Tresiba is a brand-name prescription medication. It’s FDA-approved to help manage blood sugar levels in adults and in children ages 1 year and older with type 1 or type 2 diabetes.

Tresiba is taken once a day by subcutaneous injection (an injection under the skin). It comes as a liquid solution that can be given in two ways:

  • From a vial that’s used with syringes. The 10-mL vial holds 100 units of insulin per mL of solution.
  • From disposable prefilled injection pens called FlexTouch pens. These 3-mL pens come in two strengths: 100 units of insulin per mL of solution, and 200 units of insulin per mL of solution.

Note: Tresiba isn’t approved to treat diabetic ketoacidosis (DKA), which is a possible complication of diabetes. For more information about DKA, see the “Common questions about Tresiba” section below.

Tresiba’s insulin type

Tresiba contains the active drug insulin degludec, which is a long-acting insulin. Long-acting insulins work steadily throughout the day to help manage your blood sugar between meals and overnight.

Tresiba’s effectiveness

For information on the effectiveness of Tresiba, see the “Tresiba for diabetes” section below.

Tresiba contains the active drug insulin degludec. It’s available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Tresiba can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Tresiba. These lists do not include all possible side effects.

For more information on the possible side effects of Tresiba, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Tresiba, you can do so through MedWatch.

Mild side effects

The mild side effects of Tresiba that are more common* can include:

The mild side effects of Tresiba that are less common‡ can include:

  • injection site reactions, such as pain, redness, itchiness, or swelling around the area of your injection
  • lipodystrophy (skin thickening or pitting around the injection site)
  • swelling in your legs, feet, or ankles

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* These side effects occurred in at least 5% of people in clinical studies.
† For more information about this side effect, see the “Side effect details” section below.
‡ This side effect occurred in less than 5% of people in clinical studies.

Serious side effects

Serious side effects from Tresiba aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects are explained in “Side effect details” below. These include:

Side effects in children

The side effects of Tresiba in children are similar to those experienced by adults taking this drug. However, children may have more problems with low blood sugar levels.

In clinical studies of type 1 diabetes, episodes of severe hypoglycemia (very low blood sugar levels) were more common in children than in adults. During 1 year of taking Tresiba, 17.8% of children had at least one episode of severe hypoglycemia, compared with 12.3% of adults. (See “Side effect details” below for more information about hypoglycemia.)

Side effect details

You may wonder how often certain side effects occur with this drug. Here’s some detail on several of the side effects this drug may cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Tresiba. It’s not known how often people using Tresiba have allergic reactions to the drug. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth and redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing or speaking

Call your doctor right away if you have a severe allergic reaction to Tresiba. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight gain or weight loss

Some people taking Tresiba may gain weight. In fact, weight gain is a common side effect of all insulins. It happens because of the way insulin works in your body. Insulin helps your liver, muscles, and fat cells remove excess sugar from your blood and store it for future use. Over time, this can lead to some weight gain.

In clinical studies, people with type 1 diabetes gained an average of 4 pounds (1.8 kilogram) over 1 year of taking Tresiba. People with type 2 diabetes gained an average of 6.6 lb (3 kg) over 1 year.

If you’re concerned about weight gain while using Tresiba, talk with your doctor. They can suggest diet and exercise tips to help you maintain a healthy weight.

If you’re taking Tresiba with a type of diabetes drug called a thiazolidinedione, see your doctor right away if you suddenly gain a lot of weight. This could be a symptom of heart failure, which is a possible side effect of taking Tresiba with a thiazolidinedione. Examples of thiazolidinediones include pioglitazone (Actos) and rosiglitazone (Avandia). See the “Tresiba interactions” section below for more information.

Weight loss wasn’t reported in clinical studies of Tresiba. See your doctor if you lose weight unexpectedly while taking Tresiba. They might want to look into the cause of any unexpected weight loss. And they might also need to lower your dosage of Tresiba.

Side effects on eyes

Tresiba does not cause side effects on eyes. However, diabetes itself can lead to eye problems.

You’re more likely to get eye problems if your blood sugar levels are not well controlled for a long period of time. That’s because uncontrolled blood sugar can damage the blood vessels in your eyes. This can lead to problems such as cataracts, glaucoma, and diabetic retinopathy (damage to the retina in the back of your eye). If you have diabetes, you should have regular eye exams to check for these types of problems.

Although Tresiba doesn’t affect your eyes, you may get blurry vision if you have hypoglycemia (low blood sugar) while taking it. See the section below for more information.

Hypoglycemia

Hypoglycemia (low blood sugar level) is the most common side effect of all insulin medications, including Tresiba.

Because your blood sugar levels can be affected by many different factors, it’s hard to say how likely this side effect is with Tresiba. For example, you’re more likely to get low blood sugar if you skip meals or do more physical activity than usual.

It’s important to note that making changes to your insulin treatment plan could increase your risk for both hypoglycemia (low blood sugar levels) and hyperglycemia (high blood sugar levels). This includes making changes such as taking a new dosage of insulin or using a new insulin product. It also includes administering your insulin differently than you usually do or injecting the drug into areas of skin that are thickened or pitted.

Study results

These clinical studies looked at people during 1 year of taking Tresiba:

  • In one clinical study of type 1 diabetes, 12.3% of adults had at least one episode of severe hypoglycemia.
  • In a clinical study of type 2 diabetes, 0.3% of adults had at least one episode of severe hypoglycemia. These people hadn’t taken insulin before and were also using up to two other diabetes medications taken by mouth.
  • In another clinical study of type 2 diabetes, 4.5% of adults had at least one episode of severe hypoglycemia. These people were also taking insulin aspart (Fiasp, NovoLog), and up to two other diabetes medications taken by mouth.

