Xultophy Injection 3ml
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Introduction About XULTOPHY INJECTION
XULTOPHY INJECTION is a combination of Insulin Degludec and Liraglutide which belongs to the group of medicines called Antidiabetic agents. It is used in adults to manage Type II diabetes mellitus when management with other oral anti-diabetic agents does not result in adequate sugar control.
XULTOPHY INJECTION must be injected beneath the skin (such as on the thigh, upper arm or abdomen). Avoid sharing needles, as it may increase the risk of infections. If you are already using insulin or any medicines similar to liraglutide (such as Semaglutide, exenatide), you must inform about that to your doctor as a precaution before starting therapy with XULTOPHY INJECTION.
Talk to your doctor before starting therapy with XULTOPHY INJECTION if you have any liver, or kidney problems. You must also inform your doctor if you have any low blood sugar levels, eye problems, stomach problems or severely dehydrated as a precaution.
XULTOPHY INJECTION is not recommended for use if you have Type I diabetes mellitus or diabetic ketoacidosis (increased toxin accumulation in the body). Do not use this medicine without consulting your doctor if you are pregnant or breastfeeding.
The most common side effects of receiving XULTOPHY INJECTION are low blood sugar levels, pain, redness, itching, swelling or thickening at the injection site, lump formation under the skin and swelling of body parts. Consult your doctor if any of these side effect troubles you.
Uses Of XULTOPHY INJECTION
- Management of Type II diabetes mellitus
How XULTOPHY INJECTION Works
XULTOPHY INJECTION contains two medicines namely Insulin Degludec and Liraglutide. Insulin Degludec helps your body to make utilise of the circulating blood glucose. It helps in the transport of glucose from the blood into the muscles and fat tissues. It also stops the production of glucose by the liver.
Liraglutide makes your body to secrete more insulin. Collectively, XULTOPHY INJECTION controls blood sugar levels and improve glycemic control in patients with type II diabetes.
How to use XULTOPHY INJECTION
Always inject this medicine into your thighs, buttocks, upper arm, or abdomen (i.e., subcutaneously). Do not administer this medicine into the vein or muscle directly.
Before administration, roll the vial/cartridge between your hands until the liquid becomes uniformly white and cloudy. While injecting, keep the needle under the skin for at least 6 seconds to make sure that the entire dose is injected.
Prior to the administration, visualize the cartridge/vial for any visible particulate matter and discoloration. Discard the needle and syringe after use and do not share your needles with others to avoid the risk of transmission of infections.
Avoid repeatedly injecting the medicine at the same site to manage skin damage. Instead, rotate the injection site. Make sure to consult your doctor before changing the injection site as a precaution.
Do not stop therapy with XULTOPHY INJECTION without consulting your doctor. Your doctor will decide correct dose and frequency of administration depending upon your age, body weight and health condition.
Side Effects Of XULTOPHY INJECTION
Common
- nausea, vomiting
- diarrhea, constipation
- loss of appetite, indigestion
- stomach pain, heartburn or bloating
- injection site reactions (such as bruising, bleeding, pain, redness, itching or swelling)
- lipodystrophy (shrinkage of fat tissues beneath the skin)
- lumps under the skin
Uncommon
- skin rash with itching
- dehydration (loss of fluid from the body)
- increased heart rate
- gallstones or gallbladder inflammation
Consult your doctor immediately if you experience any of the following side effects:
- allergic reaction (generalized skin rash with itching, sweating, and swelling of layers under the skin, difficulties in breathing, palpitation, vomiting, stomach upset, reduction in blood pressure and fainting)
- signs of severe hypoglycemia (such as cold sweats, cool pale skin, headache, rapid heartbeat, nausea, increased hunger, temporary vision changes, drowsiness, tiredness and weakness, nervousness or tremor, anxiety, confusion and difficulty in concentrating)
- inflammation of the pancreas causing severe persistent stomach pain which radiates towards your back along with nausea and vomiting
How To Manage Side Effects
Hypoglycemia
Managing hypoglycemia, or low blood sugar, involves prompt action to raise blood glucose levels and manage complications. When experiencing hypoglycemia, individuals should quickly consume a source of rapidly-absorbed carbohydrates, such as glucose tablets, fruit juice, or regular soda. Waiting for about 15 minutes and rechecking blood sugar levels is crucial to ensure they rise to a safe range. If hypoglycemia persists, additional carbohydrate intake may be necessary. Once blood sugar levels stabilize, a small snack containing both carbohydrates and protein can help sustain them. Regular monitoring and consultation with a healthcare professional are essential for developing a personalized plan to manage hypoglycemia effectively. In severe cases, emergency assistance may be required.
