Xultophy 100/3.6 (Insulin Degludec and Liraglutide) - Subcutaneous

Warning:

Xultophy may cause thyroid tumors, including cancerous tumors. In animal studies, liraglutide (one of the medicines in Xultophy) increased the rate of thyroid tumors in rats and mice. It is unknown if Xultophy increases the risk of thyroid tumors in humans. Let your healthcare provider know if you develop a lump or swelling in your neck, hoarseness, trouble swallowing, or difficulty breathing. Do not take Xultophy if you or a family member have ever had medullary thyroid carcinoma (MTC; a type of thyroid cancer) or if you have a condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

What Is Xultophy?

Xultophy is an injectable prescription medication for adults with type 2 diabetes. Xultophy contains two medicines—insulin degludec and liraglutide. Insulin degludec is a long-acting insulin that controls your blood sugar levels by moving glucose (sugar) from your blood into other parts of your body where it can be used for energy.

Liraglutide belongs to a group of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. It helps lower blood sugar levels by increasing insulin release from your pancreas and preventing glucose release from your liver. Liraglutide also slows down stomach emptying, which can help you feel full longer and lose weight.

Xultophy may increase your risk of thyroid tumors, so it's important to let your healthcare provider know if you develop a lump or swelling in your neck, hoarseness, trouble swallowing, or difficulty breathing. Do not take Xultophy if you or a family member have ever had medullary thyroid carcinoma (MTC; a type of thyroid cancer) or if you have a condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Drug Facts

Generic Name: Insulin degludec and liraglutide

Brand Name(s): Xultophy 100/3.6

Drug Availability: Prescription

Therapeutic Classification: Long-acting insulin and glucagon-like peptide-1 (GLP-1) receptor agonist

Available Generically: No

Controlled Substance: No

Administration Route: Subcutaneous

Active Ingredient: Insulin degludec and liraglutide

Dosage Form(s): Subcutaneous pen injector

What Is Xultophy Used For?

Xultophy, along with diet and exercise, is used to lower blood sugar levels in adults with type 2 diabetes.

Diabetes affects more than 37 million people in the United States, or about 1 in 10 people. The vast majority (90–95%) have type 2 diabetes. People with type 2 diabetes don't respond typically to insulin—a hormone your pancreas makes to lower blood sugar. As a result, your pancreas makes more insulin to regulate your blood sugar levels, but eventually, the pancreas becomes overwhelmed. Over time, high blood sugar can cause serious health problems, including heart disease, vision loss, and kidney damage.

Fortunately, maintaining a healthy diet, exercising, and taking your diabetes medicines can help prevent complications.

How to Take Xultophy

Xultophy is administered subcutaneously (under your skin) using a prefilled pen injector. Administer your dose of Xultophy once daily at the same time each day, with or without food.

Your healthcare provider will teach you how to use the pen and properly inject your dose. Follow these tips to ensure you're using Xultophy safely:

  • Do not share your Xultophy pen with another person since you or the other person may get an infection.
  • Wash your hands with soap and water before administering your dose.
  • Check to make sure the Xultophy solution looks clear and colorless. Do not use it if the solution appears cloudy or colored.
  • Use a new needle for each injection. Do not reuse or share needles since this can lead to a severe infection.
  • Following your healthcare provider's instructions, prime the Xultophy injector pen before each dose.
  • Choose an injection site on your stomach, upper thighs, or upper arms. Change the injection site each time you administer a dose—do not use the same site for each injection.
  • Avoid skin that has pits, lumps, or is thickened. Do not inject into tender, bruised, scaly, stiff, scarred, or damaged skin,
  • Wipe the injection site with an alcohol swab and let the site dry before injecting your dose.
  • Do not split your dose—give the total dose in one injection.
  • Do not rub the injection site after administering your dose.
  • Carefully remove the needle and throw it away in a sharps container. Do not store your Xultophy pen with a needle attached.