Symptoms of hypoglycemia

The symptoms of low blood sugar can vary from person to person. You may also find that your symptoms change over time. However, typical early symptoms of low blood sugar can include:

Symptoms of more severe hypoglycemia can include:

  • weakness
  • trouble concentrating
  • confusion
  • slurred speech
  • irrational or argumentative behavior
  • coordination problems (such as trouble walking)

If low blood sugar isn’t corrected, it can quickly become serious. It could lead to seizures, coma, and even death.

If you start to get symptoms of low blood sugar, eat or drink something with glucose (not diet soda or diet items) that will quickly raise your blood sugar level. Talk with your doctor about how to manage episodes of low blood sugar. Also talk with them about how to prevent low blood sugar while you’re taking Tresiba. In addition, you should know what your blood sugar level should be and how often you should test it.

Hypokalemia

Hypokalemia is a low level of potassium in your blood. It’s a possible side effect of all insulins, including Tresiba, although it’s rare. It’s not known how often it occurs with Tresiba.

Symptoms of hypokalemia can include:

  • muscle weakness
  • fatigue (lack of energy)
  • muscle cramps or twitching
  • constipation
  • urinating more often than usual
  • feeling thirsty
  • irregular heartbeat

See your doctor if you get any of these symptoms. They may want to take a blood test to check your potassium level.

The Tresiba dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of your diabetes
  • your body weight
  • your blood sugar level goals
  • how well your blood sugar has been managed in the past
  • your past insulin dosages (if you’ve used insulin before)

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. There’s no maximum dose (max dose) for insulin. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

Your Tresiba dosage may sometimes need to be adjusted. Your insulin requirement can change if you alter your usual diet or the amount of physical activity you do. It can also change during times of emotional stress or if you get sick, especially with an infection or fever. Talk with your doctor about whether you’ll need to make any changes to your Tresiba dose.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Note: Making changes to your insulin treatment plan could increase your risk for both hypoglycemia (low blood sugar levels) and hyperglycemia (high blood sugar levels). This includes making changes such as taking a new dosage of insulin or using a new insulin product. It also includes administering your insulin differently than you usually do or injecting the drug into areas of skin that are thickened or pitted.

If your doctor recommends changes to your Tresiba dosage, they’ll likely have you monitor your blood sugar levels more often than usual. This allows you to monitor for hypoglycemia and hyperglycemia.

Drug forms and strengths

Tresiba is taken by subcutaneous injection (an injection under the skin). It’s injected into the thigh, abdomen (belly), or upper arm.

Tresiba comes as a prefilled injection pen that’s available in two strengths. It also comes as a liquid solution that’s available in one strength:

  • Tresiba FlexTouch disposable prefilled pen (100 units/mL). This pen contains 3 mL of drug solution, so it contains a total of 300 units of insulin degludec. It can deliver up to 80 units of insulin degludec with one injection.
  • Tresiba FlexTouch disposable prefilled pen (200 units/mL). This pen contains 3 mL of drug solution, so it contains a total of 600 units of insulin degludec. It can deliver up to 160 units of insulin degludec with one injection.
  • Tresiba multidose vial (100 units/mL). The vial contains 10 mL of drug solution, so it contains a total of 1,000 units of insulin degludec. You should use a U-100 insulin syringe to measure a dose of Tresiba from the vial.

Dosage for type 1 diabetes

Recommended dosages of Tresiba for type 1 diabetes are described in the following dosage chart:

Recommended dose of TresibaHow often it’s taken
For adults and children ages 1 year and older not already using insulin:Your doctor will calculate your total daily insulin dose based on your body weight. Your starting dose of Tresiba will be one-half to one-third of your total daily insulin dosage.Once each day.
For adults already using insulin:Your starting dose of Tresiba will usually be the same as the total unit dose of intermediate or long-acting insulin that you’re already using.Once each day.
For children already using insulin:Your starting dose of Tresiba will be about 80% of the total unit dose of intermediate or long-acting insulin that you’re already using.Once each day.

It’s important to note that adults can take Tresiba at any time each day, but children should always stick to the same time. And the rest of your total daily insulin dosage will typically be taken using a short-acting insulin that you inject at mealtimes.

Dosage for type 2 diabetes

Recommended dosages of Tresiba for type 2 diabetes are described in the following dosage chart:

Recommended dose of TresibaHow often it’s taken
For adults and children ages 1 year and older not already using insulin:*10 units.Once each day.
For adults already using insulin:Your starting dose of Tresiba will usually be the same as the total unit dose of intermediate or long-acting insulin that you’re already using.Once each day.
For children already using insulin:Your starting dose of Tresiba will be about 80% of the total unit dose of intermediate or long-acting insulin that you’re already using.Once each day.

It’s important to note that adults can take Tresiba at any time each day, but children should always stick to the same time. And the rest of your total daily insulin dosage will typically be taken using a short-acting insulin that you inject at mealtimes.

Pediatric dosage

See above for pediatric dosage of Tresiba for type 1 and type 2 diabetes. Children should always take their Tresiba dose at the same time each day.

For children who need a Tresiba dose of fewer than 5 units per day, a Tresiba vial should be used.

What if I miss a dose?

If you forget to take a dose of Tresiba, take it as soon as you remember. Then take your next regular dose as scheduled. Just make sure there are always at least 8 hours between your Tresiba doses. Never take two doses together to make up for a missed dose.

If a child doesn’t take their dose of Tresiba at the usual time, contact their doctor for advice. The child’s blood sugar levels might need to be checked more often than usual until their next dose of Tresiba is due.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Will I need to use this drug long term?

