Seventy units a week if you are new to insulin. Your daily basal dose multiplied by seven if you are switching across.
The number you dial is not the number you know. That is where the mistakes start.
Evidence based patient guide by RealMedVision | 10 to 12 minute read
Key takeaways
- Adults new to insulin start at 70 Awiqli units once a week, on the same day each week (FDA, 2026).
- Switching from a daily basal insulin, the week 1 dose is your daily dose multiplied by 7, then by 1.5, rounded to the nearest 10 units. From week 2 it is your daily dose multiplied by 7 (FDA, 2026).
- That extra half in week 1 is a one-time loading dose. Repeating it in week 2 is an overdose (EMA, 2024).
- The FlexTouch pen holds 700 units in every mL, seven times the strength of standard insulin, and dials in steps of 10 units (FDA, 2026).
- A missed dose can be taken within 4 days. After that, skip it and return to your usual day (FDA, 2026).
- In the ONWARDS trials, adults with type 2 diabetes settled on roughly 204 to 322 units a week (FDA, 2026).
Awiqli dosage is measured by the week, not by the day. That is why many people find it confusing at first. If you are new to insulin, the usual starting dose is 70 units once a week. If you are switching from a daily basal insulin, your weekly dose is calculated by multiplying your current daily dose by seven.
Awiqli is the brand name for insulin icodec, a long-acting background insulin made by Novo Nordisk and given once a week. In the United States the label calls it insulin icodec-abae. It is the same medicine.
What follows is the starting dose, the switching chart, how the dose is adjusted, and what to do when one is missed. Approved uses differ across the United States, the United Kingdom, and India, so the country is named wherever that matters. If you are still weighing up the schedule itself, our comparison of [Awiqli vs Daily Insulin] covers that decision.
Quick answer
Awiqli dosage starts at 70 units once a week for adults new to insulin. When switching from daily basal insulin, the week 1 dose is your total daily dose multiplied by 7, then by 1.5, rounded to the nearest 10 units. From week 2 on, it is your daily dose multiplied by 7 (FDA, 2026).
What the weekly dose is doing, and who can have it
Insulin icodec holds onto albumin, a protein in your blood. While it is held there it cannot act, so it sits as a reserve and releases slowly across the whole week (FDA, 2026). Its half-life is about a week. One injection, seven days of background cover.
This is why the dose cannot be rushed. Blood levels take 2 to 3 weeks to settle if you had the one-time higher first dose and 3 to 4 weeks without it (FDA, 2026). Judging your dose after one injection tells you very little.
Approvals differ, and the dosing advice follows them. The United States FDA approved Awiqli on 26 March 2026 for adults with type 2 diabetes only (FDA, 2026). In the European Union it has been authorised since May 2024 for adults with diabetes, covering both types (EMA, 2024). India approved both types, and Novo Nordisk launched it there on 9 July 2026 (Novo Nordisk, 2026). It has not been shown to be safe or effective in children (FDA, 2026).
Insulin is rarely the first step in type 2 diabetes. Most people begin on tablets and reach insulin years later, long after the [Early Warning Signs of Type 2 Diabetes] first showed up.
Awiqli dosage if you are new to insulin
The starting dose for an adult who has never used insulin is 70 units, injected under the skin once a week (FDA, 2026). Choose a day that suits your life and keep it. Any day works, as long as it is the same one each week.
That is the whole of the starting rule. There is no loading dose for people beginning from scratch. Seventy units a week works out at roughly 10 units a day, a common opening dose for daily basal insulin, so the two are closer than the number suggests.
Awiqli dose conversion: switching from a daily basal insulin
Switching is where the arithmetic matters, and the rule has two steps.
Take your total daily basal insulin dose and multiply it by 7. That is your weekly requirement, and from week 2 onwards it becomes your Awiqli dose, rounded to the nearest 10 units (FDA, 2026).
