Novo Nordisk Awiqli, First Once-Weekly Basal Insulin for Type 2 Diabetes, Now Available Nationwide in the US

Novo Nordisk Awiqli® (insulin icodec-abae) injection 700 units/mL has officially launched across the United States, giving adults with type 2 diabetes their first nationwide access to a once-weekly basal insulin. Novo Nordisk announced on August 11, 2026, that the therapy is now stocked at more than 70,000 pharmacies, following the U.S. Food and Drug Administration approval earlier this year. The launch positions Novo Nordisk Awiqli as the only once-weekly basal insulin option available to American patients, a shift the company says could reshape how millions of people manage a daily insulin routine.

For decades, basal insulin therapy has meant a needle every single day. Novo Nordisk Awiqli changes that math by cutting the number of basal injections from seven per week to one. The drug is delivered through the prefilled Awiqli FlexTouch® pen and is indicated as an adjunct to diet and exercise to improve glycemic control in adults living with type 2 diabetes. It is not approved for use in children or adolescents, and it is available in a single concentration, U-700.

Tom Scales, Senior Vice President of Market Access & Public Affairs and Patient Support Solutions at Novo Nordisk, framed the launch as a meaningful step for basal insulin therapy broadly. He described it as meaningful progress in the options available for basal insulin therapy for the millions of adults with type 2 diabetes, adding that as the only once-weekly basal insulin available in the US, the company’s focus is ensuring broad access so eligible adults have the support they need to talk to their doctor about starting treatment.

Clinical research has increasingly pointed toward simplified insulin regimens as a way to reduce a common barrier to therapy. Daily basal dosing can be difficult for many patients to sustain, and less frequent dosing may ease that burden over time. By moving to a once-weekly schedule, Novo Nordisk Awiqli is designed to fit into routines that a daily injection schedule often disrupts, without requiring patients to recalculate their insulin needs every single day.

Novo Nordisk Awiqli Reduces Weekly Insulin Injections From Seven to One

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The core value proposition behind Novo Nordisk Awiqli is dosing frequency. Instead of injecting basal insulin every morning or evening, patients inject once, on the same day each week, using the FlexTouch pen. If a patient needs to shift their designated injection day, they can do so as long as at least four days have passed since the prior dose. A missed dose can still be taken within four days of the scheduled date, after which the patient resumes the normal weekly cadence on the next scheduled day.

This flexibility does not remove the need for careful dose selection. Because this once-weekly therapy carries a different dosing structure than daily basal insulins, the label warns against dialing the maximum single dose of 700 units unless specifically directed by a healthcare provider, and against using a syringe to withdraw insulin from the pen. Patients switching from a daily basal insulin are advised to monitor blood glucose closely during the transition, since dosing logic differs substantially between the two regimens. Readers can review for background on how basal insulin therapy fits into broader type 2 diabetes management.

Novo Nordisk built the rollout around a national retail footprint rather than a limited specialty-pharmacy release. Reaching more than 70,000 pharmacies at launch is intended to make the once-weekly option broadly accessible from day one, rather than phasing availability in by region.

Novo Nordisk Awiqli Clinical Data: Inside the ONWARDS Phase 3a Program

The FDA approval underpinning this US launch rests on the ONWARDS phase 3a clinical program, which evaluated once-weekly Awiqli across three randomized, open-label, treat-to-target, active-controlled trials and one randomized, double-blind, treat-to-target, active-controlled trial. Across these studies, Novo Nordisk Awiqli was tested against daily basal insulin in adults with type 2 diabetes, including patients also using mealtime insulin, oral anti-diabetic agents, or GLP-1 receptor agonists. Published results from the program, including the ONWARDS 1 trial in the New England Journal of Medicine, ONWARDS 2 in The Lancet Diabetes & Endocrinology, and ONWARDS 3 in JAMA, form the peer-reviewed evidence base behind the FDA decision.

The program’s primary endpoint was non-inferiority in mean change in HbA1c from baseline to trial end, and the once-weekly regimen met that bar across the pivotal trials. Across five ONWARDS trials in total, the overall safety profile of Novo Nordisk Awiqli was consistent with the daily basal insulin class used as the comparator in each study, according to the company’s announcement. That consistency matters clinically, since a new dosing interval introduces new questions about how an insulin analog behaves in the body over a full week rather than a single day. For a full record of the trial registrations, see ClinicalTrials.gov. Readers new to the topic may also find it useful for interpreting these results.

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Novo Nordisk Awiqli Safety Profile and Important Prescribing Considerations

Every insulin therapy carries a risk of hypoglycemia, and Novo Nordisk Awiqli is no exception. The company lists common adverse events as hypoglycemia, serious allergic reactions affecting the whole body, reactions at the injection site, skin thickening or pitting at the injection site known as lipodystrophy, itching, rash, swelling of the hands and feet, and weight gain. Patients are also cautioned about the risk of heart failure when Awiqli is combined with thiazolidinediones, even among people with no prior history of heart problems. Full labeling detail is available via the FDA’s drug approval database.

The prescribing guidance is explicit about a few behaviors patients need to avoid entirely: never inject Novo Nordisk Awiqli into a vein or muscle, never use it in an infusion pump, and never dilute or mix it with another insulin or solution. Injection sites should be rotated within a chosen body area, such as the thighs, upper arms, or abdomen, to reduce the risk of lipodystrophy and localized cutaneous amyloidosis. Sharing an Awiqli FlexTouch pen or needle with another person, even after changing the needle, is flagged as a serious infection risk.

Novo Nordisk Awiqli Access, Pricing, and Patient Support Programs

Affordability is central to how Novo Nordisk is positioning this launch. Through NovoCare.com, eligible patients can access a Patient Education Center that includes educational resources, tools, and healthy recipes alongside affordability offerings that can lower out-of-pocket costs to as little as $35 per month for those who qualify. The company is pairing the clinical pitch of Novo Nordisk Awiqli with a broader access strategy, betting that lower weekly injection burden combined with a manageable price point will drive adoption among both new and switching patients.

Beyond the US, Awiqli is already approved in the European Union and 13 additional countries, each with market-specific indications for diabetes care. The US nationwide rollout marks the therapy’s entry into what is likely its largest single market, and the company frames the moment as part of a longer commitment to insulin innovation at a time when some competitors have scaled back insulin investment. Novo Nordisk has spent more than a century developing diabetes treatments, and it maintains a US presence spanning roughly 40 years, with headquarters in New Jersey and approximately 10,000 employees across more than 10 manufacturing, research and development, and corporate sites in seven states plus Washington, D.C.

Awiqli Product Snapshot