Treatment of migraine headache pain when it is still mild to moderate in intensity improves response and reduces the risk of recurrence. An oral nonopioid analgesic such as a nonsteroidal anti-inflammatory drug (NSAID) or acetaminophen is often sufficient for acute treatment of mild to moderate migraine pain without severe nausea or vomiting. When moderate to severe migraine pain is not managed adequately with a nonopioid analgesic alone, addition of a triptan is recommended.1
Drugs for preventive treatment of migraine will be reviewed in a future issue.
ANALGESICS —...
RELEASE
Insulin icodec (Awiqli – Novo Nordisk), an ultra-long-acting basal human insulin analog, has been approved by the FDA for once weekly treatment of type 2 diabetes. Two once-daily, long-acting insulin analogs are available in the US: glargine U300 (Toujeo) and degludec U100 and U200 (Tresiba). Insulin icodec has been available in Canada since 2024.
INSULIN FOR TYPE 2 DIABETES — Many patients with type 2 diabetes eventually require insulin for glycemic control. When adding insulin to other glucose-lowering drugs, a basal insulin is usually the first choice (see Table 1).1,2
PHARMACOLOGY — Like other long-acting human insulin analogs, insulin icodec is synthesized using recombinant DNA technology. It forms multihexamers in subcutaneous tissue, which delays its absorption, and binds to circulating albumin, which delays its elimination (see Table …