Tresiba is a prescription brand-name medication. It’s approved by the Food and Drug Administration (FDA) to manage blood sugar levels in people with type 1 or type 2 diabetes. Tresiba can be used in adults as well as children ages 1 year and older. This drug is usually prescribed long-term.

It’s important to note that Tresiba isn’t approved for treating diabetic ketoacidosis, a possible serious complication of diabetes.

Here are some fast facts about Tresiba:

Like other drugs, Tresiba can cause side effects. Read on to learn about potential common, mild, and serious side effects. For a general overview of Tresiba, see this article.

Tresiba can cause side effects, some of which are more common than others. These effects may be temporary, lasting a few days or weeks. If any side effect lasts longer than that, bothers you, or becomes severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Tresiba in clinical studies:

Below are some of the rarer side effects reported in clinical studies of Tresiba:

  • allergic reaction
  • lipodystrophy (skin thickening or pitting around the injection site)
  • peripheral edema (see “Side effect specifics” below)
  • weight gain (see “Side effect specifics” below)

Tresiba can cause mild side effects. This list doesn’t include all possible mild side effects reported with the drug. For more information, you can refer to Tresiba’s drug label information.

Mild side effects of Tresiba can include:

  • lipodystrophy (skin thickening or pitting around the injection site)
  • reactions at the injection site, such as redness, swelling, itchiness, or pain
  • nasopharyngitis (swelling of your nasal passages and the back of your throat)
  • upper respiratory infections, such as the common cold
  • headache
  • stomach problems, such as diarrhea or symptoms similar to those of the stomach flu
  • peripheral edema (see “Side effect specifics” below)
  • weight gain (see “Side effect specifics” below)

These side effects may be temporary, lasting a few days or weeks. But if any side effect lasts longer than that, bothers you, or becomes severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while using Tresiba and want to tell the FDA about it, visit MedWatch.

Rarely, Tresiba may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Tresiba’s drug label information.

If you develop serious side effects while using Tresiba, call your doctor right away. If the side effects seem life threatening, or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects of Tresiba and their symptoms can include:

  • Hypokalemia (having too little potassium in your blood). Symptoms can include:
    • constipation
    • feeling thirsty
    • muscle cramps or twitches
    • urinating more often than usual
  • Severe hypoglycemia (low blood sugar).
  • Allergic reaction.

For more information about severe hypoglycemia and allergic reaction, see “Side effect specifics” below.

Children who use Tresiba experience similar side effects as adults who use the medication. Children may be more likely to have problems with hypoglycemia (low blood sugar), however.

In clinical studies, children with type 1 diabetes who took Tresiba had more episodes of severe hypoglycemia than adults. Severe hypoglycemia means having very low blood sugar levels.

For more information about severe hypoglycemia, see the “Side effect specifics” section below.

Tresiba may cause several side effects. Here are some frequently asked questions about these side effects and the answers.

Is hair loss a side effect of Tresiba?

No, hair loss wasn’t a reported side effect of Tresiba in clinical studies. And it hasn’t been reported as a side effect since the drug was approved.

If you’re experiencing hair loss that bothers you while using Tresiba, talk with your doctor or pharmacist. They can review your medications to see if any could be the cause. Your doctor may also suggest treatment for your hair loss.

Can Tresiba cause eye problems?

No, Tresiba doesn’t cause eye problems as a side effect.

However, blurry vision can be a symptom of hypoglycemia (low blood sugar levels). And hypoglycemia is the most common side effect of all insulins, including Tresiba.

If you have blurry vision while using Tresiba, it may be a sign of hypoglycemia. Before using the drug, your doctor may describe what to do if you develop hypoglycemia symptoms, including blurry vision. You can also learn more about the symptoms and treatment of hypoglycemia in the “Side effect specifics” section below.

While using Tresiba, if you experience blurry vision that you think might not be caused by hypoglycemia, talk with your doctor. They’ll work with you to determine the cause and the best way to treat your blurry vision.

Can stomach pain be related to Tresiba use?

It’s possible. In clinical studies of Tresiba, gastroenteritis was a relatively common side effect in people with type 1 diabetes. Gastroenteritis refers to inflammation in your intestines. This can cause stomach pain and symptoms similar to those of the stomach flu.

Also, diarrhea was a somewhat common side effect in people with type 2 diabetes who took Tresiba in clinical studies, and diarrhea and stomach pain sometimes happen together.

Mild stomach pain may go away on its own after a few days. But if you experience stomach pain that’s severe or bothers you, talk with your doctor. They may want to examine you to determine the possible causes of your pain, and they may prescribe medication or another treatment for it. The doctor may also decide to have you stop using Tresiba and try a different drug for your diabetes.

Will using Tresiba affect my heart rate?

Tresiba doesn’t usually affect people’s heart rates.

