Xultophy Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Xultophy Injection combines insulin degludec, a long-acting insulin, with liraglutide, a GLP-1 receptor agonist, to help manage type 2 diabetes. It is given as a once-daily injection under the skin and is used to improve blood sugar control alongside diet and exercise. Xultophy carries a boxed warning about a possible increased risk of thyroid tumors and is not approved for use in anyone younger than 18 years old.

What is Xultophy Injection

Xultophy is an injection pen that combines two medicines: insulin degludec, a long-acting insulin, and liraglutide, which acts like a natural body hormone that helps control blood sugar, insulin levels, and digestion.

Xultophy Injection uses

• Type 2 diabetes.
• Improving blood sugar control.
• Managing high fasting blood sugar.
• Supporting diabetes treatment alongside diet and exercise.
• Improving glucose control when other medicines are insufficient.

Benefits of Xultophy Injection

• Helps lower blood sugar.
• Improves glucose control.
• Supports long-term diabetes management.
• Helps reduce fasting blood sugar.
• Combines two medicines in one injection.

How Xultophy Injection works

Xultophy works in several ways: it causes the pancreas to release more insulin after eating, helps the body absorb sugar from the blood, reduces the amount of sugar the liver makes and releases, and slows down the movement of food through the digestive system.

Xultophy Injection dosage

Xultophy is given as an injection under the skin, usually once a day at the same time each day, and can be used with or without food. Use only the injection pen supplied with this medicine; do not dilute or mix other medicines in with it. Choose a different injection site each time, and do not inject into the same spot twice in a row. Do not inject into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.

If a dose is missed, skip it and take the next dose at the regular time; do not take two doses at once. If more than 3 days in a row are missed, contact the doctor for instructions. Never share the injection pen or needles with another person, even if the needle has been changed. Make sure there is a minimum gap between doses if the daily timing changes. Xultophy is not approved for use in anyone younger than 18 years old.

Available forms and strengths

• Injection

Side effects of Xultophy Injection

Common

• Common cold or upper respiratory infection, sore throat, sneezing, stuffy or runny nose
• Diarrhea
• Headache
• Nausea
• Mild hypoglycemia (low blood sugar)
• Vomiting, constipation, indigestion, bloating, reduced appetite
• Increased lipase levels (a digestive enzyme)
• Lipodystrophy (pitting or thickening of skin) at injection sites
• Slight increase in heart rate
• Fluid buildup in hands, lower legs, or feet
• Hyperglycemia (high blood sugar)
• Weight gain
• Injection site reactions such as pain, bruising, redness, swelling, itchiness, warmth, or a small lump

Serious

• Severe allergic reaction (hives, difficulty breathing, swelling of face, lips, tongue, or throat)
• Serious hypoglycemia (severe low blood sugar), which can cause confusion, seizures, coma, or death
• Acute pancreatitis (inflammation of the pancreas) with severe upper stomach or back pain, nausea, and vomiting
• Kidney problems, including acute kidney failure, with reduced urination, swelling in legs and feet, muscle cramps, nausea and vomiting
• Hypokalemia (low potassium), with muscle weakness or twitching, heart palpitations, constipation, fatigue
• Gallbladder problems, including gallstones and cholecystitis, with upper abdominal pain, nausea, vomiting, fever, or yellowing skin/eyes
• Thyroid tumors, including possible thyroid cancer, with a lump or swelling in the neck, hoarseness, trouble swallowing, or trouble breathing
• Heart failure symptoms (shortness of breath, swelling in feet/ankles/legs, rapid weight gain, tiredness), especially when combined with certain other diabetes medicines

Warnings and precautions

• Xultophy carries a boxed warning, the FDA's most serious type of warning, about a possible increased risk of thyroid tumors, including a type of thyroid cancer, based on animal studies. 
• Do not use Xultophy if you have a personal or family history of medullary thyroid carcinoma, multiple endocrine neoplasia syndrome type 2, type 1 diabetes, or diabetic ketoacidosis, or if you are currently having a low blood sugar episode. Xultophy is not recommended for people with inflammatory bowel disease or delayed stomach emptying (diabetic gastroparesis). U
• sing Xultophy with certain other diabetes medicines (pioglitazone or rosiglitazone) may increase the risk of heart failure. Vomiting or diarrhea can lead to dehydration, which can cause kidney failure, so contact your doctor if these occur.
• It isn't known for sure if Xultophy is safe to use during pregnancy. Some sources advise not to use it if pregnant or planning pregnancy, while others say to tell your doctor so they can discuss safety and other treatment options.
• It isn't known for sure if Xultophy is safe while breastfeeding, and some sources advise against using it while breastfeeding.
• People with kidney problems may need closer monitoring and blood sugar checks, and should tell their doctor about any kidney issues before starting this medicine.
• People with liver problems may need closer monitoring and blood sugar checks, and should tell their doctor about any liver issues before starting this medicine.
• It's best to avoid alcohol while using Xultophy, since it can affect blood sugar levels and make low or high blood sugar more likely.
• Low or high blood sugar can affect the ability to drive safely or use machines, so caution is needed until it's clear how this medicine affects you, especially if you often get low blood sugar or find it hard to notice the warning signs.

Storage

• Keep in its original container protected from heat and light
• Do not freeze; do not store near the cooling element in a refrigerator; throw away any insulin that has been frozen
• Unopened: refrigerate and use until the expiration date, or store at room temperature and use within 21 days
• Opened (in use): store at room temperature away from heat and light and use within 21 days, or store in a refrigerator and use within 21 days
• Do not store the injection pen with a needle attached
• Do not use the medicine if it looks cloudy or has changed color
• Keep out of the reach of children

When to see a doctor

• Get emergency help right away for signs of a severe allergic reaction, such as hives, trouble breathing, or swelling of the face, lips, tongue, or throat.
• Call your doctor right away for signs of pancreatitis, such as severe upper stomach pain that spreads to the back, with nausea and vomiting.
• Call your doctor right away for signs of kidney problems, such as little or no urination, or painful or difficult urination.
• Call your doctor right away for signs of low potassium, such as leg cramps, constipation, irregular heartbeats, fluttering in the chest, increased thirst or urination, numbness or tingling, or muscle weakness.
• Watch for and tell your doctor right away about signs of a thyroid tumor, such as a lump or swelling in the neck, hoarseness, trouble swallowing, or trouble breathing.
• Seek medical help right away for symptoms of severe low blood sugar, or if someone passes out due to low blood sugar.
• If signs of high blood sugar or ketoacidosis appear (such as fruity breath, extreme thirst, nausea, or vomiting), test blood sugar and ketones and get medical help right away.

Alternatives

• Trulicity
• Ozempic
• Soliqua