| Medication Name | Xultophy Prefilled Pen |
| Generic Name | Insulin degludec/liraglutide |
| Boxed/Label Warning | Possible risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). Xultophy is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). |
| Purpose | To improve glycemic control in adults with type 2 diabetes mellitus |
| Mechanism of Action | Combines a long-acting basal insulin (insulin degludec) and a GLP-1 receptor agonist (liraglutide) to lower blood glucose levels. Insulin degludec lowers blood glucose by increasing peripheral glucose uptake and decreasing hepatic glucose production. Liraglutide stimulates insulin release and decreases glucagon secretion in a glucose-dependent manner. |
| Dosage Forms | Prefilled pen |
| Available Strengths | 100 units/mL insulin degludec and 3.6 mg/mL liraglutide |
| Dosage Frequency | Once daily |
| Common Side Effects | Nausea, diarrhea, vomiting, constipation, headache, upper respiratory tract infection, nasopharyngitis |
| Serious Side Effects | Pancreatitis, gallbladder disease (cholelithiasis, cholecystitis), hypoglycemia, hypersensitivity reactions (including anaphylaxis), acute kidney injury, thyroid tumors (including medullary thyroid carcinoma) |
| Drug Interactions | Other antidiabetic agents (sulfonylureas, glinides, SGLT2 inhibitors), insulin, beta-blockers, ACE inhibitors, ARBs, salicylates, MAOIs, alcohol |
| Important Notes | Monitor blood glucose levels regularly. Educate patients about the risk of thyroid tumors and symptoms of pancreatitis and gallbladder disease. Consult a healthcare provider for proper dosing and monitoring. |
| Storage | Store unused pens in the refrigerator (36°F to 46°F [2°C to 8°C]). Do not freeze. After first use, the pen can be stored at room temperature (up to 86°F [30°C]) for up to 21 days. |
| Missed Dose | Take the missed dose as soon as you remember, unless it is close to your next scheduled dose. Do not take a double dose to make up for a missed dose. |
| Alternatives | Insulin glargine, Insulin lispro, Semaglutide (Ozempic), Trulicity (dulaglutide) |