If you have type 2 diabetes, your doctor might suggest Xultophy 100/3.6 as a treatment option. It’s a prescription drug used to manage blood sugar levels in adults with type 2 diabetes. It’s used together with frequent exercise and a healthy diet to help manage this condition.

Xultophy 100/3.6 comes in a prefilled pen. You’ll use this pen to give yourself a subcutaneous injection (an injection under your skin). Your doctor will show you how to do this. If you and your doctor agree this drug is safe and effective for you, you’ll likely use it long term.

The two active ingredients in Xultophy 100/3.6 are insulin degludec and liraglutide. An active ingredient is what makes a drug work. Insulin degludec is a type of biologic medication (a drug made from parts of living organisms).

For more information about Xultophy 100/3.6, including details about its uses, see this in-depth article.

Like other drugs, Xultophy 100/3.6 can cause mild to serious side effects. Keep reading to learn more.

Some people may experience mild to serious side effects during their Xultophy 100/3.6 treatment.

Below are some of the most commonly reported side effects in the drug’s studies. Keep in mind that not everyone who uses Xultophy 100/3.6 will have side effects. In fact, many people use this drug without having any side effects.

Examples of common side effects include:

* To learn more about this side effect, see the see the “Side effects explained” section below.

Like most medications, treatment with Xultophy 100/3.6 can cause mild side effects.

Examples that have been reported include:

* To learn more about this side effect, see the see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using Xultophy 100/3.6 unless your doctor recommends it.

Xultophy 100/3.6 may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Xultophy 100/3.6, visit MedWatch.

While not common in studies, serious side effects can occur with Xultophy 100/3.6.

Serious side effects that have been reported include:

If you develop serious side effects during Xultophy 100/3.6 treatment, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
Xultophy 100/3.6 has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

Get answers to some frequently asked questions about Xultophy 100/3.6’s side effects.

Does Xultophy 100/3.6 cause weight gain?

Like other insulin products, Xultophy 100/3.6 can cause weight gain. (Insulin degludec is one of the active drugs in Xultophy 100/3.6).

In the drug’s studies, people using Xultophy 100/3.6 gained about 4.4 pounds on average.

Talk with your doctor if you have questions or concerns about weight gain and your diabetes treatment plan. They can recommend ways to maintain a weight that’s healthy for you.

Is it safe to use Xultophy 100/3.6 if I have liver problems?

Xultophy 100/3.6 is thought to be safe for use in people with liver problems.

Studies of Xultophy 100/3.6 didn’t include anyone with liver problems. But people with liver problems may be at higher risk of hypoglycemia (low blood sugar) from using an insulin product, including Xultophy 100/3.6. (Insulin degludec is one of the active drugs in Xultophy 100/3.6.)

Due to this risk, if your doctor does prescribe Xultophy 100/3.6 for you, it will likely be a lower dose. And they may want you to monitor your blood sugar levels more closely.

Talk with your doctor or pharmacist if you have other questions about diabetes treatments, such as Xultophy 100/3.6 and liver health.

Will Xultophy 100/3.6 cause skin problems?

It’s possible, but only at sites where you inject Xultophy 100/3.6.

Using insulin products, including Xultophy 100/3.6, for a long time can cause lumpy, pitted, or thicker skin at sites where you inject the drug. (Xultophy 100/3.6 is given by subcutaneous injection, which is an injection just under your skin).

There are ways to help prevent this side effect. You should choose a new site to inject each Xultophy 100/3.6 dose. You can inject into the same body area, but try not to use the same spot. For example, if you gave your last dose into your thigh, it’s OK to inject your next dose into the other side of that same thigh.

Talk with a doctor or pharmacist if you have questions or concerns about changes to your skin during treatment with Xultophy 100/3.6.

Learn more about some of the side effects Xultophy 100/3.6 may cause.

Risk of thyroid tumors

Xultophy 100/3.6 has a boxed warning about the risk of thyroid tumors. This is the most serious warning the Food and Drug Administration (FDA) can give a medication. Boxed warnings alert healthcare professionals and patients about the most serious side effects a drug may cause.

Liraglutide, one of the active drugs in Xultophy 100/3.6, increased the risk of thyroid tumors in animal studies. It isn’t known whether the drug increases this risk in humans.

