Victoza

Indications

Liraglutide is used together with diet and exercise to improve blood sugar control in adults and children aged 10 years and older with type 2 diabetes. In adults with type 2 diabetes and heart disease, it also lowers the risk of heart attack, stroke and death from heart disease. Some higher-strength products containing Liraglutide are used separately for weight management, as prescribed. It is not for type 1 diabetes.

How It Works

Liraglutide is a GLP-1 receptor agonist. It acts like GLP-1, a natural gut hormone released after meals. It increases insulin release from the pancreas when blood sugar is high, reduces glucagon (a hormone that raises blood sugar), slows the emptying of the stomach and reduces appetite. This lowers blood sugar after meals and between meals and may help with weight loss.

Dosage and Administration

Liraglutide is injected under the skin of the stomach, thigh or upper arm once a day, at any time but ideally at the same time each day, with or without food. The dose is as prescribed by your doctor; it is usually started at a low dose for at least a week to reduce stomach upset and then increased. A doctor or nurse first shows how to use the prefilled pen, after which patients inject at home. Do not take an extra dose to make up for a missed one.

Interactions

• Insulin and sulfonylureas (such as Gliclazide or Glimepiride): higher risk of low blood sugar; their dose may need to be lowered.
• Slowed stomach emptying may affect how some oral medicines are absorbed.
• Warfarin: more frequent INR checks may be needed when starting.
• Do not use with other GLP-1 receptor agonists.

Contraindications

• Personal or family history of medullary thyroid cancer, or multiple endocrine neoplasia type 2 (MEN 2).
• Allergy to Liraglutide or any ingredient.
• Type 1 diabetes or diabetic ketoacidosis.

Side Effects

Common side effects include nausea, vomiting, diarrhoea, constipation, indigestion, loss of appetite, headache and injection-site reactions. These are usually worst in the first weeks. Low blood sugar may occur, especially with Insulin or sulfonylureas. Less common but serious effects include pancreatitis, gallstones and gallbladder inflammation, kidney problems from dehydration, and a fast heart rate.

Get urgent medical help if you have severe, persistent stomach pain that may spread to the back (with or without vomiting), pain in the upper right abdomen with fever or yellow skin, a lump or swelling in the neck, trouble swallowing, signs of a severe allergic reaction, or a severe low blood sugar episode with confusion or fainting.

Pregnancy and Lactation

Liraglutide should not be used during pregnancy; Insulin is usually preferred. Tell your doctor if you plan to become pregnant so treatment can be changed. It is not recommended while breastfeeding.

Precautions and Warnings

• Drink plenty of fluids if you have vomiting or diarrhoea to avoid dehydration and kidney problems.
• Tell your doctor if you have had pancreatitis, gallbladder disease, severe stomach or bowel disease, or thyroid disease.
• Learn the signs of low blood sugar and how to treat them.
• Inform the doctor or anaesthetist before surgery or procedures that need an empty stomach.
• Never share a pen, even with a new needle.

Overdose

An overdose may cause severe nausea, vomiting and low blood sugar. Take sugar if blood sugar is low and seek medical help; treatment is supportive.

Therapeutic Class

Antidiabetic; glucagon-like peptide-1 (GLP-1) receptor agonist.

Storage

Before first use, store in a refrigerator at 2 to 8°C, do not freeze. After first use, the pen can be kept for up to 1 month below 30°C or in the refrigerator, with the cap on to protect from light. Keep out of the reach of children.