Onswik
Onswik (insulin efsitora alfa) is an ultra long-acting insulin used along with diet and exercise to improve blood sugar control in adults with Type 2 diabetes. It comes as a prefilled KwikPen that's injected under the skin once a week on the same day each week. Side effects include low blood sugar (hypoglycemia), injection site reactions, and weight gain.
What is Onswik (insulin efsitora alfa)?
What is Onswik (insulin efsitora alfa) used for?
- Type 2 diabetes in adults
How Onswik (insulin efsitora alfa) works
Onswik (insulin efsitora alfa) is an insulin that works like the insulin your body naturally makes. It helps your body move sugar from your blood into your cells for energy or storage. It also reduces how much sugar your liver makes.
Onswik (insulin efsitora alfa) is an ultra-long-acting insulin, meaning it stays in your body much longer than daily insulins. This allows it to steadily lower your blood sugar throughout the week.
Drug facts
| Common Brands | Onswik |
|---|---|
| Drug Class | Insulin |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | No lower-cost generic available |
| Availability | Prescription only |
Side effects of Onswik (insulin efsitora alfa)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Low blood sugar
Less Common Side Effects
- Injection site reaction (e.g., itching, bruising, redness, pain, swelling, hives)
- Swelling in the arm, leg, or ankle
- Weight gain
Onswik (insulin efsitora alfa) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severely low blood sugar: dizziness, shakiness, feeling confused, feeling irritable or anxious, feeling faint, sweating, extreme hunger, can't think clearly
- Very low potassium: weakness, muscle cramps or twitches, constipation, abnormal heartbeat, tiredness, trouble breathing
- Severe allergic reaction: rash; hives; swelling of your face, tongue, or throat; trouble breathing; very low blood pressure
Pros and cons of Onswik (insulin efsitora alfa)
Pros
- Injected once a week (fewer injections)
- Can be used alone or with other diabetes medications
- Steady blood sugar control over a whole week with one injection
Cons
- Possible to cause low blood sugar levels
- Might cause some weight gain and injection site reactions
- Not approved for Type 1 diabetes
Pharmacist tips for Onswik (insulin efsitora alfa)
- Use Onswik (insulin efsitora alfa) once a week on the same day each week. Choose a day that fits your routine to help you remember your dose.
- If you miss a dose of Onswik (insulin efsitora alfa), take it as soon as possible if it's been 4 days or less. If more than 4 days have passed, ask your prescriber how to restart your weekly schedule.
- Check your blood sugar more often when starting Onswik (insulin efsitora alfa) or after a dose change. Low blood sugar can happen more easily during these times and might take longer to recover from because the medication stays in your body for a long time.
- Keep fast-acting sugar with you while using Onswik (insulin efsitora alfa). Shaking, sweating, dizziness, hunger, a fast heartbeat, or confusion can be signs of low blood sugar. Get emergency help for severe confusion, a seizure, or loss of consciousness.
- Tell your prescriber about all medications you take with Onswik (insulin efsitora alfa) since it can interact with many of them. Pioglitazone can raise your risk of fluid buildup and heart failure, prednisone can raise your blood sugar, and beta blockers such as metoprolol can hide some signs of low blood sugar.
- Pregnancy or Breastfeeding: Onswik (insulin efsitora alfa) isn't recommended during pregnancy or breastfeeding because there isn't enough information about its safety. Tell your prescriber if you're pregnant, planning to become pregnant, or breastfeeding.
- Storage: Keep Onswik (insulin efsitora alfa) refrigerated whenever possible. After first use, the pen can be used for up to 112 days (16 weeks), but it shouldn't spend more than a total of 14 days at room temperature.
How to inject Onswik (insulin efsitora alfa):
- Check the label on your pen before every injection to make sure you have the right insulin. Mixing up insulin products can cause dangerously low blood sugar.
- Check the dose window on your KwikPen before injecting. The U-500 pen dials in 5-unit steps, while the U-1,000 pen dials in 10-unit steps
- Inject under the skin of your stomach, upper arm, thigh, or buttocks. Rotate injection sites each week to help prevent lumps or changes in the fatty tissue under your skin.
- Use a new needle for every injection. Never share your pen with anyone, even if you change the needle, because this can spread infections.
