Drug Action
Liraglutide binds to, and activates, the GLP- 1 (glucagon-like peptide-1) receptor to increase insulin secretion, suppresses glucagon secretion, and slows gastric emptying.
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Drug reference
Liraglutide binds to, and activates, the GLP- 1 (glucagon-like peptide-1) receptor to increase insulin secretion, suppresses glucagon secretion, and slows gastric emptying.
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SAXENDA ® Adjunct in weight management [in conjunction with dietary measures and increased physical activity in individuals with a body mass index (BMI) of 30 kg/m2 or more, or in individuals with a BMI of 27 kg/m2 or more in the presence of at least one weight-related co- morbidity] ▶BY SUBCUTANEOUS INJECTION ▶Adult: Initially 0.6 mg once daily, then increased in steps of 0.6 mg, dose to be increased at intervals of at least 1 week; consider discontinuation if escalation to the next dose is not tolerated for 2 consecutive weeks. Discontinue if at least 5% of initial body-weight has not been lost after 12 weeks at maximum dose; maximum 3 mg per day VICTOZA ® Type 2 diabetes mellitus [monotherapy (if metformin inappropriate), or in combination with other antidiabetic drugs] ▶BY SUBCUTANEOUS INJECTION ▶Adult: Initially 0.6 mg once daily for at least 1 week, then increased to 1.2 mg once daily for at least 1 week, then increased if necessary to 1.8 mg once daily, for information on use with other antidiabetic drugs— consult product literature
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DUE TO INTERACTIONS ▶Dose of concomitant insulin or sulfonylurea may need to be reduced.
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Diabetic gastroparesis. inflammatory bowel disease. severe congestive heart failure—no information available SAXENDA ® Concomitant use with other products for weight management. elderly 75 years or over (limited information). obesity secondary to endocrinological or eating disorders VICTOZA ® Diabetic ketoacidosis
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Thyroid disease
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MHRA/CHM ADVICE: GLP-1 RECEPTOR AGONISTS: REPORTS OF DIABETIC KETOACIDOSIS WHEN CONCOMITANT INSULIN WAS RAPIDLY REDUCED OR DISCONTINUED (JUNE 2019) ▶When used for Type 2 diabetes mellitus Endocrine system Serious and life-threatening cases of diabetic ketoacidosis have been reported in patients with type 2 diabetes mellitus on a combination of a glucagon-like peptide-1 (GLP-1) receptor agonist and insulin, particularly after discontinuation or rapid dose reduction of concomitant insulin. Healthcare professionals are advised that any dose reduction of insulin should be done in a stepwise manner with careful blood glucose self-monitoring, particularly when GLP-1 receptor agonist therapy is initiated. Patients should be informed of the risk factors for and signs and symptoms of diabetic ketoacidosis, and advised to seek immediate medical attention if these develop.
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→Appendix 1: liraglutide
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▶Common or very common Appetite decreased. asthenia. burping. constipation. diarrhoea. dizziness. dry mouth. gallbladder disorders. gastrointestinal discomfort. gastrointestinal disorders. headache. increased risk of infection. insomnia. nausea. skin reactions. taste altered . toothache. vomiting ▶Uncommon Dehydration. malaise. pancreatitis. renal impairment. tachycardia ▶Frequency not known Angioedema. dyspnoea. hypotension. oedema. palpitations. pancreatitis acute (discontinue permanently). thyroid disorder SIDE-EFFECTS, FURTHER INFORMATION Discontinue if symptoms of acute pancreatitis occur, such as persistent, severe abdominal pain.
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Manufacturer advises avoid—toxicity in animal studies (recommendation also supported by tertiary sources).
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Manufacturer advises avoid—no information available; animal studies suggest that transfer into milk is low, but excretion into human milk not known (a tertiary source confirms lack of information in human lactation, but also states that risk to infants appears to be negligible. g Blood glucose monitoring of the infant should be considered). k
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SAXENDA ® Manufacturer advises use with caution in mild to moderate impairment; avoid in severe impairment (risk of decreased exposure). VICTOZA ® Manufacturer advises avoid in severe impairment (risk of decreased exposure).
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SAXENDA ® Manufacturer advises avoid if creatinine clearance less than 30 mL/minute. VICTOZA ® Manufacturer advises avoid in end-stage renal disease. l HANDLING AND STORAGE Manufacturer advises store in a refrigerator (2–8°C)—after first use can also be stored below 30°C and used within 1 month; keep cap on pen to protect from light.
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There can be variation in the licensing of different medicines containing the same drug. Solution for injection ▶Saxenda (Novo Nordisk Ltd) Liraglutide 6 mg per 1 ml Saxenda 6mg/ml solution for injection 3ml pre-filled pens | 5 pre-filled disposable injection P £196.20 ▶Victoza (Novo Nordisk Ltd) Liraglutide 6 mg per 1 ml Victoza 6mg/ml solution for injection 3ml pre-filled pens | 2 pre-filled disposable injection P £78.48 DT = £78.48 | 3 pre-filled disposable injection P £117.72 Combinations available: Insulin degludec with liraglutide, p. 756
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Manufacturer advises patients and their carers should be told how to recognise signs and symptoms of acute pancreatitis and advised to seek immediate medical attention if symptoms develop. Manufacturer advises patients and their carers should be informed of the potential risk of dehydration in relation to Endocrine system gastro-intestinal side-effects and advised to take precautions to avoid fluid depletion; they should also be informed of the symptoms of cholelithiasis and cholecystitis, and of increased heart rate. SAXENDA ® Missed doses Manufacturer advises if a dose is more than 12 hours late, the missed dose should not be taken and the next dose should be taken at the normal time.
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Initially 0.6 mg once daily, then increased in
First-line fragment. Read the complete Indications and Dose section above.
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Initially 0.6 mg once daily for at least 1 week,
First-line fragment. Read the complete Indications and Dose section above.
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