Soliqua 100/33 (insulin glargine/lixisenatide) is a prescription drug that’s used to treat type 2 diabetes. Soliqua 100/33 comes as a prefilled single-use pen for injecting the drug under your skin.

Doctors prescribe Soliqua 100/33 together with diet and exercise to help improve blood sugar levels in adults with type 2 diabetes.

Soliqua 100/33 isn’t used in certain cases, such as for treating type 1 diabetes. To learn more about this drug’s use, see the “What is Soliqua 100/33 used for?” section later in this article.

Soliqua 100/33 basics

Soliqua 100/33 contains two active ingredients: insulin glargine and lixisenatide. (An active ingredient is what makes a medication work.)

Insulin glargine belongs to a group of drugs called long-acting insulins. And lixisenatide belongs to a group of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. Both active ingredients are biologic medications, which are made from parts of living organisms.

Soliqua 100/33 isn’t available in a biosimilar form. (Biosimilars are like generic drugs. But unlike generics, which are made for nonbiologic drugs, biosimilars are made for biologic drugs.) The insulin glargine and lixisenatide combination is only available as the brand-name drug Soliqua 100/33.

Soliqua 100/33 comes as a liquid solution inside prefilled single-use pens. You’ll use these pens to give yourself an injection of the drug under your skin.

Keep reading to learn more about Soliqua 100/33’s dosage, side effects, uses, and more.

Your doctor will recommend the dosage of Soliqua 100/33 that’s right for you. The following text discusses commonly used dosages, but always follow the dosage your doctor prescribes.

Form and strength

Soliqua 100/33 comes as a liquid solution inside prefilled single-use pens. You’ll use these pens to give yourself an injection of the drug under your skin.

Each Soliqua 100/33 pen contains 3 milliliters (mL) of solution, with 300 units of insulin and 99 micrograms (mcg) of lixisenatide per pen. (This is 100 units of insulin and 33 mcg of lixisenatide per mL of solution.) There are five pens per box of Soliqua 100/33.

Recommended dosage

For treating type 2 diabetes, your doctor may recommend a low starting dose of Soliqua 100/33. Your doctor will prescribe a dose based on your current or past treatments for type 2 diabetes. Your dose may also be determined by your blood sugar levels.

Over time, your doctor may adjust the dose in response to your blood sugar levels or results of other lab tests. This is known as a dose titration. The goal is to find the right dose that works for you without causing side effects from Soliqua 100/33.

You’ll usually receive Soliqua 100/33 once per day.

For a detailed Soliqua 100/33 dosing chart, see the drug’s prescribing information. The chart lists possible doses up to the maximum dose for the drug. You can also ask your doctor or pharmacist for more information on Soliqua 100/33’s dosages.

Questions about Soliqua 100/33’s dosage

  • What if I miss a dose of Soliqua 100/33? If you miss a Soliqua 100/33 dose, skip the missed dose. Then take your usual dose the next day. You should not take more than one dose at a time to make up for a missed dose. Doing so can increase your risk of side effects from Soliqua 100/33, such as low blood sugar.
  • Will I need to use Soliqua 100/33 long term? If you and your doctor find that Soliqua 100/33 is safe and effective for you, you’ll likely use it long term. Soliqua 100/33 is meant to be used as a long-term treatment for type 2 diabetes.
  • How long does Soliqua 100/33 take to work? Soliqua 100/33 begins to work right after you inject it. But it may take a few weeks before you start to notice changes in your blood sugar levels or results of other lab tests.

Like most drugs, Soliqua 100/33 may cause mild or serious side effects. The lists that follow describe some of the more common side effects the drug may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Soliqua 100/33. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Soliqua 100/33 can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the drug’s prescribing information.

Mild side effects of Soliqua 100/33 that have been reported include:

For more information about some of these side effects, see the “Side effect focus” section later in this article.

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Soliqua 100/33 can occur, but they aren’t common. If you have serious side effects from Soliqua 100/33, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Soliqua 100/33 that have been reported include:

For more information about some of these side effects, see the “Side effect focus” section next.