Storage

Store unused Xultophy pens in the refrigerator. Do not freeze. After opening, Xultophy may be stored at room temperature or in the fridge for 21 days. Keep Xultophy away from direct heat or light. After each injection, remove and dispose of the needle.

Do not store your Xultophy pen with a needle attached since this can cause contamination or cause the pen to leak. Always use a new needle for each dose.

Store Xultophy and all your medications in a safe location, out of the reach of children and pets, preferably in a locked box in the refrigerator or high fridge shelf out of the reach of children or pets.

Avoid pouring unused and expired drugs down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. Visit the Food and Drug Administration's (FDA) website to find out where and how to discard unused, expired drugs. You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you plan to travel with Xultophy, get familiar with your final destination's regulations. In general, be sure to make a copy of your Xultophy prescription. If possible, keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

How Long Does Xultophy Take to Work?

Xultophy begins to lower your blood sugar the first day you start taking it. Talk with your healthcare provider about when to check your blood sugar and your target blood sugar range.

What Are the Side Effects of Xultophy?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

You may experience side effects while taking Xultophy. Let your healthcare provider know if you develop any side effects that bother you or don't go away.

Common side effects include:

Severe Side Effects

Contact your healthcare provider immediately if you develop any signs of a severe reaction. Call 911 if your symptoms feel life-threatening.

Serious side effects and their symptoms include:

  • Thyroid tumors, including cancer. Let your healthcare provider know if you develop a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.
  • Pancreatitis (inflammation of the pancreas). Signs may include severe stomach pain that doesn't go away, vomiting, or back pain.
  • Low blood sugar (hypoglycemia). Signs of low blood sugar include dizziness or light-headedness, sweating, confusion, tiredness, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability, hunger, and weakness.
  • Kidney problems, including kidney failure. Dehydration can increase your risk of kidney problems, so be sure to stay well hydrated. Also, tell your healthcare provider if you develop diarrhea, nausea, or vomiting since this may cause fluid loss.
  • Allergic reactions, including a severe form called anaphylaxis. Signs include hives, rash, itching, fast heartbeat, fainting or feeling dizzy, swelling of your face, lips, tongue, or throat, difficulty breathing or swallowing, coughing, and chest pain or tightness.
  • Gallbladder problems, such as gallstones or an inflamed gallbladder. Let your healthcare provider know if you develop pain in the right or middle upper stomach area, fever, nausea, vomiting, or yellowing of the whites of your eyes.
  • Low potassium in your blood (hypokalemia).
  • Heart failure, especially if you take Xultophy with thiazolidinediones (TZDs)—a type of diabetes medicine. Let your healthcare provider know if you develop new or worsening shortness of breath, tiredness, swelling of your ankles or feet, or sudden weight gain.

Report Side Effects

Xultophy may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Xultophy Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For injection dosage form:
    • For Type 2 diabetes:
      • Adults—Dose is based on your blood sugar and must be determined by your doctor.
      • Children—Use and dose must be determined by your doctor.

Modifications

The following modifications (changes) should be kept in mind when using Xultophy:

Severe allergic reaction: Avoid using Xultophy if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: In animal studies, Xultophy caused fetal harm. We don't know enough about the safety and effectiveness of Xultophy in pregnant people and their unborn fetuses. Let your healthcare provider know if you are pregnant or plan to become pregnant, and discuss the benefits and risks of taking Xultophy during your pregnancy.

Breastfeeding: In animal studies, Xultophy was present in rat breastmilk. We don't know enough about the safety of Xultophy in human breastmilk and nursing babies. Talk with your healthcare provider if you plan to breastfeed, and discuss the benefits and risks of taking Xultophy while nursing and the different ways to feed your baby.

Adults over 65: In clinical studies, no differences in safety or effectiveness were observed in adults over 65 versus younger adults.

Children: The FDA has approved Xultophy to treat adults with type 2 diabetes. The safety and effectiveness of using Xultophy in children are unknown.

Missed Dose

If you forget to take your dose of Xultophy, take it the next day at your regularly scheduled time. Do not take an extra dose or increase your dose to make up for the missed one.

