Soliqua 100/33 is a brand-name prescription medication. It’s used with diet and exercise to improve blood sugar levels in adults with type 2 diabetes.

Soliqua 100/33 contains two drugs:

  • insulin glargine, which is a long-acting insulin
  • lixisenatide, which belongs to a class of drugs called glucagon-like peptide 1 (GLP-1) receptor agonists

Soliqua 100/33 comes as an injectable pen that’s used for self-injection under the skin (subcutaneous). Each pen contains 3 milliliters (mL) of drug solution, with 100 units of insulin glargine and 33 micrograms (mcg) of lixisenatide per mL of solution. The pens are used with pen needles, which aren’t included with the pens.

Effectiveness

Soliqua 100/33 has been found effective in treating type 2 diabetes. In one clinical study, Soliqua 100/33 was tested in people with type 2 diabetes who received long-acting insulins for at least 6 months. After 30 weeks of treatment with Soliqua 100/33, these people had reduced hemoglobin A1c (HbA1c) by 1.1 percent. They also had reduced fasting blood sugar levels by 5.7 mg/dL.

In another clinical study, Soliqua 100/33 was used with metformin for 30 weeks. The study involved people who had previously received metformin alone, or with metformin and another oral diabetes drug. The treatment with Soliqua 100/33 and metformin reduced HbA1c by 1.6 percent. It also reduced fasting blood sugar levels by 59.1 mg/dL.

Soliqua 100/33 is a brand-name medication containing the active ingredients insulin glargine and lixisenatide. Soliqua 100/33 is not available in a biosimilar form.

Insulin glargine is a biologic drug (made from living cells), but lixisenatide is not a biologic. Nonbiologics can have generics, which are exact copies of the active drug in the brand-name medication. However, biologics cannot be copied exactly. Instead, biologics can come in biosimilar forms. Biosimilars are considered to be just as effective and safe as their parent drugs.

As with generics, biosimilars are often less expensive compared with brand-name medications.

Typically, your doctor will start you on a low dose of Soliqua 100/33 and adjust it over time to reach the dosage that’s right for you. This adjustment process is called titration. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

For further details about Soliqua 100/33 dosage, refer to this in-depth article.

Drug forms and strengths

Each package of Soliqua 100/33 contains five disposable, prefilled Soliqua 100/33 injectable pens per box. Pen needles aren’t included with the pens. (In most cases, you can purchase pen needles at a pharmacy. You may need a prescription.)

Each injectable pen contains 3 mL of drug solution, with a total of 300 units of insulin glargine and 100 mcg of lixisenatide.

The Soliqua 100/33 injectable pens are each meant to be used multiple times. The number of times can range from 5 to 20, depending on your dosage. Each pen can be used for up to 28 days after the initial use. After that time, you should safely dispose of the pen, even if it still contains some of the drug.

Each pen needle must only be used once.

Dosage for Soliqua 100/33

Soliqua 100/33 is typically prescribed in single injections of 15 to 60 units each. The term “units” is the form of measurement used for the insulin glargine contained in Soliqua 100/33. The maximum dose per injection is 60 units, which would mean 60 units of insulin glargine and 20 mcg lixisenatide.

Starting dosage

The recommended starting dose of Soliqua 100/33 depends on your previous diabetes treatment.

Dose of previous treatmentStarting dose of Soliqua 100/33 (in the dose window display)Insulin glargine dose in Soliqua 100/33Lixisenatide dose in Soliqua 100/33
For people who took lixisenatide, less than 30 units of long-acting insulin, or oral diabetes drugs1515 units5 mcg
For people who took 30 to 60 units of long-acting insulin3030 units10 mcg

Note: Before starting Soliqua 100/33, you should stop all other treatment with lixisenatide or long-acting insulin.

Maintenance dosage

After starting Soliqua 100/33, your doctor will monitor your blood sugar levels and may adjust your dose to reach the right amount for you. The drug’s manufacturer recommends titrating a dose up or down by 2 to 4 units every week as needed to meet blood sugar goals.

Dose adjustments

You and your doctor will work together to create a plan to meet your blood sugar goals.

Below is an example of dose adjustments your doctor may recommend. Your doctor will decide if you need these adjustments. Be sure to take the dose that your doctor recommends. (Do not change your dose without your doctor’s approval.)

Blood sugar rangeSoliqua 100/33 dose change
Above goal rangeIncrease 2 units (2 units insulin glargine, 0.66 mcg lixisenatide) to 4 units (4 units insulin glargine, 1.32 mcg lixisenatide)
Within goal range0 units
Below goal rangeDecrease 2 units (2 units insulin glargine, 0.66 mcg lixisenatide) to 4 units (4 units insulin glargine, 1.32 mcg lixisenatide)

What if I miss a dose?

If you miss a dose of Soliqua 100/33, skip that dose and continue with your next scheduled dose. Do not try to catch up by taking an extra dose or increasing the next dose. This can cause dangerous side effects.

Will I need to use this drug long term?

If Soliqua 100/33 is effective and safe for you, you’ll probably use this drug long term. Soliqua 100/33 is typically used long term to treat type 2 diabetes.

Soliqua 100/33 can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking Soliqua 100/33. This list doesn’t include all possible side effects.

For more information on the possible side effects of Soliqua 100/33, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

You can also refer to this in-depth article about potential side effects of Soliqua 100/33.

