Medication Information Leaflet

What is this medication for?

Soliqua® is an injection that contains two medications: Insulin Glargine and Lixisenatide.

These medications help to control diabetes.

Insulin glargine is long-acting and helps to lower blood sugar throughout the day.

Lixisenatide works by slowing the movement of food from your stomach to the small intestine, hence slowing down absorption of sugars into the body. It also regulates the amount of insulin made by your body in a sugar-dependent manner.

How should I take/use this medication?

• Soliqua® is to be injected once a day.
• Soliqua® should be injected 1 hour before meal, preferably the same meal every day, with the most convenient meal.
• Inject Soliqua® into the fatty tissue that is between the skin and muscle layer on the upper arms, thighs or tummy (abdomen).
• Use the injection technique advised by your doctor or nurse and as described in the manual.
• Ensure that the liquid is clear and colourless before use.
• Do not use it if it appears cloudy, grainy or if particles are seen. 

You may refer to this article for more details on insulin injection techniques.

What should I do if I forget to take/use this medication?

If you missed a dose, inject the next dose at the usual time the following day.

Do not inject two doses at the same time.

What precautions should I take?

Inform your healthcare professional if you:

• Are allergic to this medication or any of the ingredients in this medication.
• Are eating less than usual due to sickness or dietary changes as your dosage may need to be changed.
• Are travelling across different time zones. You might need to adjust the number of meals and the dose of your insulin based on where you travel to.
• Are pregnant, planning to become pregnant or breastfeeding.
• Have stomach or intestinal problems or delayed stomach emptying (gastroparesis).
• Have or have had problems with your pancreas or stones in your gallbladder.
• Have kidney or liver problems.

What are some common side-effects of this medication?

Like all medications, this medication may cause some possible side effects but not everyone experiences them. Consult your healthcare professional if any of the side effects becomes severe and bothersome.

The common side effects of Glargine and Lixisenatide include:

• Nausea
• Vomiting
• Diarrhoea
• Stuffy or runny nose
• Sore throat
• Low blood sugar (hypoglycaemia)

This medication may cause low blood sugar (hypoglycemia). Symptoms of low blood sugar include:

• Weakness
• Dizziness 
• Hunger
• Sweating
• Trembling
• Blurred vision
• Walking unsteadily
• Fast heartbeat

If you experience any of these low blood sugar symptoms, do the following immediately: 

Step 1: Check your blood sugar level with a home blood sugar meter (glucometer) if available. If your blood sugar level is less than 4 mmol/L, take 15 grams of fast-acting sugar. Examples of 15 grams of fast-acting sugar include:

• 3 glucose tablets or 
• Half a glass of fruit juice (200ml) or
• Half a can of soft drink or sweetened drink (175ml) or
• 1 can of less sugar soft drink (330ml) or
• 3 teaspoons of sugar, honey or syrup

Step 2: Monitor yourself for 15 minutes. If you have a glucometer (home blood sugar meter), check your blood sugar level again after 15 minutes.

Step 3: If your blood sugar level is still less than 4 mmol/L or you still have symptoms of low blood sugar, you should take another 15 grams of fast-acting sugar as per Step 1.

If your symptoms do not go away, see a doctor or go to the hospital immediately.

Step 4: Take your meal or snack if your blood sugar level is 4 mmol/L and above after consuming the fast-acting sugar earlier on.

Inform your doctor about your low blood sugar event during your next clinic visit.  

Low blood sugar may occur if you: 

• Inject too much insulin
• Do not eat on time, miss your meals or change your diet
• Exercise or work too hard just before or after a meal
• Do not eat well due to an infection or illness (especially diarrhoea or vomiting)
• Drink alcohol on an empty stomach while injecting insulin
• Have kidney or liver problems which have worsened

Some patients may also experience mild pain, redness, bruising, swelling, a small lump or dent of the skin at the injection site.

• Do not reuse your needles, rotate injection sites within the recommended areas and use shorter needles (4mm or 6mm) to reduce the chances of developing such reactions. 
• They also usually go away in a few days to a few weeks. 
• See a doctor if you frequently experience this. Your injection technique may need to be reviewed.

What are some rare but serious side-effects for which I need to seek medical advice immediately?

If the following serious side effects happen, you should consult your healthcare professional immediately:

• Pancreatitis (inflammation of the pancreas) is a rare but serious side effect of this medication. Symptoms of pancreatitis include:
  • Severe pain in the stomach, abdomen or back area
  • Nausea or vomiting that does not go away
  • Fever

See a doctor or go to the hospital immediately if your blood sugar level is always low (less than 4 mmol/L) or you continue to experience symptoms of low blood sugar even after taking some sugar (see instructions above for management of low blood sugar).

What food or medication should I avoid when I take this medication?

You should avoid taking alcohol with this medication as this may increase your risk of having low blood sugar.

Inform your doctor or pharmacist if you are taking oral contraceptives, as you will need to space this medication apart from some oral contraceptives.

How should I store this medication?

Store unopened Soliqua® in a refrigerator between 2 to 8 degrees Celsius. Do not freeze. 

Do not keep this medication in a hot place (eg. in a hot, closed vehicle, on top of a television set) or expose it to heat or sunlight. Do not use it if this happens.

Once opened, the Soliqua® pen should not be refrigerated. Store opened pens in a cool and dry place, away from direct heat and sunlight. Medication that has been exposed to direct sunlight for a prolonged duration may turn a yellow-brown colour. If this happens, do not use that pen and open a new one instead. Discard the Soliqua® pen 4 weeks after opening.

Keep this medication away from children. Throw away all expired medications.

How should I throw away this medication safely?

You may throw this injection away along with the used needles into a metal tin or thick plastic container (eg. detergent bottles). You can also buy a container specially designed to throw sharp items, known as a sharps box, to prevent any injuries due to the needles. 

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Disclaimers

Please take note that the above is not a complete list of all possible side effects. If you have any concerns about your medication or if you have other side effects that you think are caused by this medication, please consult your doctor or pharmacist.

If you take more than the recommended dose, please seek medical advice immediately. The information provided on this page does not replace information from your healthcare professional. Please consult your healthcare professional for more information.

This article is jointly developed by members of the National Medication Information workgroup. The workgroup consists of cluster partners (National Healthcare Group, National University Health System and SingHealth), community pharmacies (Guardian, Unity and Watsons) and Pharmaceutical Society of Singapore. The content does not reflect drug availability and supply information in pharmacies and healthcare institutions. You are advised to check with the respective institutions for such information.

Please visit www.moh.gov.sg/knowyourmeds and www.ndf.gov.sg for more information on medication.

Last updated on May 2023