Titration of IDegLira and iGlarLixi
| IDegLira (42,45) | iGlarLixi (39,46) | ||||
|---|---|---|---|---|---|
| Label | United States and Europe | Europe | United States | Europe | |
| Previous regimen | Basal insulin (<50 units) or GLP-1 receptor agonist* | Oral agents only† | Basal insulin (<60 units) or Lixi | Basal insulin | Oral agents only* |
| Recommended starting dose | 16 units | 10 units | 15 units for patients previously treated with Lixi or <30 units basal insulin; 30 units for patients previously treated with 30–60 units basal insulin | 20 units using pen A‡ (10–40 pen) for patients on ≥20–<30 units iGlar U100;§ 30 units using pen B‡ (30–60 pen) for patients on ≥30 to <60 units iGlar U100§ | 10 units using pen A‡ (10–40 pen) |
| Maximum dose | 50 units | 60 units | 60 units (pen A has a maximum dose of 40 units) | ||
| Frequency of titration | Every 3–4 days | Every week | Not stated | ||
| Dose adjustment | ± 2 units | ± 2–4 units | Not stated | ||
↵* U.S. prescribing information specifies liraglutide.
↵† In Europe, IDegLira and iGlarLixi are approved for use in GLP-1 receptor agonist– and insulin-naive patients.
↵‡ Each pre-filled pen contains 300 units insulin glargine U100 and 150 µg lixisenatide (pen A) or 100 µg lixisenatide (pen B).
Each unit of pen A delivers 1 unit insulin glargine U100 and 0.5 µg lixisenatide, and each unit of pen B delivers 1 unit of insulin glargine U100 and 0.33 µg lixisenatide. §For twice-daily basal insulin or insulin glargine U300, the total daily dose previously used should be reduced by 20%. For any other basal insulin, the same rule should be applied as for insulin glargine U100. To minimize the risk of hypoglycemia or hyperglycemia, additional titration may be needed with changes in physical activity, meal patterns (i.e., macronutrient content or timing of food intake), or renal or hepatic function; during acute illness; or when used with other medications. iGlar, insulin glargine; Lixi, lixisenatide.