Contact your healthcare provider if you forget to take Xultophy for three or more days. You may need to restart Xultophy at a lower dose to avoid an upset stomach.

Try to find ways to help you remember to keep your appointments and take your medication. If you miss too many doses, Xultophy might be less effective at managing your diabetes.

Overdose: What Happens If I Take Too Much Xultophy?

The signs of a suspected overdose of Xultophy include:

  • Low blood sugar (hypoglycemia), may sometimes be serious and life-threatening. Signs of low blood sugar include:
  • Dizziness or light-headedness
  • Sweating
  • Confusion
  • Drowsiness
  • Headache
  • Blurred vision
  • Slurred speech
  • Shakiness or feeling jittery
  • Fast heartbeat
  • Anxiety, irritability, or mood changes
  • Hunger
  • Weakness
  • Low blood potassium levels (hypokalemia)
  • Severe nausea and vomiting

If you think you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

What Happens If I Overdose on Xultophy?

If you think you or someone else may have overdosed on Xultophy, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Xultophy, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

Never share insulin pens with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles or pens can result in transmission of hepatitis viruses, HIV, or other bloodborne illnesses.

Your doctor will want to check your progress at regular visits, especially during the first few weeks you take this medicine. Blood and urine tests may be needed to check for unwanted effects.

It is very important to follow carefully any instructions from your health care team about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines during the time you are using insulin degludec and liraglutide combination unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to:

  • Wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
  • Keep an extra supply of Xultophy® and syringes with needles or injection devices on hand in case high blood sugar occurs.
  • Keep some kind of quick-acting sugar handy to treat low blood sugar.
  • Have a glucagon kit and a syringe and needle available in case severe low blood sugar occurs. Check and replace any expired kits regularly.

Too much of this medicine can cause hypoglycemia (low blood sugar). Low blood sugar also can occur if you use this medicine with another antidiabetic medicine, changes in insulin regimen (eg, insulin strength, type of insulin, injection site), delay or miss a meal or snack, exercise more than usual, or drink alcohol. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

Symptoms of low blood sugar include anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, difficulty in thinking, dizziness or lightheadedness, drowsiness, excessive hunger, fast heartbeat, headache, irritability or abnormal behavior, nervousness, nightmares, restless sleep, shakiness, slurred speech, and tingling in the hands, feet, lips, or tongue.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non diet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Get to a doctor or a hospital right away if the symptoms do not improve. Someone should call for emergency help immediately if severe symptoms such as convulsions (seizures) or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your household also should know how to use it.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine or insulin, changes in insulin regimen, you overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

Symptoms of high blood sugar include: blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination, ketones in the urine, loss of appetite, stomachache, nausea or vomiting, tiredness, troubled breathing (rapid and deep), unconsciousness, and unusual thirst.

If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

This medicine can cause low blood sugar. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Check with your doctor right away if you have the following symptoms while using this medicine: a mass in the neck, difficulty with swallowing, hoarseness, or troubled breathing. These may be symptoms of a serious thyroid problem.

Pancreatitis may occur while you are using this medicine. Tell your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you have a rash, itching, swelling of the face, tongue, and throat, trouble breathing, or chest pain after you receive the medicine.

This medicine may cause low levels of potassium in your blood. Do not use medicines, supplements, or salt substitutes that contain potassium unless you have discussed this with your doctor.

Using this medicine together with other diabetes medicine (eg, pioglitazone, rosiglitazone, Actos®, Actoplus Met®, Avandia®) may cause serious heart problems or edema (fluid retention). Check with your doctor immediately if you are rapidly gaining weight, having chest pain or discomfort, extreme tiredness or weakness, trouble breathing, uneven heartbeat, or excessive swelling of the hands, wrist, ankles, or feet.

What Are Reasons I Shouldn’t Take Xultophy?