But rarely, hypokalemia (having too little potassium in your blood) can be a side effect of Tresiba. Hypokalemia may cause heart palpitations (a fast or irregular heart rate).

Heart palpitations can also be a symptom of hypoglycemia (low blood sugar levels). Hypoglycemia is the most common side effect of all insulins, including Tresiba.

Most cases of hypoglycemia and hypokalemia from using Tresiba aren’t serious. However, these side effects can become severe in rare cases. For this reason, talk with your doctor immediately if you experience changes in your heart rate while using Tresiba.

Your doctor can help determine if your symptoms are mild or serious. And they can recommend the best way to treat both your side effects and your diabetes. This may include changing your Tresiba dosage or having you switch to a different medication.

Learn more about some of the side effects that Tresiba may cause.

Weight gain

Weight gain is a possible side effect of Tresiba. Weight gain was common, compared with other side effects that people experienced in clinical studies of the drug.

However, most people using Tresiba in these studies didn’t report weight gain, and the weight gain reported was mild. On average, people with type 1 diabetes gained about 4 pounds (lb), and people with type 2 diabetes gained about 6.5 lb. Four pounds is about 1.8 kilograms (kg), and 6.5 lb is about 3 kg.

Weight gain may also result from peripheral edema, another possible side effect of Tresiba. See “Swelling in your hands, feet, or lower legs” below for more information about peripheral edema.

Note: Certain medications may cause peripheral edema, weight gain, and rarely, heart failure when used in combination with Tresiba. For more information, see the “Precautions for Tresiba” section near the end of this article.

What you can do

While using Tresiba, you should continue to follow the diet your doctor recommends for managing diabetes. They may suggest that you monitor your weight. If you notice weight gain that bothers or concerns you, talk with your doctor. They can suggest ways to help you stay at a healthy weight. They may also have you stop using Tresiba and try a different medication for your diabetes.

Tell your doctor and pharmacist about all the medications you take before you begin Tresiba treatment. They’ll review the drugs for any possible interactions, including those that could cause weight gain.

Hypoglycemia

Hypoglycemia (low blood sugar levels) is the most common side effect of all insulins, including Tresiba. This isn’t a surprising side effect of the drug because it is used to help people with diabetes manage their blood sugar levels.

Rarely, blood sugar levels can become too low, causing severe hypoglycemia. This is rare with Tresiba use, but it can require hospitalization if it isn’t treated right away.

What you can do

Watch for symptoms of hypoglycemia while using Tresiba. These may include:

  • anxiety
  • confusion
  • dizziness
  • headache
  • shakiness

If you notice symptoms of hypoglycemia, check your blood sugar right away. If you’re unable to check your blood sugar, you should treat yourself anyway, just in case. Treating yourself right away can help prevent hypoglycemia from becoming severe.

You can treat mild low blood sugar by eating or drinking something with at least 15 grams (g) of glucose (simple sugar) in it. Examples include:

  • 1 tablespoon of sugar or honey
  • ½ cup of fruit juice, such as orange or apple juice
  • ½ cup of non-diet soda (it’s important that the soda contains at least 15 g of sugar)
  • 3 to 4 glucose tablets, which can be purchased at a pharmacy

Keep in mind that a diet soda or sugar-free candy will not treat hypoglycemia.

After having something to eat or drink, check your blood sugar again in 15 minutes. If it’s still low, you may need more glucose.

If you develop severe hypoglycemia, call 911 or your local emergency number. Or have someone drive you to an emergency room. You shouldn’t drive a car while you have hypoglycemia.

Swelling in your hands, feet, or lower legs

It’s possible that using Tresiba could cause peripheral edema. This refers to swelling in your hands, feet, or lower legs due to fluid retention (problems maintaining fluid levels).

In clinical studies, peripheral edema was more common than some other side effects. It was more likely to occur in people with type 2 diabetes than people with type 1 diabetes. But most people using Tresiba in these studies didn’t experience peripheral edema.

Note: Certain medications may cause peripheral edema, weight gain, and rarely, heart failure when used in combination with Tresiba. For more information, see the “Precautions for Tresiba” section near the end of this article.

What you can do

While using Tresiba, watch for any symptoms of fluid retention, such as swelling. This type of swelling most commonly occurs in your hands, feet, and lower legs, particularly your ankles.

If you notice swelling, talk with your doctor. They may want to examine you to determine the cause. Your doctor may recommend a medication to treat this side effect or advise you to stop using Tresiba and try a different medication for your diabetes.

Tell your doctor and pharmacist about all the medications you take before you begin Tresiba treatment. They’ll review your medications for any possible interactions, including those that could cause peripheral edema.

