Diabetes
Explore diabetes
Explore obesity
Explore rare bleeding disorders
Explore growth-related disorders
Explore hormone replacement therapy
Medical Information | Non-US Health Care Professionals
Account Settings
Communication Preferences
Sign Out
Sign In | Create Account
  • Diabetes Home
    • Products
      Diabetes Treatments
    • Professional Resources
      Product Resources Library Insulin & Type 1 Diabetes
    • Professional Training
      Insulin Pen Training
  • Sample Requests
    • Diabetes Education
      Clinical Education Library Diabetes Risk Assessment Tool
    • Treatment Guidelines
      ADA Standards of Care AACE Diabetes Guidelines
    • Additional Resources
      Utilizing Your EHR Organizations & Conferences
    • Product Education
      Product Education Materials
    • Disease Education
      Disease Education Library
    • Prescription Savings & Coverage
      Savings Cards Insurance Coverage Affordability Resources
    • Support Program
      Diabetes Management
  • Sign In
    Create Account
    • Account Settings
    • Communication Preferences
    • Sign Out
    Medical Information
    Non-US Health Care Professionals
Tresiba® (insulin degludec) injection 100 U/mL, 200 U/mL logo
Important Safety Information | Patient Site
Prescribing Information
    • How Does Tresiba® Work?
    • Product Profile
    • Tresiba® and Type 1
    • Hear from Your Peers
    • Frequently Asked Questions
    • Type 2 Efficacy and Safety
    • Type 1 Efficacy and Safety
    • Hypoglycemia Facts
    • DEVOTE Study: MACE and Severe Hypoglycemia
    • SWITCH 2 Study: Hypoglycemia Data
    • Starting Adult Patients
    • Starting Pediatric Patients
    • Dose Timing Guidance
    • Tresiba® FlexTouch® and Vial
  • Cost and Coverage
    • Samples
    • Tresiba® Sample Starts
    • Patient Support
    • For Pharmacists
    • Video Library
Tresiba® (insulin degludec) injection 100 U/mL, 200 U/mL logo

Prescribing Information
Important Safety Information | Patient Site

How to start your adult patients on Tresiba® (insulin degludec)

See dosing and titration instructions as well as details about prescribing once-daily Tresiba® and adding it to your EHR.

Tresiba® FlexTouch® U-100 image

Type 2 dosing     |     Type 1 dosing     |     EHR instructions

Type 2 dosing

Type 1 dosing

EHR instructions

Type 2 diabetes dosing for Tresiba®1

Already taking insulin

1:1 CONVERSION

Adults already taking insulin can start on the same unit dose as their current basal insulin

Insulin-naïve

10 units

once daily

Titrate2-4

Below FPG target
-2 units

Within FPG target
0 units

Above FPG target
+2 units

The recommended time between dose increases is 3 to 4 days1

  • Tresiba® was not studied in clinical trials using this algorithm
  • Individualize and titrate the dose of Tresiba® based on the patient’s metabolic needs, blood glucose monitoring results, and glycemic control goal. Dose adjustments may be needed with changes in physical activity, changes in meal patterns, changes in renal or hepatic function, or during acute illness to minimize the risk of hypoglycemia or hyperglycemia1

Type 1 diabetes dosing for Tresiba®1

Already taking insulin

1:1 CONVERSION

Adults already taking insulin can start on the same unit dose as their current basal insulin

Insulin-naïve

CALCULATE

total daily insulin dose (basal + bolus)

0.2 to 0.4
units per 1 kg of body weight

START

initial Tresiba® dose at
1/3 to 1/2 of total daily insulin dose

Titrate2-4

Below FPG target
-2 units

Within FPG target
0 units

Above FPG target
+2 units

The recommended time between dose increases is 3 to 4 days1

  • Tresiba® was not studied in clinical trials using this algorithm
  • Individualize and titrate the dose of Tresiba® based on the patient’s metabolic needs, blood glucose monitoring results, and glycemic control goal. Dose adjustments may be needed with changes in physical activity, changes in meal patterns, changes in renal or hepatic function, or during acute illness to minimize the risk of hypoglycemia or hyperglycemia1

Already taking insulin

1:1 CONVERSION

Adults already taking insulin can start on the same unit dose as their current basal insulin

