Tresiba FlexTouch 100 IU/ml | Single Insulin Degludec Pen Bangladesh

Tresiba Single Pen – Insulin Degludec 100 IU/ml by Novo Nordisk

What is Tresiba (Insulin Degludec)?

Tresiba (insulin degludec) is an ultra-long-acting basal insulin analogue by Novo Nordisk. Unlike insulin glargine or detemir, degludec forms a subcutaneous depot of multi-hexamers after injection, releasing insulin slowly at a flat, peakless rate for beyond 42 hours. This ultra-long profile produces a lower day-to-day variability compared to other basal insulins, significantly reducing nocturnal hypoglycaemia risk. The single pen (1×3ml) is ideal for patients initiating Tresiba therapy or requiring individual dosing. The clear solution requires no resuspension. Once-daily injection at any consistent time of day is recommended.

Generic Name & Composition

Each ml contains 100 IU insulin degludec. Degludec is a modified insulin where the B30 threonine is removed and a C18 fatty diacid chain is attached at B29 lysine via a glutamic acid linker. After subcutaneous injection, degludec self-assembles into stable multi-hexamers that slowly dissociate into monomers for absorption — producing a flat, peakless 42+ hour profile.

Indications

• Type 1 diabetes — as basal component in basal-bolus regimen
• Type 2 diabetes — once-daily basal insulin therapy
• Adults, adolescents, and children ≥1 year (100 IU/ml formulation)
• Patients with high nocturnal hypoglycaemia risk on other basal insulins

How It Works — Mechanism of Action

After SC injection, degludec monomers self-associate into soluble multi-hexamers — a subcutaneous depot. Zinc and albumin binding mediate gradual mono-hexamer release into capillaries. The flat pharmacokinetic profile means no pronounced peak, minimal intraday glucose variability, and reduced hypoglycaemia risk. Once-daily dosing is possible at any time due to the 42+ hr duration.

Dosage & Administration

Starting dose (Type 2 insulin-naïve): 10 IU once daily. Type 1: Individualised — replace total basal dose. Titration: Adjust by 2 IU every 3 days based on fasting glucose. Inject subcutaneously (abdomen, thigh, or upper arm). Do not inject IV or IM. FlexTouch pen allows dosing in 1-unit steps up to 80 IU.

Side Effects

Very common: Hypoglycaemia (lower rate vs. glargine U100 in clinical trials).

Common: Injection site reactions, lipohypertrophy, peripheral oedema.

Uncommon: Lipoatrophy, visual refraction changes at initiation.

Rare: Generalised hypersensitivity, anaphylaxis.

Drug Interactions

Increase hypoglycaemia risk: OADs, GLP-1 RAs, SGLT-2 inhibitors, ACE inhibitors, salicylates, MAO inhibitors, alcohol.

Reduce effect: Corticosteroids, glucagon, thyroid hormones, growth hormone, sympathomimetics, danazol, oral contraceptives.

Mask symptoms: Beta-blockers, clonidine.

Contraindications

• Hypersensitivity to insulin degludec or any excipient
• Active hypoglycaemia; intravenous or intramuscular use

Pregnancy & Lactation

Pregnancy: Clinical data limited; consider switching to well-characterised insulin under specialist supervision. Lactation: No clinically relevant absorption expected in breastfed infant.

Precautions & Warnings

• Flexible dosing: If a dose is missed, inject when remembered — ensure ≥8 hrs between doses. Resume regular schedule next day.
• Do not mix with other insulins in same syringe/pen.
• Do not freeze. Protect opened pen from light. Discard after 56 days.

Overdose

Hypoglycaemia. Mild: oral glucose. Severe: IV dextrose or IM glucagon. Monitor closely — degludec's 42+ hr duration means prolonged hypoglycaemia is possible.

Storage Instructions

• Unopened: 2–8°C. Do not freeze.
• In-use pen: Below 30°C. Do not refrigerate.
• Discard 56 days after first use.

Frequently Asked Questions (FAQs)

Q1: Can I take Tresiba at different times each day?
Yes — Tresiba's >42-hour duration allows flexible once-daily dosing. If you change injection time, ensure at least 8 hours between consecutive doses. Clinical studies confirm no loss of glycaemic control with dose-time flexibility.

Q2: Is Tresiba better than Lantus (glargine)?
Clinical trials (BEGIN series) show Tresiba achieves similar HbA1c reduction with significantly lower nocturnal hypoglycaemia vs. glargine U100. Both are effective basal insulins; choice depends on patient profile and physician preference.

Q3: Does Tresiba need to be refrigerated after opening?
No. The in-use pen can be stored below 30°C for up to 56 days — longer than most other basal insulin pens (28 days). Do not refrigerate the in-use pen.

Q4: Why is this a single pen while Tresiba FlexTouch comes as 5 pens?
The single pen option (1×3ml = 300 IU) is designed for patients starting Tresiba or needing a single pen for travel or dose trials. The 5-pen pack is more economical for long-term users.

⚕ Medical Disclaimer: For educational purposes only. Tresiba is Rx-only. Consult your diabetologist before changing insulin therapy. DiabetesStore.com.bd is a licensed online pharmacy.