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Icodec, Awiqli, Insulin U-700

  • See Also
  1. Basal insulin
  • Background
  1. Released and FDA approved in 2026, as the first weekly Basal insulin
  • Indications
  1. Type 2 Diabetes Mellitus on Basal insulin
  • Contraindications
  1. Hypoglycemia risk
  • Mechanism
  1. Binds reversibly to Serum Albumin
  2. Slowly released in a depot effect that lasts for approximately 7 days
  3. Peak plasma concentration is reached 15 hours after dose
  • Dosing
  1. New Insulin start
    1. Start 70 units once weekly and titrate dose on a weekly basis based on Glucose monitoring
  2. Switching from other daily Basal insulin (e.g. Insulin Glargine) use
    1. Week 1 Loading Dose = (prior Basal insulin dose) * 7 * 1.5 (round to nearest 10 units)
      1. Given the day after the last Basal insulin
    2. Week 2 Dose: (prior Basal insulin dose) * 7
    3. Titrate dose weekly based on Glucose monitoring
  3. Missed doses
    1. Within 4 days of missed dose
      1. Give dose and shift weekly dose to the day given
    2. More than 4 days from missed dose
      1. Skip dose and resume on upcoming next due date
  • Resources
  1. Icodec (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5162b93e-5775-4581-a5e9-e8783ae0acd7
  • References
  1. (2026) Presc Ins 33(10): 5-6