More common side effects

The more common side effects of Soliqua 100/33 can include:

  • nausea
  • respiratory infections such as the common cold or flu
  • diarrhea
  • headache
  • hypoglycemia (low blood sugar)

Most of these side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Soliqua 100/33 aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

  • Severe allergic reaction. Symptoms can include:
    • rash
    • flushing
    • swelling
    • itchy skin
    • trouble breathing
    • low blood pressure
  • Pancreatitis (inflammation of the pancreas). Symptoms can include:
    • pain or tenderness in your belly
    • back pain
    • nausea
    • vomiting
    • fever
    • weight loss
  • Gallbladder disease. Symptoms can include:
    • abdominal pain
    • bloating
    • nausea
    • vomiting
  • Kidney damage. Symptoms can include:
    • reduced urination
    • swelling in your legs, ankles, or feet
    • confusion
    • fatigue
    • nausea
    • chest pain or pressure
    • irregular heartbeat
    • seizures
  • Hypokalemia (low potassium). Symptoms can include:
    • weakness
    • fatigue
    • constipation
    • muscle cramping
    • irregular heartbeat

Weight gain or weight loss

In clinical trials, Soliqua 100/33 wasn’t found to cause weight changes. However, in one clinical study, people who took Soliqua 100/33 for 30 weeks lost about 1.5 pounds.

In addition, the individual drugs contained in Soliqua 100/33 have been linked with weight changes. Soliqua 100/33 contains insulin glargine, a long-acting insulin. Drugs containing insulin can cause weight gain.

Soliqua 100/33 also contains lixisenatide, a glucagon-like peptide 1 (GLP-1) receptor agonist. In various clinical studies, medications in the GLP-1 drug class have shown weight loss as a side effect.

If you’re concerned about weight changes while using Soliqua 100/33, talk with your doctor.

Hypoglycemia

Insulin, one of the drugs in Soliqua 100/33, is used to help lower blood sugar levels. However, blood sugar levels can be lowered too far, which results in hypoglycemia. Hypoglycemia is the most common side effect caused by insulin drugs, including Soliqua 100/33.

In clinical studies, hypoglycemia occurred in 8.1 to 17.8 percent of people taking Soliqua 100/33. And severe hypoglycemia occurred in about 1 percent of people taking the drug.

Many factors can increase your risk of hypoglycemia. These include taking higher doses of your diabetes drug and taking more than one diabetes drug. Other factors that can affect your risk include your eating and exercise habits, and whether you’re taking other medications.

Symptoms of hypoglycemia may occur suddenly and can include shakiness, fatigue, drowsiness, and confusion. Severe hypoglycemia may lead to serious side effects such as seizures or even death. Talk with your doctor about how often you should check your blood sugar levels to prevent hypoglycemia while taking Soliqua 100/33.

Depression or thickened skin

You take Soliqua 100/33 by subcutaneous injection, which means you inject it under your skin. A subcutaneous injection may cause lipodystrophy (a depression or thickening of the skin) around the injection site.

To reduce the risk of lipodystrophy, alternate the sites where you inject the drug. For instance, one day you could inject the medication into your belly, and the next you could use your outer thigh.

If you’re concerned about skin effects caused by injecting Soliqua 100/33, talk with your doctor.

Kidney damage

Kidney damage wasn’t seen in clinical studies of Soliqua 100/33. However, there have been reports of kidney damage in people who took glucagon-like peptide 1 (GLP-1) drugs. Lixisenatide, which is one of the drugs in Soliqua 100/33, is a GLP-1 drug.

Symptoms of kidney damage can include:

  • swelling of legs, ankles, or feet
  • fatigue
  • nausea
  • vomiting

Kidney damage typically occurred in people who had become dehydrated due to certain side effects of Soliqua 100/33, such as nausea, vomiting, and diarrhea.

If you develop these symptoms while taking Soliqua 100/33, or are concerned about your kidney health, talk with your doctor.

As with all medications, the cost of Soliqua 100/33 can vary. Your actual cost will depend on your insurance coverage.

Financial and insurance assistance

If you need financial support to pay for Soliqua 100/33, help is available. Sanofi Aventis, the manufacturer of Soliqua 100/33, offers a Soliqua 100/33 Savings Card. For more information, visit the program website.

Below are some basic instructions on how to give yourself an injection using the Soliqua 100/33 pen. Always be sure to take Soliqua 100/33 according to your doctor or another healthcare professional’s instructions.

How to administer

Step 1. Prepare and check your pen.

If this is your first use, take the pen out of the refrigerator and allow the pen to reach room temperature.

  • Gather alcohol swabs, a new needle, and your sharps disposal container.
  • Wash your hands.
  • Remove the pen cap and make sure the medication is clear and has no color. (Do not use if the solution isn’t clear and colorless. Air bubbles are fine.)
  • Clean the rubber seal with an alcohol swab.

Step 2. Attach a new pen needle.

For each injection, always use a new pen needle. Make sure the pen needle can be used with Soliqua 100/33. If you don’t know which needles to use, ask your doctor or pharmacist.

  • Remove the pen needle from its protective package.
  • Keeping the pen needle straight, twist it onto the pen.
  • Remove the outer pen needle cap and set it aside. (Keep it for use after the injection.)
  • Remove the inner needle cap and discard it into the trash.

Step 3. Do a safety test.

Always do a safety test before every injection to make sure the pen and needle are working correctly.

  • Adjust the dose counter so that it reads 2 units.
  • Press the injection button completely in and check for a bit of drug solution to come out from the needle tip. If this occurs, proceed to step 4.
  • If no drug comes out, repeat the safety test up to 3 times.
  • If no drug comes out after three tests, replace the needle and repeat the safety tests.
  • If no drug comes out after replacing the needle, do not use the pen because it may be damaged. Use a new pen.

Step 4. Select your dose.

  • Turn the dose counter until you reach your prescribed dose.

Step 5. Inject the dose.

