THE SOLIQUA 100/33 SOLOSTAR® PEN KEEPS TREATMENT STREAMLINED
One starting dose of SOLIQUA 100/33 for Adult patients WITH T2DM uncontrolled on either OADs or GLP-1 RAs1
Recommended Starting Dose
FOR PATIENTS UNCONTROLLED ON OADs
Start at 15 Units
The starting dose provides 15 Units of Lantus and 5 mcg of lixisenatide, a GLP-1 RA.
FOR PATIENTS UNCONTROLLED ON THESE INJECTABLE THERAPIES• GLP-1 RA
• Basal insulin <30 units
• Basal insulin ≥30 units
• GLP-1 RA
• Basal insulin <30 units
Start at 15 Units
This starting dose provides 15 Units of Lantus and 5 mcg of lixisenatide, a GLP-1 RA.
Start at 30 Units
This starting dose provides 30 Units of Lantus and 10 mcg of lixisenatide, a GLP-1 RA.• Basal insulin ≥30 units
OAD, oral antidiabetic therapy.
Dosing is once daily subcutaneously within the hour prior to the first meal of the day
- The maximum dose of SOLIQUA 100/33 is 60 Units
- Use alternative treatment if doses below 15 Units or above 60 Units are required
- One Unit of SOLIQUA 100/33 contains 1 Unit of Lantus and 0.33 mcg of lixisenatide
SOLIQUA 100/33 ALLOWS FOR GRADUAL TITRATION OF THE GLP-1 RA ALONG WITH THE BASAL INSULIN1
SOLOSTAR® TECHNOLOGY YOU AND YOUR OFFICE STAFF WILL FIND FAMILIAR
SOLIQUA 100/33 is delivered subcutaneously, via the SOLIQUA 100/33 SoloStar pen, once daily
See the full SOLIQUA 100/33 dosing story: Download the dosing guide
TITRATE BY 2-4 UNITS WEEKLY UNTIL TARGET FPG IS REACHED
- SOLIQUA 100/33 is to be dosed on the patient’s metabolic needs, blood glucose monitoring results, and glycemic goals
- The dose on the SOLIQUA 100/33 SoloStar pen can be adjusted in 1-Unit increments
- The maximum dose of SOLIQUA 100/33 is 60 Units
- Use alternative treatments if doses below 15 Units or above 60 Units are required
Move the slider to gradually adjust the dose of the GLP-1 RA and basal insulin
SOLIQUA 100/33 allows for gradual TITRATION of the GLP-1 RA along with THE BASAL insulin1
Titration of stand-alone GLP-1 RA (lixisenatide)
Gradual titration of SOLIQUA 100/33
FPG, fasting plasma glucose.
SOLIQUA 100/33 is a combination of a long-acting human insulin analog with a glucagon-like peptide-1 (GLP-1) receptor agonist (RA) indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Limitations of Use:
- Has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis.
- Not recommended for use in combination with any other product containing a GLP-1 receptor agonist.
- Not for treatment of type 1 diabetes mellitus or diabetic ketoacidosis.
- Not recommended for use in patients with gastroparesis.
- Has not been studied in combination with prandial insulin.
Important Safety Information
Important Safety Information for SOLIQUA 100/33 (insulin glargine and lixisenatide) injection 100 Units/mL and 33 mcg/mL
- During episodes of hypoglycemia.
- In patients with known serious hypersensitivity to insulin glargine, lixisenatide, or to any of the product components.
Warnings and Precautions
- Anaphylaxis and Serious Hypersensitivity Reactions: In clinical trials of lixisenatide, there have been cases of anaphylaxis and other serious hypersensitivity reactions including angioedema. Severe, life-threatening, generalized allergic reactions, including anaphylaxis and angioedema, can occur with insulins, including insulin glargine. There have been reports of serious hypersensitivity reactions, including anaphylactic reactions and angioedema, in patients treated with SOLIQUA 100/33. If hypersensitivity reactions occur, discontinue SOLIQUA 100/33. Use caution in patients with a history of anaphylaxis or angioedema with another GLP-1 RA because it is unknown whether such patients will be predisposed to anaphylaxis.
