Soliqua 100/33 (also written as Soliqua 100/33 ml) is a fixed‑ratio, once‑weekly injectable that combines two antidiabetic agents:
| Component |
Dose in Soliqua 100/33 |
Action |
| Insulin glargine |
100 units per mL |
Long‑acting basal insulin – provides a steady background insulin level for 24 h. |
| Lixisenatide |
33 µg per mL |
GLP‑1 receptor agonist – stimulates glucose‑dependent insulin secretion, suppresses glucagon, delays gastric emptying and promotes satiety. |
The “100/33” refers to the concentration of each active ingredient per millilitre, not to the total dose you inject. The actual dose you’ll receive is expressed in units of insulin and micrograms of lixisenatide, and it is usually titrated by the physician based on your blood‑glucose readings.
1. What is Soliqua 100/33 used for?
- Type 2 diabetes mellitus (T2DM)
- Used when a patient requires both basal insulin and a GLP‑1 receptor agonist but prefers a single‑injection regimen.
- It can be added to ongoing metformin or other oral agents, or it may replace a basal insulin plus a GLP‑1 agonist that the patient was already on.
2. How is it taken?
| Step |
How to prepare & administer |
Tips |
| Reconstitution |
Soliqua is pre‑filled and ready to use—no need to mix. |
Check the vial for any particles or discoloration; discard if abnormal. |
| Injection site |
Subcutaneous, usually in the abdomen, thigh, buttocks, or upper arm. Rotate sites. |
Use a new pen or needle each time. |
| Frequency |
Once weekly, on the same day each week. |
Pick a day that fits your routine; use a calendar or phone reminder. |
| Dosage |
Determined by your clinician. Typical starting dose: 1 unit of insulin glargine (≈ 1 µg lixisenatide) once weekly. |
| Titration |
Usually increased by 1 unit of insulin glargine (≈ 1 µg lixisenatide) every 1–2 weeks, based on fasting‑post‑prandial glucose or HbA1c targets. |
Do not skip doses. If you miss a dose, give it as soon as you remember, but skip the next scheduled dose if it’s close. |
3. What are the main benefits?
| Benefit |
How it works |
| Convenience |
One weekly injection replaces a basal insulin plus a daily GLP‑1 agonist. |
| Glycaemic control |
Basal insulin handles fasting glucose; lixisenatide reduces post‑meal spikes and helps with weight control. |
| Weight |
GLP‑1 agonists often lead to modest weight loss or weight neutrality; this can offset the weight gain seen with insulin alone. |
| Reduced hypoglycemia |
Because lixisenatide only stimulates insulin when glucose is high, the risk of low blood sugar is lower than with short‑acting insulin alone. |
4. Common side effects
| Symptom |
Frequency |
What to do |
| Hypoglycemia (especially if you’re on sulfonylureas or insulin) |
5–15 % |
Check glucose promptly; treat with fast‑acting carbohydrate if <70 mg/dL. |
| Nausea, vomiting, diarrhea (GI upset) |
~20 % |
Start at a lower dose, take with food, and gradually titrate. |
| Injection‑site reactions (redness, itching) |
<5 % |
Rotate sites; use a fresh needle. |
| Rare – pancreatitis |
<1 % |
Seek medical help if you develop abdominal pain, nausea, or vomiting. |
5. Precautions & contraindications
| Situation |
Why it matters |
| Pregnancy / Breastfeeding |
Category B in the U.S.; limited data. Consult your clinician before use. |
| Renal impairment |
Lixisenatide is cleared renally; dose adjustments may be needed if eGFR <30 mL/min. |
| Hypo‑ or hyper‑thyroidism |
Insulin sensitivity changes; monitor glucose closely. |
| History of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia type 2 |
GLP‑1 agonists are contraindicated. |
| Peptic ulcer disease |
Delayed gastric emptying may worsen ulcers. |
| Concurrent sulfonylurea or insulin therapy |
Risk of additive hypoglycemia. |
6. Drug interactions
| Drug class |
Interaction |
Practical advice |
| Sulfonylureas |
Additive hypoglycemia risk |
Consider reducing or holding the sulfonylurea. |
| Other insulins |
Additive effect |
Titrate carefully, monitor glucose. |
| NSAIDs |
May affect glucose levels |
Monitor closely if you start or stop NSAIDs. |
| Medications that alter gastric emptying |
Can modify lixisenatide effect |
Discuss with your provider. |
7. Storage & handling
- Keep refrigerated (2–8 °C) before first use.
- After first use – can stay at room temperature (15–25 °C) for up to 28 days.
- Never freeze.
- Discard if the solution becomes cloudy or you notice particles.
8. Practical tips for success
- Track your glucose: Keep a log (paper or app) to see how fasting and post‑prandial readings respond to dose changes.
- Plan your injection day: Choose a day and time that fits your schedule; consistency improves adherence.
- Use a reminder: Many people set an alarm or use a diabetes app to remember the weekly dose.
- Discuss side‑effect management: If nausea is bothersome, talk to your clinician—sometimes starting at a lower dose helps.
- Keep your pen handy: Carry it in a small bag or pocket so you can inject as needed.
- Regular check‑ups: Meet your diabetes care team at least every 3–6 months to review HbA1c, weight, and any issues.
9. When to seek help
- Severe or persistent hypoglycemia (symptoms: confusion, seizures, unconsciousness).
- Symptoms of pancreatitis (abdominal pain radiating to the back, nausea, vomiting).
- Signs of allergic reaction (rash, itching, swelling, difficulty breathing).
- Unexpected weight gain or loss beyond what is typical.
Bottom line
Soliqua 100/33 gives you a once‑weekly combo of a long‑acting insulin and a GLP‑1 agonist, designed to simplify complex regimens while improving blood‑glucose control, reducing post‑meal spikes, and helping with weight management. As with any medication, proper dosing, monitoring, and communication with your healthcare team are key to making it work best for you.
If you have any specific questions about your dose, side‑effects, or how Soliqua fits into your overall treatment plan, it’s best to discuss them directly with your prescribing clinician or diabetes educator.