Insulin-naïve

10 units

once daily

Titrate2-4

Below FPG target
-2 units

Within FPG target
0 units

Above FPG target
+2 units

The recommended time between dose increases is 3 to 4 days1

  • Tresiba® was not studied in clinical trials using this algorithm
  • Individualize and titrate the dose of Tresiba® based on the patient’s metabolic needs, blood glucose monitoring results, and glycemic control goal. Dose adjustments may be needed with changes in physical activity, changes in meal patterns, changes in renal or hepatic function, or during acute illness to minimize the risk of hypoglycemia or hyperglycemia1

Already taking insulin

1:1 CONVERSION

Adults already taking insulin can start on the same unit dose as their current basal insulin

Insulin-naïve

CALCULATE

total daily insulin dose (basal + bolus)

0.2 to 0.4
units per 1 kg of body weight

START

initial Tresiba® dose at
1/3 to 1/2 of total daily insulin dose

Titrate2-4

Based on ADA and AACE guidelines2,3

Below FPG target
-2 units

Within FPG target
0 units

Above FPG target
+2 units

The recommended time between dose increases is 3 to 4 days1

  • Tresiba® was not studied in clinical trials using this algorithm
  • Individualize and titrate the dose of Tresiba® based on the patient’s metabolic needs, blood glucose monitoring results, and glycemic control goal. Dose adjustments may be needed with changes in physical activity, changes in meal patterns, changes in renal or hepatic function, or during acute illness to minimize the risk of hypoglycemia or hyperglycemia1

Guidance for adult patients

What should patients do if they miss a dose of Tresiba®?

Get dose timing guidance

Dosing for pediatric patients

Find out how to prescribe Tresiba® for your pediatric patients 1 year of age and older

See pediatric dosing
Tresiba® Patient Support Brochure
PDF
Share
A link has been copied to your clipboard.

Paste it into your email or chat app to share

Close
Tresiba® Patient Support Brochure
Information for your patients on how Tresiba® works in the body and how to get savings and support.
Download
Prescribing Information | Important Safety Information

Add Tresiba® to your ePrescribing system

Tresiba® FlexTouch® U-100

Tresiba® FlexTouch® U-100 image

Form/strength:

100 units/mL


Quantity per box:

15 mL (5 X 3 mL) 1500 units total


NDC:

0169-2660-15

Tresiba® FlexTouch® U-200

Tresiba® FlexTouch® U-200 image

Form/strength:

200 units/mL


Quantity per box:

9 mL (3 X 3 mL) 1800 units total


NDC:

0169-2550-13

Tresiba® U-100, 10-mL vial

Tresiba® U-100, 10 mL vial

Form/strength:

100 units/mL


Quantity per box:

1 vial (10 mL) 1000 units total


NDC:

0169-2662-11

Prescribing Tresiba®

When sending prescribing information, be sure to specify the right formulation of Tresiba® for your patients:

  • The U-100 pen has a maximum dose of 80 units per injection and is dosed in 1-unit increments
  • The U-200 pen has a maximum dose of 160 units per injection and is dosed in 2-unit increments
  • The U-100 vial holds a volume of 10 mL

Also be sure to include:

Check icon

Starting dose (units per day)

Check icon

Titration information

Check icon

Separate prescription for pen needles (if necessary)

Request samplesa to start patients on Tresiba®

aYou must be a licensed practitioner who can legally prescribe medication in your state. (Request for product samples is limited to 1 request per health care professional.)

Get samples
Request Tresiba® samples

Indications and Usage for Tresiba® (insulin degludec) injection 100 U/mL, 200 U/mL

Tresiba® (insulin degludec) injection is indicated to improve glycemic control in patients 1 year of age and older with diabetes mellitus.

Limitations of Use

Tresiba® is not recommended for treating diabetic ketoacidosis.

Important Safety Information

Contraindications

  • Tresiba® is contraindicated during episodes of hypoglycemia and in patients with hypersensitivity to Tresiba® or one of its excipients