- Pancreatitis: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with GLP-1 RAs. Cases of pancreatitis were reported in clinical trials of lixisenatide. After initiation of SOLIQUA 100/33, observe patients for signs and symptoms of pancreatitis (e.g., persistent severe abdominal pain, sometimes radiating to the back and which may be accompanied by vomiting). If pancreatitis is suspected, SOLIQUA 100/33 should promptly be discontinued. If pancreatitis is confirmed, restarting SOLIQUA 100/33 is not recommended and other antidiabetic therapies should be considered.
- Never Share a SOLIQUA 100/33 SoloStar® Pen between Patients: Pen-sharing poses a risk for transmission of blood-borne pathogens, even if the needle is changed.
Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in insulin regimen including, strength, manufacturer, type, injection site or method of administration may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Changes should be made cautiously, and the frequency of blood glucose monitoring should be increased. Adjustments in concomitant oral antidiabetic treatment may be needed.
Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis may result in hyperglycemia; sudden change in the injection site (to unaffected area) has been reported to result in hypoglycemia. Advise patients to rotate injection site to unaffected areas and closely monitor for hypoglycemia.
- Medication Errors: SOLIQUA 100/33 contains two drugs. Do not administer more than 60 units of SOLIQUA 100/33, which may result in overdose of the lixisenatide component. Do not use other GLP-1 RAs. Accidental mix-ups between insulin products have been reported. Instruct patients to always check the label before administration. Do not withdraw SOLIQUA 100/33 from the pen with a syringe.
- Hypoglycemia: Hypoglycemia is the most common adverse reaction associated with insulin-containing therapy, which may be life-threatening. Increase frequency of glucose monitoring with changes to: insulin dosage, co-administered glucose lowering medications, meal pattern, physical activity, and in patients with renal or hepatic impairment and hypoglycemia unawareness.
- Acute Kidney Injury: There have been reports of acute renal failure and worsening of chronic failure, which may sometimes require hemodialysis in patients treated with SOLIQUA 100/33. Some of these events were reported in patients without known underlying renal disease. Most reports occurred in patients who experienced nausea, vomiting, diarrhea, or dehydration; advise patients to take precautions to avoid fluid depletion. Monitor blood glucose and renal function in patients with renal impairment. SOLIQUA 100/33 is not recommended in patients with end-stage renal disease.
- Immunogenicity: Patients may develop antibodies to insulin and lixisenatide. If there is worsening glycemic control or failure to achieve targeted glycemic control, significant injection site reactions or allergic reactions, then other antidiabetic therapy should be considered.
- Hypokalemia: All insulin containing products can cause hypokalemia, which may be life-threatening. Untreated hypokalemia may cause respiratory paralysis, ventricular arrhythmia, and death. Monitor potassium levels in patients at risk of hypokalemia and treat if indicated.
- Fluid Retention and Heart Failure with Concomitant Use of PPAR-gamma Agonists: Fluid retention, which may lead to or exacerbate heart failure, can occur with concomitant use of thiazolidinediones (TZDs) and insulin. These patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of TZD must be considered.
- Acute Gallbladder Disease: Acute events of gallbladder disease such as cholelithiasis or cholecystitis have been reported in GLP-1 receptor agonist trials and post-marketing. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated.
Most Common Adverse Reactions
The most common adverse reactions reported in ≥ 5% of patients treated with SOLIQUA 100/33 include hypoglycemia, nausea, nasopharyngitis, diarrhea, upper respiratory tract infection, headache
- Certain drugs may affect glucose metabolism, requiring dose adjustment of SOLIQUA 100/33 and close monitoring of blood glucose.
- The signs of hypoglycemia may be reduced or absent in patients taking anti-adrenergic drugs (eg, beta-blockers, clonidine, guanethidine, and reserpine).
- The lixisenatide in SOLIQUA 100/33 delays gastric emptying, which may reduce the rate of absorption of orally administered medication with a narrow therapeutic ratio or that require careful clinical monitoring. If such medications are to be administered with food, do not co-administer with SOLIQUA 100/33.
- Antibiotics, acetaminophen, or other medications that are dependent on threshold concentrations for efficacy, or where a delay in effect is undesirable, should be administered at least 1 hour before SOLIQUA 100/33 injection.
- Oral contraceptives should be taken at least 1 hour before SOLIQUA 100/33 administration or 11 hours after.
- SOLIQUA 100/33 Prescribing Information.