Side effect focus

Learn more about some of the side effects Soliqua 100/33 may cause.

Low blood sugar

Like all medications used to treat diabetes, Soliqua 100/33 may cause your blood sugar to become too low.

Low blood sugar is the most common side effect caused by drugs that contain insulin, including Soliqua 100/33. This side effect is usually mild when it does happen.

In rare cases, low blood sugar caused by Soliqua 100/33 can be severe. Your risk of this is increased if you:

Symptoms of mild low blood sugar can include:

Symptoms of severe low blood sugar can include:

In extreme cases, severe low blood sugar may result in a coma or even be fatal.

What might help

Your doctor will let you know how often to check your blood sugar levels while using Soliqua 100/33.

Before you begin Soliqua 100/33 treatment, talk with your doctor about what to do if your blood sugar levels become too low. You can often treat mild low blood sugar at home using quick-acting carbohydrates, such as:

  • 1/2 cup of juice or regular (non-diet) soda
  • 1 tablespoon of honey
  • three or four pieces of hard candy
  • glucose (sugar) tablets

For severe low blood sugar, your doctor may prescribe glucagon. This medication is a synthetic version of a hormone your body makes that can quickly raise blood sugar levels.

Talk with your doctor about your treatment plan in case you have low blood sugar while using Soliqua 100/33. If you’re having symptoms of severe low blood sugar or that feel life threatening, contact 911 or go to the closest emergency room.

Skin changes at Soliqua 100/33 injection sites

It’s possible you may have skin changes at Soliqua 100/33 injection sites. But it’s not known how often this side effect occurred in studies of the drug.

Specifically, Soliqua 100/33 injections may cause:

  • pits in your skin
  • thickened skin
  • skin lumps or bumps

What might help

To help reduce your risk of skin changes at Soliqua 100/33 injection sites, choose a new injection site for each dose. You may choose the same area of the body, but inject the drug in a different spot than your last dose.

It’s recommended that you don’t inject Soliqua 100/33 into skin that is:

  • bruised or tender
  • scaly or hard
  • scarred or damaged
  • thickened or has lumps

If you have skin changes that bother you or don’t go away, talk with your doctor. They may recommend trying a different treatment for your condition.

Low blood potassium levels

While it’s not common, using Soliqua 100/33 can cause low blood potassium levels as a side effect. This is a known risk with all drugs that contain insulin, including Soliqua 100/33. But it’s not known how often this side effect occurred in studies of the drug.

Most cases of low blood potassium levels caused by Soliqua 100/33 aren’t serious. And they can be treated. But if left untreated over time, this side effect can cause serious problems, including dangerous heart rhythms and even death.

Symptoms of low blood potassium levels can include:

What might help

Before you begin Soliqua 100/33 treatment, your doctor should review your medical history for risk factors of low blood potassium levels. If they determine you’re at high risk of this condition, they may monitor your potassium levels more closely. This will likely involve getting blood tests.

If you develop this side effect while receiving Soliqua 100/33, your doctor will determine the best treatment for it. They may prescribe a medication for you to take that will help raise your potassium levels. They may also have you switch to a different drug for your type 2 diabetes.

Allergic reaction

Some people may have an allergic reaction to Soliqua 100/33. This has been reported in studies of the drug.

Symptoms of a mild allergic reaction can include:

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. They can also include swelling of your tongue, mouth, or throat, which can cause difficulty breathing.

Call your doctor right away if you have an allergic reaction to Soliqua 100/33. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Find answers to some commonly asked questions about Soliqua 100/33.

How should I store Soliqua 100/33? Does it need to be refrigerated?

Before using a Soliqua 100/33 pen, you should store it in a refrigerator at a temperature of 36°F to 46°F (2°C to 8°C). After using the pen for the first time, you should store it at a room temperature no higher than 77°F (25°C).