Tresiba is meant to be used as a long-term treatment. If you and your doctor determine that Tresiba is safe and effective for you, you’ll likely take it long term.

Other long-acting insulins are available. Some may be a better fit for you than others. If you’re interested in finding an alternative to Tresiba, talk with your doctor. They can tell you about other medications that may work well for you.

Examples of other long-acting insulins that may be used in people with diabetes include:

Tresiba vs. Basaglar

Like Tresiba, Basaglar is FDA-approved to improve management of blood sugar levels in people with type 1 and type 2 diabetes.

Tresiba is approved for use in adults and in children ages 1 year and older. For type 1 diabetes, Basaglar is approved for use in adults and in children ages 6 years and older. For type 2 diabetes, it’s only approved for use in adults.

Tresiba contains insulin degludec, and Basaglar contains insulin glargine. Both drugs are taken by subcutaneous injection (an injection under the skin).

Both Tresiba and Basaglar are typically taken once a day. Tresiba works for up to 42 hours, and Basaglar works for up to 24 hours.

You may wonder how Tresiba compares with other medications that are prescribed for similar uses. Here we look at how Tresiba and Lantus are alike and different. (See the “Alternatives to Tresiba” section below for information about other alternative treatment options to Tresiba.)

Ingredients

Tresiba contains insulin degludec, and Lantus contains insulin glargine.

Uses

Tresiba and Lantus are both FDA-approved to improve management of blood sugar levels in people with type 1 and type 2 diabetes.

Tresiba is approved for use in adults and in children ages 1 year and older. For type 1 diabetes, Lantus is approved for use in adults and in children ages 6 years and older. For type 2 diabetes, it’s only approved for use in adults.

Both of these drugs are long-acting insulins. They work steadily throughout the day to help manage your blood sugar between meals and overnight. Lantus works for 24 hours, and Tresiba works for up to 42 hours.

Drug forms and administration

Tresiba and Lantus both come as vials that are used with syringes. They also both come as disposable prefilled injection pens. The Tresiba pen is call FlexTouch, and the Lantus pen is called SoloStar.

Both drugs are taken by subcutaneous injection (an injection under the skin). They’re typically taken once a day.

Side effects and risks

Tresiba and Lantus are both long-acting insulins. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

Mild side effects

Examples of mild side effects that can occur with both Tresiba and Lantus (when taken individually) include:

  • hypoglycemia (low blood sugar levels)
  • upper respiratory infections, such as the common cold
  • flu-like symptoms (vomiting, chills, fever, abdominal cramps)
  • headache
  • injection site reactions, such as pain, redness, itchiness, or swelling around the area of your injection
  • lipodystrophy (skin thickening or pitting around the injection site)
  • weight gain
  • swelling in your legs, feet, or ankles

Serious side effects

Examples of serious side effects that can occur with both Tresiba and Lantus (when taken individually) include:

Effectiveness

Tresiba and Lantus are both FDA-approved to help manage blood sugar levels in people with type 1 and type 2 diabetes.

The use of Tresiba and Lantus in treating type 1 and type 2 diabetes has been directly compared in several clinical studies. In a review of these studies, Tresiba and insulin glargine (the type of insulin in Lantus) were found to be equally effective at improving blood sugar levels in adults and in children with type 1 or type 2 diabetes.

However, the review found that adults and children with type 1 diabetes who took Tresiba were 32% less likely to have hypoglycemia (low blood sugar levels) at night compared with those taking Lantus. People with type 2 diabetes who took Tresiba were 27% less likely to have hypoglycemia at night compared with those who took Lantus. People with type 2 diabetes who were taking Tresiba were also less likely to have episodes of severe hypoglycemia than those taking Lantus.

Costs

Tresiba and Lantus are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Tresiba is significantly more expensive than Lantus. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

You may wonder how Tresiba compares with other medications that are prescribed for similar uses. Here we look at how Tresiba and Toujeo are alike and different.

Ingredients

Tresiba contains insulin degludec, and Toujeo contains insulin glargine.

Uses

Tresiba and Toujeo are both FDA-approved to help manage blood sugar levels in people with type 1 and type 2 diabetes.

Tresiba is approved for use in adults and in children ages 1 year and older. Toujeo is approved for use in adults and in children ages 6 years and older.

Both of these drugs are long-acting insulins. They work steadily throughout the day to help manage your blood sugar between meals and overnight. Toujeo works for up to 36 hours, and Tresiba works for up to 42 hours.

Drug forms and administration

Tresiba and Toujeo are both given by subcutaneous injection (an injection under the skin). They’re typically taken once a day.

Side effects and risks

Tresiba and Toujeo are both long-acting insulins. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

Mild side effects

Examples of mild side effects that can occur with both Tresiba and Toujeo (when taken individually) include:

  • hypoglycemia (low blood sugar levels)
  • upper respiratory infections, such as the common cold
  • flu-like symptoms (vomiting, chills, fever, abdominal cramps)
  • injection site reactions, such as pain, redness, itchiness, or swelling around the area of your injection
  • lipodystrophy (skin thickening or pitting around the injection site)
  • weight gain
  • swelling in your legs, feet, or ankles
  • headache

Serious side effects

Examples of serious side effects that can occur with both Tresiba and Toujeo (when taken individually) include:

Effectiveness

Tresiba and Toujeo are both FDA-approved to help manage blood sugar levels in people with type 1 and type 2 diabetes.

The use of Tresiba and Toujeo in treating type 1 and type 2 diabetes has been directly compared in several clinical studies.

One study of type 2 diabetes found Tresiba and Toujeo to be equally effective at improving blood sugar levels. This study found that people who took Toujeo were less likely to have hypoglycemia than people who took Tresiba. This included hypoglycemia at night, as well as episodes of severe hypoglycemia.