Injection Site Reactions
Managing injection site reactions is essential for individuals who regularly administer injections. To alleviate discomfort and minimize potential issues, it is crucial to follow proper injection techniques. Rotate injection sites to manage overuse of a single area, allowing tissues to heal. Use a clean, sterile needle and syringe for each injection. Apply an ice pack to the injection site before and after administration to reduce pain and swelling. If redness, swelling, or irritation persists, consult a healthcare professional for guidance. It is essential to report any severe or persistent reactions to ensure appropriate adjustments to the injection routine and to manage potential complications.
Warning & Precautions
Pregnancy
Consult your doctorIt is not known whether XULTOPHY INJECTION affects the unborn baby. Therefore, do not use this medicine without consulting your doctor if you are pregnant or think you may be pregnant. Consult your doctor for advice before administration.
Breastfeeding
ContraindicatedXULTOPHY INJECTION is not recommended for use in breastfeeding women. Therefore, consult your doctor before administration.
Driving and Using Machines
Use with CautionDo not drive or operate any machines if your ability is affected by XULTOPHY INJECTION.
Alcohol
Consult your doctorAvoid consumption of alcohol while undergoing therapy with XULTOPHY INJECTION as it may make this medicine less effective.
Kidney
Use with CautionXULTOPHY INJECTION should be used with caution in patients with kidney problems. Therefore, consult your doctor before administration.
Liver
Use with CautionXULTOPHY INJECTION should be used with caution in patients with liver problems. Therefore, consult your doctor before administration.
Allergy
ContraindicatedTalk to your doctor before starting therapy with XULTOPHY INJECTION if you are allergic to Insulin Degludec or Liraglutide.
Use In Pediatrics
ContraindicatedXULTOPHY INJECTION is not recommended for use in children and in adolescents (aged below 18 years) due to lack of safety data. Therefore, consult your doctor before administration.
Use In Geriatrics
Use with CautionXULTOPHY INJECTION should be used with caution among the elderly patients (aged 65 years or above). Therefore, consult your doctor before administration.
Others
XULTOPHY INJECTION is not recommended for use if you:
- have Type I diabetes mellitus (diabetes caused due to lack of insulin production in the body)
- have diabetic ketoacidosis (increased toxin accumulation in the body)
- have inflammatory bowel disease
- have delayed gastric emptying (less bowel movements that hinders digestion)
Talk to your doctor before receiving XULTOPHY INJECTION if you:
- have or at risk of developing hypoglycaemia (low blood sugar levels)
- have eye problems
- have or ever had thyroid problems
- are dehydrated due to recent sickness
Interactions
A. Drug-Drug interactions:
Before XULTOPHY INJECTION is administered, inform your doctor if you are taking any of the following medicines such as:
- other antidiabetic agents (Ex. glimepiride, glyburide, gliclazide, rosiglitazone, pioglitazone)
- sulfonamide antibiotics (Ex. sulfasalazine, sulfadiazine, sulfamethoxazole)
- anabolic steroids (Ex. testosterone, nandrolone, oxandrolone)
- Antihypertensive agents (such as atenolol, propranolol, captopril, enalapril, ramipril, lisinopril, losartan, valsartan, olmesartan, telmisartan)
- salicylates (used to relieve pain or fever) Ex. aspirin
- antidepressants (such as moclobemide, isocarboxazid, phenelzine, selegiline, tranylcypromine)
- danazol (a medicine used to manage uterine problems)
- thyroid hormones (such as thyroxine, levothyroxine)
- oral contraceptives (birth control pills) Ex. mifepristone
- growth hormone (used to increase growth)
- corticosteroids (used to manage pain and inflammation) Ex. hydrocortisone, prednisolone
- sympathomimetic agents (Ex. ephedrine, adrenaline, salbutamol, or terbutaline)
- thiazide diuretics (Ex. hydrochlorothiazide, chlorothiazide)
- octreotide and lanreotide (medicines used to manage abnormal body growth)
Overdosage:
If you or anyone else took too much of this medicine, contact your doctor immediately or go to a hospital straight away as it may cause severe hypoglycemia. Symptoms of hypoglycemia might include fainting, feel unwell, sweating, vomiting, difficulty in breathing, fast heartbeat, and dizziness.
