Xultophy Prefilled Pen: Uses, Dosing, and Safety Basics

Xultophy Prefilled Pen is a once-daily, prescription injection used in adults with type 2 diabetes to help improve blood sugar control alongside diet and activity. It combines a long-acting basal insulin with a GLP-1 receptor agonist in a single pen device. This page summarizes how the medicine works, practical use basics, key safety considerations, and where to look for reliable references.

What Xultophy Prefilled Pen Is and How It Works

This treatment combines two medicines in one fixed-ratio injection: insulin degludec (a long-acting insulin) and liraglutide (a GLP-1 receptor agonist, which supports glucose-dependent insulin release and can slow stomach emptying). CanadianInsulin operates as a prescription referral service and may confirm prescription details with your prescriber before proceeding. Some patients explore Ships from Canada to US when planning medication access, depending on eligibility and jurisdiction.

Insulin degludec helps control background (basal) glucose between meals and overnight. Liraglutide works through incretin pathways (gut-hormone signaling) to reduce post-meal glucose rises and may lower glucagon release when glucose is elevated. Because one component can affect stomach emptying, the combination may also change how quickly some oral medicines are absorbed. The pen is designed for subcutaneous use (under the skin) and is not intended for intravenous use or insulin pumps.

• Two-drug combination in one pen
• Basal insulin plus GLP-1 action
• Used with lifestyle measures
• Subcutaneous injection only

Who It’s For

This medicine is generally prescribed for adults with Type 2 Diabetes who need additional glycemic control beyond lifestyle measures and other medications. Clinicians may consider it when both basal insulin support and GLP-1 receptor agonist effects are appropriate, while aiming to simplify an injection routine. It is not used to treat diabetic ketoacidosis and is not a substitute for rapid-acting mealtime insulin when that is clinically required.

Important safety limits come from its components. People with a personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN 2) are typically advised not to use liraglutide-containing products. A clinician should also review any history of pancreatitis, severe gastrointestinal disease (such as gastroparesis), significant kidney or liver problems, or prior serious allergic reactions to similar medicines. For broader background, see the Diabetes hub for related conditions and treatment categories.

Dosage and Usage

Dosing is individualized by the prescriber and typically taken once daily at the same time each day. The dose is adjusted over time using blood glucose trends and tolerability, rather than making rapid changes day to day. Xultophy Prefilled Pen is intended for subcutaneous injection, and the label describes a maximum daily limit; dosing above that limit is not recommended.

General device steps include attaching a new needle, priming per the device instructions, dialing the prescribed dose, injecting into appropriate areas (such as abdomen, thigh, or upper arm), and holding the needle in place long enough to deliver the dose. Needles are usually single-use and should be disposed of in a sharps container. Rotating injection sites helps reduce skin thickening (lipohypertrophy) that can alter absorption and cause unpredictable glucose results.

Quick tip: Keep a simple log of injection sites and glucose checks.

If switching from another insulin or GLP-1 medicine, transitions should be clinician-directed to reduce risk of hypoglycemia, hyperglycemia, or overlapping therapy. For practical context on combination strategies, the guide on Acceptable Combinations Of Diabetes Medications can help frame common medication classes clinicians consider together.

Strengths and Forms

This product is supplied as a disposable, multi-dose pen containing a fixed ratio of insulin degludec and liraglutide in solution. Xultophy Prefilled Pen is commonly referenced as a “100/3.6” combination, reflecting insulin degludec 100 units/mL with liraglutide 3.6 mg/mL, delivered in dose steps per the device design. The pen is intended for subcutaneous injections only, and needles are typically obtained separately based on prescriber or pharmacy guidance.

Because it is a fixed-ratio combination, the insulin and GLP-1 components cannot be adjusted independently. That can be helpful for some regimens, but it also means the clinician must consider whether the paired dosing suits a person’s current needs and tolerability. Availability and specific packaging can vary by jurisdiction and pharmacy supply.

Storage and Travel Basics

Store unused pens according to the carton and product labeling, commonly in a refrigerator, and protect from light. Do not freeze the pen, and do not use it if it has been frozen. Once a pen is in use, follow the label’s guidance for allowed storage temperature range and the in-use time limit, and keep the cap on when not injecting to help protect from light exposure.

When traveling with Xultophy Prefilled Pen, plan for temperature control and easy access to supplies. Carry extra pen needles, alcohol swabs if used, and a sharps travel container. If flying, keep the pen in carry-on luggage to reduce the chance of temperature extremes in checked bags. A clinician or pharmacist can help interpret storage instructions for your situation and confirm when a pen should be discarded.

