Novo Nordisk Launches Xultophy® 100/3.6 (insulin degludec and liraglutide injection) in the United States

What is XULTOPHY^® 100/3.6?
Xultophy^® 100/3.6 is an injectable prescription medicine that contains 2 diabetes medicines, insulin degludec, 100 units/mL, and liraglutide, 3.6 mg/mL. Xultophy^® 100/3.6 should be used along with diet and exercise to lower blood sugar (glucose) in adults with type 2 diabetes mellitus when blood sugar levels are not well controlled on: 1) basal insulin (less than 50 units daily) or 2) liraglutide (less than or equal to 1.8 mg daily).

• Xultophy^® 100/3.6 is not recommended as the first choice of medicine for treating diabetes.
• It is not known if Xultophy^® 100/3.6 can be used in people who have had pancreatitis.
• Xultophy^® 100/3.6 is not recommended for use in combination with any other product containing liraglutide or another GLP-1 receptor agonist.
• Xultophy^® 100/3.6 is not for use in people with type 1 diabetes or people with diabetic ketoacidosis (increased ketones in the blood or urine).
• It is not known if Xultophy^® 100/3.6 can be used with mealtime insulin.
• It is not known if Xultophy^® 100/3.6 is safe and effective for use in children under 18 years of age.

Important Safety Information
What is the most important information I should know about Xultophy^® 100/3.6?
Xultophy^® 100/3.6 may cause serious side effects, including:

• Possible thyroid tumors, including cancer. Tell your health care provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. In studies with rats and mice, liraglutide, one of the components of Xultophy^® 100/3.6, and medicines that work like liraglutide caused thyroid tumors, including thyroid cancer. It is not known if Xultophy^® 100/3.6 will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people.

Who should not use Xultophy^® 100/3.6? Do not use Xultophy^® 100/3.6 if:

• you or any of your family have ever had MTC or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• you are allergic to insulin degludec, liraglutide, or any of the ingredients in Xultophy^® 100/3.6.
• you are having an episode of low blood sugar.

What should I tell my health care provider before using Xultophy^® 100/3.6 (insulin degludec and liraglutide injection, 100 units/mL and 3.6 mg/mL)?
Tell your health care provider about all your medical conditions, including if you:

• have or have had problems with your pancreas, kidneys, or liver.
• have severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems with digesting food.
• are pregnant or breastfeeding or plan to become pregnant or breastfeed. It is not known if Xultophy^® 100/3.6 passes into your breast milk.

Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Before using Xultophy^® 100/3.6, talk to your health care provider about low blood sugar and how to manage it.

How should I use Xultophy^® 100/3.6?

• Read the Instructions for Use and take Xultophy^® 100/3.6 exactly as your health care provider tells you.
• Do not change your dosing schedule without first talking to your health care provider.
• Do not inject Xultophy^® 100/3.6 into a muscle or vein.
• Use Xultophy^® 100/3.6 at the same time each day with or without food. Do not take more than 50 units of Xultophy^® 100/3.6 each day.
• Check the Pen label each time you give your injection to make sure you are using the correct medication.
• Do not share your Xultophy^® 100/3.6 pen with other people, even if the needle has been changed. You may give other people a serious infection, or get a serious infection from them.
• Check your blood sugar levels. Ask your health care provider what your blood sugar levels should be and when you should check them.

Your dose of Xultophy^® 100/3.6 may need to change because of change in level of physical activity or exercise, weight gain or loss, increased stress, illness, change in diet, or other medicines you take.

What should I avoid while taking Xultophy^® 100/3.6?

• Do not drive or operate heavy machinery, until you know how Xultophy^® 100/3.6 affects you. Do not drink alcohol or use prescription or over-the-counter medicines that contain alcohol.

What are the possible side effects of Xultophy^® 100/3.6?
Xultophy^® 100/3.6 may cause serious side effects that can be life-threatening, including:

• inflammation of your pancreas (pancreatitis). Stop using Xultophy^® 100/3.6 and call your health care provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back.
• low blood sugar (hypoglycemia). Signs and symptoms of low blood sugar may include: shakiness, irritability, fast heartbeat, dizziness, weakness, sweating, confusion, drowsiness, hunger, headache and feeling jittery.
• kidney problems (kidney failure). In people who have kidney problems, diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration) which may cause kidney problems to get worse.
• serious allergic reactions. Stop using Xultophy^® 100/3.6 and get medical help right away, if you have any symptoms of a serious allergic reaction including itching, rash, or difficulty breathing.
• heart failure in some people if taking diabetes medicines called peroxisome proliferator-activated receptor (PPAR) gamma agonists with insulin containing products like Xultophy^® 100/3.6 (insulin degludec and liraglutide injection, 100 units/mL and 3.6 mg/mL). This can happen even if you have never had heart failure or heart problems. If you already have heart failure, it may get worse while you take PPAR agonists with Xultophy^® 100/3.6. Tell your health care provider if you have any new or worse symptoms of heart failure including shortness of breath, tiredness, swelling of your ankles or feet and sudden weight gain.
• low potassium in your blood (hypokalemia).

The most common side effects of Xultophy^® 100/3.6 may include stuffy or runny nose, sore throat, upper respiratory tract infection, increased blood levels of lipase, nausea, diarrhea, and headache.

Please click here for Xultophy^® 100/3.6 Prescribing Information, including Boxed Warning.

About Diabetes
In the United States, more than 29 million people are affected by diabetes.³ Type 2 diabetes accounts for 90 to 95 percent of all diabetes cases.³ Diabetes is emerging as one of the most serious health problems of our time; the number of Americans with diabetes has quadrupled over the past 30 years.⁴

About Novo Nordisk
Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. This heritage has given us experience and capabilities that also enable us to help people defeat other serious chronic conditions: hemophilia, growth disorders and obesity. With U.S. headquarters in Plainsboro, N.J., Novo Nordisk Inc. has nearly 5,000 employees in the United States. For more information, visit novonordisk.us or follow us on Twitter: @novonordiskus.

References

1. Internal calculations based on IMS MIDAS database, March 2017.
2. Xultophy 100/3.6 [package insert]. Plainsboro, NJ: Novo Nordisk Inc; November 2016.
3. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2014. CDC website. http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf. Accessed December 15, 2016.
4. Centers for Disease Control and Prevention. Number (in Millions) of Civilian, Noninstitutionalized Adults with Diagnosed Diabetes, United States, 1980–2014. CDC website. http://www.cdc.gov/diabetes/statistics/prev/national/figpersons.htm. Accessed November 16, 2016.

Tresiba^®, Victoza^®, and Xultophy^® 100/3.6 are registered trademarks of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.
© 2017 Novo Nordisk    All rights reserved.    USA17XUM00843      May 2017

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SOURCE Novo Nordisk