Another study of type 2 diabetes found Tresiba and Toujeo to be similarly effective at lowering people’s hemoglobin A1c (HbA1c) over 6 months. (HbA1c is a measurement that shows your average blood sugar levels over the past few months.) Hypoglycemia occurred less often with Toujeo than with Tresiba when these medications were first started and dosages were being increased (when the risk of hypoglycemia may be higher).

A review of studies involving people with type 2 diabetes found Tresiba and Toujeo to be similarly effective at improving blood sugar. This review found that Toujeo might be less likely to cause weight gain than Tresiba.

Costs

Tresiba and Toujeo are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Tresiba may cost more than Toujeo. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Tresiba and Levemir are prescribed for similar uses. Here’s a look at how these drugs are alike and different.

Ingredients

Tresiba contains insulin degludec, and Levemir contains insulin detemir.

Uses

Tresiba and Levemir are both FDA-approved to help manage blood sugar levels in people with type 1 and type 2 diabetes.

Tresiba is approved for use in adults and in children ages 1 year and older. Levemir is approved for use in adults and in children ages 2 years and older.

Both these drugs are long-acting insulins. They work steadily throughout the day to help manage your blood sugar between meals and overnight. Levemir works for up to 24 hours, and Tresiba works for up to 42 hours.

Drug forms and administration

Tresiba and Levemir are both given by subcutaneous injection (an injection under the skin). They’re typically taken once a day.

Side effects and risks

Tresiba and Levemir both contain a form of long-acting insulin. Therefore, these medications can cause very similar side effects. Below are examples of these side effects.

Mild side effects

Examples of mild side effects that can occur with both Tresiba and Levemir (when taken individually) include:

  • hypoglycemia (low blood sugar level)
  • upper respiratory infections, such as the common cold
  • flu-like symptoms (vomiting, chills, fever, abdominal cramps)
  • headache
  • injection site reactions, such as pain, redness, itchiness, or swelling around the area of your injection
  • lipodystrophy (skin thickening or pitting around the injection site)
  • weight gain
  • swelling in your legs, feet, or ankles

Serious side effects

Examples of serious side effects that can occur with both Tresiba and Levemir (when taken individually) include:

Effectiveness

Tresiba and Levemir are both FDA-approved to help manage blood sugar levels in people with type 1 and type 2 diabetes.

The use of Tresiba and Levemir in treating type 1 and type 2 diabetes has been directly compared in several clinical studies. In a review of these studies, Tresiba and Levemir were found to be equally effective at improving blood sugar levels in adults and children with type 1 or type 2 diabetes.

The review found that people with type 1 diabetes who took Levemir gained about 2.2 fewer lb (1 fewer kg) than those who took Tresiba.

Costs

Tresiba and Levemir are both brand-name drugs. There are currently no generic forms of either drug. Brand-name medications usually cost more than generics.

According to estimates on GoodRx.com, Tresiba and Levemir generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

As with all medications, the cost of Tresiba can vary. To find current prices for Tresiba in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Your insurance plan may require you to get prior authorization before approving coverage for Tresiba. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the request and let you and your doctor know if your plan will cover Tresiba.

If you’re not sure if you’ll need to get prior authorization for Tresiba, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Tresiba, or if you need help understanding your insurance coverage, help is available.

Novo Nordisk, the manufacturer of Tresiba, offers assistance in checking your insurance coverage of the drug. For more information, visit the program website.

The manufacturer of Tresiba also offers a savings card that can help lower the cost of the drug. This card can be used by people with commercial health insurance. For more information about this cost savings card, call 877-304-6852 or visit the program website.

If you don’t have commercial health insurance, you may be able to find cost assistance for Tresiba through the Novo Nordisk Patient Assistance Program. For more information about this assistance, visit the program website.

The Food and Drug Administration (FDA) approves prescription drugs such as Tresiba to treat certain conditions. Tresiba is FDA-approved to treat both type 1 and type 2 diabetes.

Tresiba for type 1 diabetes

Tresiba is FDA-approved to help manage blood sugar levels in adults and in children ages 1 year and over with type 1 diabetes.

With type 1 diabetes, your pancreas doesn’t produce insulin, which is a hormone that helps cells in your body absorb glucose (sugar) from your blood. Without insulin, the cells can’t absorb sugar properly, and your blood sugar levels go too high. High blood sugar can damage cells in your body, especially in your eyes, kidneys, and nerves. People with type 1 diabetes need to take insulin to survive.

Tresiba is a long-acting insulin that’s taken once a day. It’s sometimes known as basal insulin. Tresiba works steadily for up to 42 hours to help manage your blood sugar between meals and overnight. This is similar to how your pancreas would usually produce insulin.

Tresiba is used with a short-acting insulin that’s taken at mealtimes. Short-acting insulin controls spikes in your blood sugar that happen after eating.

Effectiveness for type 1 diabetes in adults

Several clinical studies have found Tresiba to be effective for improving blood sugar management in adults with type 1 diabetes.

Your blood sugar management is usually assessed using blood tests that measure hemoglobin A1c (HbA1c) in your blood. This measurement shows your average blood sugar levels over the past 2 to 3 months. The American Diabetes Association recommends an HbA1c goal of less than 7% for most adults.

In clinical studies of adults with type 1 diabetes, the effect of Tresiba on HbA1c was compared with the effects of insulin glargine (Lantus) and of insulin detemir (Levemir). (These are other long-acting insulins.) All people in these studies were also taking short-acting insulin at mealtimes.

