Soliqua 100/33
Soliqua 100/33 is a combination medication for diabetes that contains insulin glargine (a long-acting insulin) and lixisenatide (a glucagon-like peptide-1 (GLP-1) receptor agonist). It helps manage blood sugar levels along with diet and exercise in adults with Type 2 diabetes. The medication comes as a prefilled pen and is injected under the skin once a day within 1 hour before you eat your first meal of the day. Soliqua 100/33 commonly causes stomach-related side effects like nausea and diarrhea.
What is Soliqua 100/33?
What is Soliqua 100/33 used for?
Type 2 diabetes in adults
How Soliqua 100/33 works
Soliqua 100/33 is a combination of two medications that work together to lower blood sugar.
Insulin glargine is a long-acting insulin. It helps control blood sugar levels throughout the day by helping your body absorb and store sugar from your blood after meals.
Lixisenatide is a glucagon-like peptide-1 (GLP-1) receptor agonist. It activates GLP-1, a hormone that helps your pancreas release more insulin, lowers the amount of sugar your liver makes, and slows how fast food leaves your stomach so you feel full longer.
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What are the side effects of Soliqua 100/33?
Common Side Effects
- Nausea (10%)
- Low blood sugar (8%)
- Common cold-like symptoms (7%)
- Diarrhea (7%)
- Headache (5%)
Other Side Effects
- Stomach pain
- Vomiting
- Heartburn
- Reduced appetite
- Passing gas
- Bloating
- Swelling
- Injection-site reactions
Serious Side Effects
- Inflammation of the pancreas (pancreatitis): severe stomach pain that spreads to your back, nausea, vomiting
- Severely low blood sugar: dizziness, shakiness, feeling confused, feeling irritable or anxious, feeling faint, sweating, extreme hunger, can't think clearly
- Kidney damage: tiredness, dry and itchy skin, urinating more often, bloody or foamy urine, swelling in your feet or ankles, muscle cramping
- Low potassium levels: weakness, muscle cramps or twitches, constipation, abnormal heartbeat, tiredness, trouble breathing
- Gallbladder problems: severe upper stomach and back pain, yellowing of the skin or eyes, fever, nausea, vomiting
- Severe allergic reaction: rash; hives; swelling of face, tongue, and throat; trouble breathing
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Low blood sugar (hypoglycemia)—tremors or shaking, anxiety, sweating, cold or clammy skin, confusion, dizziness, rapid heartbeat
- Low potassium level—muscle pain or cramps, unusual weakness or fatigue, fast or irregular heartbeat, constipation
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
- Thyroid cancer—new mass or lump in the neck, pain or trouble swallowing, trouble breathing, hoarseness
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Diarrhea
- Headache
- Loss of appetite
- Nausea
- Runny or stuffy nose
- Sore throat
- Upset stomach
Pros and cons of Soliqua 100/33
Pros
Lowers A1C by about 1%
Conveniently combines two medications in one injection
Injected under the skin once a day
Cons
Risk of low blood sugar, especially if meals are skipped or delayed
Commonly causes stomach-related side effects like nausea and diarrhea
Must be taken within 1 hour before the first meal of the day
Pharmacist tips for Soliqua 100/33
Ask your prescriber how often you should check your blood sugar levels while taking Soliqua 100/33. Keep track of your readings and share them with your care team so they can adjust your dose based on patterns.
Using Soliqua 100/33 can raise your risk of low blood sugar (hypoglycemia). Learn to recognize symptoms like sweating, shakiness, anxiety, and hunger and know how to treat it.
Soliqua 100/33 commonly causes stomach-related side effects like nausea and diarrhea, especially when you first start this medication. Contact your care team if these side effects become serious or bothersome.
Make sure to drink enough fluids while taking Soliqua 100/33 to prevent dehydration, as stomach-related side effects can make this more likely. Dehydration can also lead to kidney problems.
Store unopened Soliqua 100/33 pens in the refrigerator until the expiration date. Open pens should be kept at room temperature and used within 28 days.
Don't share your Soliqua 100/33 pen with anyone, even if you change the needle. Sharing can put both you and others at risk of serious infections.
Preparation: Attach a new needle for each Soliqua 100/33 injection to prevent infections and blocked needles.
Perform a safety test before each dose of Soliqua 100/33 by selecting 2 units and pressing the injection button. If no liquid appears, repeat the test up to 3 times or replace the needle.
Injection: Turn the dial on the Soliqua 100/33 pen to select your dose. Inject it under the skin of your stomach (2 inches away from your belly button), thighs, or back of your upper arms. Keep holding the injection button down and slowly count to 10 before releasing the button and removing the needle.
Be sure to rotate injection sites with each dose of Soliqua 100/33 to prevent lumps or irritation. Don't inject into bruised, scarred, or tender areas.
Throw away used needles and Soliqua 100/33 pens in a sharps container or a sturdy plastic container, such as an empty milk carton or laundry detergent bottle. Don't throw them away in your trash can.
Frequently asked questions about Soliqua 100/33
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What are the risks and warnings for Soliqua 100/33?
Soliqua 100/33 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.
Severe allergic reactions
Soliqua 100/33 can cause severe allergic reactions, including life-threatening ones like anaphylaxis. Symptoms include widespread skin rashes, facial swelling, trouble breathing, and low blood pressure. If you notice any symptoms of a serious allergic reaction while taking this medication, stop using it right away and get medical help.
Inflammation of the pancreas (pancreatitis)
Risk factors: History of gallstones | Alcohol use disorder
Although rare, some people using Soliqua 100/33 have experienced inflammation in their pancreas (pancreatitis). Stop using the medication and get medical help right away if you have severe and persistent stomach pain that spreads to your back, with or without vomiting.