Synopsis
| Drug | : | Insulin Degludec, Liraglutide |
| Pharmacological Category | : | Long-acting basal insulin, GLP-1 analogue |
| Therapeutic Indication | : | Type II Diabetes mellitus |
| Dosage Forms | : | Injection |
More Information
- Keep XULTOPHY INJECTION out of the sight and reach of children
- Before use: Store XULTOPHY INJECTION in the refrigerator (between 2-8?)
- In Use: Store at room temperature after opening for up to 28 days
FAQs About XULTOPHY INJECTION
Q: Should XULTOPHY INJECTION be refrigerated?
A: Yes. An unopened pack must be stored in the refrigerator (2-8°C). During use or while carrying as a spare, keep it at room temperature to ensure uniform resuspension.
Q: Can XULTOPHY INJECTION be mixed with other insulins?
A: Do not mix XULTOPHY INJECTION with other insulins. Always consult your doctor before mixing insulins.
Q: Is XULTOPHY INJECTION safe during pregnancy?
A: It is not known whether XULTOPHY INJECTION affects the unborn baby. Therefore, do not use this medicine without consulting your doctor if you are pregnant or think you may be pregnant. Consult your doctor for advice before administration.
Q: Can XULTOPHY INJECTION be given intravenously?
A: No. XULTOPHY INJECTION is meant for subcutaneous use only (i.e., thighs, buttocks, abdomen, or upper arms). It should not be directly injected into the vein or muscle as it may cause severe hypoglycemia.
Q: What is the best area for injecting XULTOPHY INJECTION? Should I inject it only at the same site every day?
A: The best place for injecting this medicine is front of your thighs, buttocks, abdomen or upper arms. The insulin would work more quickly if it were injected into the waist (abdomen). Do not repeatedly inject the medicine on the same site. Instead, rotate the injection sites within the same area to avoid the risk of developing lumps or skin pitting.
Q: What is XULTOPHY INJECTION used for?
A: XULTOPHY INJECTION is used in adults to manage Type II diabetes mellitus when management with other oral anti-diabetic agents does not result in adequate sugar control.
Q: What are the most common side effects of taking XULTOPHY INJECTION?
A: The most common side effects of injecting XULTOPHY INJECTION are low blood sugar levels, pain, redness, itching, swelling or thickening at the injection site, lump formation under the skin and swelling of body parts. Consult your doctor if any of these side effect troubles you.
Q: Can I stop therapy with XULTOPHY INJECTION without consulting your doctor?
A: No. You should not stop therapy with XULTOPHY INJECTION without consulting your doctor because it may lead to reversal of symptoms. If you feel better after using XULTOPHY INJECTION, consult your doctor for advice.
Q: Will taking a higher dose of XULTOPHY INJECTION be more effective?
A: No, taking a higher dose of XULTOPHY INJECTION will not be effective rather it can lead to toxicity. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.
Q: Can I take medication for high blood pressure along with XULTOPHY INJECTION?
A: It is not advisable to take medicines to control blood pressure while taking XULTOPHY INJECTION without consulting your doctor. Therefore, consult your doctor before taking any antihypertensive medications along with XULTOPHY INJECTION as they have known interactions with XULTOPHY INJECTION.
References
1. KD. Tripathi. Insulin, Oral hypoglycaemic drugs and glucagon. Essentials of Medical Pharmacology. 7th Edition. 2013. Page – 264.
2. David M Williams, Natasha Shrikrishnapalasuriyar, Waheeba Syed, Win L Yin, Richard Chudleigh, Stephen C Bain, David E Price, Jeffrey W Stephens. Real-world clinical experience of Xultophy in the management of patients with type 2 diabetes in a secondary care clinic. NIH. National Library of Medicine. National Center for biotechnology Information. Pubmed.gov. November 2018. [Accessed on 21st February 2023] https://pubmed.ncbi.nlm.nih.gov/30006093/
3. Novo Nordisk A/S. Xultophy® 100 units/mL + 3.6 mg/mL solution for injection insulin degludec + liraglutide. Electronic Medicines Compendium (EMC). [Revised in September 2022] [Accessed on 21st February 2023] https://www.medicines.org.uk/emc/files/pil.3469.pdf
Useful Diagnostic Tests
- Glucose-Fasting Blood
- Glucose-Postprandial Blood
- Glycosylated Haemoglobin
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