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degludec/liraglutide (Xultophy)

Indications: - adults with type 2 diabetes inadequately controlled on basal insulin (< 50 units/day) or liraglutide (<= 1.8 mg/day) - may afford better glycemic control than glargine [1] Dosage: - prefilled pen device containing a fixed dose of degludec & liraglutide - each unit of Xultophy 100/3.6 contains: - 1 unit of degludec & 0.036 mg of liraglutide - QD dosing - starting dose is 16 units (16-units degludec & 0.58 mg liraglutide - maximum dose of 50 units corresponds to 50 units of degludec & 1.8 mg of liraglutide Adverse effects: - nausea Clinical trials: DUAL V Randomized Clinical Trial [1] - study characteristics - 560 adults type 2 diabetes - hemoglobin A1c of 7-10% while taking glargine & metformin - patients randomized to either continue glargine or switch to once-daily injections of degludec/liraglutide - results - at 26 weeks, mean HbA1c diminished by 1.8% with degludec/liraglutide vs 1.1% with glargine - degludec/liraglutide recipients lost an average of 1.4 kg; glargin ecipients gained 1.8 kg - degludec/liraglutide recipients had fewer episodes of hypoglycemic

Interactions

drug adverse effects of hypoglycemic agents

General

hypoglycemic combination

References

  1. Lingvay I et al Effect of Insulin Glargine Up-titration vs Insulin Degludec/ Liraglutide on Glycated Hemoglobin Levels in Patients With Uncontrolled Type 2 Diabetes. The DUAL V Randomized Clinical Trial. JAMA. 2016;315(9):898-907 PMID: 26934259 http://jama.jamanetwork.com/article.aspx?articleid=2497908
  2. Nainggolan L IDegLira, LixiLan Go Head-to-head as FDA Okays Both for Diabetes. Medscape. Nov 22, 2016. http://www.medscape.com/viewarticle/872224

Components

insulin degludec (Tresiba) liraglutide (Victoza, Saxenda)