- Put used needles and pens in a sharps container. Don't put them in your regular trash.
Risks and warnings for Onswik (insulin efsitora alfa)
Onswik (insulin efsitora alfa) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of infections with pen sharing
Never share Onswik (insulin efsitora alfa) pens with anyone, even if you change the needle. Sharing pens can spread serious infections from one person to another.
Risk of high or low blood sugar after insulin changes
- Risk factors: First 4 to 6 weeks of using Onswik (insulin efsitora alfa)
Changes to how you use Onswik (insulin efsitora alfa) can cause your blood sugar to become too high or too low. This includes changes to your insulin dose or strength, injection site, or how you inject it. Your risk of high blood sugar might also be higher during the first 4 to 6 weeks while your dose is being adjusted.
Only make changes with your prescriber's recommendations, and check your blood sugar more often after a change. Avoid injecting into skin that's lumpy, thickened, or damaged from repeated injections.
Low blood sugar levels (hypoglycemia)
- Risk factors: Changes to diet, meal patterns, or exercise routine | Drinking alcohol | Taking other diabetes medications at the same time | Liver or kidney problems
Onswik (insulin efsitora alfa) can cause low blood sugar (hypoglycemia), which is the most common side effect of insulin. Symptoms can happen suddenly and include shaking, sweating, hunger, dizziness, or confusion. Severe low blood sugar can cause seizures, loss of consciousness, or even death.
Because Onswik (insulin efsitora alfa) works for a long time, it might take longer for your blood sugar to recover after it drops too low. Check your blood sugar as recommended and keep fast-acting sugar with you. Get emergency help for severe confusion, seizures, or loss of consciousness.
Low potassium levels
- Risk factors: Taking other medications that lower potassium
Like other insulins, Onswik (insulin efsitora alfa) can cause low potassium levels (hypokalemia). Very low potassium can cause serious problems, including abnormal heart rhythms, muscle weakness, or trouble breathing.
Your care team might check your potassium levels during treatment if you're at higher risk. Tell them about all the medications you take so they can decide if you need closer monitoring.
Swelling and heart failure when used with certain diabetes medications
- Risk factors: Taking glitazones together with Onswik (insulin efsitora alfa) | History of heart failure
Using Onswik (insulin efsitora alfa) with certain diabetes medications called glitazones, such as pioglitazone, can cause your body to hold on to extra fluid. This can lead to new or worsening heart failure.
Tell your prescriber if you have heart failure before starting Onswik (insulin efsitora alfa). Also tell them about all the diabetes medications you take so they can check your risk and make sure treatment is safe for you. Contact your care team right away if you develop swelling, sudden weight gain, or shortness of breath. They might need to adjust or stop certain diabetes medications.
Allergic reactions
Onswik (insulin efsitora alfa) can rarely cause a serious or life-threatening allergic reaction, including anaphylaxis. Get emergency medical help right away if you develop trouble breathing, swelling of your face or throat, hives, or severe dizziness.
Onswik (insulin efsitora alfa) dosage
Typical dosage for Onswik (insulin efsitora alfa)
Your prescriber will work with you to find the dose that works best for you based on your blood sugar levels and how you respond to treatment.
Onswik (insulin efsitora alfa) is injected once a week under the skin of your stomach, upper arm, thigh, or buttocks.
First time using insulin - There are two ways to start treatment:
-
Fixed-dose option
- The typical starting dose is 100 units once a week.
- After you've been on a stable dose for at least 4 weeks, your prescriber can raise your dose to 150 units, 250 units, and then 400 units once a week if your fasting blood glucose remains above 130 mg/dL and you haven't reached your goal.
-
Flexible-dose option
- Week 1 : The typical starting dose is 300 units once.
- Week 2: Inject 100 units once.
- Week 3 and after: Your prescriber can adjust your weekly dose by 20 to 40 units at a time based on your fasting blood glucose.
-
Switching from another long-acting insulin: Your care team will help calculate your starting dose based on the dose of long-acting insulin you were using before.
Note: Onswik comes in highly concentrated strengths of 500 units/mL or 1,000 units/mL, which is different from many other insulins.
Onswik (insulin efsitora alfa) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Onswik (insulin efsitora alfa) will not be safe for you to take.
- Using during episodes of low blood sugar (hypoglycemia)
