The Tresiba FlexTouch is a prefilled insulin pen that delivers insulin degludec, a long-acting basal insulin. Using it correctly involves checking the insulin, attaching a needle, priming the pen, dialing your dose, and injecting. Here’s how to do each step.
Check the Insulin Before Each Use
Read the label on your pen to confirm you have the right insulin. Tresiba should look clear and colorless. If the liquid appears cloudy, colored, or contains particles, do not use that pen.
Attach a New Needle
Use a fresh needle for every injection. Tresiba FlexTouch pens are designed for use with NovoFine, NovoFine Plus, or NovoTwist disposable needles.
Pull off the paper tab from the needle. Push the needle straight onto the pen tip and twist it until it’s tight. Then pull off both needle caps: the wide outer cap and the smaller inner cap. Keep the outer cap nearby. You’ll need it later to safely remove the needle after your injection.
Prime the Pen
Priming pushes out any air bubbles and confirms insulin is flowing. You need to prime before every injection, not just the first time you use a new pen.
Turn the dose selector to 2 units. Hold the pen with the needle pointing straight up. Press and hold the dose button until the dose counter returns to “0,” with the zero lined up with the dose pointer. You should see a small drop of insulin at the needle tip.
If no drop appears, repeat the process. You can try up to 6 times. If you still don’t see a drop after 6 attempts, remove the needle, attach a new one, and try priming again. A pen that won’t prime after a needle change may be defective.
Dial Your Dose
Turn the dose selector to the number of units your healthcare provider prescribed. The dose counter will show the exact number. If you dial past your dose, you can turn the selector back without wasting insulin. The pen clicks as you turn, and each click corresponds to one unit.
Choose and Rotate Your Injection Site
You can inject Tresiba in four areas of the body:
- Abdomen: anywhere on the belly, staying at least one inch away from the belly button
- Thighs: the top and outer sides
- Upper arms: the outer area
- Buttocks: the upper, outer area
Rotate your injection spot within the same general area each time. Using the exact same spot repeatedly can cause the tissue under the skin to harden or develop fatty lumps, which affects how well insulin absorbs. You don’t need to switch between body regions every day, but move at least a finger’s width from your last spot within the same region.
Inject the Insulin
Insert the needle into your skin at the angle recommended for your needle length (most pen needles are designed for a straight 90-degree insertion). Press the dose button all the way in and hold it there. Keep the needle in your skin for at least 6 seconds after the counter reads “0” to make sure the full dose is delivered. Then withdraw the needle.
After injecting, place the outer needle cap back on (without the inner cap) and unscrew the needle from the pen. Dispose of it in a sharps container. Never store the pen with a needle attached, as this can let air enter the cartridge or cause insulin to leak.
Timing and Flexibility
Tresiba is taken once daily. One of its advantages over some other long-acting insulins is scheduling flexibility. While it’s best to pick a consistent time each day, Tresiba’s ultra-long duration means your timing doesn’t need to be exact. If you need to shift your injection time on a given day, just make sure at least 8 hours pass between any two doses.
What to Do If You Miss a Dose
If you forget a dose, take it as soon as you remember. If it’s already close to the time for your next scheduled dose, skip the missed one and get back on your regular schedule. Never take two doses to make up for one you missed. The key rule is maintaining at least 8 hours between any two injections.
Storage
Before you start using a Tresiba pen, store it in the refrigerator between 36°F and 46°F (2°C to 8°C). Do not freeze it. Once you begin using a pen, you can keep it at room temperature (below 86°F / 30°C) or in the refrigerator for up to 56 days. After 56 days, discard the pen even if insulin remains inside. Write the date you first use each pen on the label so you can track this easily.
U-100 vs. U-200 Pens
Tresiba comes in two concentrations. The U-100 pen contains 100 units of insulin per milliliter, while the U-200 pen contains 200 units per milliliter. The dose counter on both pens shows your dose in units, so you don’t need to do any math. A setting of “10” delivers 10 units regardless of which pen you’re using. The U-200 pen simply holds more insulin in the same volume, which is helpful if you take larger doses because it means fewer pen changes and a smaller volume of liquid under the skin per injection. Never transfer insulin from a FlexTouch pen into a syringe.