Coming Soon! New Once-Weekly Insulin Pen

Published June 1, 2026

In March 2026, the US Food and Drug Administration (FDA) announced approval of a new insulin called Awiqli (insulin icodec-abae) (Figure 1). It is used by adults to treat type 2 diabetes. It helps control blood sugar (glucose) in addition to diet and exercise. This new insulin is different than most other insulin products. Awiqli is more concentrated (700 units/mL) and is only taken once a week compared to other long acting insulins (100 units/mL) that are taken every day. Taking Awiqli more than once a week can be dangerous and cause severe harm.

According to the manufacturer, Novo Nordisk, Awiqli will be available in prefilled pens (1.5 mL or 3 mL) with disposable needles (Figure 2). There will also be a 1 mL (700 unit) sample pen available. The recommended starting dose is much less than the total amount in the pen. Healthcare providers may need to adjust the dose of Awiqli based on the person’s needs, blood glucose results and goals. Doses may also need to be adjusted for those with kidney or liver issues or during illness.

Awiqli is given as a subcutaneous (under the skin) injection once weekly, on the same day each week. If the person needs to change the day of the week to administer Awiqli, they should check with their doctor and may do so if their last dose has been at least 4 days prior. If they missed a dose, they should administer the missed dose as soon as possible if it has been 4 days or less, and then continue the once-weekly schedule 1 week from the day the missed dose was administered. If more than 4 days have passed, they should skip the missed dose and take their next Awiqli dose on their regularly scheduled day. *Please note: all of this information can be confusing! So, it is important to talk to your healthcare provider when a dose is missed or when you want to change the day you take the medicine.

Caution should also be taken since the Awiqli pen may look similar to other insulin pens. We have written about insulin pen mix-ups in the past, so extra precautions should be taken to prevent mix-ups. In addition, the labels and dosing dial on insulin pens are small and may be difficult to read. So, it is important to make sure you can read the label and know how to dial the correct dose.

According to Novo Nordisk, Awiqli is expected to be available in the United States this summer (2026).

Here’s what you can do: It is important to talk to your healthcare providers (doctors, pharmacists, and nurses) about Awiqli and how to take it. Ask to speak to the pharmacist when picking up the prescription. Make sure you understand how much to take, when to take it, and that it should only be taken once each week on the same day.

• Never, use an insulin syringe to withdraw Awiqli from the pen cartridge.
• Only use the needles that come with the pen and change the needle after each use.
• Never take more than one dose of Awiqli in one week.
• Before each injection, confirm you are using Awiqli and not another insulin product.
• Visually verify the dialed dose on the Awiqli pen before each injection to make sure it is correct.
• Do not dial the maximum single dose (700 units) of Awiqli unless this is the prescribed dose.
• Ensure you understand how to recognize and manage low blood sugar (hypoglycemia).
• If you make a mistake and take too much insulin, contact your doctor immediately and seek emergency medical attention.  

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