There are three areas on your body you can use for an injection site: your belly (except within 2 inches of your belly button), the back of your upper arm (the fatty area), and your outer thigh.

  • Choose an injection site and wipe the skin at the site with an alcohol swab.
  • At the injection site, insert the needle into your skin at a 90-degree angle.
  • Press the injection button down completely and hold it until there’s a “0” in the dose window.
  • After the dose counter turns to “0,” count to 10 before releasing the injection button and removing the needle. This pause helps ensure that you get the full dose.
  • Release the injection button and remove the needle from your skin.

Step 6. Discard the needle and store the pen.

  • Place the outer pen needle cap back onto the needle.
  • Remove the needle from the injectable pen and immediately discard the needle in a sharps container. (Discard it right away to avoid confusing it with a new needle.)
  • Place the pen cap back onto the pen.
  • Store the pen at room temperature after the first use.

Timing

You should take Soliqua 100/33 within the hour before your first meal of the day.

Taking Soliqua 100/33 with food

Soliqua 100/33 should not be taken with food. It should be taken within the hour before your first meal of the day.

Other drugs are available that can treat type 2 diabetes. Some may be better suited for you than others. If you’re interested in finding an alternative to Soliqua 100/33, talk with your doctor to learn more about other medications that may work well for you.

Soliqua 100/33 contains two drugs: a long-acting insulin called insulin glargine, and a glucagon-like peptide 1 (GLP-1) receptor agonist called lixisenatide.

Examples of drugs that may be used as alternatives to Soliqua 100/33 include:

  • long-acting insulins, such as:
    • insulin glargine (Lantus, Toujeo)
  • GLP-1 receptor agonists, such as:
    • liraglutide (Victoza, Saxenda)
    • lixisenatide (Adlyxin)
    • semaglutide (Ozempic)
  • dipeptidyl peptidase-4 (DPP-4) inhibitors, such as:
    • alogliptin (Nesina)
    • linagliptin (Tradjenta)
    • saxagliptin (Onglyza)
  • meglitinides, such as:
    • repaglinide (Prandin)
    • nateglinide (Starlix)
  • sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as:
    • canagliflozin (Invokana)
  • sulfonylureas, such as:
  • thiazolidinediones, such as:
    • pioglitazone (Actos)
    • rosiglitazone (Avandia)

You may wonder how Soliqua 100/33 compares to other medications that are prescribed for similar uses. Here we look at how Soliqua 100/33 and Xultophy are alike and different.

Uses

Soliqua 100/33 and Xultophy are both FDA-approved to improve blood sugar levels in adults with type 2 diabetes. They’re both prescribed for use with diet changes and exercise.

Soliqua 100/33 and Xultophy both contain two drugs, and these drugs belong to the same classes of medication. This means they work the same way within the body.

Soliqua 100/33 contains:

  • insulin glargine (long-acting insulin)
  • lixisenatide (glucagon-like peptide 1 [GLP-1] receptor agonist)

Xultophy contains:

  • insulin degludec (long-acting insulin)
  • liraglutide (GLP-1 receptor agonist)

Drug forms and administration

Soliqua 100/33 and Xultophy both come as a liquid solution in a disposable injectable pen. They’re both self-injected under the skin (subcutaneous) once per day.

Side effects and risks

Soliqua 100/33 and Xultophy have similar effects in the body and therefore cause very similar side effects.

More common side effects

This list contains examples of more common side effects that can occur with both drugs (when taken individually).

  • Can occur with both Soliqua 100/33 and Xultophy:
    • respiratory infections such as common cold or flu
    • nausea
    • diarrhea
    • headache
    • hypoglycemia (low blood sugar)

Serious side effects

These lists contain examples of serious side effects that can occur with Soliqua 100/33, with Xultophy, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
    • few unique serious side effects
  • Can occur with Xultophy:
    • thyroid cancer*
  • Can occur with both Soliqua 100/33 and Xultophy:

* Xultophy has a boxed warning from the FDA for thyroid cancer. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

Effectiveness

Soliqua 100/33 and Xultophy haven’t been compared directly in clinical studies, but both have been found effective for treating type 2 diabetes.

In separate studies, Soliqua 100/33 and Xultophy were both effective in reducing both HbA1c and fasting blood sugar levels.

  • In a clinical study, Soliqua 100/33 reduced hemoglobin A1c (HbA1c) by 1.1 percent and fasting blood sugar levels by 5.7 mg/dL after 30 weeks of treatment.
  • In clinical studies, Xultophy reduced HbA1c by 1.31 to 1.94 percent and fasting blood sugar levels by 49.9 mg/dL to 63.5 mg/dL after 26 weeks of treatment. People using Xultophy also gained about 4.4 pounds over 26 weeks of treatment.

Note: It’s important to keep in mind that how well either of these drugs would lower your HbA1c or blood sugar levels would depend on many factors, including:

  • your blood sugar levels when you start the drug
  • your diet and exercise regimens
  • the other diabetes medications that you take
  • how closely you follow your treatment regimen

Costs

Soliqua 100/33 and Xultophy are both brand-name drugs. There are currently no biosimilar forms available of either drug. Brand-name medications usually cost more than biosimilars.

The actual price you would pay for either drug would depend on your dose, your insurance plan, your location, and the pharmacy you use.

There are other drugs besides Soliqua 100/33 and Xultophy (above) that can be used to treat type 2 diabetes. Below are comparisons between Soliqua 100/33 and several other medications.

Soliqua 100/33 vs. Lantus

Soliqua 100/33 contains two drugs:

  • insulin glargine, which is a long-acting insulin
  • lixisenatide, which belongs to a class of drugs called glucagon-like peptide 1 (GLP-1) receptor agonists

Insulin glargine is the drug contained in Lantus. Because Soliqua 100/33 and Lantus share an active ingredient, they work in similar ways within the body.

