GLP-1 ANALOG DOSING

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 dose Store below 86°F (30°C) Discard pen 14 days after first use

Drug	Dosage form	Dosing / Other	Generic/Price	Food / Storage
Semaglutide Ozempic®	Prefilled pen Comes in two types of pens that deliver different doses. Both pens contain 2 mg of semaglutide. 0.25/0.5 mg pen delivers 0.25 or 0.5 mg per injection. Comes in carton with 1 pen. 1 mg pen delivers 1 mg per injection. Comes in carton with 2 pens.	Type 2 diabetes Starting: 0.25 mg SQ once weekly for 4 weeks Maintenance: 0.5 - 1 mg SQ once weekly Max: 1 mg SQ once weekly After 4 weeks of 0.5 mg, increase to 1.0 mg if additional control is needed The 0.25 mg dose is for titration only and is not effective for glycemic control The day of weekly administration can be changed if necessary as long as the time between two doses is at least 2 days (> 48 hours) If a dose is missed, administer as soon as possible within 5 days after the missed dose. If > 5 days have passed, skip the missed dose and administer the next dose on the regularly scheduled day. 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 May administer without regard to food Storage Unused pens Keep refrigerated Good until expiration date Do not freeze After first dose Store at room temperature or refrigerated Good for 56 days

• 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 dose 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 dose Store at room temperature or in a refrigerator Good for 21 days