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insulin degludec

Generic Name: insulin degludec (IN su lin de GLOO dek)
Brand Name: Tresiba FlexTouch

What is insulin degludec?

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.

Insulin degludec is used to improve blood sugar control in adults with diabetes mellitus. This medicine may be used for type 1 or type 2 diabetes.

Insulin degludec may also be used for purposes not listed in this medication guide.

What is the most important information I should know about insulin degludec?

Never share an injection pen with another person, even if the needle has been changed.

What should I discuss with my healthcare provider before using insulin degludec?

You should not use insulin degludec if you are allergic to it, or if you are having an episode of hypoglycemia (low blood sugar).

Insulin degludec is not approved for use by anyone younger than 18 years old.

To make sure insulin degludec is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • low levels of potassium in your blood (hypokalemia); or

  • diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while you are using insulin may increase your risk of serious heart problems.

Follow your doctor's instructions about using insulin if you are pregnant or breast-feeding a baby. Blood sugar control is very important during pregnancy, and your dose needs may be different during each trimester of pregnancy. Your dose needs may also be different while you are breast-feeding.

How should I use insulin degludec?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended. A dose counter on the injection pen shows your dose in units. Do not convert your dose.

Insulin is injected under the skin. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

Insulin degludec must not be given with an insulin pump, or mixed with other insulins. Do not inject insulin degludec into a vein or a muscle.

Insulin degludec is usually given once daily, at any time of the day. Follow your doctor's dosing instructions very carefully.

Your care provider will show you the best places on your body to inject insulin degludec. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

Use only the prefilled injection pen that comes with this medicine. Attach a new needle before each use. Do not transfer the insulin from the pen into a syringe.

Never share an injection pen 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.

Use a disposable needle and syringe only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and 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, blurred vision, headache, and tiredness.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.

Insulin degludec is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

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:

  • Refrigerate and use until expiration date; or

  • Store at room temperature and use within 8 weeks (56 days).

Storing opened (in use) insulin degludec:

  • Store the injection pen at room temperature (do not refrigerate) and use within 8 weeks. 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.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Wear a diabetes medical alert tag in case of emergency. Any medical care provider who treats you should know that you have diabetes.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Then continue your regular dosing schedule, allowing at least 8 hours to pass between doses. Do not use extra insulin to make up a missed dose.

Keep insulin on hand at all times. Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Insulin overdose can cause life-threatening hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizure (convulsions), or loss of consciousness.

What should I avoid while using insulin degludec?

Insulin can cause low blood sugar. Avoid driving or operating machinery until you know how this medicine will affect you.

Avoid medication errors by always checking the medicine label before injecting your insulin.

Avoid drinking alcohol. It can cause low blood sugar and may interfere with your diabetes treatment.

Insulin degludec side effects

Get emergency medical help if you have signs of an allergic reaction: hives, itching, skin rash; wheezing, tiredness, trouble breathing; feeling like you might pass out; nausea, diarrhea; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • fluid retention--weight gain, swelling in your hands or feet, feeling short of breath; or

  • low potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling.

Common side effects may include:

  • low blood sugar;

  • itching, mild skin rash; or

  • thickening or hollowing of the skin where you injected the medicine.

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.

See also: Side effects (in more detail)

Insulin degludec dosing 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.

What other drugs will affect insulin degludec?

Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of insulin. 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.

Where can I get more information?

  • Your pharmacist can provide more information about insulin degludec.
  • 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.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.04. Revision Date: 2016-06-22, 1:10:24 PM.

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