Xultophy® Prefilled Pen for Type 2 Diabetes: Uses, Dosing, and Safety

What Xultophy® Is and How It Works

Xultophy is a fixed-dose combination of insulin degludec and liraglutide for adults with type 2 diabetes. Each dose step contains 1 unit of insulin degludec and 0.036 mg of liraglutide. It is given once daily by subcutaneous injection using a prefilled pen. Many people compare prices for the Xultophy Prefilled Pen, including options without insurance, to manage ongoing therapy costs.

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Insulin degludec provides long, steady glucose lowering. Liraglutide (a GLP‑1 receptor agonist) helps the body release insulin when glucose rises, lowers glucagon, slows gastric emptying, and may reduce appetite. The pair targets fasting and post‑meal glucose. Xultophy is used when diet, exercise, and oral medicines, or basal insulin alone, do not provide sufficient control. It is not for type 1 diabetes or diabetic ketoacidosis.

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The pen delivers doses from 10 to 50 steps once daily. Inject in the abdomen, thigh, or upper arm at the same time each day. Rotate sites to reduce skin reactions. Do not share pens or needles.

Dosage and Usage

• Typical starting dose for adults naive to basal insulin or GLP‑1 RA: 10 dose steps once daily.
• Starting dose for adults currently on basal insulin (less than 50 units daily) or a GLP‑1 RA: 16 dose steps once daily.
• Titrate by 2 dose steps based on fasting glucose, usually every 3–4 days or as directed by a prescriber.
• Maximum dose: 50 dose steps once daily. Do not exceed the pen’s maximum.
• If a dose is missed, take the missed dose when remembered the same day and then resume the usual schedule. Ensure at least 8 hours between doses. If more than 3 days are missed, product labeling recommends restarting at 10 dose steps and retitrating.
• Injection steps: check the pen label and expiration date; attach a new needle; prime the pen per instructions; dial the prescribed dose; inject subcutaneously; count slowly before removing the needle; dispose of the needle safely.
• Use only for subcutaneous injection. Do not use in an insulin pump. Do not dilute or mix with other products.
• Rotate injection sites within the same area to lower the risk of lipodystrophy or skin irritation.

• Storage (unopened): refrigerate at 2–8 °C (36–46 °F). Do not freeze. Keep in the carton to protect from light.
• Storage (in use): keep below 30 °C (86 °F) or refrigerate. Do not freeze. Keep the cap on. Discard the pen 21 days after first use.
• Heat and light: avoid direct sunlight, heaters, and car glove boxes. If a pen freezes, discard it.
• Travel: carry pens and supplies in a hand‑carried insulated pouch. Use cold packs with a barrier, not direct ice. Bring extra needles, a spare pen, and your prescription. Do not check pens with luggage.

Benefits and Savings

Xultophy simplifies intensification with one daily injection. In studies, many adults achieved greater A1C reductions than with basal insulin alone. The GLP‑1 component can offset weight gain seen with insulin. Hypoglycemia rates were lower than with traditional basal‑bolus approaches at comparable control. The prefilled pen is discreet and easy to learn.

Ordering from a Canadian pharmacy can reduce costs by 60–80% versus typical US prices. That can help those paying Xultophy without insurance. You can set gentle reorder reminders and choose multi‑month supplies where appropriate to lower per‑month costs.

Looking for extra savings? See our Xultophy coupon offers when available.

Side Effects and Safety

• Nausea, vomiting, diarrhea, or decreased appetite
• Indigestion or constipation
• Headache or dizziness
• Injection‑site redness or itching
• Cold‑like symptoms (nasopharyngitis)
• Fatigue
• Hypoglycemia, especially when combined with sulfonylureas or prandial insulin

Serious risks are uncommon but include pancreatitis, gallbladder disease, kidney problems, dehydration, and severe allergic reactions. Liraglutide carries a boxed warning for risk of medullary thyroid carcinoma (MTC). Avoid use in patients with a personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Rapid glucose improvement can transiently worsen diabetic retinopathy. Dose reductions of sulfonylureas or mealtime insulin may lower hypoglycemia risk.

Onset Time

Fasting glucose can improve within days as titration begins. Gastrointestinal symptoms, if present, often settle over 1–2 weeks. Most people see clearer changes in average glucose within 2–4 weeks. A1C reflects the full effect after about 12 weeks at a stable dose. Weight effects, if any, emerge over 4–12 weeks.

Compare With Alternatives

Soliqua (insulin glargine/lixisenatide) is another once‑daily basal insulin plus GLP‑1 option. It uses insulin glargine and a different GLP‑1 RA, with distinct dose ranges and pen devices. Choice may depend on fasting glucose needs, tolerability, and prior therapy.

Some patients use a basal insulin alone. For instance, Tresiba® Flextouch Pens (insulin degludec) allow flexible timing and very long action, but lack the GLP‑1 benefits on weight and post‑meal control.

Oral combinations are an option when injections are not preferred. Xigduo® (dapagliflozin/metformin) lowers glucose without injections and can be paired with injectable therapies in some regimens. Suitability depends on kidney function, side‑effect profile, and treatment goals.

Combination Therapy

• Metformin is commonly continued with Xultophy, unless not tolerated or contraindicated.
• SGLT2 inhibitors (e.g., dapagliflozin, empagliflozin) are often paired for added A1C and cardiorenal benefits.
• Sulfonylureas may require dose reduction to reduce hypoglycemia risk.
• Do not use with another GLP‑1 RA or with separate basal insulin.
• Thiazolidinediones can increase edema; monitor when used with insulin.
• Standard cardiovascular risk therapies (statins, ACE inhibitors, ARBs) generally remain unchanged.

Patient Suitability and Cost-Saving Tips

Adults with type 2 diabetes who need stronger control after oral drugs or basal insulin may be candidates. It is not approved for children. It should not be used in type 1 diabetes or for diabetic ketoacidosis. It is for subcutaneous use only.

Do not use if there is a personal or family history of MTC, or in MEN 2. People with prior pancreatitis, severe gastrointestinal disease such as gastroparesis, or significant renal or hepatic impairment need careful assessment by a prescriber. Discuss pregnancy and breastfeeding plans with a clinician.

To manage costs, consider a multi‑month order when appropriate, since shipping and bulk promotions can lower the monthly price. Reorder reminders help prevent gaps in therapy, especially before travel. Those paying Xultophy no insurance may see meaningful savings when ordering from Canada.

Authoritative Sources

Xultophy (insulin degludec/liraglutide) US Prescribing Information

Health Canada Product Monograph for Xultophy

FDA Medication Guide and Labeling for Xultophy

Order Xultophy® from YouDrugstore: add to cart, upload your prescription, and we ship with prompt, express, cold-chain handling.

This content is educational and does not replace advice from your own healthcare professional.