For week 1 only, take that weekly figure and multiply it by 1.5, again rounded to the nearest 10 units (FDA, 2026). Your first injection goes in the day after your last daily basal injection, not on the same day (EMA, 2024).
| Your total daily basal dose | Week 1 Awiqli dose, one time only | Week 2 onwards |
|---|---|---|
| 10 units | 110 units | 70 units |
| 15 units | 160 units | 110 units |
| 20 units | 210 units | 140 units |
| 25 units | 260 units | 180 units |
| 30 units | 320 units | 210 units |
| 40 units | 420 units | 280 units |
| 50 units | 530 units | 350 units |
| 100 units | 1,050 units, given as two injections | 700 units |
Worked examples from the United States prescribing information (FDA, 2026). Your own basal insulin dose conversion is set by your doctor, not by this table.
The sum does not change with the brand. To switch from Lantus to Awiqli, or from Tresiba (insulin degludec), you still start with your total daily basal dose and multiply by seven. If you split your basal insulin across two injections a day, add both together first.
Why the first dose is higher
Because insulin icodec builds up slowly. The one-time extra half fills the gap while your levels are still climbing, so your blood sugar does not drift upward during the changeover (FDA, 2026).
Take the higher dose once. Repeating it in week 2 is an overdose, and the label names dose selection and dosing frequency errors among the causes of severe low blood sugar that has needed hospital treatment (FDA, 2026).
The two big labels frame this differently. The United States label presents the higher week 1 dose as the recommended way to switch (FDA, 2026). The European label treats it as a choice in type 2 diabetes, used when faster control is wanted, and always advises it in type 1 diabetes (EMA 2024).
Week 3 onwards: how the weekly insulin dose is adjusted
From week 3 the dose is titrated, which means your doctor moves it in small steps based on what your readings show (FDA, 2026).
In the ONWARDS trials, the insulin icodec weekly dose changed in steps of 20 units, judged on the average of the three most recent fasting readings, aiming for a fasting blood sugar of 80 to 130 mg/dL (4.4 to 7.2 mmol/L) (FDA, 2026). Your clinic may work to a different target, so ask for yours as a number. Our [Normal Blood Sugar Levels Chart by Age] shows how those readings are usually read.
Where does it land? By the end of those trials, adults with type 2 diabetes were on roughly 204 to 322 units a week (FDA, 2026). Over the longer run the number that counts is HbA1c, your average blood sugar over the past two to three months, and our [HbA1c Normal Range Chart by Age] sets out the targets.
Low blood sugar is most likely in the first few weeks after starting and after any dose rise, so that is when checking matters most (FDA, 2026).
When the Awiqli dose needs changing
| Situation | What the label advises |
|---|---|
| A short illness, or a few unusual days of exercise or food | Do not change the dose. A week of insulin is already in you. Adjust food or your other diabetes medicines instead, with advice from your team (FDA, 2026) |
| Kidney problems, including dialysis | No set dose reduction for the kidneys alone, but check blood sugar more often and expect the dose to be set individually (FDA, 2026) |
| Liver problems | Same position. No automatic change, closer monitoring, individual dosing (FDA, 2026) |
| Age 65 and over | Starting dose, dose steps, and the ongoing dose are kept conservative, because low blood sugar is harder to spot in later life (FDA, 2026) |
| Medicines that lower blood sugar, such as GLP-1 medicines or SGLT-2 inhibitors | The Awiqli dose may need lowering, with more frequent monitoring (FDA, 2026) |
| Medicines that raise blood sugar, such as steroids or thyroid hormone | The dose may need raising, with more frequent monitoring (FDA, 2026) |
That first row catches people out. With a daily insulin you can trim tomorrow’s dose before a long walk. With Awiqli you cannot, because the week is already inside you (FDA, 2026).
Many adults with type 2 diabetes take a weekly GLP-1 medicine alongside basal insulin. Both lower blood sugar, so the insulin dose often has to come down (FDA, 2026). If you are weighing those medicines up, our comparison of [Mounjaro vs Ozempic] explains how they differ. Sulfonylurea tablets matter too. In the ONWARDS trials they were either stopped when Awiqli was started or cut by about half (FDA, 2026).
