Generic Name and Formulations:
Insulin degludec 100 Units/mL, 200 Units/mL; SC inj; contains zinc, m-cresol.
Indications for TRESIBA:
To improve glycemic control in patients with diabetes mellitus.
Limitations Of use:
Not for treating diabetic ketoacidosis. Not for use in pediatric patients requiring <5 Units.
Give by SC inj once daily at any time of day into thigh, upper arm, or abdomen. Rotate inj sites. Individualize. Titrate every 3–4 days. Insulin-naïve with type 1 diabetes: initially ⅓–½ of total daily insulin dose (usually 0.2–0.4 Units/kg). Give remainder of the total dose as short-acting insulin divided between each daily meal. Insulin-naïve with type 2 diabetes: initially 10 Units once daily. May need to adjust dose of concomitant oral antidiabetic drugs. Already on insulin therapy (Types 1 and 2): start at same unit dose as total daily long- or intermediate-acting insulin unit dose.
<1yrs: not established. ≥1yrs: Give by SC inj once daily at same time every day into thigh, upper arm, or abdomen. Rotate inj sites. Individualize. Titrate every 3–4 days. Insulin-naïve with type 1 diabetes: initially ⅓–½ of total daily insulin dose (usually 0.2–0.4 Units/kg). Give remainder of the total dose as short-acting insulin divided between each daily meal. Insulin-naïve with type 2 diabetes: initially 10 Units once daily. May need to adjust dose of concomitant oral antidiabetic drugs. Already on insulin therapy (Types 1 and 2): start at 80% of the total daily long- or intermediate-acting insulin unit dose.
During episodes of hypoglycemia.
Instruct patients on diet, exercise, changes in insulin, manufacturer, type, or method of administration, and management of hypoglycemia. Do not reuse or share pens, needles, or syringes between patients. Increased risk of hypoglycemia with intensity of glycemic control; changes in physical activity, meal patterns, or insulin regimen; renal or hepatic impairment; and if acute illness occurs; monitor. Discontinue if hypersensitivity reactions occur. Elderly. Pregnancy. Nursing mothers.
Do not mix or dilute with other insulins or solutions. Caution with K+-depleting drugs or those sensitive to serum K+ concentrations; may cause hypokalemia. Concomitant thiazolidinediones (TZDs) may cause fluid retention and heart failure; consider dose reduction or discontinue TZDs. Increased risk of hypoglycemia with concomitant antidiabetics, ACEIs, ARBs, disopyramide, fibrates, fluoxetine, MAOIs, pentoxifylline, pramlintide, propoxyphene, salicylates, somatostatin analogs (eg, octreotide), sulfonamides, GLP-1 receptor agonists, DPP-4 inhibitors, SGLT-2 inhibitors; monitor more frequently and reduce dose as needed. Reduced efficacy with concomitant atypical antipsychotics (eg, olanzapine), steroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, protease inhibitors, somatropin, sympathomimetics, thyroid hormones; monitor more frequently and increase dose as needed. Variable effects with alcohol, β-blockers, clonidine, lithium salts, pentamidine; may need to adjust dose. Concomitant β-blockers, clonidine, guanethidine, reserpine may mask hypoglycemia.
Hypoglycemia, allergic reactions, inj site reactions, lipodystrophy, pruritus, rash, edema, weight gain, hypokalemia (monitor).
FlexTouch pen (3mL)—5 (U-100), 3 (U-200)
Sign Up for Free e-newsletters
Psychiatry Advisor Articles
- Triiodothyronine in the Treatment of Bipolar Depression
- Antidepressants Increase Seizure Risk in Youth and Severely Depressed
- Intranasal Oxytocin Reduces Negative Effects, Improves Cognitive Function in Schizophrenia
- E-Cigarettes Associated With More Harms Than Benefits at Population Level
- Examining Rates of Long-Term Opioid Use in Youth With Psychiatric Disorders
- Suicide-Screening Toolkit Can Help Identify Youths at High Risk for Suicide
- Researchers Identify Novel Potential Biomarkers for Autism
- Agoraphobia: An Evolving Understanding of Definitions and Treatment
- Parental Pressure to Diet Linked With Long-term Harm in Adolescents
- Does Access to Medical Cannabis Reduce Risk for Opioid Abuse?
- Personal Health Information Found in Recycling
- Nightmares in Military Personnel Frequently Comorbid With Mental Health Disorders
- Potential for SERMs as Adjunctive Therapy for Schizophrenia
- Addressing Racial Disparities in Bipolar Disorder Treatment
- Negative Symptoms Increase Cardiovascular Risk in Schizophrenia