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Xultophy 100/ 3.6
insulin degludec/ liraglutide
Black Box Warnings .
Thyroid C-cell Tumor Risk
contraindicated in pts w/ medullary thyroid carcinoma (MTC) hx or family hx, or in pts w/ multiple endocrine neoplasia syndrome type 2 (MEN 2); liraglutide causes dose-related and duration-dependent incr. in thyroid C-cell tumor incidence observed in rodents, but human relevance unknown; uncertain value of routine serum calcitonin or thyroid ultrasound monitoring; counsel pts on potential MTC risk and thyroid tumor sx (e.g., neck mass, dysphagia, dyspnea, persistent hoarseness)
Adult Dosing .
Dosage forms: INJ (pen): 100 units/3.6 mg per mL
Special Note
- [dosing clarification]
- Info: dosing based on insulin degludec component
diabetes mellitus, type 2
- [basal insulin or GLP-1 agonist tx-naive pts]
- Dose: 10-50 units SC qd; Start: D/C basal insulin or GLP-1 agonist, then start insulin degludec/liraglutide 10 units SC qd, may adjust dose by 2 units/day no more frequently than 1-2x/wk; Max: 50 units/day; Info: retitrate from 10 units SC qd if tx interrupted for >3 days
- [conversion from basal insulin or GLP-1 agonist]
- Dose: 10-50 units SC qd; Start: D/C basal insulin or GLP-1 agonist, then start insulin degludec/liraglutide 16 units SC qd, may adjust dose by 2 units/day no more frequently than 1-2x/wk; Max: 50 units/day; Info: retitrate from 16 units SC qd if tx interrupted for >3 days
renal dosing
- [see below]
- renal impairment: consider decr. usual start dose
- HD/PD: not defined
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.