In these studies, Tresiba lowered people’s HbA1c by a similar amount to insulin glargine and insulin detemir. An HbA1c of less than 7% was achieved in about 40% of people who took either Tresiba, insulin detemir, or insulin glargine.

In one 12-month clinical study, Tresiba lowered HbA1c by an average of 0.36%, while insulin glargine lowered HbA1c by an average of 0.34%. An HbA1c of less than 7% was achieved in 39.8% of people who took Tresiba. In comparison, 42.7% of people who took insulin glargine achieved an HbA1c of less than 7%.

In a 6-month clinical study, Tresiba lowered HbA1c by an average of 0.71%, while insulin detemir lowered HbA1c by an average of 0.61%. An HbA1c of less than 7% was achieved in 41.1% of people who took Tresiba. In comparison, 37.3% of people who took insulin detemir achieved an HbA1c of less than 7%.

Effectiveness for type 1 diabetes in children

In a clinical study of children ages 1 year and older with type 1 diabetes, Tresiba was compared with insulin detemir. All children were also taking mealtime insulin.

In this study, Tresiba and insulin detemir were found to be similarly effective. HbA1c was lowered by an average of 0.19% in children who took Tresiba, compared with 0.34% in children who took insulin detemir.

Tresiba for type 2 diabetes

Tresiba is also FDA-approved to help manage blood sugar levels in adults and in children ages 1 year and older with type 2 diabetes.

With type 2 diabetes, cells in your body become resistant to the effects of insulin. This means they don’t absorb glucose (sugar) from your blood as well as they should. As a result, your blood sugar levels can start to get too high. Over time, your pancreas can also stop producing insulin. If that happens, you need to take insulin to help manage your blood sugar.

Tresiba is a long-acting insulin. It works steadily for up to 42 hours to help keep blood sugar levels under control. It’s typically used along with other medications for type 2 diabetes that you take by mouth.

Effectiveness for type 2 diabetes

Tresiba has been found to be effective for improving blood sugar management in adults with type 2 diabetes.

Your blood sugar management is usually assessed using blood tests that measure hemoglobin A1c (HbA1c) in your blood. This measurement shows your average blood sugar levels over the past 2 to 3 months. The American Diabetes Association recommends an HbA1c goal of less than 7% for most adults.

In clinical studies of adults with type 2 diabetes, the effect of Tresiba on HbA1c was compared with insulin glargine (Lantus) and sitagliptin (Januvia). Insulin glargine is a long-acting insulin, and sitagliptin is a medication for type 2 diabetes that’s taken by mouth.

All people in these studies were also taking one or more other medications for type 2 diabetes that are taken by mouth.

In a 6-month clinical study comparing Tresiba with sitagliptin, Tresiba lowered people’s HbA1c significantly more than sitagliptin. Tresiba lowered HbA1c by an average of 1.52%, while sitagliptin lowered HbA1c by an average of 1.09%. An HbA1c of less than 7% was achieved in 40.9% of those who took Tresiba. In comparison, 27.9% of those who took sitagliptin achieved an HbA1c of less than 7%.

Tresiba and children

Tresiba is FDA-approved for use in children ages 1 year and older with type 1 or type 2 diabetes. It’s not known if it’s safe or effective in younger children.

You’ll likely use Tresiba with other drugs to help manage your blood sugar levels.

If you have type 1 diabetes, you’ll typically take Tresiba with a short-acting or rapid-acting insulin. These types of insulin are taken at mealtimes to manage spikes in blood sugar after eating.

Examples of these drugs include:

If you have type 2 diabetes, you’ll likely take Tresiba along with diabetes medications that you take by mouth. Examples of these include:

  • metformin (Glucophage, Riomet, others)
  • acarbose (Precose)
  • glipizide (Glucotrol)
  • liraglutide (Victoza, Saxenda)
  • canagliflozin (Invokana)
  • sitagliptin (Januvia)

Talk with your doctor about whether you’ll need to use other drugs with Tresiba.

Tresiba is used to treat type 1 and type 2 diabetes in adults and in children ages 1 year and older.

What happens with diabetes

With type 1 diabetes, your pancreas doesn’t produce insulin, which is a hormone that helps cells in your body absorb glucose (sugar) from your blood. Without insulin, the cells can’t absorb sugar properly, and your blood sugar levels get too high. People with type 1 diabetes need to take insulin to survive.

With type 2 diabetes, cells in your body become resistant to the effects of insulin. This means they don’t absorb sugar from your blood as well as they should. As a result, your blood sugar levels can start to get too high. Over time, your pancreas can also stop producing insulin. If that happens, you need to take insulin to help manage your blood sugar.

What does insulin do?

Insulin is a hormone that helps cells in your body absorb sugar from your blood. Sugar gets into your blood every time you eat, and it’s also constantly released into your blood by your liver.

Insulin stops your blood sugar level from getting too high. It controls your blood sugar levels by:

  • helping cells in your body absorb sugar from your bloodstream, so they can use the sugar for energy
  • helping your muscles use sugar for energy
  • preventing your liver from making and releasing more sugar into your bloodstream
  • helping your body make proteins and store sugar as fat

The higher the level of sugar in your blood, the more insulin your pancreas releases. If your body can’t make enough insulin, your blood sugar levels get too high. High blood sugar can damage cells in your body, especially in your eyes, kidneys, and nerves. Insulin helps keep your blood sugar at safe, normal levels.

For people with type 1 diabetes and some people with type 2 diabetes, insulin is a vital medication.

How does Tresiba work?

Tresiba is a form of insulin that’s made in a laboratory. It’s very similar to the natural insulin your body makes. When you inject Tresiba under your skin, the insulin gets absorbed into your bloodstream, where it works as a replacement for your natural insulin.

