Learning how to use the Lyxumia pen correctly is essential for effective blood glucose management in type 2 diabetes. Lyxumia (lixisenatide) is a once-daily GLP-1 receptor agonist delivered via a pre-filled injection pen called Lyxumia SoloStar. Proper technique ensures you receive the full prescribed dose—either 10 micrograms during the initial 14-day period or 20 micrograms for ongoing maintenance. This guide provides step-by-step instructions on preparing your pen, selecting injection sites, administering your dose safely, and troubleshooting common issues. Whether you're starting treatment or need a refresher, understanding correct pen use helps optimise your diabetes control and minimises the risk of complications.

What Is Lyxumia and How Does It Work?

Lyxumia (lixisenatide) is a once-daily injectable medicine used to improve blood glucose control in adults with type 2 diabetes mellitus. It belongs to a class of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of a naturally occurring hormone that helps regulate blood sugar levels after meals.

Lyxumia is not suitable for type 1 diabetes or diabetic ketoacidosis, and it is not a substitute for insulin. It is prescribed alongside other diabetes medicines—such as metformin, sulfonylureas, or basal insulin—when diet and exercise alone are insufficient to control blood sugar levels.

The medication works through several complementary mechanisms. Firstly, Lyxumia stimulates the pancreas to release insulin when blood glucose levels are elevated, particularly after eating. Secondly, it slows gastric emptying, which means food moves more slowly from the stomach into the small intestine, helping to prevent sharp rises in blood sugar after meals. Additionally, it suppresses the release of glucagon, a hormone that raises blood glucose levels. These combined actions help achieve better glycaemic control throughout the day.

Dosing regimen: Treatment begins with 10 micrograms once daily for 14 days, then increases to a maintenance dose of 20 micrograms once daily thereafter. Your doctor will prescribe the appropriate pen strength for each stage. Lyxumia is administered via a pre-filled pen device (Lyxumia SoloStar), designed for subcutaneous injection (under the skin). It must be taken within one hour before the same meal each day—usually the first meal of the day, or the evening meal if preferred—maintaining consistency in timing.

Important safety information:

• Hypoglycaemia (low blood sugar) risk increases when Lyxumia is used with a sulfonylurea or basal insulin. Your doctor may reduce the dose of these medicines when starting Lyxumia. Signs of hypoglycaemia include trembling, sweating, confusion, rapid heartbeat, or hunger. If you experience these symptoms, eat or drink something containing sugar immediately and contact your healthcare team.

• Pancreatitis: Stop using Lyxumia and seek urgent medical attention if you develop severe, persistent abdominal pain (with or without vomiting), as this may indicate pancreatitis.

• Renal impairment: Use Lyxumia with caution if you have moderate kidney impairment. It is not recommended if you have severe kidney impairment or end-stage renal disease.

• Pregnancy and breastfeeding: There is limited data on use during pregnancy or breastfeeding. Discuss with your doctor or diabetes specialist nurse if you are pregnant, planning pregnancy, or breastfeeding.

• Drug interactions: Because Lyxumia slows digestion, it may affect the absorption of other oral medicines. Take oral contraceptives at least 1 hour before or 11 hours after your Lyxumia injection. Take paracetamol at least 1 hour before or 4 hours after Lyxumia. If you take other time-critical medicines, ask your pharmacist or doctor for specific timing advice.

Common side effects include nausea (particularly when starting treatment), vomiting, diarrhoea, and headache. These effects often diminish as your body adjusts to the medication. If you experience persistent vomiting, severe abdominal pain, or signs of hypoglycaemia, contact your GP or diabetes specialist nurse promptly.

Reporting side effects: If you experience any side effects, including those not listed in the patient information leaflet, report them via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk or via the Yellow Card app. Reporting helps improve the safety information available about this medicine.

Preparing Your Lyxumia Pen for First Use

Before using your Lyxumia SoloStar pen for the first time, proper preparation is essential to ensure safe and effective administration. Always read the patient information leaflet and Instructions for Use provided with your medication and follow your healthcare professional's instructions carefully.

