Indications for: SOLIQUA 100/33
As adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Limitations of Use:
Not studied in patients with history of pancreatitis. Not for use with any GLP-1 receptor agonist-containing products. Not for treating type 1 diabetes mellitus or diabetic ketoacidosis. Not recommended in gastroparesis. Not studied in combination with prandial insulin.
Discontinue basal insulin or GLP-1 agonist prior to initiation. Give by SC inj once daily within the hour prior to first meal into thigh, upper arm or abdomen; rotate inj sites. Individualize; monitor and adjust as needed. Naive to basal insulin or GLP-1 agonist, currently on GLP-1 agonist, or on <30 Units/day of basal insulin: initially 15 Units once daily. Currently on 30–60 Units/day of basal insulin (with or without a GLP-1 receptor agonist): initially 30 Units once daily. All: titrate dose by 2–4 Units weekly until desired FPG achieved; max 60 Units daily.
SOLIQUA 100/33 Contraindications:
During episodes of hypoglycemia.
SOLIQUA 100/33 Warnings/Precautions:
Instruct patients on diet, exercise, blood testing, proper administration of insulin, and management of hypoglycemia. Do not reuse or share pens, needles, or syringes between patients, even if the needle is changed. Do not inject into areas of lipodystrophy or localized cutaneous amyloidosis. History of anaphylaxis or angioedema with another GLP-1 receptor agonist. Discontinue if hypersensitivity reactions occur. Monitor for pancreatitis; discontinue if suspected; do not restart if confirmed. History of pancreatitis: consider alternative antidiabetics. Increased risk of hyperglycemia or hypoglycemia if changes in physical activity, meal patterns, renal or hepatic function, insulin regimen, administration site, and if acute illness occurs: monitor glucose more frequently and may need to adjust dose. Monitor potassium levels in patients at risk for hypokalemia (eg, concomitant K+-lowering or K+-sensitive drugs). Acute gallbladder disease (eg, cholelithiasis, cholecystitis). Perform gallbladder studies and appropriate clinical follow-up if cholelithiasis is suspected. Patients with visual impairment. Hepatic impairment: monitor; may need to adjust dose. Renal impairment or severe GI reactions: monitor and avoid fluid depletion. ESRD: not recommended. Elderly. Pregnancy. Nursing mothers.
SOLIQUA 100/33 Classification:
Human insulin analog + glucagon-like peptide-1 (GLP-1) receptor agonist.
SOLIQUA 100/33 Interactions:
Do not mix or dilute with other insulins or solutions. Concomitant thiazolidinediones (TZDs) may cause fluid retention and heart failure; consider dose reduction or discontinue TZDs. Increased risk of hypoglycemia with concomitant antidiabetics, ACE inhibitors, ARBs, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, pramlintide, salicylates, somatostatin analogs, sulfonamide antibiotics. Reduced efficacy with concomitant atypical antipsychotics, corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens, protease inhibitors, somatropin, sympathomimetics, thyroid hormones. Variable effects with β-blockers, clonidine, lithium salts, alcohol, pentamidine. Concomitant β-blockers, clonidine, guanethidine, reserpine may blunt hypoglycemia. Concomitant antibiotics, APAP, other drugs dependent on threshold concentration: administer ≥1hr before Soliqua; for oral contraceptives, take ≥1hr before or 11hrs after Soliqua.
Hypoglycemia, nausea, nasopharyngitis, diarrhea, upper RTI, headache, lipodystrophy, weight gain; inj site reactions, hypokalemia, anaphylaxis, renal failure, possibly antibody formation.
Generic Drug Availability:
SoloStar prefilled pen (3mL)—5