GLP-1 ANALOG DOSING

All dosing is for ADULTS unless otherwise specified
GLP-1 ANALOGS
Albiglutide (Tanzeum™) Dulaglutide (Trulicity™) Exenatide (Byetta®) Exenatide (Bydureon®) Liraglutide (Victoza®) Lixisenatide (Adlyxin®)
COMBINATION PRODUCTS WITH INSULIN
Soliqua® (lixisenatide + insulin glargine) Xultophy® (liraglutide + insulin degludec)
OTHER RELATED PAGES
GLP-1 analog review Saxenda® review Type one diabetes Type two diabetes Diabetes management
Pricing ($) info
PRICING INFO


Drug Dosage form Dosing / Other Generic/Price Food / Storage
Albiglutide

(Tanzeum™)
 Single-dose pen
  • 30 mg dose
  • 50 mg dose
  • Comes in cartons of 4 pens
 Type 2 diabetes
  • Starting: 30 mg once a week
  • Maintenance: 30 - 50 mg once a week
  • Max: 50 mg once a week
  • If dose is missed, patient should administer ASAP within 3 days of missed dose. Resume dosing on usual day of administration.
  • If 3 days have passed, patient should administer next dose on day of their next regularly scheduled dose
  • See precautions for dosing in kidney and liver disease
Other
  • If adding to insulin or sulfonylurea, consider lowering dose of these drugs when initiating to prevent hypoglycemia
  • Inject subcutaneously in thigh, abdomen, or upper arm
  • Pen comes with powder and diluent inside. Patient must follow instructions to allow them to mix inside the pen.
  • After mixing, patient must wait to inject for 15 minutes (30 mg pen) or 30 minutes (50 mg pen)
 NO/$$$$
FOOD
  • May administer without regard to food
STORAGE
    REFRIGERATED (UNMIXED)
    • Good until expiration date if refrigerated
    ROOM TEMP (UNMIXED)
    • Good for 4 weeks
    MIXED PENS
    • Dose should be administered within 8 hours

Drug Dosage form Dosing / Other Generic/Price Food / Storage
Dulaglutide

(Trulicity™)
 Single-dose pen
  • 0.75 mg dose
  • 1.5 mg dose
  • Comes in carton with 4 pens
 Type 2 diabetes
  • Starting: 0.75 mg once a week
  • Maintenance: 0.75 - 1.5 mg once a week
  • Max: 1.5 mg once a week
  • If a dose is missed, administer ASAP if there are at least 3 days until the next scheduled dose
  • If less than 3 days remain before the next scheduled dose, skip the missed dose and administer the next dose on the regularly scheduled day
  • In each case, patients can then resume their regular once weekly dosing schedule
  • The day of weekly administration can be changed if necessary as long as the last dose was administered 3 or more days before
  • See precautions for dosing in kidney and liver disease
Other
  • Inject subcutaneously in thigh, abdomen, or upper arm
  • If adding to insulin or sulfonylurea, consider lowering dose of these drugs when initiating to prevent hypoglycemia
 NO/$$$$
FOOD
  • May administer without regard to food
STORAGE
    REFRIGERATED PENS/SYRINGES
    • Good until expiration date

    ROOM TEMP PENS/SYRINGES
    • Good for 14 days

Drug Dosage form Dosing / Other Generic/Price Food / Storage
Exenatide

(Byetta®)
 5 mcg dose
  • 1.2 ml prefilled syringe with 60 doses
10 mcg dose
  • 2.4 ml prefilled syringe with 60 doses
 Type 2 diabetes
  • Starting: 5 mcg twice a day
  • Maintenance: 5 - 10 mcg twice a day
  • Max: 10 mcg twice a day
  • Increase dose at intervals of ≥ 4 weeks
  • See precautions for dosing in kidney and liver disease
Other
  • Inject subcutaneously in thigh, abdomen, or upper arm
  • To limit GI side effects, the recommended starting dose is 5 mcg twice a day
 NO/$$$$
FOOD
  • Give within the 60-minute time period before the morning and evening meal
STORAGE
    UNPUNCTURED PENS
    • Keep refrigerated
    • Good until expiration date on product

    PUNCTURED PENS
    • Keep at temperature below 77° F (25°C)
    • Good for 30 days
    • Do not freeze

Drug Dosage form Dosing / Other Generic/Price Food / Storage
Exenatide

(Bydureon®)
 Single-dose pen
  • Each pen contains 2 mg
  • Comes in carton of 4 pens
Dosing tray
  • Each dosing tray comes with a syringe, needle, and vial
  • Each vial has a 2 mg dose
  • Comes in carton of 4 trays
 Type 2 diabetes
  • Dosing: 2 mg once a week
  • Max: 2 mg once a week
  • Missed doses: administer missed dose ASAP, provided the next regularly scheduled dose is due at least 3 days later. Thereafter, patients can resume their usual dosing schedule of once a week.
  • If a dose is missed and the next regularly scheduled dose is due 1 or 2 days later, the patient should not administer the missed dose and instead resume Bydureon with the next regularly scheduled dose.
  • Do not take 2 doses within 3 days of each other
  • See precautions for dosing in kidney and liver disease
Other
  • Tray requires patient to mix the drug. After suspension, the mixture should be white to off-white and cloudy.
  • Inject subcutaneously in abdomen, thigh, or upper arm
 NO/$$$$
FOOD
  • May administer without regard to food
STORAGE
    REFRIGERATED PENS/TRAYS
    • Good until expiration date