Uses

Soliqua 100/33 is FDA-approved for use with diet changes and exercise to improve blood sugar levels in adults with type 2 diabetes.

Lantus is FDA-approved to improve blood sugar levels in adults and children who have type 1 diabetes, and adults with type 2 diabetes.

Drug forms and administration

Soliqua 100/33 comes as a liquid solution in a disposable injectable pen. Lantus comes as a liquid solution in a multiple-dose vial or in a disposable injectable pen. Both drugs are self-injected under the skin (subcutaneous) once per day.

Side effects and risks

Soliqua 100/33 and Lantus both contain the same long-acting insulin, insulin glargine. Therefore, both drugs can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Soliqua 100/33, with Lantus, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
    • nausea
    • respiratory infections such as common cold or flu
    • headache
    • diarrhea
  • Can occur with Lantus:
    • weight gain
    • lipodystrophy (indentation or thickening of skin at injection site)
    • injection site reactions
  • Can occur with both Soliqua 100/33 and Lantus:
    • hypoglycemia (low blood sugar)

Serious side effects

These lists contain examples of serious side effects that can occur with Soliqua 100/33, with Lantus, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
  • Can occur with Lantus:
    • few unique serious side effects
  • Can occur with both Soliqua 100/33 and Lantus:
    • severe allergic reaction
    • severe hypoglycemia (severe low blood sugar)
    • low potassium levels (hypokalemia)

Effectiveness

The effectiveness of Soliqua 100/33 and Lantus has been directly compared in two studies. In the first study, the two drugs were each used alone. In the second, they were each used in combination with metformin (an oral diabetes drug).

Use alone

The first study focused on adults with type 2 diabetes who had previously received long-acting insulins. It showed that Soliqua 100/33 may work slightly better than Lantus for decreasing hemoglobin A1c (HbA1c), but not as well in reducing fasting blood sugar levels.

After 30 weeks of treatment, Soliqua 100/33 reduced HbA1c by 1.1 percent, and fasting blood sugar levels by 5.7 mg/dL. During the same time period, Lantus reduced HbA1c by 0.6 percent, and fasting blood sugar levels by 7.0 mg/dL.

Use with metformin

The second study tested Soliqua 100/33 with metformin against Lantus with metformin in adults with type 2 diabetes. These people had previously received metformin alone, or metformin and another oral diabetes drug.

Over 30 weeks, Soliqua 100/33 with metformin was slightly more effective than Lantus with metformin. Soliqua 100/33 with metformin reduced HbA1c by 1.6 percent and fasting blood sugar levels by 59.1 mg/dL. Lantus and metformin, on the other hand, reduced HbA1c by 1.3 percent and fasting blood sugar levels reduced by 55.8 mg/dL.

Note: It’s important to keep in mind that how well either of these drugs would lower your HbA1c or blood sugar levels would depend on many factors, including:

  • your blood sugar levels when you start the drug
  • your diet and exercise regimens
  • the other diabetes medications that you take
  • how closely you follow your treatment regimen

Costs

Soliqua 100/33 and Lantus are both brand-name drugs. There are currently no biosimilar forms available for Soliqua. Lantus, though, is available in certain biosimilar forms. Brand-name medications usually cost more than biosimilars.

The actual price you would pay for either drug would depend on your dose, your insurance plan, your location, and the pharmacy you use.

Soliqua 100/33 vs. Victoza

Soliqua 100/33 contains two drugs:

  • insulin glargine, which is a long-acting insulin
  • lixisenatide, which belongs to a class of drugs called glucagon-like peptide 1 (GLP-1) receptor agonists

Victoza contains the drug liraglutide, which is also a GLP-1 receptor agonist. Because Soliqua 100/33 and Victoza share an active ingredient in the same drug class, they work in similar ways within the body.

Uses

Soliqua 100/33 is FDA-approved to improve blood sugar levels in adults with type 2 diabetes. It’s prescribed to be used with diet changes and exercise.

Victoza is also approved to improve blood sugar levels in adults with type 2 diabetes in combination with improved diet and exercise. In addition, it’s approved to reduce the risk of major heart problems such as heart attacks and stroke in people with type 2 diabetes and heart disease.

Drug forms and administration

Both Soliqua 100/33 and Victoza come as a liquid solution in a disposable injectable pen. Both drugs are self-injected under the skin (subcutaneous) once per day.

Side effects and risks

Because Soliqua 100/33 and Victoza both contain a drug that belongs to the GLP-1 drug class, both drugs can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Soliqua 100/33, with Victoza, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
    • hypoglycemia (low blood sugar)
    • respiratory infections such as the common cold or flu
    • headache
  • Can occur with Victoza:
    • decreased appetite
    • vomiting
    • constipation
    • stomach upset
  • Can occur with both Soliqua 100/33 and Victoza:
    • nausea
    • diarrhea

Serious side effects

These lists contain examples of serious side effects that can occur with Soliqua 100/33, with Victoza, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
    • hypokalemia (low potassium levels)
  • Can occur with Victoza:
    • thyroid cancer*
  • Can occur with both Soliqua 100/33 and Victoza:
    • severe allergic reaction
    • severe hypoglycemia (severe low blood sugar)
    • pancreatitis (inflammation of the pancreas)
    • gallbladder disease
    • kidney damage

* Victoza has a boxed warning from the FDA for thyroid cancer. A boxed warning is the strongest warning the FDA requires. It alerts doctors and patients about drug effects that may be dangerous.

