Short answer: Both are once-daily pens that combine a long-acting insulin with a GLP-1 drug for adults with type 2 diabetes. Soliqua 100/33 pairs insulin glargine with lixisenatide and doses 15 to 60 units; Xultophy 100/3.6 pairs insulin degludec with liraglutide and doses 10 to 50 units.12 Only Xultophy carries a boxed thyroid C-cell tumor warning.
| Soliqua 100/33 | Xultophy 100/3.6 | |
|---|---|---|
| Ingredients | Insulin glargine 100 units/mL + lixisenatide 33 mcg/mL1 | Insulin degludec 100 units/mL + liraglutide 3.6 mg/mL2 |
| Approved for | Adults with type 2 diabetes, with diet and exercise1 | Adults with type 2 diabetes, with diet and exercise2 |
| Dose range per injection | 15 to 60 units; 60 units = 60 units glargine + 20 mcg lixisenatide1 | 10 to 50 units; 50 units = 50 units degludec + 1.8 mg liraglutide2 |
| Starting dose | 15 units if new to basal insulin or GLP-1, on a GLP-1, or on under 30 units of basal insulin; 30 units if on 30 to 60 units1 | 10 units if new to basal insulin and GLP-1; 16 units if on basal insulin or a GLP-12 |
| Titration | Up or down 2 to 4 units every week, by fasting glucose1 | Up or down 2 units once or twice weekly (every 3 to 4 days), by fasting glucose2 |
| When to inject | Once daily within the hour before the first meal of the day1 | Once daily at the same time each day, with or without food2 |
| Missed dose | Resume with the next scheduled dose; no extra dose1 | Resume with the next scheduled dose; if more than 3 days have passed, restart at the starting dose2 |
| Boxed warning | None | Risk of thyroid C-cell tumors (from liraglutide)2 |
| After first use | Room temperature up to 77°F; discard after 28 days1 | Room temperature (59°F to 86°F) or fridge; discard after 21 days2 |
No trial on either label compares Soliqua with Xultophy. Each was tested against its own parts and other insulins:
These numbers come from separate placebo-controlled trials with different people, lengths and methods, so they are not a head-to-head comparison. The Soliqua labels note the insulin glargine dose in its trials was capped at 60 units by design.1
No. A unit of Soliqua carries 1 unit of insulin glargine and about 0.33 mcg of lixisenatide; a unit of Xultophy carries 1 unit of insulin degludec and 0.036 mg of liraglutide.12 Both labels say to stop any basal insulin or GLP-1 drug before starting, and not to use either with another GLP-1 drug.12
More detail: Soliqua side effects, Xultophy side effects, and the Soliqua and Xultophy dosing schedules.
That is for you and your prescriber. Timing (before breakfast vs any consistent time), the dose range your insulin needs fall into, the boxed warning and insurance coverage are the practical differences on the labels.