump in your neck, trouble swallowing, a hoarse voice, or shortness of breath.
Before taking this medicine
You should not use insulin degludec and liraglutide if you are allergic to insulin or liraglutide. Do not use this medicine during an episode of low blood sugar, or if you have:
multiple endocrine neoplasia type 2 (tumors in your glands);
a personal or family history of medullary thyroid carcinoma (a type of thyroid cancer);
diabetic ketoacidosis (call your doctor for treatment); or
a condition for which you use liraglutide (Saxenda, Victoza) or a medicine like liraglutide (albiglutide, dulaglutide, exenatide, lixisenatide, Adlyxin, Byetta, Bydureon, Tanzeum, Trulicity).
Tell your doctor if you have ever had:
kidney or liver disease;
stomach problems causing slow digestion;
if you also use a meal-time insulin.
In animal studies, liraglutide caused thyroid tumors or thyroid cancer. It is not known whether these effects would occur in people using regular doses. Ask your doctor about your risk.
Tell your doctor if you are pregnant or breastfeeding.
Follow your doctor's instructions about using insulin if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby.
Insulin degludec and liraglutide is not approved for use by anyone younger than 18 years old.
How should I take insulin degludec and liraglutide?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Insulin degludec and liraglutide is injected under the skin, usually once daily at the same time each day. A healthcare provider will teach you how to properly use the medication by yourself. Use only the injection pen supplied with this medicine. Do not dilute or mix other medicines in the injection with insulin degludec and liraglutide.
You may use this medicine with or without food.
Your care provider will show you the best places on your body to inject this medicine. Use a different place each time you give an injection. Do not inject into the same place two times in a row.
Do not inject this medicine into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.
Call your doctor if you have ongoing vomiting or diarrhea. You can easily become dehydrated while using this medicine, which lead to kidney failure.
Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.
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 dose or medication schedule.
Never share an injection pen, cartridge, or syringe 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.
Keep this medicine 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) insulin degludec and liraglutide:
Refrigerate and use until expiration date; or
Store at room temperature and use within 21 days (3 weeks).
Storing opened (in use) insulin degludec and liraglutide:
Store at room temperature away from heat and light, and use within 21 days; or
Store in a refrigerator and use within 21 days.
Do not store the injection pen with a needle attached.
Do not use the medicine if it looks cloudy or has changed colors. Call your pharmacist for new medicine.
What happens if I miss a dose?
Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.
If you miss your dose for more than 3 days in a row, call your doctor for instructions.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. You should not use more than 50 units of insulin degludec and liraglutide in one day.
What should I avoid while taking insulin degludec and liraglutide?
Do not drink alcohol. Check your other medicine labels to be sure these products do not contain alcohol.
Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.
Insulin degludec and liraglutide side effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Insulin degludec and liraglutide may cause serious side effects. Call your doctor at once if you have:
severe nausea and vomiting;
shortness of breath (even with mild exertion);
swelling in your feet or ankles, rapid weight gain;
signs of pancreatitis--severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;
kidney problems--little or no urination, painful or difficult urination; or
low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.
Common side effects of insulin degludec and liraglutide may include:
cold symptoms such as stuffy or runny nose, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Insulin degludec and liraglutide dosing information
Usual Adult Dose for Diabetes Type 2:
Dose is directed in units of insulin degludec
Basal Insulin or GLP-1 Receptor Agonist Naive:
-Initial dose: 10 units subcutaneously once a day
Currently Receiving a Basal Insulin or GLP-1 Receptor Agonist: Discontinue therapy with basal insulin and/or liraglutide prior to initiating:
-Initial dose: 16 units subcutaneously once a day
TITRATION: Adjust dose up or down in increments of 2 units every 3 to 4 days based on individual metabolic needs, blood glucose monitoring, and glycemic goal until desired fasting plasma glucose is achieved
Maximum daily dose: 50 units (insulin degludec 50 units; liraglutide 1.8 mg)
-Insulin degludec 1 unit and liraglutide 0.036 mg are provide per unit; a table providing the corresponding milligrams of liraglutide may be found in the manufacturer product labeling.
-To minimize the risk of hypoglycemia or hyperglycemia, additional titration may be necessary with changes in physical activity, food intake, during acute illness, or with use of concomitant medications.
-This combination drug is not recommended as first-line therapy because of the uncertainty of rodent C-cell tumor finding to humans.
-The combination drug has not been studied in combination with prandial insulin.
Use: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
What other drugs will affect insulin degludec and liraglutide?
Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of insulin degludec and liraglutide. 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.
Insulins are usually grouped as fast-acting, intermediate-acting, or long-acting. Within these groups, they can be further classified as human insulin and human insulin analogs. An insulin analog is a human insulin that has one or two amino acids changed which affects how quickly it is absorbed after injection and how fast or slow it acts. Insulin analogs are usually given within 15 minutes of a meal or at the same time as food. Continue reading
Injecting insulin is not difficult, but it does take a bit of practice. There are three main sites where insulin can be injected: the stomach area except for a 2-inch circle around your navel, and the soft part of your waist, but not anywhere near your spine; the top and outer part of your thighs, but not your inner thighs or anywhere close to your knee; the outer back of your upper arm where there is a pocket of fatty tissue. Continue reading
Both Soliqua and Xultophy combine a long-acting insulin with a GLP-1 agonist: Xultopy brings together Tresiba (insulin degludec) and Victoza (liraglutide), while Soliqua combines Lantus (insulin glargine) with Adlyxin (lixisenatide). When used with diet and exercise for the treatment of type 2 diabetes, these agents can help you control blood sugar, insulin levels, and digestion and may help you lose weight. Continue reading
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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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