Is Tresiba long acting?

Yes. Tresiba is a long-acting insulin. It’s sometimes known as a basal insulin or background insulin.

Tresiba contains a form of insulin called insulin degludec. When you inject it under your skin, this form of insulin gets absorbed slowly and steadily into your bloodstream from the tissues under your skin.

Tresiba’s duration of action is up to 42 hours. This means that it works for up to 42 hours after you inject a dose. This provides background control of your blood sugar between meals and overnight.

What is Tresiba’s peak time?

A drug’s peak time is the amount of time it takes for it to reach its highest concentration in your body. Tresiba was made to provide a steady supply of insulin without a peak. Because of this steady supply, you probably won’t notice a peak time while taking Tresiba.

How long does it take to work?

Tresiba starts to work within about 1 hour of injecting your first dose. You should start seeing a difference in your blood sugar levels soon after that.

When you get Tresiba from the pharmacy, the pharmacist will add an expiration date to the label on the box. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk to your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Unopened Tresiba vials and pens

Unopened Tresiba vials and pens can be stored in the following ways:

  • in a refrigerator, between 36°F to 46°F (2°C to 8°C) until the expiration date printed on the packaging
  • out of fridge at room temperature (up to 86°F/30°C) for up to 8 weeks

If you refrigerate Tresiba, make sure it doesn’t touch the freezer compartment. Do not use Tresiba if it has been frozen.

Opened Tresiba vials and pens

Once opened or punctured, Tresiba vials and pens are good for 8 weeks. They can be stored in the following ways:

  • in a refrigerator, between 36°F and 46°F (2°C to 8°C)
  • out of fridge at room temperature (up to 86°F/30°C)

Tresiba vials and pens should be disposed of 8 weeks after opening, even if there is some solution left.

Disposal

If you no longer need to take Tresiba and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

The FDA website provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.

Drinking alcohol while using Tresiba can raise your risk for hypoglycemia (low blood sugar levels). That’s because Tresiba and alcohol can each lower your blood sugar levels on their own.

If you drink alcohol, ask your doctor about how much is safe for you to drink while you’re using Tresiba. You might need to monitor your blood sugar levels more closely if you drink alcohol with Tresiba.

Tresiba can interact with several other medications.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Tresiba and other medications

Below is a list of medications that can interact with Tresiba. This list does not contain all drugs that may interact with Tresiba.

Before taking Tresiba, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Tresiba and diabetes drugs called thiazolidinediones

Taking Tresiba with a type of diabetes drug called a thiazolidinedione can cause heart failure. If you already have heart failure, taking the two drugs together can worsen your condition.

Examples of thiazolidinedione drugs include rosiglitazone (Avandia) and pioglitazone (Actos).

If you take Tresiba with a thiazolidinedione, tell your doctor right away if you get any new or worsening symptoms of heart failure. These can include:

  • shortness of breath
  • tiredness
  • swollen legs, ankles, or feet
  • sudden weight gain

Tresiba and certain other diabetes drugs

Taking Tresiba with certain other diabetes medications can raise your risk for hypoglycemia (low blood sugar levels). Examples of these drugs include:

If you take Tresiba with another diabetes drug, your doctor may adjust your dosage of one or both drugs. This will help reduce your risk for low blood sugar. Your doctor may also ask you to monitor your blood sugar levels more often than you typically would.

Tresiba and drugs that raise your risk for low blood sugar

Taking Tresiba with certain other drugs can raise your risk for hypoglycemia (low blood sugar levels). If you take Tresiba with one of these medications, you may need to check your blood sugar levels more often than you typically would. Your doctor may also need to lower your dosage of Tresiba.

Examples of drugs that can raise your risk for low blood sugar with Tresiba include:

  • angiotensin converting enzyme (ACE) inhibitors, such as:
    • benazepril (Lotensin)
    • enalapril (Vasotec)
    • perindopril
    • quinapril (Accupril)
    • ramipril (Altace)
  • angiotensin II receptor blockers (ARBs), such as:
    • candesartan (Atacand)
    • irbesartan (Avapro)
    • olmesartan (Benicar)
    • valsartan (Diovan)
  • certain antidepressants, such as:
    • isocarboxazid (Marplan)
    • phenelzine (Nardil)
    • tranylcypromine (Parnate)
  • certain cholesterol-lowering drugs, such as:
    • fenofibrate (Antara)
    • gemfibrozil (Lopid)
  • certain other medications, such as:
    • disopyramide (Norpace)
    • pentoxifylline
    • sulfamethoxazole/trimethoprim (Bactrim, Septra)
    • octreotide (Sandostatin)

Tresiba and drugs that increase your blood sugar levels

Certain medications can raise your blood sugar levels. If you take Tresiba with one of these medications, you may need to check your blood sugar levels more often than you typically would. Your doctor may also need to increase your dosage of Tresiba.

Examples of medications that can increase your blood sugar levels include:

  • certain antipsychotic drugs, such as:
    • chlorpromazine
    • clozapine (Clozaril, Fazaclo)
    • olanzapine (Zyprexa)
  • corticosteroids, such as:
    • budesonide (Entocort EC, Pulmicort, Uceris)
    • prednisone (Rayos)
    • prednisolone (Orapred, Prelone)
    • methylprednisolone (Medrol)
    • hydrocortisone (Cortef, many others)
  • diuretics, such as:
    • chlorthalidone
    • hydrochlorothiazide (Microzide)
    • metolazone
    • indapamide
  • protease inhibitors for HIV, such as:
    • atazanavir (Reyataz)
    • darunavir (Prezista)
    • fosamprenavir (Lexiva)
    • ritonavir (Norvir)
    • tipranavir (Aptivus)
  • oral contraceptives (birth control pills)
  • certain other medications, such as:
    • danazol
    • isoniazid
    • levothyroxine (Levoxyl, Synthroid, Tirosint, Unithroid)
    • niacin (Niaspan, Slo-Niacin, others)
    • somatropin (Genotropin, Norditropin, Saizen, others)

Tresiba and certain blood pressure medications

Taking Tresiba with certain blood pressure medications can make the symptoms of hypoglycemia (low blood sugar levels) hard to detect. This can make you unaware of when your blood sugar has gone too low, and as a result you might not treat it. Untreated hypoglycemia can lead to serious problems.