Be sure to remove the needle from the pen after giving yourself a dose. Do not store the pen with a needle attached.

You should safely dispose of Soliqua 100/33 pens 28 days after opening them, even if they still have medication inside. For information about how to dispose of the drug safely, see this medication safety article. Or ask your doctor about safe ways to dispose of expired medication.

If you have additional questions about storing Soliqua 100/33, talk with your doctor or pharmacist.

Does Soliqua 100/33 cause weight gain or weight loss?

It’s not likely. In studies of Soliqua 100/33, neither weight gain nor weight loss were reported.

It’s important to note that Soliqua 100/33 contains insulin glargine. Weight gain is possible with any insulin product. Soliqua also contains lixisenatide, which is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 receptor agonists may cause weight loss.

If you have questions or concerns about your weight and Soliqua 100/33, talk with your doctor or pharmacist. They can suggest ways to maintain a moderate weight.

How does Soliqua 100/33 work?

Soliqua 100/33 contains two active ingredients, insulin glargine and lixisenatide. (An active ingredient is what makes a medication work.) Each active ingredient has its own mechanism of action (how it works to treat a condition):

  • Insulin glargine tells your body’s cells to bring in sugar from your blood. It also stops your liver from producing more sugar. Both actions help lower blood sugar levels.
  • Lixisenatide increases insulin levels in your body. It also slows down how quickly your digestive tract works. This lowers the amount of sugar in your blood after a meal. And it decreases how much glucagon your body makes. (Glucagon is a hormone that increases blood sugar levels.)

If you have additional questions about how Soliqua 100/33 works, talk with your pharmacist or doctor.

If you’d like to know more about using an alternative for Soliqua 100/33, such as insulin glargine (Lantus, Toujeo), talk with your doctor. They can recommend the drug that’s best for your condition.

Soliqua 100/33 vs. Lantus and others

If you’d like to read how Soliqua 100/33 compares with Lantus and Toujeo, as well as liraglutide (Victoza), see the “Soliqua 100/33 vs. other drugs” section in this Soliqua overview.

Soliqua 100/33 vs. Xultophy 100/3.6

To see a detailed comparison of Soliqua 100/33 with the combination drug insulin degludec and liraglutide (Xultophy 100/3.6), refer to the “Soliqua 100/33 vs. Xultophy” section in this Soliqua overview.

Soliqua 100/33 is used together with diet and exercise to help improve blood sugar levels in adults with type 2 diabetes.

Type 2 diabetes is a condition that causes blood sugar levels to become too high. Usually, the hormone insulin works to keep blood sugar in your body at healthy levels. But with type 2 diabetes, your body’s cells don’t respond to insulin like they should. Over time, your body may stop making its own insulin or may not make enough.

Without appropriate treatment, type 2 diabetes can cause some serious problems, including:

Soliqua 100/33 contains two active ingredients: insulin glargine and lixisenatide. Each works in its own way to decrease blood sugar levels. For specifics, see “How does Soliqua 100/33 work?” in the “What are some frequently asked questions about Soliqua 100/33?” section.

Note: Your doctor likely won’t prescribe Soliqua 100/33 in the following situations:

As with all prescription drugs, the cost of Soliqua 100/33 can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. Or visit the Soliqua 100/33 manufacturer’s website to see if it has support options you may be eligible for.

Learn more about saving money on prescriptions.

Cost information and savings coupons

You can visit Optum Perks to get price estimates of what you’d pay for Soliqua 100/33 when using coupons from the site. Here are some coupon options. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)

Your doctor will explain how you should use Soliqua 100/33. They’ll also explain how much to use and how often. Be sure to follow your doctor’s instructions.

Injecting Soliqua 100/33

Soliqua 100/33 comes as a liquid solution inside prefilled single-use pens. You’ll use these pens to give yourself an injection of the drug under your skin. You’ll also have to get pen needles, which don’t come with your Soliqua 100/33 prescription. You should use a new needle with each dose. Never reuse a needle.

