Short answer: The Tresiba label gives adults one injection under the skin once daily at any time of day; children inject at the same time every day. Insulin-naive adults with type 2 diabetes start at 10 units once daily; in type 1 it is about one-third to one-half of the total daily insulin. Dose increases are 3 to 4 days apart. A missed adult dose is taken when found, at least 8 hours from the next.
This is what the FDA label says. Follow your prescriber. Your prescriber may use a different dose or pace than the label's standard schedule.
What Tresiba is approved for: Tresiba is a long-acting human insulin analog approved to improve blood sugar control in people 1 year of age and older with diabetes (section 1). It is not recommended for treating diabetic ketoacidosis.
Source
TRESIBA (insulin degludec) injection, for subcutaneous use, prescribing information, Patient Information and Instructions for Use. Novo Nordisk. DailyMed, version published July 20, 2022. DailyMed setid 456c5e87-3dfd-46fa-8ac0-c6128d4c97c6
Tresiba is injected under the skin of the thigh, upper arm or abdomen once a day, rotating sites within the same area. It is never given into a vein or muscle, in an insulin pump, or mixed with other insulins (section 2.1).
It comes as U-100 (FlexTouch pen in 1-unit steps up to 80 units, or 10 mL vial) and U-200 (FlexTouch pen in 2-unit steps up to 160 units). The pen dose window shows units, so no dose conversion is done (sections 2.2 and 3).
Children who need less than 5 units a day use the U-100 vial (section 2.1).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| Situation | What the label says |
|---|---|
| When to inject, adults | Once daily at any time of day |
| When to inject, children 1 year and older | Once daily at the same time every day |
| Insulin-naive, type 1 diabetes | About one-third to one-half of the total daily insulin dose; the rest as short-acting insulin divided between meals. As a general rule, 0.2 to 0.4 units/kg to calculate the starting total daily dose |
| Insulin-naive, type 2 diabetes | 10 units once daily |
| Switching from other long or intermediate-acting insulin, adults | Same unit dose as the total daily long or intermediate-acting insulin dose |
| Switching from other long or intermediate-acting insulin, children | 80% of the total daily long or intermediate-acting insulin dose |
| Time between dose increases | 3 to 4 days |
| Type 1 diabetes | Must be used with short-acting insulin |
| Product | Not in use, refrigerated | Not in use, room temperature (up to 86 F) | In use, room temperature or refrigerated |
|---|---|---|---|
| 3 mL single-patient-use TRESIBA U-100 FlexTouch | Until expiration date | 56 days (8 weeks) | 56 days (8 weeks) |
| 10 mL multiple-dose TRESIBA U-100 Vial | Until expiration date | 56 days (8 weeks) | 56 days (8 weeks) |
| 3 mL single-patient-use TRESIBA U-200 FlexTouch | Until expiration date | 56 days (8 weeks) | 56 days (8 weeks) |
The dose is individualized by metabolic needs, blood glucose results and glucose goal. Changes may be needed with changes in activity, meals, kidney or liver function, or acute illness.
Blood glucose is checked more often during any change in the insulin regimen. Tresiba is not drawn from the pen into a syringe.
For people with type 2 diabetes, other diabetes medicines may need adjusting when Tresiba is started or changed.
Unused Tresiba is refrigerated at 2 to 8 C, in the carton away from light, and never frozen; Tresiba that has been frozen is not used.
Adults who miss a dose inject their daily dose during waking hours when they discover it, making sure at least 8 hours pass between consecutive injections. Children who miss a dose contact their healthcare provider and check blood glucose more often until the next scheduled dose.
More on this: missed a dose of Tresiba.
Adults switching from another long or intermediate-acting insulin start Tresiba at the same unit dose as their total daily long or intermediate-acting dose. Children 1 year and older start at 80% of that dose, to lower the risk of low blood sugar.
In Dose Track you set up Tresiba as a protocol with the dose and schedule your prescriber gave you. A protocol can hold dose steps, each with its own dose and length in days or weeks, so a step-up plan like the one on the label can be entered once and the app moves to the next step on its own. Reminders follow the schedule, and every dose is logged with the date and time, so you can see which step you are on and when your last dose was. The app follows what you enter; it does not choose or change a dose.
This page is what the FDA label says, in plain words. It is not medical advice. Follow your prescriber, and ask them or your pharmacist about anything here.