Risk of high and low blood sugar levels
Changing your insulin routine, like where you inject Soliqua 100/33, can affect how your body reacts to it. This can lead to either high or low blood sugar levels. Injecting Soliqua 100/33 repeatedly into areas with lipodystrophy, like thickened or pitted skin, can also cause high blood sugar levels. And switching to a healthy injection site can suddenly cause low blood sugar.
Always talk to your diabetes care team before making any changes to your Soliqua 100/33 dose or routine, and check your blood sugar more often during this time.
Dangerously low blood sugar levels (hypoglycemia)
Risk factors: Changes in diet and exercise | Changes in other medications | Liver or kidney problems
Using Soliqua 100/33 by itself or with other medications that lower blood sugar can cause hypoglycemia, which means your blood sugar drops to dangerously low levels. If not treated quickly, this can be life-threatening.
Check your blood sugar regularly to make sure it stays in a safe range. Let your care team know if you change your diet, meal schedule, other medications, or how much you exercise. They might need to adjust your dose of Soliqua 100/33.
Learn the symptoms of hypoglycemia, like feeling shaky, nervous, sweaty, or very hungry. Always carry fast-acting sugars, like glucose tablets, with you in case you need to treat low blood sugar. If your blood sugar doesn’t improve after taking fast-acting sugars, get medical help right away.
Kidney damage
Risk factors: History of kidney problems | Dehydration
Some people taking Soliqua 100/33 developed new or worsening kidney problems, called acute kidney injury. In some cases, treatment required dialysis, even in people without a history of kidney problems. Most of the time, this happened in people who had nausea, vomiting, diarrhea, or dehydration after taking the medication.
If you have kidney problems or experience severe stomach-related side effects while using Soliqua 100/33, your prescriber will need to check your kidney labs. Make sure to drink plenty of fluids during treatment to stay hydrated and prevent kidney damage. Tell your prescriber if you're having trouble urinating or if you're not urinating as much as usual while you're taking this medication.
Low blood potassium levels
Risk factors: Taking other medications with Soliqua 100/33 that lower potassium
Soliqua 100/33 can lower the levels of potassium in your blood, which can be dangerous. The risk is higher if you're taking medications that lower your potassium, such as certain diuretics or water pills. If needed, your prescriber might check your potassium levels regularly to make sure they stay in a healthy range. Symptoms of low potassium levels include weakness, muscle cramps or twitches, digestive problems, or abnormal heartbeats. Contact your prescriber right away if you notice these symptoms while taking this medication.
Fluid buildup and heart failure with certain diabetes medications
Risk factors: Taking glitazones together with Soliqua 100/33 | History of heart failure
Taking Soliqua 100/33 with glitazones (also called thiazolidinediones or PPAR-gamma agonists), like pioglitazone (Actos), can cause your body to hold onto extra fluid. This can lead to or worsen heart failure by putting extra stress on your heart. If you're taking a Soliqua 100/33 with a glitazone, your prescriber will monitor you for signs of heart failure. Contact your care team right away if you notice swelling, sudden weight gain, or trouble breathing, as these could be signs of fluid buildup or heart failure.
Gallbladder problems
In studies, some people who took Soliqua 100/33 developed gallbladder problems like gallstones. Contact your prescriber right away if you have symptoms like severe stomach pain, nausea, or vomiting. Your prescriber might need to order blood tests to check your gallbladder.
Aspiration during anesthesia or sedation
Soliqua 100/33 can slow how quickly your stomach empties. Rarely, this has led to cases of food or liquid entering the lungs (aspiration) during surgeries or procedures requiring anesthesia or deep sedation. Make sure to tell your prescriber if you’re taking Soliqua 100/33 before any planned surgery or procedure.
Soliqua 100/33 dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5 solostar pens of 3ml | 1 carton | $879.44 | $879.44 |
Typical dosing for Soliqua 100/33
Each Soliqua 100/33 pen contains 100 units/mL of insulin glargine and 33 mcg/mL of lixisenatide. The dose is based on the number of units of insulin glargine.
If you've never taken long-acting insulin or a GLP-1 agonist, are currently taking a GLP-1 agonist, or use less than 30 units of long-acting insulin per day: The typical starting dose is 15 units injected under the skin into the stomach, thigh, or upper arm once a day, within 1 hour before the first meal of the day.
If you're currently taking 30 to 60 units of long-acting insulin per day, with or without a GLP-1 agonist: The typical starting dose is 30 units injected under the skin into the stomach, thigh, or upper arm once per day, within 1 hour before the first meal of the day.
Your prescriber will adjust your dose based on your blood sugar levels. The maximum dose is 60 units a day.
How much does Soliqua 100/33 cost?
Soliqua 100/33 contraindications
Taking during episodes of low blood sugar (hypoglycemia)
What are alternatives to Soliqua 100/33?
Type 2 diabetes in adults
What is the latest news about Soliqua 100/33?
Soliqua 100/33 images
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References
Best studies we foundCanadian Agency for Drugs and Technologies in Health. (2019). Discussion. Clinical Review Report: Insulin glargine and lixisenatide injection (Soliqua): (Sanofi-Aventis): Indication: Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus inadequately controlled on basal insulin (less than 60 units daily) alone or in combination with metformin.
MedlinePlus. (2024). Aspiration.
National Kidney Foundation. (2024). Acute kidney injury (AKI).
sanofi-aventis U.S. LLC. (2021). Instructions for use - Soliqua® 100/33 (so - lee - kwa) (insulin glargine and lixisenatide) injection, for subcutaneous use.
sanofi-aventis U.S. LLC. (2024). Soliqua 100/33- insulin glargine and lixisenatide injection, solution [package insert]. DailyMed.
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