Classes
DEA Class; Rx
Common Brand Names; Tresiba
- Antidiabetics, Insulins;
- Antidiabetics, Long-Acting Insulins
Description
Long-acting, insulin analog; given subcutaneously once daily
Used in adult and pediatric patients 1 year and older with type 1 or type 2 diabetes mellitus
Provides A1C control similar to other long-acting once-daily insulin analogs; severe, life threatening allergic reactions, including anaphylaxis, may occur
Indications
Contraindications
During episodes of hypoglycemia
Documented hypersensitivity
Adverse Effects
Nasopharyngitis (12.9-23.9%)
Severe hypoglycemic episode (0.3-12.3%)
Upper respiratory tract infection (8.4-11.9%)
Headache (8.8-11.8%)
1-10%
Diarrhea (6.3%)
Sinusitis (5.1%)
Gastroenteritis (5.1%)
Injection site reactions (3.8%)
Peripheral edema (0.9-3%)
Lipodystrophy
Localized cutaneous amyloidosis at the injection
Warnings
Do not share, even if the needle is changed; sharing poses a risk for transmission of blood-borne pathogens
Changes in insulin, manufacturer, type, or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia; these changes should be made cautiously and only under medical supervision, and the frequency of blood glucose monitoring should be increased
Severe, life-threatening, generalized allergy, including anaphylaxis, can occur; if hypersensitivity reactions occur, discontinue therapy; treat per standard of care and monitor until symptoms and signs resolve
All insulin products cause a shift in potassium from the extracellular to intracellular space, possibly leading to hypokalemia; monitor potassium levels in patients at risk for hypokalemia including patients using potassium-lowering medications or those taking medications sensitive to serum potassium concentrations; treat if indicated
To avoid dosing errors and potential overdose, never use a syringe to remove drug from pen injector into a syringe
Thiazolidinediones, which are peroxisome proliferator-activated receptor (PPAR)-gamma agonists can cause dose-related fluid retention, particularly when used in combination with insulin; this may lead to or exacerbate heart failure
Pregnancy and Lactation
Available data from one unpublished trial and the published literature on use during pregnancy have not identified drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes
There are no data on the presence of insulin degludec in human milk, the effects on the breastfed infant, or the effects on milk production
Maximum Dosage
Specific maximum dosage information is not available. Individualize dosage based on careful monitoring of blood glucose and other clinical parameters in all patient populations.
How supplied
Insulin degludec
injectable solution (prefilled pen, FlexTouch)
- 100 units/mL
- 200 units/mL