Reactions at the injection site

Tresiba is given by subcutaneous injection. These types of drugs can sometimes cause reactions at the place where they’re injected. The reactions can include:

  • itchy skin
  • pain
  • redness
  • swelling

In clinical studies of Tresiba, injection site reactions were some of the more common side effects. But most people using Tresiba didn’t report injection site reactions.

What you can do

For each dose of Tresiba, change the spot you use for the injection. Tresiba may be injected under the skin of the abdomen, triceps (upper arm), or thigh. Switching your injection site on a rotating basis may help minimize or prevent these reactions.

Keep in mind that injection site reactions are often mild and usually go away within a few hours or days.

But if you experience reactions that bother you or don’t go away, talk with your doctor. They may want to examine the area to determine if the cause is your Tresiba injection or something else. Depending on their findings, they may suggest that you switch from Tresiba to a different diabetes medication.

Allergic reaction

Like most drugs, Tresiba can cause an allergic reaction in some people. This was rare in clinical studies of the drug. Symptoms can be mild or serious and can include:

  • rash
  • itching
  • flushing (warmth, swelling, or redness in your skin)
  • swelling under your skin, typically in your lips, eyelids, feet, or hands
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

Even if symptoms of an allergic reaction are mild, call your doctor right away because the reaction could become severe. They may recommend ways to ease your symptoms and determine whether you should keep using Tresiba. But if your symptoms are serious, and you think it’s a medical emergency, immediately call 911 or your local emergency number.

Be sure to talk with your doctor about your health history before you use Tresiba. It may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Heart failure. If you have heart failure, taking certain type 2 diabetes drugs with Tresiba may worsen your heart failure symptoms. These drugs are called thiazolidinediones. Examples include pioglitazone (Actos) and rosiglitazone (Avandia).

Before using Tresiba, tell your doctor if you have heart failure. Also, make sure your doctor and pharmacist are aware of all the medications you take.

If your heart failure symptoms get worse while using Tresiba, your doctor may have you stop taking your thiazolidinedione drug. And they may have you use a different medication for your diabetes while you’re using Tresiba.

Kidney or liver disease. People with kidney or liver problems may have a higher risk for hypoglycemia while using Tresiba. Before using this drug, let your doctor know if you have a history of kidney or liver problems. They can recommend ways to help prevent hypoglycemia.

Hypokalemia. Tresiba may cause hypokalemia. If you already have hypokalemia, using Tresiba may make this condition worse. Tell your doctor if you have hypokalemia or have had it in the past. They may want to monitor your potassium levels while you’re using Tresiba.

Allergic reaction. You shouldn’t use Tresiba if you’ve ever had an allergic reaction to the drug or any of its ingredients. Talk with your doctor about what other treatments are better choices for you.

Alcohol use with Tresiba

Tresiba and alcohol each can lower your blood sugar levels. Drinking alcohol while using Tresiba may increase your risk for hypoglycemia (low blood sugar levels).

If you drink alcohol, talk with your doctor before using Tresiba. They can determine how much alcohol, if any, is safe. Also, your doctor may recommend that you monitor your blood sugar levels more closely if you drink alcohol.

Pregnancy and breastfeeding while taking Tresiba

It’s unclear whether Tresiba is safe to use while pregnant. The drug hasn’t been studied in pregnant people.

Animal studies of Tresiba use during pregnancy have shown that the drug has effects similar to those of normal human insulin. This means that no harmful effects of Tresiba were seen in these studies. However, animal studies don’t always reflect what will happen in people.

That said, the American Diabetes Association still recommends insulin as the preferred treatment during pregnancy in people with type 1 or type 2 diabetes.

Insulin, including Tresiba, is generally considered safe to use while breastfeeding. Because insulin cannot be absorbed from your digestive tract into your bloodstream, using insulin while nursing can’t affect a breastfed child.

Side effects can occur while using Tresiba, but they’re usually mild. Most mild side effects of the drug go away with time and don’t require medical attention.

It’s important to note that Tresiba may be used on its own to treat type 1 or type 2 diabetes. Or, it may be used in combination with other drugs. Some side effects of other diabetes drugs and Tresiba overlap, but the drugs can cause different side effects, as well. Your doctor or pharmacist can help explain the similarities and differences in the side effects that you may expect from each drug.

The most common side effects from Tresiba treatment include:

Talk with your doctor if you experience symptoms of:

  • severe hypoglycemia
  • peripheral edema (swelling in your hands, feet, or lower legs)
  • vision changes that don’t seem to be caused by low blood sugar, such as blurry vision
  • changes in your heart rate

These could be symptoms of serious side effects and may require medical attention. It’s also important to note that Tresiba isn’t approved for treating diabetic ketoacidosis, a possible serious complication of diabetes.

If you’d like to learn more about Tresiba, talk with your doctor or pharmacist. They can help answer any questions about the side effects of the drug.

Note: For more information about diabetes, see Medical News Today’s other diabetes articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.