Why it matters: Temperature extremes can reduce insulin potency and change glucose control.

Side Effects and Safety

Because this medicine contains both insulin and a GLP-1 receptor agonist, side effects can reflect either component. With Xultophy Prefilled Pen, common issues may include low blood sugar (especially if used with other glucose-lowering therapies), nausea, diarrhea or constipation, decreased appetite, headache, and injection-site reactions. Gastrointestinal symptoms often occur early and may improve over time, but persistent or severe symptoms should be reviewed with a clinician.

Serious risks can include severe hypoglycemia, pancreatitis (inflammation of the pancreas), acute kidney injury (sometimes related to dehydration from vomiting or diarrhea), gallbladder problems, and serious allergic reactions. Liraglutide-containing products carry a boxed warning related to thyroid C-cell tumors seen in animal studies, and they are contraindicated in patients with MTC or MEN 2. Seek urgent medical care for symptoms such as severe abdominal pain that does not go away, swelling of the face or throat, trouble breathing, or signs of very low blood sugar that do not respond to a prescribed rescue plan.

• Hypoglycemia risk increases with other agents
• GI upset may occur early
• Watch for pancreatitis symptoms
• Report severe allergy signs urgently

Drug Interactions and Cautions

Medication interactions are often driven by overlapping glucose-lowering effects and by liraglutide’s impact on stomach emptying. Combining this therapy with sulfonylureas or other insulins can raise hypoglycemia risk, so clinicians may adjust accompanying medicines. Alcohol can also increase the risk of low blood sugar in some people, and beta-blockers may mask typical hypoglycemia symptoms such as tremor or palpitations.

Because gastric emptying may slow, the absorption of some oral medicines can change. This is especially important for drugs that require careful timing or rapid absorption. Always share an updated medication list, including over-the-counter products and supplements, at each visit. For medication-class context, the overview on Common Diabetes Medications and the explainer on Dpp 4 Inhibitors can help clarify why certain combinations need closer monitoring.

Clinicians may use glucose logs, A1C trends, weight changes, kidney function, and symptom review to guide follow-up. If nausea, reduced food intake, or illness occurs, additional monitoring may be needed to reduce dehydration risk and to keep glucose in a safe range.

Compare With Alternatives

This medicine is one option among several injectable and oral approaches for type 2 diabetes. Xultophy Prefilled Pen may be considered when a clinician wants basal insulin support plus GLP-1 receptor agonist activity in a single daily injection, but it is not the only way to reach those goals. Alternatives may include basal insulin alone, a GLP-1 receptor agonist alone, or separate injections of basal insulin and a GLP-1 agent so each component can be titrated independently.

Oral combination therapies are also used in many treatment plans, including metformin-based combinations and other classes that work through the kidneys or gut. For examples of oral combination products, see Janumet Xr and Invokamet, which clinicians may consider in appropriate patients. To browse medication categories and compare options by class, the Diabetes Medications hub and the Non Insulin Medications list can provide a structured starting point.

Choosing between approaches depends on factors such as A1C pattern (fasting vs post-meal highs), weight goals, hypoglycemia history, kidney function, gastrointestinal tolerability, and how complex a regimen feels day to day. Any change in therapy should be planned with a prescriber to avoid gaps or overlaps.

Pricing and Access

Access depends on prescription requirements, local regulations, and clinical appropriateness. Xultophy Prefilled Pen requires a valid prescription, and documentation may be reviewed to confirm the intended product and directions. Coverage varies across insurers and public plans, and prior authorization or step-therapy rules may apply. For people without insurance, cash-pay considerations can include pharmacy pricing differences, manufacturer programs, and the total supply needed for a given period.

Where permitted, dispensing and fulfilment are handled by licensed third-party pharmacies rather than the referral platform. Patients may also encounter cross-border fulfilment considerations depending on jurisdiction and prescriber documentation requirements. If available for your situation, the site’s Programs And Promotions page may list general program information, but eligibility is not guaranteed and terms can change.

If using mail transit, packaging and handling may involve prompt, express, cold-chain shipping to help maintain temperature control.

Authoritative Sources

For full prescribing details and boxed warnings, review the official label at DailyMed drug labeling resource.

For evidence-based diabetes care standards, see American Diabetes Association Standards of Care.

This content is for informational purposes only and is not a substitute for professional medical advice.