Short answer: The Xultophy label starts at 10 units once daily for people new to basal insulin or a GLP-1, and 16 units for people already on basal insulin or a GLP-1. The dose is adjusted by 2 units once or twice a week based on fasting blood sugar. The range is 10 to 50 units once daily at the same time each day; 50 units is the maximum.
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 Xultophy is approved for: Xultophy 100/3.6 is approved, along with diet and exercise, to improve blood sugar control in adults with type 2 diabetes (section 1). The label says it is not recommended with any other product containing liraglutide or another GLP-1 receptor agonist, is not for diabetic ketoacidosis, and has not been studied with mealtime (prandial) insulin.
Source
XULTOPHY 100/3.6 (insulin degludec and liraglutide) injection, for subcutaneous use, prescribing information and Medication Guide. Novo Nordisk. DailyMed, version published November 17, 2025. DailyMed setid 21335fe4-d395-4501-ac2a-2f20d7520da9
Xultophy is injected under the skin once a day at the same time each day, with or without food, into the thigh, upper arm or abdomen. Injection sites are rotated within the same region to lower the risk of lipodystrophy and skin amyloid (sections 2.1, 2.5).
It is not given into a vein or through an insulin pump, not diluted or mixed with any other insulin or solution, and the dose is not split. The pen dials in 1-unit steps and delivers 10 to 50 units per injection (sections 2.1, 2.5).
Each mL has 100 units of insulin degludec and 3.6 mg of liraglutide, in a 3 mL single-patient-use pen. Each unit holds 1 unit of insulin degludec and 0.036 mg of liraglutide (sections 2.1, 3).
The table below is the label's schedule, from the Dosage and Administration section. Numbers are copied exactly; the section is in brackets.
| XULTOPHY 100/3.6 (dose counter display) | Insulin degludec component dose | Liraglutide component dose | Comment |
|---|---|---|---|
| 10 | 10 units | 0.36 mg | Recommended starting dose for patients naïve to basal insulin or GLP-1 receptor agonist |
| 16 | 16 units | 0.58 mg | Recommended starting dose for patients currently on basal insulin or GLP-1 receptor agonist |
| 20 | 20 units | 0.72 mg | |
| 30 | 30 units | 1.08 mg | |
| 40 | 40 units | 1.44 mg | |
| 50 | 50 units | 1.8 mg | Maximum daily dosage |
The full Table 1 lists every unit from 10 to 50. The dose counter shows numbers for even units and lines for odd units.
| Self-Monitored Fasting Plasma Glucose | XULTOPHY 100/3.6 Dosage Adjustment |
|---|---|
| Above target range | + 2 units (2 units of insulin degludec and 0.072 mg of liraglutide) |
| Within target range | 0 units |
| Below target range | - 2 units (2 units of insulin degludec and 0.072 mg of liraglutide) |
Basal insulin or a GLP-1 receptor agonist is stopped before Xultophy is started.
After the starting dose, the dose goes up or down by 2 units once or twice a week (every three to four days) based on metabolic needs, blood sugar results and the fasting glucose goal.
More adjustment may be needed with changes in physical activity, meal patterns, kidney or liver function, during acute illness, or with other medicines.
The maximum dose is 50 units daily (50 units insulin degludec and 1.8 mg liraglutide). More than 50 units a day can mean an overdose of liraglutide (section 5.5).
Experience in mild and moderate kidney impairment is limited and extra glucose checks and dose changes may be needed; Xultophy has not been studied in severe kidney impairment or in liver impairment (section 8.7).
In older adults, the label says starting dose, increases and maintenance dose should be conservative to avoid low blood sugar.
If a dose is missed, the once-daily schedule resumes with the next scheduled dose, with no extra or larger dose to make up for it. If more than three days have passed since the last dose, Xultophy is restarted at the recommended starting dose to lower the risk of stomach and gut side effects.
More on this: missed a dose of Xultophy.
People on basal insulin or a GLP-1 receptor agonist stop it before starting Xultophy, and start at 16 units once daily. People new to both start at 10 units.
Using Xultophy with any other product containing liraglutide or another GLP-1 receptor agonist is not recommended.
In Dose Track you set up Xultophy 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.