Xultophy Dosage, forms & strengths
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Xultophy (insulin degludec/liraglutide) is a once-daily subcutaneous injection manufactured by Novo Nordisk Inc. It is a combination drug that contains a long-acting insulin and a glucagon-like peptide 1 (GLP-1) receptor agonist. Xultophy is FDA-approved along with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus (T2DM). It is not indicated to treat patients with type 1 diabetes (T1DM) or diabetic ketoacidosis.
How does Xultophy work?
Xultophy combines a long-acting basal insulin called insulin degludec and a GLP-1 receptor agonist called liraglutide. Insulin degludec works exactly like the insulin your pancreas makes to regulate blood sugar levels in your blood. It helps remove and store sugar from your bloodstream and it blocks your liver’s production of sugar.
Liraglutide binds and activates the GLP-1 receptors in your pancreas to produce and release more insulin. Liraglutide also blocks the secretion of glucagon and delays how fast your stomach empties. This leads to decreased food intake and lower blood glucose levels.
Xultophy dosage forms and strengths
- 100 units of insulin degludec and 3.6 mg of liraglutide per milliliter in a 3ml single-patient-use pen
You should stop taking liraglutide or basal insulin before starting Xultophy. The recommended starting dose of Xultophy in patients who are not on basal insulin or GLP-1 receptor agonist is 10 units (10 units of insulin degludec and 0.36 mg of liraglutide) injected under the skin (subcutaneous) once daily. The recommended starting dose in patients currently taking basal insulin or GLP-1 receptor agonist is 16 units (16 units of insulin degludec and 0.58 mg of liraglutide) injected under the skin once daily. Your dose can then be titrated once or twice weekly if needed.
Xultophy dosage restrictions
There is limited data on Xultophy use in patients with mild and moderate renal impairment. If Xultophy has to be used in these patients, additional glucose monitoring and dose adjustments may be needed. It has not been studied in patients with severe renal impairment or any level of hepatic impairment.
How to take Xultophy
- Read the Full Prescribing Information, Patient Information, and Medication Guide that comes with Xultophy.
- Use Xultophy exactly as your healthcare provider tells you to. Do not change your dose or stop taking Xultophy without discussing it with them first.
- Your healthcare provider will show you how to properly use your prefilled pen before you give your first dose.
- Xultophy is given as an injection under the skin of your upper arm, thigh, or stomach. Do not inject Xultophy into a vein or use it in an insulin pump. You should take Xultophy at the same time every day with or without food.
- If you miss a dose of Xultophy, skip the missed dose and take the next one at its scheduled time. Do not take extra doses of Xultophy to make up for a missed dose.
- Changes to your insulin regimen, diet, and physical activity may cause hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar). You may need to check your blood glucose levels more often if these changes occur.
- Do not mix Xultophy with other liquids or medicines in the same injection.
- Rotate your injection site with each injection to reduce the risk of lipodystrophy (thickened skin) or cutaneous amyloidosis (lumps under your skin). Do not inject this medication where your skin is tender, bruised, or damaged.
- Before its first use, store Xultophy in the refrigerator between 2°C and 8°C (36°F to 46°F) until the expiration date that is printed on the label. After first using Xultophy, you can store it for 21 days at room temperature between 59°F to 86°F (15°C to 30°C) or in the refrigerator between 36°F to 46°F (2°C to 8°C).
Xultophy dosage FAQs
What are the most common possible side effects of Xultophy?
Some common adverse events of Xultophy include:
- Common cold symptoms
- Injection site reactions
- High lipase levels
- Abdominal pain
- Decreased appetite
- Weight gain
Xultophy can sometimes cause more serious side effects, including:
- Severe, life-threatening allergic reactions (hives, angioedema, and shortness of breath)
- Increased risk of thyroid tumors
- Gallbladder disease
- Low potassium levels (hypokalemia)
- Increased risk of heart failure
- Kidney impairment
- Severe hypoglycemia (low blood sugar)
Contact your healthcare professional for medical advice about any possible side effects you may experience while taking Xultophy. You can report any adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What drug interactions occur with Xultophy?
When Xultophy is taken with other medications, it may change the way they work or increase the frequency and severity of side effects. You should discuss with your doctor whether any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:
- Antidiabetic drugs
- ACE inhibitors
- Certain atypical antipsychotics
- Thyroid hormones
Are there any contraindications or precautions with Xultophy?
You should not use Xultophy if you have a personal or family history of medullary thyroid carcinoma (MTC), Multiple Endocrine Neoplasia syndrome type 2, low blood sugar, or known hypersensitivity to insulin degludec, liraglutide, or any inactive ingredients in this medication. You should make sure your healthcare provider is aware of your medical conditions, including thyroid tumors, pancreatitis, and heart failure.
Can you take Xultophy while you are pregnant or breastfeeding?
Based on animal studies, there is a risk of harm to your unborn baby if liraglutide is used during pregnancy. There is no data on the use of this medication during lactation. Animal studies showed that both active ingredients were found in their milk. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
When is the best time to take Xultophy?
You can take Xultophy at any time of the day but you should take it at the same time each day.
What are the minimum and maximum doses you can give with a Xultophy pen?
The Xultophy 100/3.6 pen can deliver 10 units to 50 units in a single injection. Doses can be adjusted in 1-unit increments.
How many doses are in a Xultophy pen?
Your dose of Xultophy will determine how long your Xultophy pen will last. Each prefilled pen contains 300 units of Xultophy.
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