Insulin Degludec
Pronunciation: (in-SOO-lin dee-GLOO-dek).
- Generic name
- insulin degludec
- Brand names
- Degludec, Ryzodeg, Tresiba
- Drug class
- Long-acting basal insulin analogue
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What insulin degludec is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how insulin degludec works
Insulin degludec is a long-acting human insulin analogue. After subcutaneous injection, it forms multi-hexamers, creating a subcutaneous depot from which insulin monomers are slowly and continuously released into the circulation. This provides a stable, peakless, and prolonged glucose-lowering effect, mimicking basal insulin secretion. (1)
What insulin degludec is used for
Type 1 diabetes mellitus
Type 1 diabetes mellitus (1)
Type 2 diabetes mellitus
Type 2 diabetes mellitus (1)
Before taking insulin degludec
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to insulin degludec or any excipients, and during episodes of hypoglycemia. (Contraindication) (1)
Tell your clinician about
(1)How to take insulin degludec
- General Instructions: Use Tresiba exactly as prescribed by your healthcare provider. It is usually injected once daily, at any time of day, but at the same time each day.. Adult Dosing: The dose is individualized based on your blood glucose levels and response. Typical starting doses for type 1 diabetes are about one-third to one-half of the total daily insulin requirement; for type 2 diabetes, dosing is individualized.. Pediatric Dosing: Tresiba is approved for use in children aged 1 year and older. Dosing is individualized and should be determined by a pediatric endocrinologist.. Administration: Inject subcutaneously into the thigh, upper arm, or abdomen. Rotate injection sites to reduce the risk of lipodystrophy. Do not inject into a vein or muscle.. When To Seek Review: Do not ask the prescriber about stopping $1 without consulting your healthcare provider. Stopping suddenly can lead to dangerously high blood sugar.. Storage: Store unopened Tresiba pens/cartridges in the refrigerator (36°F to 46°F/2°C to 8°C). Once in use, store at room temperature (below 86°F/30°C) and use within 8 weeks. Do not freeze.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
If you miss a dose, take it as soon as you remember, as long as there are at least 8 hours until your next scheduled dose. Do not take two doses at once. If you are unsure, contact your healthcare provider for advice.
Overdose
An overdose of Tresiba can cause severe hypoglycemia. If you suspect an overdose, seek emergency medical attention immediately. Treatment may include oral glucose, intravenous glucose, or glucagon injection, along with close monitoring. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Hypoglycemia
Incidence: Reported in the clinician-authored database; frequency not established
Injection site reactions
Incidence: Reported in the clinician-authored database; frequency not established
Allergic reactions
Incidence: Reported in the clinician-authored database; frequency not established
Lipodystrophy
Incidence: Reported in the clinician-authored database; frequency not established
Weight gain
Incidence: Reported in the clinician-authored database; frequency not established
Peripheral edema
Incidence: Reported in the clinician-authored database; frequency not established
Hypokalemia
Incidence: Reported in the clinician-authored database; frequency not established
Serious warnings
Monitor for signs of hypoglycemia and always carry a source of fast-acting sugar — serious
Symptoms: Monitor for signs of hypoglycemia and always carry a source of fast-acting sugar. Adjustments may be needed during illness, stress, or changes in physical activity. Do not use if solution is cloudy or contains particles. Use caution in patients with liver or kidney impairment. Insulin requirements may change during pregnancy or breastfeeding.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in patients with hypersensitivity to insulin degludec or any excipients, and during episodes of hypoglycemia. Use with caution in patients with renal or hepatic impairment, as insulin requirements may be reduced. Monitor closely in elderly, pregnant, or breastfeeding patients.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Tresiba may interact with other diabetes medications (such as sulfonylureas, meglitinides), beta-blockers (which can mask hypoglycemia), corticosteroids, oral contraceptives, and certain antidepressants. Always inform your healthcare provider about all medications and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Insulin, including insulin degludec, is a standard and often necessary treatment for diabetes during pregnancy — poorly controlled blood glucose itself carries risks to both mother and baby. The FDA label does not identify a specific pregnancy contraindication for insulin degludec; blood glucose control should be closely monitored and insulin dose adjusted throughout pregnancy under the care of the treating clinician, as insulin needs typically change during pregnancy and postpartum. (1)
Breastfeeding
There are no data on the presence of insulin degludec in human milk, its effects on the breastfed infant, or its effects on milk production, per the FDA label (insulin degludec is present in rat milk in animal studies). Insulin is generally considered compatible with breastfeeding, since it is a naturally occurring hormone, but discuss monitoring and dose adjustment with your prescriber while breastfeeding. (1)
Children
Frequency: Not recommended for pediatric use.. Weight Based: Not established; dosing should be individualized based on blood glucose levels.. Max Daily Dose: Not recommended for pediatric use.. Max Single Dose: Not recommended for pediatric use.. Age Restrictions: Safety not established in children. (1)
Renal_impairment
FDA label: hemodialysis did not affect clearance of insulin degludec in subjects with end-stage renal disease, and no systematic trend in exposure was seen across renal-impairment subgroups; insulin degludec has also been studied across mild, moderate, and severe hepatic impairment with no meaningful pharmacokinetic differences compared with healthy subjects. Despite this pharmacokinetic stability, blood glucose monitoring should be intensified and dose individualized in patients with renal or hepatic impairment, since insulin requirements can still change with organ function — this should be managed by the treating clinician. (1)
Hepatic_impairment
FDA label: hemodialysis did not affect clearance of insulin degludec in subjects with end-stage renal disease, and no systematic trend in exposure was seen across renal-impairment subgroups; insulin degludec has also been studied across mild, moderate, and severe hepatic impairment with no meaningful pharmacokinetic differences compared with healthy subjects. Despite this pharmacokinetic stability, blood glucose monitoring should be intensified and dose individualized in patients with renal or hepatic impairment, since insulin requirements can still change with organ function — this should be managed by the treating clinician. (1)
Monitoring
(1)Storage
Store unopened Tresiba (insulin degludec) in a refrigerator (36°F to 46°F/2°C to 8°C); do not freeze, and discard if it has been frozen. In-use pens/vials may be kept at room temperature (do not store above 86°F/30°C) or refrigerated; discard an in-use pen or vial after the time specified on the product label (commonly 8 weeks, but always confirm against your specific product's labeling), even if it still contains insulin.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Type 1 diabetes mellitus
Dose summary: Initial dosing is typically 10 units once daily or 0.1 to 0.2 units/kg body weight.