Effectiveness

Soliqua 100/33 and Victoza haven’t been compared directly in clinical studies, but both have been found effective for treating type 2 diabetes.

In separate studies, both Soliqua 100/33 and Victoza lowered HbA1c and fasting blood sugar levels in people with type 2 diabetes.

  • In a clinical study, after 30 weeks of treatment, Soliqua 100/33 reduced hemoglobin A1c (HbA1c) by 1.1 percent and fasting blood sugar levels by 5.7 mg/dL.
  • In other clinical studies, over 52 weeks of treatment, Victoza reduced HbA1c by about 0.8 to 1.1 percent and fasting blood sugar levels by 15 to 26 mg/dL.

A separate clinical study showed that Victoza reduced the risk of major heart problems such as heart attacks and stroke by 13 percent. This outcome was not studied in research on Soliqua 100/33.

Note: It’s important to keep in mind that how well either of these drugs would lower your HbA1c or blood sugar levels would depend on many factors, including:

  • your blood sugar levels when you start the drug
  • your diet and exercise regimens
  • the other diabetes medications that you take
  • how closely you follow your treatment regimen

Costs

Soliqua 100/33 and Victoza are both brand-name drugs. There are currently no biosimilar forms available of either drug. Brand-name medications usually cost more than biosimilars.

The actual cost you would pay for either drug would depend on your dosage, your insurance plan, your location, and the pharmacy you use.

Soliqua 100/33 vs. Toujeo

Soliqua 100/33 contains two drugs:

  • insulin glargine, which is a long-acting insulin
  • lixisenatide, which belongs to a class of drugs called glucagon-like peptide 1 (GLP-1) receptor agonists

Insulin glargine is the drug contained in Toujeo. Because Soliqua 100/33 and Toujeo share an active ingredient, they work in similar ways within the body.

Uses

Soliqua 100/33 is FDA-approved to improve blood sugar levels in adults with type 2 diabetes. It’s approved for use with diet changes and exercise.

Toujeo is FDA-approved to improve blood sugar levels in adults with type 2 diabetes, and adults and children with type 1 diabetes.

Drug forms and administration

Soliqua 100/33 and Toujeo both come as a liquid solution in a disposable injectable pen. Both drugs are self-injected under the skin (subcutaneous) once per day.

Soliqua 100/33 comes in one amount. Each pen contains 3 mL of drug solution, with 300 units of insulin glargine and 100 mcg of lixisenatide. The maximum dose per injection is 60 units, which would mean 60 units of insulin glargine and 20 mcg lixisenatide.

Toujeo comes in two different amounts:

  • Toujeo SoloStar contains 450 units of insulin glargine in 1.5 mL of solution, with a maximum dose of 80 units per injection.
  • Toujeo Max SoloStar contains 900 units of insulin glargine in 3 mL of solution, with a maximum dose of 160 units per injection.

Side effects and risks

Soliqua 100/33 and Toujeo both share the same long-acting insulin, insulin glargine. Therefore, both drugs can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Soliqua 100/33, with Toujeo, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
    • nausea
    • diarrhea
    • headache
  • Can occur with Toujeo:
    • weight gain
    • injection site reactions
    • lipodystrophy (indentation or depression at area of injection)
    • itchiness
    • rash
    • swelling in your legs, ankles, or feet
  • Can occur with both Soliqua 100/33 and Toujeo:
    • respiratory infections such as the common cold or flu
    • hypoglycemia (low blood sugar)

Serious side effects

These lists contain examples of serious side effects that can occur with Soliqua 100/33, with Toujeo, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
    • pancreatitis (inflammation of the pancreas)
    • gallbladder disease
    • kidney damage
  • Can occur with Toujeo:
    • few unique serious side effects
  • Can occur with both Soliqua 100/33 and Toujeo:
    • severe allergic reaction
    • severe hypoglycemia (severe low blood sugar)
    • hypokalemia (low potassium levels)

Effectiveness

Soliqua 100/33 and Toujeo haven’t been directly compared in clinical studies. However, individual studies have shown that both Toujeo and Soliqua 100/33 can be effective in reducing both HbA1c and fasting blood sugar levels.

  • In a clinical study, Soliqua 100/33 reduced hemoglobin A1c (HbA1c) by 1.1 percent and fasting blood sugar levels by 5.7 mg/dL after 30 weeks of treatment.
  • In other clinical studies, Toujeo reduced HbA1c by about 0.73 to 1.42 percent and fasting blood sugar levels by 18 to 61 mg/dL over 26 weeks of treatment.

Note: It’s important to keep in mind that how well either of these drugs would lower your HbA1c or blood sugar levels would depend on many factors, including:

  • your blood sugar levels when you start the drug
  • your diet and exercise regimens
  • the other diabetes medications that you take
  • how closely you follow your treatment regimen

Costs

Soliqua 100/33 and Toujeo are both brand-name drugs. There are currently no generic forms available of either drug. Brand-name medications usually cost more than generics.

The actual price you would pay for either drug would depend on your dose, your insurance plan, your location, and the pharmacy you use.

Soliqua 100/33 vs. Adlyxin

Soliqua 100/33 contains two drugs:

  • insulin glargine, which is a long-acting insulin
  • lixisenatide, which belongs to a class of drugs called glucagon-like peptide 1 (GLP-1) receptor agonists

Lixisenatide is also the drug contained in Adlyxin. Because Soliqua 100/33 and Adlyxin share an active ingredient, they work in similar ways in the body.

Uses

Soliqua 100/33 is FDA-approved for use with diet changes and exercise to improve blood sugar levels in adults with type 2 diabetes.

Adlyxin is FDA-approved for use with diet and exercise to improve blood sugar levels in adults with type 2 diabetes.