What to do if you miss an Awiqli dose
| Your situation | What to do |
|---|---|
| You remember within 4 days | Take it as soon as you can. Your next dose is one week from the day you took the late one, so your weekly day moves (FDA, 2026) |
| More than 4 days have passed | Skip it. Take your next dose on your usual day (FDA, 2026) |
| You want to move to a different day | You can, as long as at least 4 days have passed since your last dose (FDA, 2026) |
| After any missed or late dose | Check your blood sugar more often than usual until the schedule settles (FDA, 2026) |
An Awiqli missed dose is not the emergency people fear, but it is not nothing either. One injection carries a week of background insulin, so a gap leaves a longer stretch uncovered than a skipped daily dose would.
Notice the detail in that first row. A late dose resets the clock. If your day was Sunday and you inject on Wednesday, Wednesday is now your day until you move it again.
Awiqli units, the FlexTouch pen, and storage
The Awiqli FlexTouch pen holds 700 units in every mL. Almost every other insulin pen holds 100. Seven times the strength in the same drop of liquid, which is why the next few lines are not routine small print.
Severe low blood sugar needing hospital care has happened when Awiqli was mixed up with another insulin, when the wrong dose was selected, and when it was taken too often (FDA, 2026). Three habits protect you:
- Read the label on the pen before every single injection.
- Look at the dose counter and check the number before you press.
- Never draw Awiqli out with a syringe, and never dial 700 units unless 700 units is your prescribed dose (FDA, 2026).
The pen moves in steps of 10 units, up to 700, so in-between numbers are not possible (FDA, 2026). If your dose falls between two steps, your doctor rounds it. Do not do that yourself. Pens come in three sizes: 1 mL holding 700 units, 1.5 mL holding 1,050 units, and 3 mL holding 2,100 units (FDA, 2026). Never share a pen, even with a fresh needle. Inject into the thigh, upper arm, or stomach, moving the spot around within that area (FDA, 2026).
Unopened pens stay in the fridge at 36 to 46 F (2 to 8 C) until the expiry date. Once a pen is in use, keep it below 86 F (30 C) or in the fridge and use it within 12 weeks. Total time out of the fridge cannot pass 12 weeks, including while in use. Never freeze it (FDA, 2026).
Awiqli dosage and cost in India
India approved Awiqli for adults with type 1 and type 2 diabetes, and Novo Nordisk launched it on 9 July 2026, making India the seventh country to get it (Novo Nordisk, 2026).
Two pen sizes reached the Indian market. The 700-unit pen is priced at Rs 2,611 and the 2,100-unit pen at Rs 7,833, which works out at about Rs 3.73 per unit (Novo Nordisk, 2026).
| Weekly Awiqli dose | Roughly what Awiqli costs a week | Same units of daily basal insulin |
|---|---|---|
| 70 units | Rs 261 | Rs 345 to Rs 453 |
| 140 units | Rs 522 | Rs 690 to Rs 906 |
| 210 units | Rs 783 | Rs 1,035 to Rs 1,359 |
| 280 units | Rs 1,044 | Rs 1,380 to Rs 1,812 |
Worked out at the July 2026 launch price (Novo Nordisk, 2026). These figures are time sensitive, so check before you buy.
Awiqli is a patented biologic, so no generic or biosimilar version exists in 2026, while daily basal insulins come in many Indian brands across a wide price spread. CGHS and ESI cover medicines on their approved lists, and a newly launched drug takes time to be added, so ask your scheme office rather than assuming cover. Full pricing sits in our guide to the [Awiqli insulin price in India].
Novo Nordisk pointed to fear of daily injections as one of the biggest barriers to starting insulin in India (Novo Nordisk, 2026). That delay starts early, which is part of what makes [Type 2 Diabetes in Young Indians] such a hard problem. A weekly schedule removes one reason to put it off, though it does not change the arithmetic above.
In the United States, Awiqli was approved in March 2026 and the company has said it expects to launch in the second half of 2026 (Novo Nordisk, 2026).