Renal context: FDA label: hemodialysis did not affect clearance of insulin degludec in patients with end-stage renal disease, and no systematic trend in exposure was observed across renal-impairment subgroups. No specific numeric dose-adjustment schedule is defined; blood glucose should be monitored closely and the dose individualized in renal impairment, since overall insulin requirements can still change. (1)
Hepatic guidance
FDA label: insulin degludec has been studied in subjects with normal, mild, moderate, and severe hepatic impairment, with no meaningful pharmacokinetic differences identified compared with healthy subjects. No specific numeric dose-adjustment schedule is defined; blood glucose should be monitored closely and the dose individualized in hepatic impairment.
Frequently asked questions
How long does Tresiba last in the body?
Tresiba has an ultra-long duration of action, lasting at least 42 hours, which allows for once-daily dosing and flexibility in injection timing.
Can Tresiba be mixed with other insulins?
Tresiba should not be mixed with other insulins or solutions. It must be administered as a separate injection.
What should I do if I experience low blood sugar while using Tresiba?
Treat low blood sugar immediately with a fast-acting carbohydrate (such as glucose tablets or juice). Monitor your blood sugar and seek medical help if symptoms are severe or do not improve.
Is Tresiba safe during pregnancy and breastfeeding?
Tresiba may be used during pregnancy and breastfeeding if clearly needed. Insulin requirements may change during these periods, so close monitoring by your healthcare provider is essential.
How should I store Tresiba pens or cartridges?
Store unopened pens/cartridges in the refrigerator. Once in use, keep at room temperature and use within 8 weeks. Do not freeze or expose to excessive heat.
What are the signs of an allergic reaction to Tresiba?
Signs include rash, itching, swelling, severe dizziness, or difficulty breathing. Seek emergency medical attention if these occur.
Can children use Tresiba?
Yes, Tresiba is approved for use in children aged 1 year and older. Dosing and monitoring should be managed by a pediatric diabetes specialist.
What happens if I take too much Tresiba (insulin degludec)?
Taking too much Tresiba (insulin degludec) can lead to severe hypoglycemia, characterized by symptoms like dizziness, confusion, sweating, tremors, and in severe cases, seizures or loss of consciousness. If you suspect an overdose, consume a fast-acting sugar source immediately. Seek emergency medical attention without delay, as severe hypoglycemia can be life-threatening and requires prompt professional intervention.
Can I drink alcohol while taking Tresiba (insulin degludec)?
Drinking alcohol while taking Tresiba (insulin degludec) can increase the risk of hypoglycemia. Alcohol can interfere with the liver's ability to release stored glucose, potentially causing blood sugar levels to drop significantly. It is crucial to discuss alcohol consumption with your healthcare provider. They can provide personalized advice on safe limits or recommend avoiding alcohol entirely to prevent dangerous fluctuations in blood glucose.
Is Tresiba (insulin degludec) safe during pregnancy?
Tresiba (insulin degludec) is categorized as Pregnancy Category B, meaning animal reproduction studies have shown no risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Managing diabetes during pregnancy is critical for both maternal and fetal health. Therefore, it is essential to consult your doctor if you are pregnant, planning to become pregnant, or breastfeeding, to determine the safest and most effective treatment plan.
What is the mechanism of action of insulin degludec?
Insulin degludec is a long-acting human insulin analogue. After subcutaneous injection, it forms multi-hexamers, creating a subcutaneous depot from which insulin monomers are slowly and continuously released into the circulation. This provides a stable, peakless, and prolonged glucose-lowering effect, mimicking basal insulin secretion. (1)
What is the generic name of Insulin Degludec?
The generic name is insulin degludec. It is sold under brand names including Degludec, Ryzodeg, Tresiba.
What class of drug is insulin degludec?
Insulin Degludec is classed as: Long-acting basal insulin analogue.
References
- Tresiba (insulin degludec) injection - prescribing informationDailyMed (U.S. National Library of Medicine) · United States · accessed 2026-08-03 · source 1
- INSULIN DEGLUDEC INJECTION, SOLUTION [NOVO NORDISK PHARMA, INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
- Insulin Degludec (rDNA Origin) Injection — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
- Xultophy 100/3.6 — FDA approval record (Drugs@FDA BLA208583)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- insulin degludec — RxNorm normalized drug concept (RXCUI 1670007)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient insulin degludec names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Tresiba100 U/mL, 200 U/mL · novo nordisk