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Xultophy
Xultophy (generic name: insulin degludec and liraglutide) is a combination medication used to manage type 2 diabetes in adults. It helps control blood sugar levels by combining a long-acting insulin (insulin degludec) with a GLP-1 receptor agonist (liraglutide). Xultophy is typically prescribed when other medications, such as oral antidiabetic agents or individual components, are not enough to control blood sugar.
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Frequently Asked Questions
How long does it take for Xultophy to start working?
Xultophy starts working within a few hours of injection, but full glucose control benefits may take several days to become noticeable.
Can I take Xultophy with other diabetes medications?
Xultophy can be taken with oral antidiabetic agents like metformin but should not be combined with other GLP-1 receptor agonists or long-acting insulins without medical advice.
What should I do if I miss a dose of Xultophy?
If you miss a dose of Xultophy, take it as soon as you remember. However, if it’s close to your next dose, skip the missed dose and take the next one at the regular time. Do not double the dose.
Does Xultophy cause weight gain?
Xultophy, particularly due to the liraglutide component, may actually help with weight loss in some patients, unlike insulin-only treatments which are more likely to cause weight gain.
Is Xultophy safe during pregnancy?
The safety of Xultophy during pregnancy has not been established. It should only be used if clearly needed and prescribed by a healthcare provider. Always consult your provider if you are pregnant or planning to become pregnant.
Comprehensive Drug Guide
How Does Xultophy Work?
- Insulin degludec: A long-acting insulin that helps control blood sugar by facilitating glucose uptake in muscle and fat and inhibiting glucose production in the liver.
- Liraglutide: A GLP-1 receptor agonist that stimulates insulin secretion in response to high blood sugar, inhibits glucagon release, and slows gastric emptying, helping lower blood sugar after meals.
Common Dosages
- 100 units of insulin degludec per mL and 3.6 mg of liraglutide per mL.
Typical Dosing
- Xultophy is typically dosed once daily by subcutaneous injection. The dose is individualized based on the patient’s needs and blood sugar levels, with a maximum dose of 50 units per day (50 units of insulin degludec and 1.8 mg of liraglutide).
- The pen should be administered once daily, at the same time each day, with or without food.
Typical Dosing
FDA Approved Indications
- Improving glycemic control in adults with type 2 diabetes, when used along with diet and exercise. It is used when oral medications or basal insulin alone are not sufficient.
Who Shouldn't Take Xultophy?
- Personal or family history of medullary thyroid carcinoma (MTC).
- Multiple endocrine neoplasia syndrome type 2 (MEN 2).
- Severe allergic reaction to insulin degludec, liraglutide, or any component of the formulation.
Advice From The Pharmacist
- Administer Xultophy once daily, at the same time each day. It can be taken with or without food, but try to be consistent with the timing.
- Rotate the injection sites to avoid skin problems (e.g., lipodystrophy) and ensure proper absorption.
- Monitor your blood sugar levels regularly, as directed by your healthcare provider, and adjust the dose accordingly.
- Store unopened pens in the refrigerator, but once in use, the pen can be kept at room temperature for up to 21 days.
Side Effects of Xultophy
Common Side Effects
- Nausea
- Diarrhea
- Headache
- Low blood sugar (hypoglycemia), especially when used with other diabetes medications
- Injection site reactions (redness, swelling)
Uncommon/Severe Side Effects
- Pancreatitis
- Thyroid tumors (especially in patients with a history of thyroid cancer or MEN 2)
- Severe allergic reactions (rash, swelling, difficulty breathing)
Risks and Warnings of Xultophy
- Thyroid Tumors: Xultophy contains liraglutide, which may increase the risk of thyroid tumors, including medullary thyroid carcinoma (MTC). Patients with a history of thyroid cancer should not use Xultophy.
- Pancreatitis: Xultophy may increase the risk of pancreatitis. Patients should seek medical attention if they experience severe abdominal pain that radiates to the back, as this could be a sign of pancreatitis.
- Hypoglycemia: Xultophy can cause low blood sugar (hypoglycemia), especially when used with other glucose-lowering medications. Regular monitoring of blood sugar levels is essential to avoid serious hypoglycemia.
Interactions with Xultophy
Common Drug Interactions
- Sulfonylureas or insulin: Using Xultophy with sulfonylureas (e.g., glipizide) or other insulin products increases the risk of hypoglycemia.
- GLP-1 receptor agonists: Avoid using other GLP-1 receptor agonists (e.g., exenatide) with Xultophy.
- Beta-blockers: These may mask the symptoms of hypoglycemia, making it harder to detect low blood sugar levels.
Alternatives to Xultophy
- Basaglar (insulin glargine): A long-acting insulin used for glycemic control in type 2 diabetes.
- Soliqua: Another combination product containing insulin glargine and lixisenatide (a GLP-1 receptor agonist).
- Victoza (liraglutide): A GLP-1 receptor agonist that can be used alongside other diabetes medications.