Initial checks are crucial before first use:

• Remove the pen from the refrigerator approximately 30 minutes before use to allow it to reach room temperature, which makes injection more comfortable

• Check the expiry date printed on the pen label—never use an expired pen

• Inspect the solution through the cartridge window; it should be clear and colourless. Do not use if the solution appears cloudy, discoloured, or contains particles

• Ensure you have the correct pen strength as prescribed by your doctor: 10 micrograms (for the first 14 days of treatment) or 20 micrograms (for maintenance)

Attaching a new needle is required for each injection:

• Wash your hands thoroughly with soap and water

• Remove the pen cap by pulling it straight off

• Take a new pen needle (these are prescribed separately) and remove the protective seal

• Push the needle straight onto the pen and twist firmly until it is securely attached

• Remove the outer needle cap and keep it for later disposal; then remove and discard the inner needle cap

Performing a safety check before your first injection with a new pen, and each time you attach a new needle, ensures the pen is working correctly:

• Turn the dose selector to select the safety check dose as shown in the Instructions for Use

• Hold the pen with the needle pointing upwards and tap the cartridge holder gently to move any air bubbles towards the needle

• Press the injection button fully until the dose indicator returns to the starting position

• A drop of solution should appear at the needle tip, confirming the pen is ready for use

If no drop appears, repeat this process up to three times with a new needle. If the problem persists, do not use the pen and contact your pharmacist for a replacement.

Note: The Lyxumia SoloStar pen delivers a fixed daily dose (either 10 micrograms or 20 micrograms, depending on which pen you have been prescribed). Follow the device-specific instructions in your patient information leaflet exactly to avoid dosing errors.

Step-by-Step Guide to Injecting Lyxumia

Administering Lyxumia correctly ensures optimal medication delivery and minimises discomfort. The injection must be given subcutaneously (under the skin) within one hour before the same meal each day—usually your first meal of the day, or your evening meal if you prefer.

Selecting and preparing the injection site:

• Choose an injection site on your abdomen (avoiding the area around your navel) or thigh. The upper arm may also be used if someone else is giving you the injection (self-injection in the upper arm can be difficult)

• Rotate injection sites with each dose to prevent lipodystrophy (changes in fat tissue under the skin)

• Clean the chosen area with an alcohol wipe if recommended by your healthcare team, and allow the skin to dry completely

• Do not inject into areas that are tender, bruised, red, or hard

Preparing your dose:

• Attach a new needle as described in the previous section

• Perform the safety check if this is your first injection with a new pen or if you have not used the pen for several days

• Your Lyxumia pen delivers a fixed dose of either 10 micrograms or 20 micrograms (depending on which pen has been prescribed). Follow the Instructions for Use to set the dose indicator to the correct position for your pen

• Check the dose indicator window to confirm the correct dose before proceeding

Administering the injection:

• Pinch a fold of skin gently between your thumb and forefinger

• Insert the needle straight into the skin at a 90-degree angle using a quick, dart-like motion

• Press the injection button fully and hold it down

• Keep the button pressed and count slowly to 10 to ensure the full dose is delivered

• Check that the dose indicator has returned to the starting position

• Release the button, then withdraw the needle straight out from the skin

• Do not rub the injection site afterwards

Post-injection steps:

• Carefully place the outer needle cap back onto the needle without touching the needle itself

• Unscrew and remove the used needle, disposing of it immediately in a sharps container

• Replace the pen cap and store the pen appropriately

• Never store the pen with a needle attached, as this can cause air bubbles, leakage, or needle blockage

If you notice a small amount of blood at the injection site, apply gentle pressure with a clean tissue. This is normal and does not affect the medication's effectiveness. If you are unsure whether you received the full dose, do not inject again—wait until your next scheduled dose and contact your diabetes specialist nurse or pharmacist for advice.

Storage and Disposal of Your Lyxumia Pen

Proper storage of your Lyxumia pen is essential to maintain the medication's effectiveness and safety. Incorrect storage can reduce the medication's potency, potentially affecting your blood glucose control.