    ROOM TEMP PENS/TRAYS
    • Good for 4 weeks

    MIXED DOSE FROM TRAY
    • Use immediately

Drug Dosage form Dosing / Other Generic/Price Food / Storage
Liraglutide

(Victoza®)
 Pen - 3ml
  • Pen can be dialed to all 3 doses
  • For 1.8 mg dose has 10 doses
  • For 1.2 mg dose has 15 doses
  • For 0.6 mg dose has 30 doses
  • Comes in packages of 2 or 3 pens
 Type 2 diabetes
  • Starting: 0.6 mg once daily for 1 week
  • Maintenance: 1.2 - 1.8 mg once daily
  • Max: 1.8 mg once daily
  • To limit GI side effects, the recommended starting dose is 0.6 mg once daily
  • 0.6 mg dose is not effective for blood sugar control
  • See precautions for dosing in kidney and liver disease
Other
  • If adding to insulin or sulfonylurea, consider lowering dose of these drugs when initiating to prevent hypoglycemia
  • It is acceptable to inject Victoza and insulin in the same body region but the injections should not be adjacent to each other
  • If > 3 days have elapsed since last dose, reinitiate at 0.6 mg dose
 NO/$$$$
FOOD
  • May be administered without regard to food
STORAGE
    UNPUNCTURED PENS
    • Keep refrigerated
    • Good until expiration date if refrigerated
    • Do not freeze

    PUNCTURED PENS
    • Keep at room temperature or refrigerate
    • Good for 30 days
    • Do not freeze

Drug Dosage form Dosing / Other Generic/Price Food / Storage
Lixisenatide

(Adlyxin®)
 Prefilled pen
  • Starter pen - delivers 14 doses of 10 mcg
  • Maintenance pen - delivers 14 doses of 20 mcg
  • Starter pen comes in package with one pen
  • Maintenance pen comes in package of 2 pens
 Type 2 diabetes
  • Starting: 10 mcg once daily for 14 days
  • Maintenance: 20 mcg once daily
  • Max: 20 mcg once daily
  • See precautions for dosing in kidney and liver disease
Other
  • Inject subcutaneously in thigh, abdomen, or upper arm
  • Rotate injections sites with each dose. Do not use the same site for each injection.
 NO/$$$$
FOOD
  • Administer within one hour before the first meal of the day preferably the same meal each day
  • If a dose is missed, administer within one hour prior to the next meal
STORAGE
    UNUSED PENS
    • Keep refrigerated
    • Good until expiration date
    • Do not freeze

    AFTER FIRST USE
    • Store below 86°F (30°C)
    • Discard pen 14 days after first use

  • COMBINATION PRODUCT WITH INSULIN

Drug Dosage form Pharmacokinetics Mixing / Dosing / Other Storage
Soliqua®

insulin glargine + lixisenatide
 Pen (100/33)
  • 100 units/ml insulin glargine and 33 mcg/ml lixisenatide
  • Pens contain 3 ml
  • Comes in package of 5 pens
  • Pen window shows units of insulin glargine
 NOTE: Parameters are for insulin glargine only

Onset of action
  • 1 - 3 hours

Duration of action
  • 24+ hours

Peak effect
  • No peak
 MIXING
  • DO NOT MIX with other insulins
DOSING
  • Pen is dialed to units of insulin glargine. Minimum dose pen can deliver is 15 units and max is 60 units.
  • If inadequate control on < 30 units of basal insulin or lixisenatide, starting dose is 15 units once daily
  • If inadequate control on 30 - 60 units of basal insulin, starting dose is 30 units once daily
  • Titrate dose up or down by 2 - 4 units every week based on blood sugar goals
  • Max dose is 60 units
  • Administer once a day within the hour prior to the first meal of the day
  • See insulin dosing and GLP-1 analogs for more
OTHER
  • Soliqua should be clear and colorless to almost colorless
 UNOPENED / UNUSED PENS
  • Store in refrigerator
  • Good until expiration date on product

AFTER FIRST USE
  • Store at room temperature
  • Good for 28 days

Drug Dosage form Pharmacokinetics Mixing / Dosing / Other Storage
Xultophy®

insulin degludec + liraglutide
 Pen (100/3.6)
  • 100 units/ml insulin degludec and 3.6 mg/ml liraglutide
  • Pens contain 3 ml
  • Comes in package of 5 pens
  • Pen window shows units of insulin degludec
Needles
  • Recommended use with NovoFine®, Novofine® Plus or NovoTwist®
 NOTE: Parameters are for insulin degludec only

Onset of action
  • 1 - 3 hours

Duration of action
  • 24+ hours

Peak effect
  • No peak
 MIXING
  • DO NOT MIX with other insulins
DOSING
  • Pen is dialed to units of insulin degludec. Minimum dose pen can deliver is 10 units and max is 50 units.
  • Recommended starting dose is 16 units once daily
  • Titrate dose up or down by 2 units every 3 - 4 days based on blood sugar goals
  • Max dose is 50 units
  • Administer at the same time each day with or without food
  • Patients who persistently require less than 16 units should discontinue Xultophy and use another product
  • See insulin dosing and GLP-1 analogs for more
OTHER
  • Xultophy should be clear and colorless
 UNOPENED / UNUSED PENS
  • Store in refrigerator
  • Good until expiration date on product

AFTER FIRST USE
  • Store at room temperature or in a refrigerator
  • Good for 21 days