You can view a video on how to inject a Soliqua 100/33 dose on the manufacturer’s site. The drug’s full prescribing information also contains step-by-step instructions. And your doctor or pharmacist can explain how to give yourself an injection of the drug.

Using Soliqua 100/33 with other drugs

Soliqua 100/33 may be used alone or with other drugs to help improve blood sugar levels in adults with type 2 diabetes.

Keep in mind that Soliqua 100/33 contains two active ingredients. (An active ingredient is what makes a medication work.) Other drugs for treating diabetes may contain the same or similar ingredients. To make sure there’s no overlap between your medications, talk with your doctor or pharmacist.

Should I receive Soliqua 100/33 with food?

You should inject your daily dose of Soliqua 100/33 within 1 hour before your first meal of the day.

Questions for your doctor

You may have questions about Soliqua 100/33 and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions such as:
    • How will Soliqua 100/33 affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

Before beginning treatment with Soliqua 100/33, there are important considerations to discuss with your doctor. These include your overall health, any medical conditions you may have, and all medications that you take.

Here are some of the things you should discuss with your doctor.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before using Soliqua 100/33, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Soliqua 100/33.

Interactions with drugs or supplements

Soliqua 100/33 can interact with several types of drugs, including:

This list does not contain all types of drugs that may interact with Soliqua 100/33. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Soliqua 100/33.

Warnings

Soliqua 100/33 may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you start Soliqua 100/33 treatment. Factors to consider include those in the following list:

  • history of pancreas or gallbladder problems
  • kidney problems
  • liver problems
  • slowed stomach emptying
  • planned surgery
  • allergic reaction
  • pregnancy
  • breastfeeding

Soliqua 100/33 and alcohol

If you consume alcohol, it’s recommended that you drink minimally or moderately during Soliqua 100/33 treatment.

Alcohol can affect your blood sugar levels, which can cause Soliqua 100/33 not to work as effectively. It can also increase your risk of certain side effects from the medication. These include nausea, diarrhea, and low blood sugar.

In rare cases, treatment with Soliqua 100/33 can result in pancreatitis as a side effect. Heavy alcohol use can increase your risk of this side effect.

If you drink alcohol or have questions about alcohol consumption and Soliqua 100/33, talk with your doctor. They can discuss with you whether Soliqua 100/33 is the best treatment for your condition.

Pregnancy and breastfeeding

It isn’t known whether it’s safe to use Soliqua 100/33 while pregnant. If you’re pregnant or thinking about becoming pregnant, talk with your doctor about the best treatment options for you. Keep in mind that unmanaged diabetes can cause problems with a pregnancy.

It’s also not known whether Soliqua 100/33 passes into human breast milk or whether it could cause side effects in a breastfed child. If you’re using Soliqua 100/33, talk with your doctor about safe ways to feed your child.

Do not use more Soliqua 100/33 than your doctor prescribes. Using more than this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you receive too much Soliqua 100/33

Call your doctor if you think you’ve given yourself too much Soliqua 100/33. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. However, if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Q:

I have heart failure and diabetes. Are there diabetes drugs that are better or worse to use together with Soliqua 100/33?

Anonymous

A:

Yes, there are. Certain diabetes drugs may worsen heart failure if used together with Soliqua 100/33.

Before starting Soliqua 100/33, be sure to tell your doctor if you’re already taking diabetes drugs called thiazolidinediones (TZDs). Examples of TZDs include rosiglitazone and pioglitazone (Actos).

Using Soliqua 100/33 with TZDs can raise your risk of swelling, which may lead to new or worsening heart failure. Your doctor will let you know if it’s safe for you to use Soliqua 100/33 while taking these drugs.

If you use Soliqua 100/33 together with TZDs, your doctor will likely watch you closely for symptoms of heart failure. Tell them right away if you have sudden weight gain, swelling in your feet or ankles, or shortness of breath. If you have new or worsened heart failure, your doctor may adjust your treatment plan.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline 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.

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