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Overview: Awiqli is a long-acting insulin used to lower blood sugar levels in people with type 2 diabetes. Common side effects include low blood sugar, weight gain, and pain, itching, or swelling at the injection site. Contact your health care provider right away if you have severe or frequent low blood sugar or if you feel weak or unusually tired. Awiqli is injected under the skin once weekly.

Uses

What is Awiqli used for?

Awiqli (insulin icodec-abae) is commonly used to help lower blood sugar levels in people with type 2 diabetes.

What to Know About Awiqli for Type 2 Diabetes

Awiqli may also be used for other conditions as determined by your health care provider.

How does Awiqli work (mechanism of action)?

Awiqli is a type of insulin. It helps sugar (glucose) move from your blood into your muscles and other tissues where your body can use it for energy. It also reduces how much sugar your liver makes.

Awiqli is a long-acting insulin. After you inject it, Awiqli attaches to a protein in your blood and is slowly released. This allows Awiqli to work steadily for a full week.

How is Awiqli supplied (dosage forms)?

Brands and other names

  • Awiqli

Dosage forms and strengths

  • 700 units/mL solution for injection (FlexTouch pen)

How should I store Awiqli?

Store unopened Awiqli in the refrigerator, between 36 F and 46 F (2 C and 8 C) until the expiration date on the label, or at room temperature up to 86 F (30 C) for up to 12 weeks. Do not freeze or place it near the cooling element in the fridge. Do not use it if it has been frozen.

After opening, you can store Awiqli at room temperature or in the refrigerator. If you keep it at room temperature, the total time spent out of the refrigerator (before and after opening) must not be longer than 12 weeks. Once it has been opened, throw the pen away after 12 weeks, even if there is medicine left and it has been kept in the refrigerator.

Side Effects

What are the most common side effects of Awiqli?

The most common side effects of Awiqli are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Low blood sugar (see below)
  • Allergic reactions (see below)
  • Pain, itching, swelling, or redness near the injection site
  • Lumpy, thickened, or sunken skin at the injection site
  • Fluid retention
  • Weight gain

There may be other side effects of Awiqli that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Awiqli?

While less common, the most serious side effects of Awiqli are described below, along with what to do if they happen.

Severe Allergic Reactions. Awiqli may cause allergic reactions, which can be serious. Stop using Awiqli and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Low Blood Sugar (Hypoglycemia). Awiqli can cause low blood sugar, which can be serious and may lead to death. You may need to check your blood sugar more often if you have changes to your diet, exercise regimen, or medicines for diabetes. Do not use Awiqli and call your health care provider right away if you have any of the following symptoms of hypoglycemia.

  • Headache
  • Crankiness or anxiety
  • Hunger
  • Dizziness or confusion
  • Blurry vision
  • Slurred speech
  • Sweating
  • Feeling jittery or shakiness
  • Fast heartbeat
  • Seizures

Low Potassium Levels (Hypokalemia). Awiqli can cause a low potassium level, which can be serious and may lead to death. Your health care provider may check your potassium levels, especially if you take other medicines that can lower potassium. Keep all appointments to have your blood checked. Call your health care provider if you have any of the following symptoms of a low potassium level.

  • Weakness
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation

Warnings & Precautions

Who should not use Awiqli?

Allergies to Ingredients. People who are allergic to any of the following should not use Awiqli.

  • Awiqli
  • Insulin icodec
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Awiqli.

Low Blood Sugar (Hypoglycemia). Awiqli should not be used when you have low blood sugar. Be familiar with the symptoms of low blood sugar, including dizziness, sweating, confusion, and shakiness. Ask your health care provider how often to check your blood sugar and what to do when it is low.

What should I know about Awiqli before using it?

Do not use Awiqli unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share Awiqli with other people, even if they have the same condition as you. It may harm them. Do not reuse or share needles with other people because you may get a serious infection. Always use a new needle for each injection.

Keep Awiqli out of the reach of children. Since this medicine may be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

This medicine is injected under the skin. Read the instructions and make sure that you or a caregiver understands how to prepare and use Awiqli. If you have any questions, talk to your health care provider.

Be careful if you are using more than one injectable medicine. To prevent mistakes, always double check the label and dialed units on the Awiqli FlexTouch pen to make sure you are using the right product and dose. Do not use a syringe to remove Awiqli from the FlexTouch pen, as this can lead to an overdose.