Drug forms and administration

Soliqua 100/33 and Adlyxin both come as a liquid solution in a disposable injectable pen. Both drugs are self-injected under the skin (subcutaneous) once per day.

The Soliqua 100/33 pen comes in one amount. Each pen contains 3 mL of drug solution, with 100 units of insulin glargine and 33 mcg of lixisenatide per mL. The maximum dose per injection is 60 units, which would mean 60 units of insulin glargine and 20 mcg lixisenatide.

The Adlyxin pen comes in two different amounts:

  • The green Adlyxin pen contains 50 mcg/mL in 3 mL of solution, with a dose of 10 mcg per injection.
  • The burgundy Adlyxin pen contains 100 mcg/mL in 3 mL of solution, with a dose of 20 mcg per injection.

Side effects and risks

Soliqua 100/33 and Adlyxin both contain the drug lixisenatide. Therefore, both medications can cause very similar side effects. Below are examples of these side effects.

More common side effects

These lists contain examples of more common side effects that can occur with Soliqua 100/33, with Adlyxin, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
    • respiratory infections such as common cold or flu
  • Can occur with Adlyxin:
    • vomiting
    • dizziness
  • Can occur with both Soliqua 100/33 and Adlyxin:
    • nausea
    • diarrhea
    • headache
    • hypoglycemia (low blood sugar)

Serious side effects

These lists contain examples of serious side effects that can occur with Soliqua 100/33, with Adlyxin, or with both drugs (when taken individually).

  • Can occur with Soliqua 100/33:
    • hypokalemia (low potassium levels)
    • gallbladder disease
  • Can occur with Adlyxin:
    • few unique serious side effects
  • Can occur with both Soliqua 100/33 and Adlyxin:
    • severe allergic reaction
    • severe hypoglycemia (severe low blood sugar)
    • pancreatitis (inflammation of the pancreas)
    • kidney damage

Effectiveness

The use of either Soliqua 100/33 or Adlyxin as single-drug treatment for type 2 diabetes has not been directly compared in clinical research. However, the use of each drug in combination with metformin (an oral diabetes drug) has been directly compared.

Separate studies when used alone

In separate clinical studies, Soliqua 100/33 and Adlyxin were both effective alone in reducing fasting blood sugar in those with type 2 diabetes.

  • In a clinical study, Soliqua 100/33 reduced hemoglobin A1c (HbA1c) by 1.1 percent and fasting blood sugar levels by 5.7 mg/dL after 30 weeks of treatment.
  • In a different clinical study, Adlyxin reduced HbA1c by 0.57 to 0.71 percent and fasting blood sugar levels by 4.48 to 24.56 mg/dL over 24 weeks of treatment.

Direct comparison when used with metformin

Another study tested the use of Soliqua 100/33 with metformin directly against the use of Adlyxin with metformin in adults with type 2 diabetes. The people in the study had previously received metformin alone, or metformin and another oral diabetes drug.

After 30 weeks, Soliqua 100/33 with metformin was more effective than Adlyxin with metformin. Soliqua 100/33 with metformin reduced HbA1c by 1.6 percent and fasting blood sugar levels by 59.1 mg/dL. Adlyxin and metformin, on the other hand, reduced HbA1c by 0.9 percent and fasting blood sugar levels by 27.2 mg/dL.

Note: It’s important to keep in mind that how well either of these drugs would lower your HbA1c or blood sugar levels would depend on many factors, including:

  • your blood sugar levels when you start the drug
  • your diet and exercise regimens
  • the other diabetes medications that you take
  • how closely you follow your treatment regimen

Costs

Soliqua 100/33 and Adlyxin are both brand-name drugs. There are currently no generic forms available of either drug. Brand-name medications usually cost more than generics.

The actual price you would pay for either drug would depend on your dosage, your insurance plan, your location, and the pharmacy you use.

The Food and Drug Administration (FDA) approves prescription drugs such as Soliqua 100/33 to treat certain conditions. Soliqua 100/33 is FDA-approved for use with diet changes and exercise to improve blood sugar levels in adults with type 2 diabetes.

In a 30-week clinical study of people who received a type of basal insulin (such as insulin glargine), Soliqua 100/33 was found to be effective. It reduced hemoglobin A1c (HbA1c) by 1.1 percent and fasting blood sugar levels by 5.7 mg/dL.

A 30-week clinical study focused on people who received metformin alone, or metformin and another oral diabetes drug. For the people in the study, Soliqua 100/33 and metformin reduced their HbA1c by 1.6 percent and fasting blood sugar levels by 59.1 mg/dL.

Soliqua 100/33 can be used alone or in combination with other drugs to improve blood sugar levels in people with type 2 diabetes. In diabetes treatment, it’s typical for more than one medication to be used to control blood sugar levels if one drug alone hasn’t improved blood sugar levels enough.

Examples of drugs that can be used with Soliqua 100/33 include:

Avoid drinking too much alcohol while taking Soliqua 100/33. Alcohol can change your blood sugar levels and increase your risk of hypoglycemia (low blood sugar) and pancreatitis (inflamed pancreas).

If you drink alcohol, talk with your doctor about how much alcohol is safe for you.

Soliqua 100/33 can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Soliqua 100/33 and other medications

Below is a list of medications that can interact with Soliqua 100/33. This list doesn’t contain all drugs that may interact with Soliqua 100/33.

Before taking Soliqua 100/33, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Other diabetes medications

Taking Soliqua 100/33 with other diabetes medications can lead to severe low blood sugar levels and increase your risk of hypoglycemia (low blood sugar). If you take any of these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change your dosage of Soliqua 100/33.

