What is the half-life of Soliqua (insulin glargine and lixisenatide) in an adult patient with type 2 diabetes?

Half-Life of Soliqua

Soliqua contains lixisenatide with a half-life of approximately 2-3 hours and insulin glargine with an effective duration of action up to 24 hours, though insulin glargine does not have a traditional elimination half-life due to its unique absorption-dependent pharmacokinetics.

Lixisenatide Component

• Lixisenatide displays an absorption-dependent elimination half-life of 2-3 hours following subcutaneous administration 1
• This short half-life classifies lixisenatide as a short-acting GLP-1 receptor agonist, which primarily exerts postprandial effects after the meals with which it is administered 2
• The short duration of action means lixisenatide's effects on gastric emptying and postprandial glucose control are most pronounced after breakfast, with diminished effects after later meals 3

Insulin Glargine Component

• Insulin glargine has an onset of action of approximately 1 hour, a peakless profile, and duration of action up to 24 hours, making it suitable for once-daily dosing 4
• Rather than a traditional elimination half-life, insulin glargine's pharmacokinetics are characterized by its slow, consistent absorption from subcutaneous tissue, providing relatively uniform insulin coverage throughout 24 hours 4
• The peakless absorption profile results in more stable glycemic control compared to intermediate-acting insulins like NPH 4

Clinical Implications of Combined Pharmacokinetics

• The complementary pharmacokinetic profiles in Soliqua allow insulin glargine to mainly target fasting glycemia while lixisenatide mainly targets postprandial hyperglycemia 5
• This dual mechanism results in greater HbA1c reduction than either component alone, with a higher percentage of patients reaching HbA1c ≤7% 5
• The fixed-ratio combination provides more gradual titration of the GLP-1 receptor agonist component, resulting in fewer gastrointestinal adverse effects compared to lixisenatide alone 5

Important Caveats

• In some patients, insulin glargine may not provide full 24-hour coverage, and dividing the dose into two daily injections should be considered if glycemic control is inadequate 4
• The lixisenatide component's effects on gastric emptying and postprandial glucose control are time-dependent and diminish significantly by a late lunch 8 hours after administration 3
• Soliqua is administered once daily at the same time each day, typically within 1 hour before the first meal of the day, to optimize the postprandial effects of lixisenatide 5, 6