Do not use the same exact spot for each Awiqli injection. Do not inject areas of your skin that are thickened, bruised, tender, hard, or damaged.

Do not drive or do other activities that require alertness or coordination until you know how Awiqli affects you.

Talk with your health care provider about how to recognize and treat low blood sugar (hypoglycemia). Because Awiqli is a long-acting insulin, low blood sugar may last longer and take more time to improve than with shorter-acting insulin products.

Checking your blood sugar regularly can help you prevent and manage low blood sugar. If you are at higher risk of low blood sugar, or if you do not always feel symptoms, your health care provider may recommend checking your blood sugar more often.

If you need to change the day you use Awiqli, you can do this as long as it has been at least 4 days since your last dose. Ask your health care provider if you have questions about when to use Awiqli.

What should I tell my health care provider before using Awiqli?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Awiqli is right for you.

In particular, make sure that you discuss any of the following.

Heart Failure. Awiqli may increase your risk of heart failure when used with other diabetes medicines, such as pioglitazone (Actos). If you have heart failure, it may get worse if you take these medicines while using Awiqli. Tell your health care provider right away if you have any of the following new or worse symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Other Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Diet and Lifestyle Changes. Tell your health care provider if you have any changes in your diet, timing of meals, level of physical activity, illnesses, weight, or stress. Such changes may affect the amount of Awiqli you need.

Other Medicines and Supplements. Awiqli may interact with other medicines and supplements. Before using Awiqli, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section below for more details.

Pregnancy. It is not known if or how Awiqli could affect pregnancy or harm a fetus. Tell your health care provider if you are or plan to become pregnant. Your health care provider will let you know if you should use Awiqli while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if Awiqli passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Awiqli while breastfeeding.

How can I get more information about Awiqli?

For more information about Awiqli, you can visit the drugmaker’s website at www.awiqli.com or call them at 800-727-6500.

Interactions

Does Awiqli interact with foods or drinks?

There are no known interactions between Awiqli and foods or drinks.

Alcohol may affect blood sugar levels in people with diabetes. This may interfere with the effect of Awiqli. Do not drink alcohol or use any medicines that have alcohol in them while using Awiqli.

Does Awiqli interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Awiqli.

  • Any other medicine for diabetes, including pioglitazone (Actos)
  • A glucagon-like peptide-1 (GLP-1) receptor agonist, such as semaglutide (Ozempic, Wegovy), which is a medicine for diabetes or weight loss
  • A salicylate, such as diflunisal or salsalate, which is a medicine used for arthritis 
  • An angiotensin-converting enzyme (ACE) inhibitor, such as enalapril or lisinopril, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • An angiotensin II receptor blocker (ARB), such as losartan or valsartan, which is a medicine for high blood pressure, heart failure, and other heart conditions
  • Fluoxetine (Prozac), which is a medicine commonly used for anxiety and depression
  • A sulfonamide, such as sulfamethoxazole, which is an antibiotic used for certain infections
  • A corticosteroid, such as dexamethasone, methylprednisolone, or prednisone, which is a medicine for certain inflammatory conditions
  • A diuretic, also called a water pill, which is a medicine used to reduce fluid retention or blood pressure
  • A birth control pill
  • A beta-blocker, such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL, and others), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to lower blood pressure 
  • Clonidine (Catapres-TTS and others), which is a medicine used for high blood pressure or attention deficit hyperactivity disorder (ADHD) 

Many other medicines may affect your blood sugar levels, which may alter the effect of Awiqli on your blood sugar. Talk to your pharmacist or other health care provider before starting or stopping other medicines while using Awiqli. You may need to check your blood sugar levels more closely during these times.

This may not be a complete list of medicines that can interact with Awiqli. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Awiqli?

If you or someone else has used too much Awiqli, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Awiqli?

Awiqli is typically injected one time each week, on the same day each week. If you miss a dose, inject it as soon as possible within 4 days. Then inject your next dose 1 week later as your new scheduled day. But if you miss a dose of Awiqli and more than 4 days have passed since it was due, skip the missed dose. Use your next dose on your regularly scheduled day. Do not use double or extra doses.

Check your blood sugar more often if you miss a dose, and call your health care provider if you have any questions.