What patients often get wrong
The most common mistake is reading the weekly number as if it were a daily one. Seventy units of Awiqli in a week is not seventy units a day. It is about ten units a day, spread out.
So when a three-figure number appears on the dose counter, people assume something has gone wrong. Some quietly take less. That is how blood sugar drifts upward in the first month, and it is a mistake made out of care, not carelessness. If the number worries you, ring your clinic before you change it.
CLINICAL NOTE:
I once accompanied someone to a diabetes appointment. The doctor explained that his blood sugar was no longer controlled with tablets alone and that insulin was now the safer option. The patient was worried he would become “addicted” to insulin and admitted he was afraid of injections.
Outside the clinic, he showed me his report. His blood sugar was around 340 mg/dL despite taking his medicines regularly. I told him about someone I knew through a friend who had also started insulin and was doing well. Hearing a real life example seemed to make insulin feel less frightening. He went back to his doctor with a different mindset and agreed to start the treatment that had been recommended.
That experience stayed with me because it reminded me that many people are not afraid of insulin itself. They are afraid of what they believe insulin means. Clear medical advice, combined with reassurance and real life examples, can help patients make more informed decisions.
When to see a doctor
Do not set or change your own Awiqli dosage. Every number in this guide is the start of a conversation, not a prescription.
Book an appointment before you change anything if you take basal insulin now and want to switch, if you take sulfonylurea tablets alongside insulin, if you also use a GLP-1 medicine, if your kidneys or liver are not working well, or if you are over 65.
See your doctor within the week if your fasting readings sit above target for several days after a switch, if low blood sugar keeps landing on the same day each week, or if you have missed more than one dose. Skin changes, itching, or swelling where you inject are worth reporting too, and our guide to [Awiqli insulin side effects] covers what is common and what is not.
Emergency symptoms
Get emergency help straight away if low blood sugar brings confusion, a seizure, or loss of consciousness. That is severe hypoglycaemia, and it needs treatment now, not a biscuit and a wait. Because Awiqli is long-acting, recovery from a low can take longer than with a shorter insulin, so someone should stay with the person afterwards (FDA, 2026).
Get help right away too for a rash across the whole body with trouble breathing, a fast heartbeat, or sweating, which can signal a severe allergic reaction (FDA, 2026).
The bottom line
Awiqli dosage runs on one sum: your daily basal dose multiplied by seven. Week 1 adds half again on top, once and only once. Week 2 settles back. If you are new to insulin, you start at 70 units a week and grow from there.
The rest is care. A pen seven times stronger than the one you know, a dose you cannot walk back once it is in, and a 4 day window if you miss one. None of that is hard. It is different, and different is where mistakes live. Take these numbers to your doctor and have them write yours down.
Frequently asked questions
Can I take Awiqli twice a week if my blood sugar is high?
No. Awiqli is a once weekly insulin, and taking it more often is an overdose. Dosing frequency errors are listed in the label among the causes of severe low blood sugar that has needed hospital care (FDA, 2026). High readings are handled by titration, meaning your doctor lifts the weekly dose in steps, not by adding an extra injection.
What should I do if I take two Awiqli doses by mistake?
Contact your doctor or diabetes team straight away and check your blood sugar far more often than usual over the following days. Too much insulin can cause severe, long lasting low blood sugar and low potassium (FDA, 2026). Mild lows are treated with glucose by mouth. If confusion, seizures, or fainting happen, get emergency help at once.
How is the dose worked out when I switch from Lantus to Awiqli?
Your total daily Lantus (insulin glargine) dose is multiplied by 7 to give your weekly Awiqli dose from week 2 onwards, rounded to the nearest 10 units. For week 1 only, that figure is multiplied by 1.5 (FDA, 2026). The first Awiqli injection goes in the day after your last Lantus dose. Your doctor sets the final numbers.
How long does Awiqli take to reach its full effect?