Warnings and Precautions

  • Never Share a Tresiba® FlexTouch® Pen, Needle, or Syringe Between Patients, even if the needle is changed. Patients using Tresiba® vials should never share needles or syringes with another person. Sharing poses a risk for transmission of blood-borne pathogens
  • Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in an insulin regimen (e.g., insulin strength, manufacturer, type, or injection site or method of administration) may affect glycemic control and predispose to hypoglycemia or hyperglycemia. Repeated insulin injections into areas of lipodystrophy or localized cutaneous amyloidosis have been reported to result in hyperglycemia; and a sudden change in the injection site (to an unaffected area) has been reported to result in hypoglycemia. Make any changes to a patient’s insulin regimen under close medical supervision with increased frequency of blood glucose monitoring. Advise patients who have repeatedly injected into areas of lipodystrophy or localized cutaneous amyloidosis to change the injection site to unaffected areas and closely monitor for hypoglycemia. Adjustments in concomitant anti-diabetic treatment may be needed.
  • Hypoglycemia is the most common adverse reaction of insulin, including Tresiba®, and may be life-threatening. Increase monitoring with changes to: insulin dose, co-administered glucose lowering medications, meal pattern, physical activity; and in patients with hypoglycemia unawareness or renal or hepatic impairment
  • Accidental mix-ups between basal insulin products and other insulins, particularly rapid-acting insulins, have been reported. To avoid medication errors, always instruct patients to check the insulin label before each injection
  • Severe, life-threatening, generalized allergy, including anaphylaxis, can occur with insulin products, including Tresiba® 
  • As with all insulins, Tresiba® use can lead to life-threatening hypokalemia, which then may cause respiratory paralysis, ventricular arrhythmia, and death. Closely monitor potassium levels in patients at risk of hypokalemia and treat if indicated
  • Fluid retention and heart failure can occur with concomitant use of thiazolidinediones (TZDs), which are PPAR-gamma agonists, and insulin, including Tresiba®. Patients should be observed for signs and symptoms of heart failure. If heart failure occurs, dosage reduction or discontinuation of the TZD must be considered

Adverse Reactions

  • Adverse reactions commonly associated with Tresiba® are hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema, and weight gain

Drug Interactions

  • There are certain drugs that may cause clinically significant drug interactions with Tresiba®.
    • Drugs that may increase the risk of hypoglycemia: antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), sulfonamide antibiotics, GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT-2 inhibitors
    • Drugs that may decrease the blood glucose lowering effect: atypical antipsychotics (e.g., olanzapine and clozapine), corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (e.g., in oral contraceptives), protease inhibitors, somatropin, sympathomimetic agents (e.g., albuterol, epinephrine, terbutaline), and thyroid hormones
    • Drugs that may increase or decrease the blood glucose lowering effect: alcohol, beta-blockers, clonidine, lithium salts, and pentamidine
    • Drugs that may blunt the signs and symptoms of hypoglycemia: beta-blockers, clonidine, guanethidine, and reserpine

 

Please click here for Tresiba® Prescribing Information.

References:

  1. Tresiba [package insert]. Plainsboro, NJ: Novo Nordisk Inc; November 2019.
  2. Garber AJ, Handelsman Y, Grunberger G, et al. Endocr Pract. 2020;26(1):107-139.
  3. Inzucchi SE, Bergenstal RM, Buse JB, et al. Diabetes Care. 2015;38(1):140-149.
  4. Philis-Tsimikas A, Brod M, Niemeyer M, Ocampo Francisco AM, Rothman J. Adv Ther. 2013;30(6):607-622.
Diabetes
Explore diabetes
Explore obesity
Explore rare bleeding disorders
Explore growth-related disorders
Explore hormone replacement therapy
  • Diabetes Home
  • Product Information
    Products
    • Diabetes Treatments
    Professional Resources
    • Product Resources Library
      Insulin & Type 1 Diabetes
    Professional Training
    • Insulin Pen Training
  • Sample Requests
  • Professional Education
    Diabetes Education
    • Clinical Education Library
      Diabetes Risk Assessment Tool
    Treatment Guidelines
    • ADA Standards of Care
      AACE Diabetes Guidelines
    Additional Resources
    • Utilizing Your EHR
      Organizations & Conferences
  • Patient Support
    Product Education
    • Product Education Materials
    Disease Education
    • Disease Education Library
    Prescription Savings & Coverage
    • Savings Cards
      Insurance Coverage
      Affordability Resources
    Support Program
    • Diabetes Management

Cornerstones4Care®, FlexTouch®, Levemir®, NovoFine®, NovoLog®, PenFill®, and Tresiba® are registered trademarks and novoMEDLINK™ is a trademark of Novo Nordisk A/S.

Novo Nordisk is a registered trademark of Novo Nordisk A/S.

All other trademarks, registered or unregistered, are the property of their respective owners.

Non-US Health Care Professionals, please go to www.novonordiskpro.com.

Legal Notice | Privacy Policy | Cookie Policy | Contact Us |
novonordisk-us.com    
© 2022 Novo Nordisk All rights reserved. US21TSM00200 January 2022

Quick links

Request medication samples

Diabetes treatment guidelines

Patient savings card offer

Patient support program