Type 2 diabetes is the most common type of diabetes. It occurs when your blood has high levels of sugar, also known as glucose. This can cause your pancreas, which is the organ that produces insulin, to not make enough insulin or not allow your body to use insulin properly.
Type 2 diabetes is a chronic (long-term) condition. For some people, diet and exercise alone may help manage blood sugar. For others, one or more medicines may be needed. You take some diabetes medicines by mouth and others as a shot.
Soliqua (So-lee-kwa) was approved in 2016 for managing blood sugar in people with type 2 diabetes along with diet and exercise.
How Does It Work?
Type 2 diabetes can have many symptoms, which are listed below.
- Extreme thirst
- Extreme hunger
- Peeing a lot
- Tiredness
- Blurry vision
- Numbness or tingling in your hands or feet
Your health care provider can look at your blood sugar or look at your hemoglobin A1c (HbA1c) to monitor your type 2 diabetes. Your HbA1c looks at your average blood sugar levels over the past 2-3 months. Soliqua is a medicine that can help lower your blood sugar and HbA1c.
Soliqua contains two medicines: insulin glargine and lixisenatide. Insulin glargine is a type of insulin, while lixisenatide is a glucagon-like peptide-1 (GLP-1) agonist. Insulin glargine works by giving your body more insulin. Insulin works to move sugar from the blood into your cells and stops your liver from producing sugar. Lixisenatide helps to stimulate your pancreas to make more insulin, prevents your liver from releasing stored sugars, and slows down the movement of food through your body.
How Do I Use It?
Soliqua comes as an injectable pen. Soliqua is used once a day, within 1 hour before your first meal of the day. The medicine is injected in either your stomach, thigh, or upper arm. It is important that with each dose, you change where you get the shot to help prevent skin problems. Do not inject the medicine in places where your skin is broken, bruised, or damaged. Use it as prescribed by your health care provider. Do not mix Soliqua with any other type of insulin. Do not reuse or share needles with other people.
Talk to your health care provider or follow the Instructions For Use paper that comes with your prescription. Your health care provider can find out what dose you will inject based on your blood sugar levels, how much you exercise, your diet, stress levels, and if you have any illnesses. Ask your health care provider how often you should check your blood sugar levels while using Soliqua.
Do not use more than the recommended dose of Soliqua. Using too much of it can cause nausea and vomiting.
How Was It Studied for Type 2 Diabetes?
Two studies were done to look at the safety and efficacy of Soliqua. Both studies included people who were diagnosed with type 2 diabetes and whose blood sugar levels were not controlled. Most people’s HbA1c in the study was between 7.5% and 10%. Both studies looked at the change in HbA1c at 30 weeks.
In the first study, people were taking metformin (a medicine for diabetes) by itself or metformin with another by-mouth medicine for diabetes such as a sulfonylurea, a glinide, a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, or a dipeptidyl peptidase-4 (DPP-4) inhibitor. People in the study either used Soliqua, insulin glargine, or lixisenatide. The study included White people (90%), Black people (7%), Asian people (2%), those classified as “Other” (2%), and Hispanic people (19%). The average age was 58 years old.
In the second study, people were using insulin alone or insulin with a by-mouth diabetes medicine (metformin, sulfonylurea, glinide, an SGLT-2 inhibitor, or a DPP-4 inhibitor). People in the study either used Soliqua or insulin. The study included White people (92%), Black people (6%), Other (2%), and Hispanic people (18%). The average age was 60 years old.
What Benefits Were Seen?
In the first study, people who used Soliqua had a greater reduction in their HbA1c (-1.6%) compared to people who used insulin glargine (-1.3%) or lixisenatide (-0.9%).
In the second study, people who used Soliqua had a greater reduction in their HbA1c (-1.1%) compared to people who used insulin glargine (-0.6%).
How Can I Tell if It Is Working?
Soliqua is working when you start noticing your blood sugar readings and your HbA1c becoming lower. When you start using Soliqua, your health care provider may adjust your dose every week or so until your blood sugar readings are at goal. This may take some time. Talk to your health care provider about measuring your blood sugar while using Soliqua. Do not stop using Soliqua unless your health care provider tells you to do so. Stopping Soliqua may cause your blood sugar to increase.
What Are Possible Side Effects and How Can I Manage Them?
The most common side effects seen with Soliqua are:
- Low blood sugar
- Nausea
- Infection in the nose or throat, a sore throat, or common cold symptoms
- Diarrhea
- Headache
Low blood sugar is also known as hypoglycemia, which is a blood sugar reading of 70 milligrams per deciliter (mg/dL) or less. If your blood sugar gets too low, eat some sugar. Sugar sources include glucose tablets, glucose gel, 4 ounces of juice or non-diet soda, or a tablespoon of sugar, honey, or corn syrup. Wait for 15 minutes and then check your blood sugar again. If it is still low, repeat the process. Call your health care provider if you have any of the following symptoms of low blood sugar or if your blood sugar is below 70 mg/dL.
