Insulin Degludec

Tresiba

Tresiba is an FDA-approved long-acting basal insulin for controlling blood sugar in individuals with type 1 and 2 diabetes mellitus. It contains insulin degludec. It provides consistent, all-day control of blood sugar levels and helps prevent diabetes-related complications. It can be used alone or with rapid-acting insulin or other antidiabetic medications. It is available as Penfill cartridges and FlexTouch pre-filled pens. The medication dosage depends upon the patient’s age, medical condition, needs, and response to treatment. For personalized dosage and guidance, consult your doctor and follow their instructions for a safe and efficient use of the medication. 

Product Overview

Tresiba is an ultra-long-acting basal insulin containing the active ingredient insulin degludec, indicated for improving glycemic control in individuals aged 1 year and older with diabetes mellitus. It is designed to provide a steady level of insulin for a full day, helping maintain consistent blood sugar levels and prevent diabetes-related complications. Tresiba can be prescribed alone or in combination with rapid-acting insulin or other diabetes medications.

Available in Tresiba Penfill cartridge and Tresiba FlexTouch pen forms, each with a strength of 3 ml, Tresiba is typically administered once daily at the same time each day. However, it allows flexibility in dosing time if needed, with a minimum gap of 8 hours between doses. The insulin dosage is tailored to meet each patient’s specific needs and response. For patients who have not previously used insulin and have type 1 diabetes, the initial doses range from one-third to one-half of the total daily insulin dose. For patients with type 2 diabetes, the starting dose is 10 units once daily.

Common side effects of Tresiba include hypoglycemia, injection site reactions, weight gain, itching, and rashes. You should monitor your blood glucose levels, rotate injection sites, and avoid using Tresiba insulin if experiencing hypoglycemia or allergic to insulin degludec. If you are pregnant, planning to become pregnant, or are breastfeeding a baby, it is important to consult your doctor before using Tresiba. Proper storage is crucial, with unopened Tresiba pens and vials kept in the refrigerator and in-use products stored at room temperature for up to eight weeks.

Uses

Targeted Treatment

• It is used in the treatment of diabetes mellitus.  

Benefits

• It is used to manage type 1 diabetes in adults, adolescents, and children over 2 years of age. 
• It is used to treat adults with type 1 or type 2 diabetes. 
• It helps prevent diabetes-related complications.

[Note: Do not take Tresiba without consulting your doctor. They will determine whether you need this medication based on your conditions.]

Tresiba Dosage

Forms & Strengths

Form 1:  Penfill cartridge

Strength: 3 ml

Form 2: FlexTouch Pre-filled pen

Strength: 3 ml

Recommended Dosages

For Type 1 Diabetes 

• Insulin-naïve patients: The recommended initial insulin dose is typically one-third to one-half of the total daily insulin dose.
• To be used once daily in regimens with short or rapid-acting insulin.
• Current insulin users: same as the long or intermediate-acting insulin (SC). 

For Type 2 Diabetes

• Insulin-naïve patients: The recommended initial insulin dose is 10 units once daily. 
• Current insulin users: same as the long or intermediate-acting insulin (SC). 

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• Read the patient information leaflet with your prescription and ensure safe and effective medication use by following the instructions given by your doctor.
• Before using Tresiba insulin, your doctor will show you how to administer the insulin. Learn all preparation and usage steps. 
• Ensure that you have the correct type and dose of insulin before use.
• Check the product for any change in appearance. Do not use it if it appears to be discolored, cloudy, or has particles in it.
• If you are using a vial, do not roll or shake it. 
• Do not mix insulin degludec with any other insulin or medication. 
• Do not use Tresiba in an infusion pump. 
• Do not change your type, brand, and dose of insulin without consulting your doctor. 
• Do not share your Tresiba flextouch pen with others, even if the needle is changed, as it may cause infection to spread from one person to another.
• Wash your hands with soap and water before injecting the insulin. 
• Choose an injection spot and clean it with rubbing alcohol and a cotton swab. 
• Do not reuse the needle, as it may cause contamination. Use a new needle each time you inject. 
• Rotate the injection spot each time you inject to reduce the chance of pits and lumps under your skin. 
• For subcutaneous injection, you can inject Tresiba into your upper arm, abdomen, or front thigh. 
• Do not inject the insulin into a vein or muscle. 
• Do not inject into red, swollen, torn, itchy skin, scars, or stretch marks. 
• Do not inject cold insulin, as it may be painful. 
• The dosage of the medication is based on the patient’s age, condition, needs, and response to treatment. 
• Check your blood glucose levels regularly and share the report with your doctor to determine the best dose. 
• To get the most benefit from your medication, use it regularly. Try to take it simultaneously daily to help you remember it and maintain consistency. 
• Inject Tresiba exactly as instructed by your doctor once every day.  

