Prescription Required
Xultophy is a prescription Type 2 diabetes combination insulin for blood sugar control when patients have difficulty with A1C hemoglobin test scores staying above the standard 7% threshold for acceptable blood sugar levels. This insulin pen is used for subcutaneous injection and combines two active ingredients – Degludec and Liraglutide – for effective blood sugar management. Degludec works as a long-acting insulin for up to 24 hours of blood sugar leveling and Liraglutide mimics a natural hormone in the body to control blood sugar levels, insulin levels, and digestion.
Standard dosage for Xultophy insulin is to take 1 injection per day.
Injection may be made into one of 3 acceptable injection sites: back of upper arms / thighs / abdomen (but not within a 2” radius of navel).
Switch to a different injection site for each day’s injection, never inject the same location twice with an injection. Repeated injections at the same site increases the risk of lipodystrophy.
Remove new pen from fridge approximately 1 hour before planned injection.
Preparation:
Priming:
Turn the dose counter to line it up with the priming symbol shown on the dial. Then press the injection button in fully until reading ‘0’ (zero) and check to see a small amount of solution to come from the needle tip. You will need to see this before you proceed with administering the injection.
Administration:
Turn dose counter until correct prescribed dose is loaded / inject the dose.
At the injection site, insert the needle into your skin at a 90-degree angle / press the injection button down completely and hold it until ‘0’ shows in dose window / count to 6 before releasing the injection button and removing the needle / release the injection button and remove the needle from your skin.
Remove and discard needle following the proper procedure shown in your prescription.
Store the pen at room temperature after the first use.
The active ingredient in Xultophy are Insulin Degludec and Liraglutide.
Tell your doctor if you have any history of multiple endocrine neoplasia type 2, medullary thyroid carcinoma, diabetic ketoacidosis, pancreatitis, kidney or liver disease, gastroparesis (slow stomach emptying), gallstones or alcoholism before starting on Xultophy.
Medication may not be suitable for use with a mealtime insulin at the same time.
Keep insulin refrigerated at between 36°F to 46°F (2°C to 8°C) and at room temperature after first dose has been administered for each Xultophy 100 36 pen.
Be sure to change needles as indicated and do not remove outer cap on pen until you are going to give yourself an injection right after.
There is the possibility of negative drug interaction risks between Xultophy and other Rx or OTC medications, including:
Tell your doctor of all medications you are currently taking before receiving a prescription and proceeding to buy Xultophy insulin online.
Side effects from using Xultophy are possible, and some users may experience diarrhea, headache, nausea, or common cold symptoms. If side effects are seen you may want to discontinue use and speak to your doctor again about insulin pen alternatives to Xultophy as part of Type 2 diabetes treatment.
What is Xultophy 100/3.6?
Xultophy 100/3.6 is a once-daily injectable medication used to improve glycemic control in adults with type 2 diabetes, alongside diet and exercise. It combines liraglutide, a glucagon-like peptide-1 receptor agonist, and insulin degludec, a long-acting basal insulin.
How does Xultophy 100/3.6 work?
It contains two molecules that control blood sugar for 24 hours: insulin for glucose absorption and retention, and GLP-1 RA, which slows glucose entry into the bloodstream, aids insulin release when glucose is high, and prevents the liver from releasing glucose when glucose levels are high.
How should Xultophy 100/3.6 be dosed?
There are two starting doses: 10 units for patients naïve to basal insulin or GLP-1 RA, and 16 units for those converting from these treatments. Doses should be titrated every 3-4 days based on fasting plasma glucose (FPG) levels.
How should Xultophy 100/3.6 be stored?
Before use, it should be refrigerated between 36°F to 46°F. After first use, it can be kept at room temperature (59°F to 86°F) or refrigerated for up to 21 days.
What are the side effects of Xultophy 100/3.6?
It has a Boxed Warning for potential risks. Common adverse reactions include nasopharyngitis, headache, nausea, diarrhea, increased lipase, and upper respiratory tract infection.
What are the recommendations for use?
Xultophy 100/3.6 is not recommended as first-line therapy for inadequate glycemic control with diet and exercise alone, not for use with other liraglutide-containing products, not indicated for type 1 diabetes or diabetic ketoacidosis, and has not been studied in combination with prandial insulin.
What are the contraindications?
It's contraindicated in patients with a history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), during hypoglycemia episodes, and in those with hypersensitivity to its components.
What are the key warnings and precautions?
Risks include thyroid C-cell tumors, pancreatitis, blood-borne pathogen transmission from sharing pens, hypoglycemia or hyperglycemia with insulin regimen changes, overdose, acute kidney injury, hypersensitivity and allergic reactions, acute gallbladder disease, hypokalemia, and fluid retention leading to heart failure.
Are there any drug interactions to be aware of?
Certain drugs may affect glucose metabolism and the absorption of oral medications due to delayed gastric emptying caused by liraglutide. This requires dose adjustment and close blood glucose monitoring.
What is the maximum daily dose?
Do not administer more than 50 units of Xultophy 100/3.6 daily and avoid exceeding the 1.8 mg maximum recommended dose of liraglutide or using it with other GLP-1 receptor agonists.