- Dizziness
- Shakiness
- Sweating
- Anxiety
- Crankiness or mood changes
- Hunger
- A fast heartbeat
- Sleepiness
- Headache
- Tingling in your cheeks, lips, or tongue
If you have nausea, there are some things you can do to manage this:
- Avoid spicy and greasy food.
- Eat smaller, more frequent meals.
- Drink plenty of water.
- Eat slowly.
- Avoid strong smells.
Call your health care provider if your nausea symptoms do not get better or get worse. Your health care provider may prescribe you medicine or ask you to keep certain over-the-counter medicines on hand.
Call your health care provider if you have a sore throat or common cold symptoms. Your health care provider will advise you on how to best treat these symptoms, including if you can take any medicine for it.
Diarrhea may occur while you are using Soliqua. To limit diarrhea, you can try simple steps such as eating bland foods like rice, bananas, and toast, drinking plenty of water, and lowering the amount of caffeine you are drinking. Call your health care provider if your diarrhea symptoms do not improve or become worse.
If you get headaches, you may be able to use over-the-counter medicines such as Tylenol or ibuprofen. Talk to your health care provider if your symptoms do not improve or become worse.
What Type of Drug Interactions Can Happen?
Taking certain medicines with Soliqua may increase your risk of having low blood sugar. If you are taking these medicines, your health care provider may need to lower your Soliqua dose and may ask you to monitor your blood sugar more often. These medicines include:
- Medicines for diabetes, including pioglitazone (Actos) and pramlintide (Symlin)
- An angiotensin-converting enzyme (ACE) inhibitor, such as enalapril or lisinopril, which is a medicine for high blood pressure, heart failure, and certain kidney problems
- An angiotensin II receptor blocking agent (ARB), such as losartan or valsartan, which is a medicine for high blood pressure, heart failure, and other heart conditions
- Disopyramide (Norpace), which is a medicine used to treat irregular heartbeats
- A fibrate, such as fenofibrate (Tricor), fenofibric acid (Fibricor, Trilipix), or gemfibrozil (Lopid), which is a medicine for high cholesterol
- Fluoxetine (Prozac), which is a medicine used to treat depression, obsessive-compulsive disorder (OCD), and panic disorders
- A monoamine oxidase inhibitor, which is a medicine used for depression and Parkinson’s disease
- Pentoxifylline, which is a medicine that can help increase your blood flow for certain medical conditions
- A salicylate (aspirin), which is a medicine used to treat pain, fever, and inflammation, and to prevent blood clots
- Somatostatin analogs such as octreotide, which can affect your hormone levels and your stomach
- A sulfonamide antibiotic (sulfamethoxazole, sulfasalazine, and others), which is a medicine used to treat infections caused by certain bacteria
There are certain medicines that can cause Soliqua to not work as well. These medicines include:
- An atypical antipsychotic (clozapine, olanzapine, and others), phenothiazines, and lithium, which are medicines used for certain mental health conditions
- Corticosteroids (prednisone), which are commonly used for inflammatory conditions
- Danazol, which is used to treat endometriosis and certain breast diseases
- A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
- An estrogen or progestogen, which is a hormone
- Birth control
- Glucagon, which is used to treat low blood sugar
- Isoniazid, which is used to treat tuberculosis
- A vitamin called niacin (vitamin B3), which is used for high cholesterol
- A protease inhibitor, which is used to treat human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS)
- Somatropin, which is used to increase growth and development in children
- A sympathomimetic agent that mimics your sympathetic nervous system, such as albuterol, epinephrine, and terbutaline
- A thyroid medicine, such as levothyroxine, which is used to raise thyroid hormone levels
Certain medicines, when taken with Soliqua, can affect your blood. These medicines include:
- Alcohol
- Lithium, which is a medicine for certain mental health conditions
- Pentamidine (Nebupent), which is used to treat certain fungal infections
Certain medicines, when taken with Soliqua, can affect your blood sugar and cover up potential symptoms of low blood sugar. These medicines are listed below.
- A beta-blocker, such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL, and others), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
- Clonidine (Catapres-TTS and others), which is a medicine used for high blood pressure or attention deficit hyperactivity disorder (ADHD)
Talk to your health care provider about all the prescription drugs, over-the-counter medications, and supplements you are taking. Soliqua works by slowing down the movement of food through your body. Because of this, it may affect how other medicines that you take by mouth are absorbed. Talk with your health care provider if you feel that other medicines that you take by mouth are not working as well as they used to while using Soliqua. In particular, if you are taking birth control, it is recommended to take your birth control pill 1 hour before or 11 hours after using Soliqua. It is also recommended to take antibiotics and acetaminophen 1 hour before using Soliqua.
Is There a Cost Savings Program?
There is a copay card offered by the drugmaker that may allow you to pay as little as $35 for a 30-day supply of Soliqua. Whether you are eligible depends on the type of insurance you have. You can find out more at www.soliqua100-33.com/soliqua-100-33-copay-card or by calling 888-847-4877.
