Long-acting insulin + GLP-1 agonist
Insulin degludec with liraglutide
Brand names: Xultophy
Adult dose
Dose: Initial 16 dose-steps OD (16 units degludec + 0.6mg liraglutide); titrate; max 50 dose-steps
Route: SC
Frequency: OD
Clinical pearls
- Type 2 DM uncontrolled on basal insulin or GLP-1 alone (NICE NG28)
- One injection daily, fixed ratio
Contraindications
- Personal/family hx medullary thyroid carcinoma or MEN2
- Pregnancy
- Severe GI disease
Side effects
- Hypoglycaemia
- Nausea (liraglutide)
- Pancreatitis
- Cholelithiasis
Interactions
- Insulin secretagogues (hypoglycaemia)
- β-blockers
Monitoring
- HbA1c
- Weight
- Pancreatic symptoms
Reference: BNF; NICE NG28; https://bnf.nice.org.uk/drugs/insulin-degludec-with-liraglutide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016