Examples of diabetes medications include:

In addition, using Soliqua 100/33 with diabetes drugs called thiazolidinediones (TZDs) can cause fluid retention. It can also increase your risk of heart failure or worsen symptoms of heart failure (refer to the warning below). Examples of these drugs include:

  • pioglitazone (Actos)
  • rosiglitazone (Avandia)
TZDs and heart failure warning

If you’re taking a TZD, talk with your doctor before starting Soliqua 100/33. If your doctor approves your use of a TZD while using Soliqua 100/33, be sure to watch for symptoms of heart failure. If you develop heart failure, your doctor may reduce the dose of your TZD or have you stop taking it.

Symptoms of heart failure may include:

  • trouble breathing
  • swelling in legs, ankles, and feet
  • fast or irregular heartbeat
  • chest pains

High blood pressure medications

Taking Soliqua 100/33 with certain high blood pressure medications can lead to severe low blood sugar levels and increase your risk of hypoglycemia (low blood sugar). If you take any of these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change your dosage of Soliqua 100/33.

Examples of high blood pressure medications that can increase the risk of hypoglycemia when taken with Soliqua 100/33 include:

Other blood pressure medications can mask the symptoms of severe low blood sugar levels. These drugs may also increase or decrease how effective Soliqua 100/33 is at lowering blood sugar levels. If you take these medications with Soliqua 100/33, you may need to check your blood sugar levels more often. Also, your doctor may need to change your dosage of Soliqua 100/33.

Examples of blood pressure medications that can mask the signs of low blood pressure or affect how well Soliqua 100/33 works include:

Other drugs that may hide signs of hypoglycemia

Some medications can mask the signs and symptoms of severe low blood sugar levels. If you take these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change your dosage of Soliqua 100/33.

Examples of these medications include:

  • albuterol (ProAir, Proventil, Ventolin)
  • guanethidine
  • reserpine

Other medications that can lower blood sugar levels

Taking Soliqua 100/33 with certain other medications can lead to severe low blood sugar levels and increase your risk of hypoglycemia (low blood sugar). If you take any of these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change your dosage of Soliqua 100/33.

Examples of these medications include:

  • disopyramide (Norpace)
  • certain cholesterol medications, such as fenofibrate (Tricor, Triglide) and gemfibrozil (Lopid)
  • certain antidepressants, such as fluoxetine (Prozac, Sarafem) and selegiline (Emsam, Zelapar)
  • octreotide (Sandostatin)
  • sulfamethoxazole-trimethoprim (Bactrim, Septra)

Other medications that increase your blood sugar levels

Some medications can increase blood sugar levels in your body. If you take these medications, you may need to check your blood sugar levels more often to prevent hyperglycemia (high blood sugar). Also, your doctor may need to change your dosage of Soliqua 100/33.

Examples of these medications include:

  • albuterol (ProAir, Proventil, Ventolin)
  • certain antivirals, such as atazanavir (Reyataz) and lopinavir/ritonavir (Kaletra)
  • certain steroids, such as budesonide (Entocort EC, Pulmicort, Uceris), prednisone, and fluticasone (Flonase, Flovent)
  • certain diuretics, such as chlorothiazide (Diuril) and hydrochlorothiazide (Microzide)
  • certain antipsychotics, such as clozapine (Clozaril, Fazaclo) and olanzapine (Zyprexa)
  • certain hormones, such as danazol (Danazol), levothyroxine (Levoxyl, Synthroid) and somatropin (Genotropin)
  • glucagon (GlucaGen)
  • niacin (Niaspan, Slo-Niacin, others)
  • oral contraceptives (birth control pills)

Drugs that increase or decrease the effects of Soliqua 100/33

Some medications can affect how Soliqua 100/33 works in your body. If you take these medications, you may need to check your blood sugar levels more often. Also, your doctor may need to change your dosage of Soliqua 100/33.

Examples of these medications include:

  • albuterol (ProAir, Proventil, Ventolin)
  • lithium

Soliqua 100/33 and herbs and supplements

Taking Soliqua 100/33 with certain herbs or supplements might increase your risk of hypoglycemia (low blood sugar levels). Examples of these include:

Soliqua 100/33 helps improve blood sugar levels in people with type 2 diabetes.

How insulin affects blood sugar

Normally, when you eat food, your body releases a hormone called insulin. Glucose (sugar) from the food travels to your bloodstream, and the insulin helps transport it into the cells of your body. The cells then turn the glucose into energy.

People with type 2 diabetes usually have insulin resistance. This means their body doesn’t respond to insulin the way it should. Over time, people with type 2 diabetes may also stop producing enough insulin.

When your body doesn’t respond to insulin the way it should, or if it doesn’t produce enough insulin, this causes problems. The cells of your body may not get the glucose they need to work correctly.

Also, you may get too much glucose in your blood. This is called hyperglycemia (high blood sugar). Having too much glucose in your blood can damage your body and organs, including your eyes, heart, nerves, and kidneys.

What Soliqua 100/33 does

Soliqua 100/33 contains two drugs. These are insulin glargine, which is a long-acting insulin, and lixisenatide, which is a glucagon-like peptide 1 (GLP-1) receptor agonist.

Insulin glargine works in one way: it lowers your blood sugar levels by moving glucose from your bloodstream into your cells.

Lixisenatide works in three ways. First, it increases the amount of insulin your body makes. This increased insulin helps move more glucose out of your bloodstream and into your cells. Second, it causes your stomach to empty more slowly after a meal, making you feel full longer. And third, it tells your liver to release less glucose into your blood.

How long does it take to work?

Soliqua 100/33 begins to work right after you inject it. However, it reaches its highest effect about 2.5 to 3 hours after each injection.

