Writing a prescription for Xultophy® 100/3.6 could be a step toward glycemic control for your adult patients with type 2 diabetes. Before prescribing, know the starting dose and see how to titrate Xultophy® 100/3.6.
Starting treatment and titrating Xultophy® 100/3.6
START

In patients naïve to basal insulin or a GLP-1 RA at
10 UNITS
10 units=10 units of insulin degludec and 0.36 mg liraglutide1
In patients converting from basal insulin or a GLP-1 RA at
16 UNITS
16 units=16 units of insulin degludec and 0.58 mg liraglutide1

- Therapy with basal insulin and liraglutide should be discontinued prior to initiation of Xultophy® 100/3.61
A basal insulin dose is dialed, GLP-1 RA automatically adjusts
The Xultophy® 100/3.6 Pen delivers a fixed-ratio combination in increments of 1 unit
(1 unit=1 unit of insulin degludec and 0.036 mg liraglutide)1

Dose once daily at the same time each day with or without food1

No waiting to inject when removed from the refrigerator1

Glycemic control when starting Xultophy® 100/3.6
A post-hoc analysis of DUAL™ V revealed that patients did not lose FPG control when converting from insulin glargine U-100 to Xultophy® 100/3.6.1,2 In the trial, patients on 20-50 units of insulin glargine U-100 at baseline were started on 16 units of Xultophy® 100/3.6 per day.2
Exploratory prespecified secondary endpoint in DUAL V, a 26-week open-label trial vs insulin glargine U-100, both plus MET
Change in FPG over time1,2

Weeks 4, 8, and 12 were exploratory prespecified endpoints in the trial.
Change in mean FPG for insulin degludec/liraglutide was –50.9 mg/dL; for insulin glargine U-100, –49.9 mg/dL.
NS=not significant.
ETD=estimated treatment difference.
Weeks 4, 8, and 12 were exploratory prespecified endpoints in the trial.

“I know there are concerns within the medical community about taking somebody from a higher basal insulin dose like 30 or 40 units and starting them on a Xultophy® 100/3.6 dose of 16 units. However, the data has already demonstrated that there is no loss of glucose control in those first several weeks while patients are titrating to their goal.”
Jodi Strong, DNP, FNPBC, APNP, CDE, BCARM

“I know there are concerns within the medical community about taking somebody from a higher basal insulin dose like 30 or 40 units and starting them on a Xultophy® 100/3.6 dose of 16 units. However, the data has already demonstrated that there is no loss of glucose control in those first several weeks while patients are titrating to their goal.”
Jodi Strong, DNP, FNPBC, APNP, CDE, BCARM


TITRATE
Every 3-4 days based on FPG1
Below
FPG target range
-2 units
Within
FPG target range
0 units
Above
FPG target range
+2 units
- Maximum dose: 50 units=50 units of insulin degludec and 1.8 mg liraglutide1
- In clinical trials, patients adjusted their dose on Monday and Thursday of each week2

PRESCRIBE
Ready to prescribe Xultophy® 100/3.6?
How to prescribe

Dispense 1 box of 5 pens1

NDC 0169-2911-151
NDC 0169-2911-151
Provide a second prescription for pen needles
Provide titration instructions with FPG target range
NDC 0169-2911-151
Provide a second prescription for pen needles
Provide titration instructions with FPG target range

Starting dose of 10 units or 16 units1

Provide a second prescription for NovoFine® Plus 32G pen needles

Provide titration instruction with FPG target range

Add Xultophy® 100/3.6 to your ePrescribing system
NDC: 0169-2911-15
Drug name: Xultophy® 100/3.6
Form / Strength: 100 units insulin degludec and 3.6 mg liraglutide per mL, 3 mL
Quantity: 15 mL (5 x 3 mL); 1500 units total
Dosage Form: Solution
The Xultophy® 100/3.6 Pen delivers doses from 10 to 50 units in a single injection with dose increments of 1 unit (1 unit = 1 unit of insulin degludec and 0.036 mg liraglutide).

Study design
DUAL™ V (Study C): A 26-week, randomized, parallel, open-label, treat-to-target trial in adult patients with type 2 diabetes inadequately controlled (A1C 7%-10%) on insulin glargine U-100 (20-50 units) + metformin, comparing the efficacy and safety of Xultophy® 100/3.6 (n=278) with continued up-titration of insulin glargine U-100 (n=279), both + metformin. The primary endpoint was change in A1C after 26 weeks of treatment. Exploratory prespecified endpoints included insulin dose, change from baseline in fasting plasma glucose (FPG) level, 9-point self-measured blood glucose (SMBG) profile, responders for A1C level (predefined targets of <7.0% and ≤6.5%), and for composite targets based on A1C level without hypoglycemia and/or without weight gain.1,2