Before first use:

• Store new, unused Lyxumia pens in the refrigerator at 2°C to 8°C

• Keep the pen in its original packaging to protect it from light

• Do not freeze the medication; if accidentally frozen, discard the pen as it will no longer be safe to use

• Do not store near the freezer compartment or cooling elements

After first use:

• Once you start using a pen, it may be stored at room temperature (not above 30°C) for up to 14 days, or you may continue to store it in the refrigerator

• Keep the pen cap on when not in use to protect from light

• Do not store with a needle attached, as this can cause air bubbles, leakage, or needle blockage

• Discard the pen 14 days after first use, even if solution remains—write the date of first use on the pen label as a reminder

• Never store in direct sunlight, in a car, or near heat sources

Safe disposal practices:

• Used needles must be disposed of immediately after each injection in an approved sharps container (available from your pharmacy)

• Never recap needles using both hands or point them towards yourself

• Do not dispose of needles in household waste or recycling bins

• When your sharps container is three-quarters full, seal it and return it to your pharmacy or local authority clinical waste collection point for safe disposal

• Dispose of used or expired pens according to local regulations—your pharmacist can advise on the correct disposal method in your area

Travel considerations:

• When travelling by air, carry your Lyxumia pen in hand luggage (not in the aircraft hold, where it may freeze) along with a letter from your doctor and the original packaging for security checks

• Use a cool bag (not in direct contact with ice packs) if refrigeration is unavailable during travel

• Protect the pen from extreme temperatures during transit

If you have questions about storage or disposal, consult your pharmacist or diabetes specialist nurse for guidance specific to your circumstances.

Common Mistakes and Troubleshooting Tips

Understanding common errors when using your Lyxumia pen can help you avoid problems and ensure you receive the correct dose consistently. If you encounter difficulties, your diabetes specialist nurse or pharmacist can provide additional support and training.

Common mistakes to avoid:

• Not performing the safety check before first use of a new pen or when attaching a new needle, which may result in air bubbles or incomplete doses

• Failing to count to 10 after pressing the injection button—releasing too quickly means you may not receive your full dose

• Reusing needles, which can cause pain, infection, needle blockage, and inaccurate dosing. Always use a new needle for each injection

• Injecting through clothing rather than directly into clean skin

• Not rotating injection sites, leading to lipodystrophy and unpredictable medication absorption

• Storing the pen with the needle attached, causing air bubbles and medication leakage

Troubleshooting common issues:

If the pen does not contain enough medication for your full dose:

• Check the amount of solution remaining in the cartridge window

• Do not inject a partial dose. Use a completely new pen to deliver your full prescribed dose (either 10 micrograms or 20 micrograms)

• Never attempt to force the dose selector or combine doses from two pens

If no medication appears at the needle tip during the safety check:

• Repeat the safety check up to three times with a new needle each time

• Check the needle is properly attached and not blocked

• If the problem persists after three attempts, do not use the pen—contact your pharmacist for a replacement

If you forget a dose:

• Take it as soon as you remember, provided it is within one hour before your next meal

• If it is too close to your next scheduled dose or you have already eaten, skip the missed dose entirely

• Never take two doses on the same day to make up for a forgotten dose

• Resume your normal schedule with the next meal

If you accidentally inject too much:

• Monitor closely for signs of hypoglycaemia (low blood sugar): trembling, sweating, confusion, rapid heartbeat, hunger, or dizziness

• Eat or drink something containing sugar immediately if symptoms develop

• Contact your GP, diabetes specialist nurse, or NHS 111 for advice

• Seek immediate medical attention (call 999) if you experience severe symptoms, seizures, or loss of consciousness

If you experience severe or persistent side effects:

• Severe, persistent abdominal pain (with or without vomiting): Stop using Lyxumia and seek urgent medical attention, as this may indicate pancreatitis

• Persistent injection site reactions (redness, swelling, pain lasting more than a few days): Contact your diabetes specialist nurse or GP

• Repeated hypoglycaemia: Your doctor may need to adjust the dose of your sulfonylurea or insulin

When to seek professional help:

Contact your healthcare team if you experience persistent injection site reactions, repeated difficulty using the pen, concerns about your blood glucose control, or any unexpected side effects. Your diabetes specialist nurse can arrange additional training sessions to review your injection technique and address any concerns.

Remember: Report any side effects via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk or via the Yellow Card app. This helps improve the safety information available about Lyxumia.

Frequently Asked Questions