Insulin glargine / lixisenatide (iGlarLixi)

also known as: Soliqua, Soliqua 100/33, Suliqua, iGlarLixi

Sanofi's fixed-ratio insulin/GLP-1 combo pen (Soliqua, FDA 2016) — 100 units/mL insulin glargine + 33 mcg/mL lixisenatide; a parallel to Xultophy, differentiated by using short-acting prandial-biased lixisenatide rather than liraglutide.

A fixed-ratio combination pen of insulin glargine (100 units/mL) and lixisenatide (33 mcg/mL) administered once daily, FDA-approved as Soliqua in 2016 (marketed as Suliqua in the EU); the lixisenatide component contributes prandial glucose control via its short-acting gastric-emptying-slowing effects, making this combination prandial-biased in contrast with the basal-biased Xultophy (IDegLira).

Mechanism of action

Dual mechanism: insulin glargine provides 24-hour basal insulin coverage; lixisenatide provides prandial-biased GLP-1 agonism — because of its short half-life and once-daily dosing before the largest meal, lixisenatide most effectively controls postprandial glucose for that meal.

Primary uses

Type 2 diabetes mellitus inadequately controlled on basal insulin or GLP-1 monotherapy

Typical dosing

15–60 dose units once daily before first meal (subcutaneous)

1 dose unit = 1 unit glargine + 0.33 mcg lixisenatide. Max 60 units daily.

Regulatory status

FDA-approved November 2016 as Soliqua 100/33 (Sanofi) for T2DM. EMA-approved 2017 as Suliqua.

References

[fda-pi] FDA. Soliqua 100/33 (insulin glargine and lixisenatide) prescribing information. Sanofi.
[pubmed] Rosenstock J, et al. "Benefits of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide, versus insulin glargine and lixisenatide monocomponents in T2DM (LixiLan-O)." Diabetes Care, 2016;39:2026-2035.

Related peptides

Insulin glargine

The dominant once-daily basal insulin for two decades (Lantus, Sanofi, 2000) — the pI-shift design causes microprecipitation in subcutaneous tissue for a nearly peakless 24-hour absorption profile; Toujeo (U-300) is the same molecule at 3× concentration.

Lixisenatide

A short-acting, prandial GLP-1 agonist primarily used to target postprandial glucose excursions.

Insulin degludec / liraglutide (IDegLira)

Novo Nordisk's fixed-ratio insulin/GLP-1 combo pen (Xultophy, FDA 2016) — 100 units/mL insulin degludec + 3.6 mg/mL liraglutide; simplifies T2DM therapy intensification into a single daily injection with additive glycemic benefit and less weight gain than basal insulin alone.

Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.