Around 2 to 3 weeks if you had the one-time higher first dose when switching, and 3 to 4 weeks if you started without it (FDA, 2026). Insulin icodec builds up gradually because it holds onto albumin in your blood and releases slowly. Judging your dose after a single injection tells you very little.
Why is my Awiqli dose number so much bigger than my old insulin dose?
Because it covers seven days instead of one. Ten units a day becomes about 70 Awiqli units a week (FDA, 2026). The pen is also made at 700 units per mL, seven times the strength of standard insulin, so the same volume of liquid carries far more. The large number is expected. Never lower it yourself.
What if my Awiqli dose comes to more than 700 units?
It is split into two injections. The pen delivers up to 700 units at once, so a 1,050 unit dose might be given as 700 units followed by 350 units (FDA, 2026). Doses this size come up for someone who was taking around 100 units of daily basal insulin. Your doctor decides how the split is done.
Is the Awiqli dose different for type 1 diabetes?
The switching sum is the same, but the one-time higher first dose is always advised in type 1 diabetes rather than optional (EMA, 2024). This applies only where Awiqli is approved for type 1, such as the European Union and India. The United States approved type 2 only (FDA, 2026). It has not been studied in newly diagnosed type 1 diabetes.
Do I need to change my mealtime insulin when I start Awiqli?
Possibly. The label says doses and timing of rapid-acting or short-acting insulin may need adjusting when you move to Awiqli, along with your other diabetes medicines (FDA, 2026). Awiqli replaces only your background insulin. Mealtime injections carry on, and your team may fine tune them once your weekly dose settles.
Does the Awiqli dose change if I have kidney disease?
Not automatically. Kidney problems, including end stage disease and dialysis, did not change how insulin icodec behaves in the body, so no set dose reduction is built into the label (FDA, 2026). Even so, low blood sugar is more likely when kidneys are struggling, so checks are stepped up and the dose is set individually.
Can I use a syringe instead of the Awiqli FlexTouch pen?
No, and this one is serious. Drawing Awiqli out of the pen with a syringe can cause an overdose and severe low blood sugar because syringes are marked for standard insulin while Awiqli is seven times stronger (FDA, 2026). Use the FlexTouch pen as supplied, and check the dose counter before every injection.
References and sources
US Food and Drug Administration. Awiqli (insulin icodec-abae) prescribing information. 2026. dailymed.nlm.nih.gov
Novo Nordisk. Awiqli (insulin icodec-abae) prescribing information. 2026. novo-pi.com
European Medicines Agency. Awiqli (insulin icodec) medicine overview. 2024. ema.europa.eu
European Medicines Agency. Awiqli (insulin icodec) summary of product characteristics. 2024. ema.europa.eu
European Medicines Agency. Awiqli: measures intended to reduce the risk of confusion with dosing requirements. 2024. ema.europa.eu
Novo Nordisk. FDA approves Awiqli, the first and only once-weekly basal insulin treatment for adults with type 2 diabetes. 2026. prnewswire.com
American Journal of Managed Care. FDA approves novel weekly basal insulin for type 2 diabetes. 2026. ajmc.com
Business Today. Diabetes care gets easier: Novo Nordisk launches once-weekly insulin at Rs 261 a week. 2026. businesstoday.in
Medical Dialogues. Novo Nordisk brings once-weekly insulin Awiqli to India. 2026. medicaldialogues.in
Medically reviewed by
This guide was checked for medical accuracy by our review board before publishing.
Dr Praveen Verma, MBBS, MD (Pathology), Pathologist and Clinical Laboratory Specialist.
Dr Himanshu Morya, MBBS, Medical Educator.
Kalpna Singh Shekhawat, BSN, RN
About the author
Iraphan Khan, BSN, RN, D.Pharm, Public Health Researcher is the founder of RealMedVision and creates evidence-based health content from trusted medical sources.
Medical disclaimer
This article is for education only. It is not medical advice and cannot replace a consultation with your own doctor. Do not start, stop, or change any insulin dose on your own. If low blood sugar brings confusion, seizures, or fainting, treat it at once and get emergency help.