Xultophy

Insulin degludec/liraglutide, sold under the brand name Xultophy, is a fixed-dose combination medication for the treatment of adults with type 2 diabetes to improve glycemic control in combination with diet and exercise. It contains insulin degludec and liraglutide. It is administered by subcutaneous injection.

Xultophy (insulin degludec / liraglutide) contains an insulin, insulin degludec, and another medication called a GLP-1 agonist, liraglutide. Insulin degludec is a long-acting, basal insulin that helps control your sugar levels throughout the day, even when you’re not eating.

Xultophy 100/3.6 consists of two molecules that work together throughout the body to control blood sugar for a full 24 hours.

These components are insulin and GLP-1 RA. Insulin helps muscle, liver, and fat cells absorb and retain glucose from the bloodstream for energy. GLP-1 RA activity prevents processes that can cause sugar fluxes.

> In the gut, it slows down the rate at which glucose enters the bloodstream
> In the pancreas, it helps beta cells release insulin, but only when blood glucose is high
> When blood glucose is high, GLP-1 acts on alpha cells in the pancreas in ways that prevent the liver from releasing glucose.

How Should I Use Xultophy

Use Xultophy exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Xultophy 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 Xultophy.

You may use Xultophy 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 Xultophy 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 Xultophy 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 Xultophy 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.

Keep Xultophy 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.

Dosing

Usual Adult Dose of Xultophy for Diabetes Type 2:

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
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).

Side Effects

Get emergency medical help if you have signs of an allergic reaction to Xultophy: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

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.