How to Help Your Patients Who Were on the Adlyxin Starter Kit: A Provider's Guide

Three years after the US market withdrawal of Adlyxin (lixisenatide), some patients are still encountering confusion when trying to fill or refill the Adlyxin Starter Kit. Whether they are long-standing patients whose records still reflect an old prescription, or new patients who found an outdated prescription pad note, providers play a critical role in helping these patients transition safely and access appropriate therapy.

Identifying Patients Who May Still Be Seeking Adlyxin

In clinical practice, the patients most likely to still be asking about Adlyxin include:

Patients with older standing prescriptions that were never updated after the January 2023 discontinuation

Patients who traveled or moved and are now presenting at a new pharmacy or provider office

Patients who found lixisenatide referenced in historical medication records and are asking about it

Patients researching GLP-1 options online who see Adlyxin mentioned in older content

The Clinical Case for Proactive Transition

Any patient whose active medication list still shows Adlyxin should be proactively transitioned. In addition to the obvious access problem (the drug does not exist in the US market), clinical guidelines have evolved. The American Diabetes Association 2025 Standards of Care now recommend GLP-1 receptor agonists with proven cardiovascular benefit as preferred agents for patients with type 2 diabetes and atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease.

Lixisenatide (ELIXA trial) demonstrated cardiovascular safety (non-inferiority vs placebo) but no superiority benefit. Patients with ASCVD, CKD, or HFrEF deserve transition to an agent with proven outcome data.

Step-by-Step: Transitioning a Patient from Adlyxin

Review the patient's current glycemic profile. Check the most recent HbA1c, fasting glucose, postprandial patterns, weight, and any cardiovascular or renal comorbidities before selecting a replacement.

Select an evidence-based replacement. For most patients, semaglutide (Ozempic) or dulaglutide (Trulicity) offer superior efficacy, proven cardiovascular outcomes, and once-weekly dosing. For patients requiring daily injection scheduling or who prefer it, liraglutide (Victoza) is the closest equivalent. For patients with high cardiovascular risk or those not at glycemic goal, tirzepatide (Mounjaro) offers maximum efficacy.

Address the insulin question. If the patient was on Adlyxin plus basal insulin, consider whether Soliqua 100/33 (still available) is appropriate, or whether transitioning to a standalone weekly GLP-1 and continuing current insulin is preferable.

Prior authorization planning. Ozempic, Trulicity, and Mounjaro typically require prior authorization for type 2 diabetes. Prepare supporting documentation including diagnosis, failure of first-line agents (usually metformin), current HbA1c, and cardiovascular risk factors. Most commercial plans process PA requests within 3–7 business days.

Patient education. Explain why lixisenatide is no longer available and orient the patient to the new medication — dosing schedule, injection technique, titration plan, and what side effects to expect during the first weeks.

Help the patient locate the new medication. GLP-1 agents continue to face intermittent supply issues at some pharmacies. Refer patients to medfinder to locate the specific medication and dose at pharmacies in their area.

Soliqua 100/33: When It Is the Right Transition

Soliqua 100/33 is most appropriate when:

The patient requires both basal insulin and GLP-1 coverage

The patient's total basal insulin requirement is under 60 units daily

Reducing injection burden is a clinical priority for adherence

The patient ate consistently with the main meal while on Adlyxin and postprandial control was a primary target

Helping Patients with Access and Affordability

Cost and availability are two distinct challenges for GLP-1 patients. On the cost side, most GLP-1 manufacturers offer savings programs for commercially insured patients: Ozempic's Novo Nordisk savings program can bring copays to as low as $25/month for eligible patients; Eli Lilly's Mounjaro savings card offers similar reductions. On the access side, GLP-1 stock varies by pharmacy location and medication dose.

Directing patients to medfinder can reduce calls back to your office from patients unable to fill their prescriptions. For the patient-facing version of what happened with Adlyxin, see our Adlyxin patient update article.