Due to this potential risk, doctors usually won’t prescribe Xultophy 100/3.6 if you have a personal or family history of:

Symptoms of a thyroid tumor may include:

What might help

If you notice symptoms of a thyroid tumor, call your doctor right away. Your doctor will want to examine you. They’ll also likely order lab tests to evaluate your symptoms. They will help determine whether it’s safe for you to continue Xultophy 100/3.6 treatment.

Low blood sugar levels

Like all medications used to treat diabetes, Xultophy 100/3.6 may cause your blood sugar level to become too low. This is known as hypoglycemia.

Low blood sugar is the most common side effect caused by drugs that contain insulin, including Xultophy 100/3.6. But this side effect is usually mild in most people when it does occur.

Symptoms of mild low blood sugar can include:

In rare cases, low blood sugar caused by Xultophy 100/3.6 can be severe. You may have an increased risk if you:

Symptoms of severe hypoglycemia can include:

In extreme cases, it can even lead to death.

What might help

Before you begin treatment, ask your doctor how often you should check your blood sugar while being treated with Xultophy 100/3.6.

You should also talk with your doctor about what to do if your blood sugar level becomes too low. You can often treat mild low blood sugar at home using quick-acting carbohydrates, such as:

  • 3 or 4 pieces of hard candy
  • ½ cup of juice or regular (non-diet) soda
  • 1 tablespoon of honey
  • glucose (sugar) tablets

For severe low blood sugar, your doctor may prescribe glucagon for you. It’s a medication used to quickly increase blood sugar levels that are dangerously low.

Talk with your doctor about your treatment plan in case you have low blood sugar during Xultophy 100/3.6 treatment. But contact 911 or go to the closest emergency room if you have symptoms of severe low blood sugar or symptoms that feel life threatening.

Injection site reactions

Using Xultophy 100/3.6 may cause injection site reactions as a side effect. These weren’t common in the drug’s studies, though.

Injection reactions to the skin at the injection sites include:

In most cases, these reactions went away with continued use of the medication.

What might help

To help reduce your risk of injection site reactions, choose a different injection site for each dose. You can use the same body area but choose a different spot from your previous injection.

You also should not inject Xultophy 100/3.6 into skin that is:

  • bruised or tender
  • scaly or hard
  • scarred or damaged
  • thickened or lumpy

If you have injection site reactions with Xultophy 100/3.6 that bother you or don’t go away, talk with your doctor. They may recommend a different treatment for your diabetes.

Allergic reaction

Like most drugs, Xultophy 100/3.6 can cause an allergic reaction in some people. But these weren’t common in the drug’s studies.

Symptoms can be mild or serious and include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a medication to manage your symptoms, such as:

  • an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine)
  • a topical product, such as hydrocortisone cream

If your doctor confirms you have had a mild allergic reaction to Xultophy 100/3.6, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Xultophy 100/3.6, they may have you switch to a different treatment.

Keeping track of side effects

During your Xultophy 100/3.6 treatment, consider keeping notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Taking notes and sharing them with your doctor will help them learn more about how Xultophy 100/3.6 affects you. And they can use this information to adjust your treatment plan if needed.

There are important things to consider before using Xultophy 100/3.6, including a boxed warning about the risk of thyroid tumors.

Boxed warning: Risk of thyroid tumors

Xultophy 100/3.6 has a boxed warning for the risk of thyroid tumors. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Liraglutide, one of the active drugs in Xultophy 100/3.6, increased the risk of thyroid tumors in animal studies. It is not known whether the drug also increases this risk in humans.

To learn more, see the “Side effects explained” section above.

Other warnings

Xultophy 100/3.6 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 starting Xultophy 100/3.6. Below are some factors to consider.

Heart failure. Tell your doctor if you have a history of heart failure before starting treatment with Xultophy 100/3.6. Taking certain other diabetes medications, known as thiazolidinediones, along with Xultophy 100/3.6 can increase your risk of heart problems. Heart failure can even occur in people who have not had heart problems. Your doctor will recommend the safest diabetes treatment plan for you.

