What is Xultophy Uses, warnings & interactions
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Xultophy (insulin degludec/liraglutide) is a once-daily injection manufactured by Novo Nordisk Inc. It was approved in 2016 by the U.S. Food and Drug Administration (FDA) to be used along with diet and exercise to manage blood glucose levels in adults with type 2 diabetes mellitus (T2DM).
If your doctor has prescribed Xultophy to you, you may want to know more about what it is and how it works. Here we’ll explain what Xultophy is used for, how it works, its side effects, and more.
What is Xultophy used for?
Xultophy is a combination medication containing a long-acting insulin and a glucagon-like peptide 1 (GLP-1) receptor agonist that is used in combination with diet and exercise to lower blood sugar levels in adults with T2DM. Xultophy is not approved to treat patients with type 1 diabetes (T1DM) or diabetic ketoacidosis.
How does Xultophy work?
Xultophy is a combination of a long-acting insulin (insulin degludec) and a GLP-1 receptor agonist (liraglutide). Insulin degludec acts like the natural insulin your pancreas produces to manage blood glucose levels in your blood. Insulin helps you absorb and store glucose from the bloodstream and it inhibits your liver from making more glucose.
Liraglutide binds and activates the GLP-1 receptors in your pancreas to make and release more insulin. In addition to this, liraglutide blocks glucagon secretion and slows down how fast your stomach empties, leading to reduced food intake and lower blood glucose levels.
What are the most commonly prescribed doses of Xultophy?
- 100 units of insulin degludec and 3.6 mg of liraglutide per milliliter in a 3ml single-patient-use pen.
Before taking Xultophy
Before beginning Xultophy, tell your doctor about your medical conditions, including:
- Liver, kidney, or pancreas problems
- Heart failure
- Gastroparesis (delayed emptying of your stomach)
- Are pregnant, plan on becoming pregnant, or are breastfeeding
How to take Xultophy
- Read the Full Prescribing Information, Patient Information, and Medication Guide that comes with Xultophy.
- Use Xultophy exactly as your doctor prescribes it. Do not change your dose or stop taking this medication without talking with them first.
- Your doctor should show you how to use your Xultophy pen before you give your first dose.
- Xultophy is given as an injection under the skin of your upper arm, thigh, or abdomen. You should not inject this medication into a vein or use it in an insulin pump. Xultophy should be taken at the same time every day with or without food.
- If you miss a dose of Xultophy, skip it and take your next dose at its regularly scheduled time. Do not take extra doses to make up for a missed dose.
- Do not mix Xultophy with other liquids or medications in the same injection.
- Rotate your injection site with each injection to reduce the risk of thickened skin or lumps under your skin. Do not inject this medication where your skin is tender, bruised, or damaged.
- Prior to 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).
You should not use Xultophy if you:
- have a personal or family history of medullary thyroid carcinoma (MTC).
- have Multiple Endocrine Neoplasia syndrome type 2.
- currently have low blood sugar.
- have a known allergy to insulin degludec, liraglutide, or any inactive ingredients in this medication.
- There is an increased risk of thyroid tumors with Xultophy. Notify your doctor immediately if you have symptoms such as a mass in your neck, trouble breathing or swallowing, or hoarseness.
- Hypoglycemia, which may be life-threatening can occur with the use of this medication. Make sure you are aware of the symptoms of low blood sugar, which can include shakiness, fast heartbeat, dizziness, weakness, sweating, confusion, drowsiness, and extreme hunger.
- Pancreatitis has been reported with the use of Xultophy. It should be immediately stopped if pancreatitis is suspected.
- Changes in your insulin regimen can cause high blood sugars (hyperglycemia) or low blood sugars (hypoglycemia). You may need to check your blood sugars more often when making changes to your medications.
- Serious, life-threatening hypersensitivity reactions may occur with the use of Xultophy. Discontinue this medication and seek immediate medical assistance if a hypersensitivity reaction occurs.
- Xultophy may cause congestive heart failure, especially in patients taking thiazolidinediones such as pioglitazone or rosiglitazone.
Xultophy drug interactions
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 medications
- ACE inhibitors
- Atypical antipsychotics
- Monoamine oxidase inhibitors
- Thyroid hormones
- Oral contraceptives
Xultophy side effects
Some common side effects of Xultophy include:
- Common cold symptoms
- Injection site reactions
- Elevated lipase levels
- Stomach pain
- Loss of appetite
- Weight gain
Xultophy can sometimes cause more serious side effects, including:
- Serious allergic reactions (hives, swelling of the face or throat, and shortness of breath)
- Increased risk of thyroid cancer
- Gallbladder problems
- Hypokalemia (low potassium levels)
- Increased risk of heart failure
- Kidney problems
- Severe hypoglycemia (low blood sugar)
Contact your healthcare professional for medical advice about any possible adverse events you experience while taking Xultophy. You can report your adverse reactions to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Your doctor can prescribe other medications if Xultophy is not right for you. They will vary by factors such as side effects and costs. Some FDA-approved alternatives to Xultophy include:
- Victoza (liraglutide)
- Soliqua (insulin glargine/lixisenatide)
- Levemir FlexTouch (insulin detemir)
- Toujeo Max SoloStar (insulin glargine)
- Tresiba FlexTouch (insulin degludec)
- Oseni (alogliptin/pioglitazone)
- Trijardy XR (empagliflozin/linagliptin/metformin)
Can you take Xultophy while you are pregnant or breastfeeding?
Based on animal studies, there is a risk of fetal harm from exposure to liraglutide if used while pregnant. Xultophy 100/3.6 should be only used in pregnant women if the possible benefits outweigh the possible risks to the fetus. 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.
What type of insulin is Xultophy?
Xultophy is a combination medication used to lower blood sugar in type 2 diabetic patients. It contains a long-acting basal insulin (insulin degludec) and a GLP-1 receptor agonist, (liraglutide).
Can Xultophy be used to treat type 1 diabetes?
Xultophy is used to reduce blood sugar levels in patients with type 2 diabetes. It should not be used if you have type 1 diabetes or diabetic ketoacidosis.
Can Xultophy be used for weight loss?
While Xultophy is not a weight loss drug, the manufacturer states that a clinical study showed that patients who took Xultophy lost an average of 2 lbs when compared to a combination of insulin glargine U-100 and insulin aspart.
What is the cost of Xultophy?
The average cost for #5, 3ml Xultophy 100units/3.6mg per ml prefilled pens is around $1,400.
Is there a generic for Xultophy?
Currently, there is no generic Xultophy available on the market. However, you can still save on brand-name drugs like Xultophy through NiceRx if eligible for assistance.