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Overview: Tresiba is a long-acting insulin used to lower blood sugar levels in people with diabetes. It works by helping sugar (glucose) in the blood move into cells so the body can use the sugar for energy. It also reduces sugar production by the liver. Common side effects include low blood sugar, weight gain, and pain, redness, 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. Tresiba is a liquid that is injected under the skin, and it comes in a vial or pen device.

Uses

What is Tresiba used for?

Tresiba (insulin degludec) is commonly used to help lower blood sugar levels in people with either type 1 diabetes or type 2 diabetes.

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

How does Tresiba work (mechanism of action)?

Tresiba works to help keep your blood sugar levels from getting too high. Tresiba provides a substance called insulin that works throughout the day. Insulin helps move sugar (glucose) from the blood into cells and reduces sugar production by the liver. 

How is Tresiba supplied (dosage forms)?

Brands and other names

  • Tresiba

Dosage forms and strengths

  • 100 units/mL solution for injection (vial and FlexTouch pen)
  • 200 units/mL solution for injection (FlexTouch pen)

How should I store Tresiba?

Store unopened Tresiba in a 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 56 days. 

Store opened Tresiba in a refrigerator, between 36 F and 46 F (2 C and 8 C), or at room temperature up to 86 F (30 C) for up to 56 days. 

Store Tresiba in the original carton to protect it from light. Do not freeze Tresiba.

Side Effects

What are the most common side effects of Tresiba?

The most common side effects of Tresiba 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, such as rash and itching (see below)
  • Pain, itching, swelling, or redness near the injection site
  • More or less fat tissue at the injection site
  • Fluid retention (edema)
  • Weight gain

There may be other side effects of Tresiba 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 Tresiba?

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

Low Blood Sugar (Hypoglycemia). Tresiba can cause low blood sugar (hypoglycemia), 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 Tresiba 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

Severe Allergic Reactions. Tresiba can cause allergic reactions, which can be serious. Stop using Tresiba 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 Potassium Level (Hypokalemia). Tresiba 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 certain other medicines. 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 Tresiba?

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

  • Insulin degludec
  • Tresiba
  • Any of the ingredients in the specific product dispensed

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

Low Blood Glucose (Hypoglycemia). Tresiba 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 about your blood sugar levels and when to check them.

What should I know about Tresiba before using it?

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

Do not share Tresiba 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 or syringe for each injection.

Keep Tresiba 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 and follow the instructions for Tresiba and make sure that you or a caregiver understands how to properly prepare and use it. If you have any questions, talk to your health care provider.

Be careful if you are using multiple insulin products. To prevent a medicine mistake, do not use a syringe to remove Tresiba from the FlexTouch pen. Before you inject any insulin, check the label to be sure you are using the right product and dose. 

Do not use the same exact spot for each Tresiba injection. Do not inject where your skin is thickened, bruised, tender, hard, or damaged. 

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

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

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 Tresiba is right for you.

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

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

Heart Failure. Tresiba may increase your risk of heart failure when used with other diabetes medicines called pioglitazone (Actos) or rosiglitazone (Avandia). If you have heart failure, it may get worse if you take these medicines with Tresiba. 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

Diet and Lifestyle Changes. Tell your health care provider if you have any changes in your diet, level of physical activity, or illnesses. These may affect the amount of Tresiba you need.

Other Medicines and Supplements. Tresiba may interact with other medicines and supplements. Before using Tresiba, 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 Tresiba 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 Tresiba while you are pregnant or trying to get pregnant. 

Breastfeeding. It is not known if Tresiba 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 Tresiba while breastfeeding.

How can I get more information about Tresiba?

For more information about Tresiba, you can visit the drugmaker's website at www.tresiba.com or call them at 800-727-6500. 

Interactions

Does Tresiba interact with foods or drinks?

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

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

Does Tresiba 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 Tresiba.

  • Any other medicine for diabetes, including pioglitazone (Actos) 
  • 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)
  • Guanethidine or reserpine, which is a medicine for high blood pressure 

Many other medicines may affect your blood sugar, or may increase or decrease the effect of Tresiba on your blood sugar. Talk to your pharmacist or other health care provider before starting or stopping other medicines while using Tresiba. 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 Tresiba. 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 Tresiba?

If you or someone else has used too much Tresiba, 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 Tresiba?

If you are an adult and you miss a dose, use it as soon as you remember if there is at least 8 hours before your next dose. Do not use double or extra doses. If a child misses a dose, call their health care provider to get instructions for checking blood sugar levels until the next scheduled dose.