Insulin Glargine+Lixisenatide, Soliqua
Description: Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist, Long-Acting Insulin
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Soliqua is a combination therapy that consists of a three-to-one mixture of two different drugs, the basal insulin Lantus, and the GLP-1 agonist Adlyxin. Insulin acts via specific membrane-bound receptors on target tissues to regulate the metabolism of carbohydrates, proteins, and fats. Target organs for insulin include the liver, skeletal muscle, and adipose tissue. Within the liver, insulin stimulates hepatic glycogen synthesis. Insulin promotes the hepatic synthesis of fatty acids, which are released into the circulation as lipoproteins. Skeletal muscle effects of insulin include increased protein synthesis and increased glycogen synthesis. Within adipose tissue, insulin stimulates the processing of circulating lipoproteins to provide free fatty acids, facilitating triglyceride synthesis and storage by adipocytes; also directly inhibits the hydrolysis of triglycerides. Lixisenatide is a selective glucagon-like peptide-1 (GLP-1) receptor, an agonist. Acting on the same receptor as the endogenous hormone incretin, Lixisenatide increases glucose-dependent insulin secretion, decreases inappropriate glucagon secretion, and slows gastric emptying.
Indications For Use
Diabetes, Type 2
Precautions
Before using Insulin Glargine+Lixisenatide, Soliqua makes sure your physician is aware of any allergies or medications you currently take, pre-existing medical conditions, and activities you perform. Glargine+Lixisenatide, Soliqua which consists of insulin glargine and lixisenatide may be associated with the development of anti-lixisenatide antibodies, higher risk of gallbladder and bile duct disease, including cholelithiasis and cholecystitis. Lixisenatide has been reported to cause acute pancreatitis and should be monitored closely for signs and symptoms of pancreatitis (eg, persistent severe abdominal pain which may radiate to the back, and which may or may not be accompanied by vomiting). Insulin can cause hypoglycemia and must be carefully dosed during illness, emotional disturbances, or other stressors. Insulin can cause hypokalemia and should be used with caution in patients susceptible to potassium loss. Insulin Glargine+Lixisenatide, Soliqua should be used with caution in patients with mild to moderate renal impairment.
Usual Dosing
Usual (SubQ): Titrate the dosage upwards or downwards by 2 to 4 units (insulin glargine 2 to 4 units/lixisenatide 0.66 to 1.32 mcg) every week until the desired fasting plasma glucose is achieved; usual dosage range: 15 units (insulin glargine 15 units/lixisenatide 5 mcg) to 60 units (insulin glargine 60 units/lixisenatide 20 mcg)/day. Maximum dose: 60 units (insulin glargine 60 units/lixisenatide 20 mcg)/day.
Note: Discontinue therapy with basal insulin or a GLP-1 agonist prior to initiation of the combination product.
Pharmacist Tips On Using
How to Take: Administer subcutaneously in the abdomen, thigh, or upper arm. Rotate injection sites for each dose; do not use the same site for each injection. Administer within one hour before the first meal of the day, preferably the same meal each day. The solution should appear clear and colorless; do not use if particulate matter or coloration is seen. For each new prefilled pen, activate the device before the first injection by attaching a pen needle, pulling the injection button out, and then injecting into the air or a container (continue to depress the button until it stops and for an additional 2 seconds); these activation steps should not be performed for subsequent injections. Use a new needle for each injection. Once injected, continue to depress the button until it stops and for an additional 2 seconds. Then, remove the needle.
Side Effects
Hypoglycemia, antibody development, diarrhea, nausea, vomiting, nasopharyngitis, upper respiratory tract infection, headache, injection site reaction
Note this is not a complete list of side effects, only the most common.
Frequently Asked Questions
What do I do if the side effects are not tolerable?
If the side effects are causing a lot of distress speak to our physician as soon as possible to discuss options.