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Onswik ™ (insulin efsitora alfa-gobe) injection
500 units/mL (U-500), 1,000 units/mL (U-1,000)
This information is provided in response to your request. Resources may contain information about doses, uses, formulations and populations different from product labeling. See Prescribing Information above, if applicable.
How do patients inject ONSWIK™ (insulin efsitora alfa-gobe) with the KwikPen?
Patients inject efsitora once weekly with a single-patient-use KwikPen. The pen is primed before each injection, the dose is checked in the dose window, and the dose is never selected by counting clicks.
Content Overview
- What KwikPen strengths are available for efsitora?
- What should patients know before injecting efsitora?
- How is the efsitora KwikPen stored?
- What are the steps for injecting efsitora with the KwikPen?
- How are used pens and needles disposed of, and what troubleshooting advice is available?
- Enclosed Prescribing Information
- References
What KwikPen strengths are available for efsitora?
Efsitora is supplied in a disposable, single-patient-use prefilled KwikPen that is available in 2 strengths (Table 1). Patients are advised to read the Instructions for Use before they start injecting efsitora and each time they get another pen.1,2
Feature |
U-500 KwikPen |
U-1,000 KwikPen |
|---|---|---|
Concentration |
500 units/mL |
1000 units/mL |
Total insulin in the pen |
1500 units |
3000 units |
Pen color |
light gray |
light gray |
Dose knob color |
yellow |
green |
Units dialed with each click |
5 units |
10 units |
Dose range in a single injection |
5 to 400 units |
10 to 800 units |
Priming dose |
5 units |
10 units |
Notes: If a dose is more than the maximum single-injection dose, more than 1 injection is needed.
What should patients know before injecting efsitora?
Before injecting efsitora, patients are advised that
- efsitora is used once weekly, and marking a calendar may help as a reminder of the next dose
- the KwikPen works differently from other pens, and the dose is not selected by counting clicks of the dose knob because this may result in too much or not enough insulin
- insulin is not transferred from the pen into a syringe, because a severe overdose causing very low blood sugar can happen
- the pen delivers the dose in insulin units, which may not be the same as syringe markings
- people who are blind or have vision problems do not use the pen without help from a person trained to use the pen, and
- the pen is not shared with other people, even if the needle has been changed.1,2
How is the efsitora KwikPen stored?
The pen in use is stored in the refrigerator at 36F-46F [2C-8C] at all times. If refrigeration is not possible, the pen can be stored at room temperature up to 86F [30C] for up to a total of 14 days and is thrown away if it has been at room temperature for more than 14 days. Efsitora is not frozen or used if it has been frozen, and the pen is kept away from heat and light.1,2
A refrigerated pen in use is thrown away after 112 days (16 weeks), even if it still contains insulin. The pen is not used past the expiration date printed on the label.1,2
What are the steps for injecting efsitora with the KwikPen?
The steps for preparing, priming, and injecting a dose with the efsitora KwikPen are summarized in Table 2.1,2
Stage |
Steps |
Key Points |
|---|---|---|
Preparing the pen (steps 1-4) |
wash hands with soap and water; check the pen to make sure it is the right type of insulin; pull the pen cap straight off and wipe the rubber seal with an alcohol swab; check that the insulin is clear and colorless to yellow; pull the paper tab off a new needle, push the capped needle straight onto the pen, and twist it clockwise until tight; pull off the outer needle shield (keep it) and the inner needle shield (throw it away) |
do not use if the insulin is cloudy, discolored, or has particles or clumps in it; do not use the pen past the expiration date or for more than 112 days after first use; always use a new needle for each injection, and do not reuse or share needles |
Priming the pen (steps 5-7) |
turn the dose knob to select 5 units (U-500) or 10 units (U-1,000); hold the pen with the needle pointing up and tap the cartridge holder gently to collect air bubbles at the top; push the dose knob in until it stops and “0” is seen in the dose window, then hold it in and count to 5 slowly; insulin should be seen at the tip of the needle |
prime before each injection, as not priming may result in too little insulin; if no insulin is seen, repeat steps 5 to 7 no more than 8 times, and if there is still no insulin, change the needle and repeat priming; small air bubbles are normal and will not affect the dose |
Selecting the dose (step 8) |
turn the dose knob to select the number of units needed so that the dose indicator lines up with the dose; correct the dose by turning the dose knob in either direction; always check the number in the dose window |
do not dial the dose by counting clicks; the pen will not dial more than the number of units left in the pen, and if the dose is more than the units left, either inject the amount left and use a new pen for the rest of the dose or use a new pen for the full dose; a dose above the single-injection maximum is given as more than 1 injection, each with a new needle and priming |
Giving the injection (steps 9-11) |
choose an injection site on the stomach area, buttocks, thigh, or back of the upper arms; wipe the skin with an alcohol swab and let it dry; insert the needle, push the dose knob all the way in, and hold it all the way in while slowly counting to 5 before removing the needle; check that “0” is shown in the dose window |
rotate injection sites within the chosen area for each injection; do not inject where the skin has pits, is thickened, has lumps, is tender, bruised, scaly, or hard, or into scars or damaged skin; do not inject by turning the dose knob or change the dose while injecting; if “0” is not shown, do not redial, but reinsert the needle and finish the injection; if a full dose is still not thought to have been received, do not repeat the injection and monitor blood sugar as instructed |
After the injection (steps 12-14) |
carefully replace the outer needle shield; unscrew the capped needle and throw it away; replace the pen cap by lining up the cap clip with the dose indicator and pushing straight on |
do not store the pen with the needle attached, to prevent leaking, blocking the needle, and air from entering the pen; if blood is seen, press the injection site lightly with a piece of gauze or an alcohol swab and do not rub the area |
How are used pens and needles disposed of, and what troubleshooting advice is available?
Used needles are put in a US Food and Drug Administration (FDA)–cleared sharps disposal container right away after use and are not thrown away loose in household trash. If an FDA-cleared sharps disposal container is not available, a household container that is made of heavy-duty plastic, can be closed with a tight-fitting, puncture-resistant lid, is upright and stable during use, is leak resistant, and is properly labeled to warn of hazardous waste may be used. When the container is almost full, community guidelines are followed for the right way to dispose of it, and the container is not recycled. The used pen may be thrown away in household trash after the needle has been removed.1,2
The pen and needles are kept out of the sight and reach of children, the pen is not used if any part looks broken or damaged, and patients are advised to always have an extra pen in case theirs is lost or damaged. Troubleshooting advice in the Instructions for Use includes
- gently twisting the pen cap back and forth, then pulling it straight off, if the cap cannot be removed
- pushing the dose knob more slowly if it is hard to push
- putting on a new needle and priming the pen if the needle may be blocked, and
- throwing the pen away and getting a new pen if dust, food, or liquid may be inside the pen.1,2
Patients switching from another type of insulin device or pen are advised that the efsitora KwikPen dials 5 units (U-500) or 10 units (U-1,000) with each click of the dose knob, and that the dose is not selected by counting clicks.1,2
Enclosed Prescribing Information
ONSWIK™ (insulin efsitora alfa-gobe) injection, for subcutaneous use, Lilly
References
- Onswik U-500 KwikPen [instructions for use]. Indianapolis, IN: Eli Lilly and Company; 2026.
- Onswik U-1,000 KwikPen [instructions for use]. Indianapolis, IN: Eli Lilly and Company; 2026.
Date of Last Review: October 23, 2026