Study data is limited for use of Soliqua 100/33 during pregnancy in humans. However, animal studies show that there may be a risk of congenital anomalies (also known as birth defects) with the use of lixisenatide during pregnancy. Lixisenatide is one of the drugs found in Soliqua 100/33. Therefore, Soliqua 100/33 should only be used during pregnancy if the potential benefit outweighs the potential risks.

If you’re pregnant or planning to become pregnant, talk with your doctor about the risks and benefits of using Soliqua 100/33 during pregnancy.

It is not known if Soliqua 100/33 passes into breast milk. Before breastfeeding, you should discuss with your doctor the risks and benefits of taking this drug while breastfeeding.

Here are answers to some frequently asked questions about Soliqua 100/33.

Does Soliqua 100/33 cause weight gain?

In clinical trials, Soliqua 100/33 was not found to cause weight gain. In fact, in one clinical study, people who took Soliqua 100/33 for 30 weeks lost about 1.5 pounds.

It’s interesting to note that the individual drugs contained in Soliqua 100/33 seem to have differing effects on weight. One of the drugs is insulin glargine, which is a long-acting insulin. Typically, drugs containing insulin have been linked with weight gain.

However, the other drug in Soliqua 100/33 is called lixisenatide, which is a glucagon-like peptide 1 (GLP-1) receptor agonist. Medications in the GLP-1 drug class have shown weight loss as a side effect in various clinical studies.

If you’re concerned about the effects that Soliqua 100/33 might have on your weight, talk with your doctor.

Is Soliqua 100/33 insulin?

Yes, Soliqua 100/33 contains insulin. Soliqua 100/33 is made of two drugs, one of which is insulin glargine, a long-acting insulin.

The second drug is lixisenatide, which is a glucagon-like peptide 1 (GLP-1) receptor agonist.

Is Soliqua 100/33 long-acting?

Yes. Soliqua 100/33 contains two active drugs. One of these is insulin glargine, which is a long-acting insulin.

Can Soliqua 100/33 be used to treat type 1 diabetes?

No, Soliqua 100/33 should not be used to treat type 1 diabetes. Soliqua 100/33 has not been studied nor approved by the Food and Drug Administration (FDA) to treat that condition. It’s only approved to treat type 2 diabetes.

Before taking Soliqua 100/33, talk with your doctor about your health history. Soliqua 100/33 may not be right for you if you have certain medical conditions. These include:

  • Kidney disease. If you have kidney disease, taking Soliqua 100/33 may worsen your condition. If your condition worsens, you may need to stop taking Soliqua 100/33. Do not take this medication if you have severe kidney disease.
  • Slow stomach emptying. Lixisenatide, one of the drugs in Soliqua 100/33, slows the action of your stomach muscles. If you have gastroparesis, which means your body digests food slowly, taking Soliqua 100/33 may worsen your condition. People with severe gastroparesis should not take this medication.
  • Pancreas or gallbladder problems, or alcohol use disorder. Soliqua 100/33 may increase your risk of pancreatitis. You may be at greater risk of pancreatitis if you have a history of pancreatitis, gallbladder stones, or alcoholism. If you have a history of these problems, talk with your doctor about whether Soliqua 100/33 is right for you.

Taking too much of this medication can increase your risk of serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • severe hypoglycemia (severe low blood sugar), which can cause shakiness, anxiety, and confusion
  • hypokalemia (low potassium levels), which can cause weakness, constipation, and muscle cramps
  • gastrointestinal problems, which can cause diarrhea, nausea, and vomiting

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

When Soliqua 100/33 is dispensed from the pharmacy, the pharmacist will add an expiration date to the label on the container. This date is typically 1 year from the date the medication was dispensed.

The purpose of such expiration dates is to guarantee the effectiveness of the medication during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications.

How long a medication remains good can depend on many factors, including how and where the medication is stored. Store your Soliqua 100/33 pens in your refrigerator, at a temperature between 36°F and 46°F (2°C and 8°C). Never freeze your pens.

After the first use of each pen, you can store it at room temperature (77°F/25°C), but be sure to protect it from light. Discard each pen after 28 days from its first use.

If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

The following information is provided for clinicians and other healthcare professionals.

Indications

Soliqua 100/33 is FDA-approved for use with diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Mechanism of action

Soliqua 100/33 is a combination of insulin glargine (a basal insulin analog) and lixisenatide (a glucagon-like peptide 1 [GLP-1] receptor agonist).

Insulin glargine lowers blood glucose by increasing peripheral glucose uptake and reducing glucose production from the liver. Lixisenatide reduces blood glucose by increasing insulin secretion, decreasing glucagon secretion, and slowing gastric emptying.

Pharmacokinetics and metabolism

The insulin glargine-to-lixisenatide ratio has no impact on the pharmacokinetics of either component.

Insulin glargine doesn’t have a peak and is metabolized partially at the carboxyl terminus of the B chain in the subcutaneous depot.

Time to max concentration for lixisenatide is 2.5 to 3 hours. Lixisenatide has a 55 percent protein binding rate and is eliminated via urine and proteolytic degradation. Mean half-life is about 3 hours.

Contraindications

Soliqua 100/33 is contraindicated in patients:

  • during hypoglycemic episodes
  • with a history of severe hypersensitivity to insulin glargine or lixisenatide

Storage

Soliqua 100/33 pens should be stored in a refrigerator, at a temperature between 36°F and 46°F (2°C and 8°C), but never frozen. After the first use, pens can be stored at room temperature 77°F (25°C). They should be protected from light. Safely discard the pen after 28 days from first use.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Soliqua 100/34 Images