Do not take Xultophy if:

  • You or a family member has ever had medullary thyroid carcinoma (MTC; a type of thyroid cancer) or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • You are currently experiencing an episode of hypoglycemia (low blood sugar)
  • You are allergic to insulin degludec, liraglutide, or any other ingredient in Xultophy

What Other Medications Interact With Xultophy?

Certain medications can affect how your body metabolizes glucose (sugar) and impact your blood sugar levels. Your healthcare provider may recommend a different dose of Xultophy or careful monitoring. Use caution when taking Xultophy with the following medications:

Other medicines may interact with Xultophy. Be sure to let your healthcare provider and pharmacist know about all the medicines you take, including over-the-counter, nonprescription products, vitamins, herbal, or plant-based medicines.

What Medications Are Similar?

Xultophy is a combination product containing a long-acting insulin (insulin degludec) and a GLP-1 receptor agonist (liraglutide). Xultophy offers the benefits of two diabetes medicines with only one injection. Other long-acting insulin and a GLP-1 receptor agonist combination products include:

Xultophy and Soliqua are approved to treat adults with type 2 diabetes and are administered once daily.


Frequently Asked Questions

  • What is Xultophy used for?

    Xultophy is used to lower blood sugar in adults with type 2 diabetes.

  • How does Xultophy work?

    Xultophy contains two diabetes medicines—insulin degludec and liraglutide. Insulin degludec is a long-acting insulin. It helps lower blood sugar by moving sugar from the blood into tissues in the body where it's used for energy. Liraglutide is a GLP-1 receptor agonist. It helps lower blood sugar by increasing insulin release from the pancreas, preventing glucose release from the liver, and slowing how fast food empties from your stomach.

  • What drugs should not be taken with Xultophy?

    Let your healthcare provider know about all the medicines you take, especially GLP-1 receptor agonists—a type of diabetes medicine. Taking these with Xultophy can cause an overdose.

  • What are the side effects of Xultophy?

    The most common side effects of Xultophy include a stuffy or runny nose, sore throat, headache, nausea, diarrhea, increased levels of lipase in your blood, and upper respiratory tract infections.

  • How much does Xultophy cost?


    A generic version of Xultophy isn't available, so it's likely expensive without insurance. If cost is a concern, Xultophy's manufacturer offers a savings program. For eligibility questions, visit the Novo Nordisk website or call 844-668-6463.

How Can I Stay Healthy While Taking Xultophy?

If you're taking Xultophy, you're likely trying to get better control of your diabetes. You may have tried different approaches or treatments. While living with type 2 diabetes does have its challenges, there are ways to help improve your quality of life. Refer below for some general tips to support your health:

  • Take diabetes-related medications as recommended by your healthcare provider.
  • Talk with your healthcare provider about checking your blood sugar, what the values mean, and how often you should check it.
  • Follow-up with all appointments, including appointments with your dentist, podiatrist (healthcare provider specialized in treating conditions affecting the feet and lower leg), and optometrist or ophthalmologist to help prevent diabetes complications.
  • Consider working with a team that includes a registered dietitian nutritionist (RD or RDN) and particularly one that's a Certified Diabetes Care and Education Specialist (CDCES). CDCES RDs can help you explore your eating, movement, medication habits, and more. In addition, RDs can help you build your toolkit and capacity to avoid spikes in blood sugar and help you feel good. Navigating blood sugar control and your eating patterns can be challenging, but you don't have to do this alone.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. DailyMed. Xultophy 100/3.6- (insulin degludec and liraglutide) injection, solution.

  2. MedlinePlus. Liraglutide injection.

  3. Centers for Disease Control and Prevention. Type 2 diabetes.

  4. DailyMed. Victoza- liraglutide injection.

  5. DailyMed. Tresiba- insulin degludec injection, solution.

  6. DailyMed. Siliqua 100/33- insulin glargine and lixisenatide injection, solution.

By Christina Varvatsis, PharmD
Christina Varvatsis is a hospital pharmacist and freelance medical writer. She is passionate about helping individuals make informed healthcare choices by understanding the benefits and risks of their treatment options.