History of gallbladder problems. Rarely, using Xultophy 100/3.6 can cause gallbladder problems (including gallstones) as a side effect. It isn’t known if you’re at higher risk if you have a history of gallbladder problems. Ask your doctor if Xultophy 100/3.6 is safe for you if you have a history of this condition.

Liver problems. If you have liver problems, you may be at higher risk of hypoglycemia (low blood sugar) with Xultophy 100/3.6 treatment. Your doctor can help determine if this medication is safe for you. If they do prescribe Xultophy 100/3.6 for you, they may have you check your blood sugar more often. They may also start you on a lower dose of this medication.

Problems with stomach emptying, such as gastroparesis. Liraglutide, one of the active drugs in Xultophy 100/3.6, slows down how quickly your stomach empties. People with this type of stomach problem (such as gastroparesis) were not included in studies of Xultophy 100/3.6. But it is possible that this drug could worsen your condition and dramatically slow how quickly your stomach empties. Due to this risk, doctors may not prescribe Xultophy 100/3.6 if you have problems with stomach emptying.

Allergic reaction. If you’ve had an allergic reaction to Xultophy 100/3.6 or any of its ingredients, your doctor will likely not prescribe Xultophy 100/3.6. Ask your doctor what other medications are better options for you.

Alcohol and Xultophy 100/3.6

You should not use Xultophy 100/3.6 with alcohol. This includes prescription and over-the-counter drugs containing alcohol. If you do consume alcohol, use extreme caution until you are comfortable with your dose of Xultophy 100/3.6.

Because alcohol contains sugar, it can affect your blood sugar level. And since Xultophy 100/3.6 is used to regulate blood sugar, drinking during treatment can cause the drug to not work as well.

Consuming alcohol can also increase your risk of certain other side effects from Xultophy 100/3.6, including:

Talk with your doctor if you have questions about alcohol consumption and Xultophy 100/3.6. They may adjust your dosage or check your blood sugar level more often during treatment with this drug.

Pregnancy and breastfeeding while using Xultophy 100/3.6

It’s not known whether it’s safe to use Xultophy 100/3.6 while pregnant.

If you’re pregnant or considering it, talk with your doctor about the best diabetes treatment for you. Keep in mind that diabetes that isn’t well managed can also cause problems during pregnancy.

It’s unknown whether Xultophy 100/3.6 is present in human breast milk or if it could cause side effects in a breastfed child. Talk with your doctor about safe feeding options for your child if you’re using Xultophy 100/3.6.

Like most drugs, Xultophy 100/3.6 can cause side effects. Some side effects, such as low blood sugar, are more common than others. Many people receiving Xultophy 100/3.6 treatment do not experience side effects. But keep in mind each person’s experience with this drug may be different.

Before starting Xultophy 100/3.6, talk with your doctor. Ask them questions that help you feel comfortable about the risks and benefits of this treatment. Some examples to help get you started are:

  • How do side effects with Xultophy 100/3.6 compare to other drugs for treating diabetes?
  • If I have side effects from Xultophy 100/3.6, is there a lower dose I can try?
  • Are there other ways to help me manage side effects from Xultophy 100/3.6?

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Q:

Is it safe to use Xultophy 100/3.6 if I have heart failure?

Anonymous

A:

Maybe, but it depends on certain factors.

People with heart failure were included in studies of Xultophy 100/3.6. Researchers didn’t note any differences in how safe or effective the drug was in people with heart failure.

But like other insulin products, Xultophy 100/3.6 can cause salt and fluid retention, which can lead to edema (swelling). If you have heart failure, this means your symptoms may get worse if you use Xultophy 100/3.6. This is most likely at the beginning of treatment or if your doctor increases your dose. And it’s more likely if your blood sugar level was very high before starting the drug.

Using Xultophy 100/3.6 may not be safe if you have heart failure and take a type of diabetes drug called a thiazolidinedione. One example is rosiglitazone (Avandia). Using an insulin product, such as Xultophy 100/3.6, together with a thiazolidinedione can cause fluid retention and worsening heart failure. For this reason, it is very important you tell your doctor or pharmacist about all medications you take before starting Xultophy 100/3.6. They can review your medications and check for any that may not be safe to take with this drug.

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.