Examples of these blood pressure medications include:

  • metoprolol (Lopressor, Toprol XL)
  • propranolol (Inderal, Innopran XL)
  • clonidine (Catapres, Kapvay)
  • atenolol (Tenormin)
  • nadolol (Corgard)
  • reserpine

If you take Tresiba with one of these blood pressure medications, your doctor may recommend that you check your blood sugar levels more often than you typically would.

Using more than the recommended dosage of Tresiba can lead to serious side effects.

Overdose symptoms

Symptoms of an overdose can include:

  • severe hypoglycemia (very low blood sugar levels), which can cause anxiety, shakiness, confusion, seizures, and coma
  • hypokalemia (low level of potassium in your blood), which can cause weakness, constipation, muscle cramping, and heart palpitations (fast or irregular heartbeat)

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or visit their website. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

It’s not known if Tresiba is safe to use during pregnancy. This is because the drug hasn’t been studied in pregnant women. However, studies in animals found that the effects of Tresiba in pregnancy were similar to those seen with normal human insulin. (This means it didn’t cause harmful effects.)

Having untreated diabetes during pregnancy is known to be unsafe for both the mother and fetus.

Insulin is recommended by the American Diabetes Association as the preferred treatment for managing blood sugar levels in pregnant women with type 1 and type 2 diabetes.

If you’re pregnant or planning to become pregnant while using Tresiba, talk with your doctor about the risks and benefits. Your body’s insulin requirements may change during pregnancy. If you’ll be using Tresiba, your dosage may need to be different during your pregnancy.

It’s not known if Tresiba is safe to take during pregnancy. If you’re sexually active and are able to become pregnant, talk with your doctor about your birth control needs while you’re using Tresiba.

Insulin (including Tresiba) is usually considered safe to use during breastfeeding. Insulin can’t be absorbed from your gut, so even if insulin does get into your breast milk, a nursing child can’t absorb any insulin that they consume in the milk. Therefore, if you take insulin while you’re breastfeeding, it can’t affect your nursing child.

However, your doctor will likely change your insulin dosage while you’re breastfeeding. Your body goes through many changes after you’ve given birth. Plus, your sleeping and eating patterns may be inconsistent once you have a baby. These changes can affect your blood sugar levels.

If you plan to breastfeed while taking Tresiba, talk with your doctor about how your dosage may need to change.

You should take Tresiba according to your doctor’s or healthcare provider’s instructions.

Tresiba is taken as a subcutaneous injection (an injection under the skin). You’ll usually take it once a day. When you first get your Tresiba prescription, your healthcare provider or pharmacist will explain how to inject the medication.

Step-by-step instructions for giving an injection using the Tresiba FlexTouch pen or the Tresiba vial are provided in the leaflet that comes with your medication. There’s also a step-by-step instruction video for using the FlexTouch pens on the manufacturer’s website.

Key points about taking Tresiba

  • Tresiba FlexTouch pens and vials are meant to be used more than once, but you need to use a new needle each time.
  • The manufacturer recommends using NovoFine Plus 32G tip needles with Tresiba FlexTouch pens. Needles can be purchased from your pharmacy.
  • Do not share Tresiba FlexTouch pens with another person, even if the needle has been changed. If you’re using Tresiba vials, do not share needles or syringes with other people. Sharing needles could put you at risk for catching or spreading infections that are carried in the blood.
  • Tresiba should be injected under the skin of the thigh, abdomen (belly), or upper arm. Do not inject it into a vein or muscle.
  • Use a different injection site each time you inject Tresiba. This reduces the risk of changes to your skin, such as pitting, thickening, or lumps.
  • Don’t inject Tresiba into skin that is tender, bruised, scaly, hard, scarred, or damaged.

It’s important to note that making changes to your insulin treatment plan could increase your risk for both hypoglycemia (low blood sugar levels) and hyperglycemia (high blood sugar levels). This includes making changes such as taking a new dosage of insulin or using a new insulin product. It also includes administering your insulin differently than you usually do or injecting the drug into areas of skin that are thickened or pitted.

When to take

You can take your daily dose of Tresiba at any time of day. Your doctor will recommend the best time of day for you, based on how your blood sugar levels change throughout the day and night. For children, it’s important to always take Tresiba at the same time of day.

To help make sure you don’t miss a dose, try setting a reminder on your phone. A medication timer may be useful, too.

Taking Tresiba with food

You don’t need to eat when you take your dose of Tresiba. Tresiba doesn’t need to be taken with meals (unlike shorter-acting insulins, which need to be taken with a meal).

Here are answers to some frequently asked questions about Tresiba.

Can you take Tresiba twice a day?

No, Tresiba should only be taken once daily. This drug works to help control your blood sugar levels for 42 hours after you inject a dose. So, with once daily dosing, it controls your blood sugar between meals and overnight. And the level of Tresiba also stays consistent in your body with once daily dosing.

Can Tresiba be used to treat diabetic ketoacidosis?