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Tresiba Work?

Tresiba is a long-acting insulin that consistently controls blood sugar levels throughout many hours of the day. Its mechanism of action is the same as the naturally occurring insulin in the body. It facilitates the reuptake of glucose in fat and muscle cells so that the body can utilize it for energy. It provides all-day sugar control by suppressing sugar production in the liver.

Important Safety Information

Side Effects

Common side effects of Tresiba may include: 

• Fever
• Diarrhea 
• Sore throat 
• Low blood sugar
• Weight gain 
• Itching
• Rashes 
• Headache 

Mild side effects of Tresiba may include:

• Lipodystrophy
• Mild allergic reactions
• Peripheral edema
• Injection site reactions
• Upper respiratory tract infection

Adverse side effects of Tresiba may include:

• Severe hypoglycemia 
• Severe allergic reaction
• Hypokalemia

[Note: This list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings 

• Hypoglycemia is the most common adverse side effect of Tresiba insulin. You should look for signs and symptoms of low blood sugar and always carry a sugar-containing food or fruit juice.
• Do not take insulin if you have severe low blood sugar.
• Tresiba is not recommended for use in patients who have diabetic ketoacidosis. 
• Tresiba should not be used on children younger than two years of age. 
• Do not share your injection with others even if the needle is changed, as it may cause infections to spread from one person to another.
• A medical professional should make changes to insulin brand, type, and method of administration with careful monitoring of blood sugar levels. 
• If you experience severe hypersensitivity to Tresiba, discontinue using the medication and call your doctor at once.
• All insulins, including Tresiba, may cause a shift in the body’s potassium levels and lead to hypokalemia. If left untreated, hypokalemia may further cause ventricular arrhythmia, respiratory paralysis, and death.
• All insulins, including Tresiba, increase the risk of stroke and heart attack when used with thiazolidinediones. If you have a history of heart failure, taking both medicines together may worsen your condition.
• Ensure to measure your insulin carefully, as even a slight change in the medication can cause unwanted side effects.
• Do not skip a meal or insulin dosage, as it may lead to hyperglycemia. Untreated hyperglycemia may lead to diabetic ketoacidosis, unconsciousness, coma, seizures, and death.

Precautions

• It is considered to be unsafe to consume alcohol while receiving treatment with Tresiba as it may affect your blood sugar levels. 
• If you are pregnant, planning to get pregnant, or if you are breastfeeding a baby, let your doctor know. They may adjust your dosage and diet to regulate your blood sugar levels. 
• Insulin may cause temporary changes in vision and confusion. Do not drive, operate heavy machinery, or indulge in activities that require concentration unless you determine how Tresiba affects you. 
• Tresiba insulin should be used cautiously in patients with kidney, liver, and heart problems. 
• Rotate the injection spot each time you inject the insulin to reduce the chances of pits and lumps.
• Before using insulin degludec, it is important to inform your doctor about any allergies you may have, including any allergies to Tresiba, insulin degludec, or any of the ingredients in the medication. 
• If you are using Tresiba for the first time, it is important to share your medical history with your doctor, especially if you have a history of kidney or liver disease. This will help your doctor determine if Tresiba is safe for you to use.
• Before use, check the product for any change in appearance. Do not use it if it is discolored or has particles in it.  
• Monitor your blood glucose levels regularly and share the report with your doctor to help them determine your correct dosage. 
• It may be harder to control blood sugar levels when you are stressed or have an infection. It is crucial to consult your doctor and discuss the blood sugar testing, treatment plan, and medications you should follow. 
• If you are planning to have surgery, it is important to inform your doctor of all medications you are taking, including prescription drugs, over-the-counter medication, and herbal supplements.
• You should check your blood glucose levels before and after exercising. If your blood sugar levels are low, you should have a snack beforehand. 
• If you are planning to travel across time zones, consult with your doctor regarding how to adjust your dosing schedule.

Contraindications 

• Individuals who have hypersensitivity to Tresiba, insulin degludec and other ingredients. 
• During episodes of hypoglycemia. 

Missed Dose

• It is important to maintain consistency and take Tresiba simultaneously every day for the best results. 
• If you missed a dose of Tresiba insulin, take it as soon as you remember. 
• If it is almost time for your next dose of Tresiba, you can skip the missed dose and resume your medication as per your dosing schedule.
• Do not take two doses of the same medications together, as it may lead to hypoglycemia. 
• To avoid missing doses, you can set a reminder on your phone.

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

Overdose of Tresiba insulin may lead to life-threatening hypoglycemia. Symptoms of an overdose include dizziness, confusion, blurred vision, muscle weakness, seizures, loss of consciousness, and numbness or tingling in your mouth. Jerky movements and trouble speaking are also possible. If someone has taken the medication more than recommended and has serious symptoms such as passing out, difficulty breathing seizures, or if they can’t be woken up, immediately seek medical assistance. You can call 911 or head to the nearest emergency room. 

