Tresiba - timing of dose

Hi - I’m switching from Levemir to Tresiba. I have been taking 14 units of Levemir 2x daily around 6:30am and 6:30pm. For those who are using Tresiba, do you find it better to dose in the am or in the pm, or does it make any difference ?

Also, I am assuming that I should start with a dose similar to the total amount of Levemir I use over 24 hours (28units). That seems like a lot, but it’s probably just psychological.

Many thanks for any insights from your experience.

I don’t think it matters one iota with tresiba. You can take it Monday morning, then Tuesday evening, then Wednesday morning, or whatever . Take it whenever you want as longn as its 1x daily time doesn’t matter

Yes it seems like a lot but it is psychological.


I was on Tresiba for four months last year (not curretnly) and found the timing of the dose didn’t matter much. I used to take it before bedtime. One night I forgot the dose and just took it the next morning with no measurable performance change. I found Tresiba very forgiving with dosage timing. It’s only real requirement is to space out doses by at least eight hours.

If you don’t like the idea of trusting Tresiba with an initial dose of 28 units, you could experiment with less, say 21 units, and see what happens. I found Tresiba a very easy insulin to live with.


I actually just did this (went from pm to am). Was taking around 10pm in the evening and one day decided to switch as it’s more convenient to take in morning when I wake up. I was worried but it worked out well. Had a rise over night but nothing dramatic and I ultimately attributed that to the couple slices of pizza I ate late and not enough bolus.

Not sure on the Tresiba to Levemir dosage as I went from a pump (Humalog) to Tresiba however my total daily on the pump is essentially the same as the amount of my Tresiba injection.

Good luck.

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Thank you for the feedback. I think I’ll dose in the morning when I get up since it fits in with the routine of checking sugar 1st thing. Also will let me watch over the day. Had some bad experiences with overnight hypos when I started on Levemir. Would like to avoid any such episodes.

I switched from Levemir (2x/day) to Tresiba (1x/day). I use the same number of basal units per day and it works great. I agree with other comments about the forgiving nature of timing.
I thought Levemir was pretty good (and way better for me than Lantus), but I like Tresiba even more – especially with overnight stability.


Typically I would take my tresiba in the evenings… but then a few times I forgot to take it in the evening… so now I’m back to morning dosing…doesn’t seem to make too much difference… The best time to take it will be the time that suits you.


Me too…I use less Tresiba and find that it is pretty even for me and I’m not tied to the clock for dosing, which is nice…well awesome really. The only thing I have is some lows overnight but it is not THAT low and I found that a snack at night helpful…

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If Tresiba lasts 48 hours, why can’t we take it every two days? Seems like too much in the system if it lasts 48 hours, I don’t get it??

Essentially because you’re taking X amount per day and X amount is also wearing off each day also regardless of how long it lasts… they’re the units you took a couple days ago wearing off currently and the units you take today are the ones wearing off a couple days in the future… I had trouble wrapping my mind around it at first too… but it works and it doesn’t stack

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I was hoping I could cut it in half by taking it every other day. I have experience significant weight gain (20 lbs) in the first weeks of going on insulin. Was hoping I could take my 16 units every other day, guess that was a big PIPE DREAM!!

Check this out. Just Googled the Tresiba-people are taking it every 2 days!!

What’s Really Different About Tresiba?
What’s new about Tresiba is that it is actually a long-lasting basal insulin. It stays effective for 42 hours between doses, meaning it offers patients the flexibility to take some injections every other day, if they need to. Granted, Novo recommends that patients take it daily and that’s what the FDA’s approved it for, but with that 42-hour effectiveness it offers flexibility unprecedented by other background insulins.

So let’s say you take one Tresiba dose on Monday at 9 a.m. You could theoretically wait to take the next dose until Tuesday at 5 p.m., and you might want to take Ryzodeg instead with dinner before you take the next dose of Tresiba on Wednesday morning at 9 a.m. again. Go, flexibility!

Another unique aspect of this new Tresiba is that it’s available in both U100 and U200 concentrations. In the U100 pen, you can give a max of 80 units for a single dose, while in the U200 pen, you can give a maximum single dose of 160 units. That’s way more than any competitors offer, and a big benefit for anyone with T2 who needs large amounts of insulin.

Don’t read too much into it… it is a once daily insulin. I wouldn’t recommend using it every other day.

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I agree with this (once daily recommended), but I disagree that it doesn’t stack, unless I misunderstand what that means. I would say it doesn’t peak.
If its duration is 40+ hours and it’s being injected every 24, that means the new dose is riding on the base of the previous dose. That’s stacking, right? But your point is well taken: because its duration is long, doing daily doses doesn’t mean you get more than your daily dose in any 24-hour period, even though they’re overlapping.

Sure you could call it that… but there isn’t the negative effect of stacking where today’s dose is compounding yesterday’s and you end up with 2x the dose working simultaneously like you might get if you took two shorter acting insulins too close together

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I agree with Sam. I would so recommend against taking it every other day. The pharmacokinetics of Tresiba just don’t work that way. I’d like to see a 48-hour BG graph of someone claiming success with every-other-day dosing.

LOL how appropriate a thread as I ran out of the house this morning and forgot to take my Tresiba for the first time!!! I also have an endo appointment this afternoon!!! Debating whether I run back home (45 minute commute) and take the Tresiba or just want until later this afternoon.

@Sam19 thoughts?

I think you’d be fine to take it when you get home tonight, then take it as normal tomorrow

Thanks buddy. My endo has a pen set aside for me so I’ll just take when I get there. That way I’ll only be about 4 hours off. Although my CGM is stellar right now so clearly the Tresiba is still working.

4 hours off is a good day for me

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