No, it’s not recommended for this. Diabetic ketoacidosis (DKA) is a medical emergency that’s caused by very high blood sugar levels. DKA usually needs to be treated in a hospital, where insulin is given intravenously (into your vein) until your blood sugar falls to a safe level.

Tresiba should not be injected into your vein. And when given subcutaneously (an injection under the skin), it doesn’t lower blood sugar quickly enough to treat DKA.

If I’m taking another form of insulin with Tresiba, can I take the drugs at the same time?

Yes, you can take Tresiba at the same time of day as other insulin injections. However, don’t dilute or mix Tresiba with any other insulin solutions, and always give the injections at different sites.

Can I take Tresiba using an insulin pump?

No. Tresiba can’t be used in an insulin pump. An insulin pump is used to give a continuous low dose of short-acting insulin. Using an insulin pump means you don’t need to have multiple daily injections of insulin.

Tresiba is a long-acting insulin that forms a store of insulin under your skin after you inject a dose. The insulin is gradually absorbed into your bloodstream over the course of 42 hours. This type of insulin won’t work in an insulin pump.

Is it safe to take Tresiba with diabetes drugs that are taken by mouth?

In general, yes. In clinical studies, Tresiba was used with various other diabetes drugs taken by mouth. However, taking Tresiba with this type of drug may increase your risk for hypoglycemia (low blood sugar levels). Talk with your doctor if you have questions or concerns about taking other drugs with Tresiba.

Will Tresiba cure my diabetes?

No. There is currently no cure for diabetes that needs treatment with insulin. That’s because if your pancreas has stopped producing insulin or can’t make enough insulin, there’s currently no way to make it work again. Therefore, you’ll need to continue taking insulin.

Although there is no cure, insulin drugs like Tresiba can help you manage your diabetes and keep your blood sugar levels under control.

Before taking Tresiba, talk with your doctor about your health history. Tresiba may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Hypoglycemia. Don’t take your Tresiba dose if you’re having an episode of hypoglycemia (low blood sugar level).
  • Allergy to Tresiba. Don’t take Tresiba if you’ve ever had an allergic reaction to any of its ingredients.
  • Hypokalemia. Tresiba can cause and worsen hypokalemia (low level of potassium in your blood). This can raise your risk for serious side effects. Your doctor may monitor your potassium levels while you take Tresiba if you already have low potassium or are at risk for this problem.
  • Kidney or liver disease. If you have kidney or liver problems, you’re more likely to get low blood sugar levels while taking Tresiba. Talk with your doctor about steps you can take to prevent low blood sugar.
  • Heart failure. Taking Tresiba with diabetes medications called thiazolidinediones, such as pioglitazone (Actos) or rosiglitazone (Avandia), can worsen symptoms of heart failure. If you have heart failure and your symptoms get worse, talk with your doctor. You may need to stop taking thiazolidinediones while you take Tresiba.
  • Pregnancy. It’s not known if Tresiba is safe to take during pregnancy. For more information, please the “Tresiba and pregnancy” section above.
  • Breastfeeding. In general, Tresiba is considered safe to use during breastfeeding. However, your doctor may need to adjust your dosage. For more information, see the “Tresiba and breastfeeding” section above.

Note: For more information about the potential negative effects of Tresiba, see the “Tresiba side effects” section above.

Also, keep in mind that making changes to your insulin treatment plan could increase your risk for both hypoglycemia (low blood sugar levels) and hyperglycemia (high blood sugar levels). This includes making changes such as taking a new dosage of insulin or using a new insulin product. It also includes administering your insulin differently than you usually do or injecting the drug into areas of skin that are thickened or pitted.

The following information is provided for clinicians and other healthcare professionals.

Indications

Tresiba is FDA-approved to improve control of blood glucose in adults and in children ages 1 year and older with type 1 or type 2 diabetes mellitus.

Tresiba is not recommended for treating diabetic ketoacidosis.

Mechanism of action

Tresiba contains insulin degludec, a long-acting basal insulin analog. When injected subcutaneously, it forms multi-hexamers to create a depot of insulin degludec in the subcutaneous tissue. Insulin degludec is slowly absorbed into the bloodstream from this depot, providing a prolonged action on blood glucose levels over the course of 42 hours.

Insulin lowers blood glucose levels by increasing glucose uptake in muscle and fat tissue and by decreasing hepatic gluconeogenesis. It also decreases breakdown of fats and proteins and increases protein synthesis.

Peak time and duration

Tresiba starts working within 1 hour of the first injection. It has a fairly constant blood glucose-lowering effect over at least 24 hours, although a maximum effect is seen an average of 12 hours after injection. The effects of Tresiba last for approximately 42 hours.

Pharmacokinetics and metabolism

Insulin degludec is slowly absorbed into the systemic circulation from the subcutaneous depot.

Steady state is reached after 3 to 4 days of once-daily dosing. Insulin degludec is more than 99% bound to albumin in plasma.

Insulin degludec is metabolized in a similar way to human insulin. It has an average half-life of 25 hours.

Contraindications

Tresiba is contraindicated in:

  • episodes of hypoglycemia
  • people with known allergy to insulin degludec or any of the excipients in Tresiba

Storage

Unopened Tresiba vials and pens can be stored in the following ways:

  • in a refrigerator at temperatures of 36°F to 46°F (2°C to 8°C) until the expiration date printed on the packaging
  • out of fridge at room temperature (up to 86°F/30°C) for up to 8 weeks

Once opened or punctured, Tresiba vials and pens will keep for 8 weeks. They can be stored in the following ways:

  • in a refrigerator at temperatures of 36°F to 46°F (2°C to 8°C)
  • out of fridge at room temperature (up to 86°F/30°C)

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 other 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.