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

Storage

• Store unopened Tresiba Flextouch and Tresiba vials in the refrigerator, but do not allow them to freeze. 
• If it is frozen, do not use it. Discard it safely and get a new one from your pharmacist. 
• When stored in the refrigerator, the unopened Tresiba pens and vials are food for use until expiration. 
• When Tresiba is in use, you can keep it in the refrigerator or at room temperature. 
• Keep Tresiba in its original container away from direct light, excess heat, and moisture. 
• Keep all insulins, including Tresiba, away from the sight and reach of children. 
• Discard the medication after eight weeks, even if insulin is left in it. 
• Do not keep medications that are outdated or no longer needed. 
• Discard all syringes, injection pens, and cartridges in a sharps container. 
• If you don’t have a sharps container, you can use a container made of hard plastic and a tightly fitting lid. 
• Do not throw Tresiba in wastewater or your household garbage bin. 
• Do not flush the medication unless instructed to do so. 
• For more information on storage and disposal of the insulin, ask your pharmacist or healthcare provider. 

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Tresiba Interactions

• Alcohol 
• ACE inhibitors
• Angiotensin receptor blockers 
• Antipsychotics  
• Beta-blockers
• Diuretics 
• Clarithromycin 
• Corticosteroids 
• Danazol 
• Elagolix 
• Epinephrine 
• Estrogens  
• Fibrates
• Ginseng 
• Glucagon
• GLP-1 Receptor Agonists
• Goserelin 
• hepatitis C antivirals
• HIV protease inhibitors 
• Isoniazid 
• Lanreotide 
• Leuprolide 
• Lithium 
• Mifepristone 
• MAOIs
• Niacin 
• Nilotinib 
• Octreotide
• Oral contraceptives
• Other diabetes medications 
• Pasireotide 
• Pegvisomant 
• Pentoxifylline 
• Progestogens
• Quinine 
• Quinolone antibiotics
• Salbutamol 
• Salicylates 
• SGLT-2 Inhibitors
• SSRIs
• Sirolimus 
• Somatostatin Analogs
• Sulfa antibiotics
• Sunitinib 
• Tacrolimus 
• Terbutaline 
• Testosterone 
• Thyroid hormone
• Tramadol

[Note: This isn’t a complete list, and there could be other drugs that interact with Tresiba. Tell your doctor about prescription, over-the-counter medicines, and herbal products.]

Tresiba Alternatives 

• Lantus (insulin glargine)
• Basaglar (insulin glargine)
• Toujeo (insulin glargine)
• Levemir (insulin detemir)
• Xultophy (insulin degludec)
• Apidra (insulin glulisine)
• Fiasp (insulin aspart)
• Novolin (insulin regular/ insulin NPH)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

1. What are the recommended dosages and uses of Tresiba medication?

For individuals with type 1 diabetes who have not previously used insulin, the initial Tresiba® dosage usually ranges from one-third to one-half of the total daily insulin requirement. The remaining portion of the daily insulin requirement should be administered as short-acting, divided between meals. 

As a general guideline, the initial daily insulin dose for insulin-naive patients with type 1 diabetes can be calculated based on 0.2 to 0.4 units per kg of body weight. In the case of insulin-naive patients with type 2 diabetes, the recommended starting dose of Tresiba® is 10 units once daily.

2. What are the potential side effects of using the Tresiba Flextouch Pen?

Some of the common side effects of Tresiba are:

• Hypoglycemia (sometimes due to Medication errors)
• Hypersensitivity reactions
• Hypokalemia

3. Is it safe to store Tresiba Insulin without refrigeration?

Yes, Tresiba (insulin degludec) remains viable for up to 56 days (8 weeks) when stored at room temperature (below 86°F [30°C]), both when opened and unopened. Proper storage at room temperature provides flexibility in managing your medication. It’s important to note that this extended shelf life allows for more convenient usage, especially when refrigeration isn’t readily available. 

However, it is crucial to discard Tresiba after this period to ensure its effectiveness and safety. Adhering to the recommended storage guidelines guarantees the potency and reliability of the medication, promoting optimal health management for individuals with diabetes.

4. Is weight gain a side effect of insulin Tresiba?

Yes, taking insulin like Tresiba can lead to weight gain. Research studies have shown that individuals with type 1 or type 2 diabetes experienced weight gain while using a Tresiba pen. However, it’s important to note that weight loss is not a documented side effect of Tresiba insulin; if you lose weight while on Tresiba medication, it’s advisable to consult your doctor, as they may need to adjust your treatment plan accordingly.

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