VICTOZA (Liraglutide)

What is this medication?

VICTOZA (Liraglutide)
Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist

VICTOZA (Liraglutide) is officially indicated for the treatment of Diabetes mellitus type 2.

ALERT: WARNING

Thyroid C-cell tumor risk:
Liraglutide causes dose-dependent and treatment duration–dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether liraglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, because the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined.

Liraglutide is contraindicated in patients with a personal or family history of MTC and in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of liraglutide and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with liraglutide.

How does this medication work? 

VICTOZA (Liraglutide) is a long-acting analog of human glucagon-like peptide-1 (GLP-1) (an incretin hormone). Liraglutide works in multiple of ways to lower blood glucose and hemoglobin A1C.  Liraglutide stimulates the beta cells of the pancreas to release insulin when blood glucose levels are high.  Liraglutide slow down gastric emptying and the rate at which glucose enters the blood after meals.  Liraglutide also helps lower hepatic glucose output by suppressing pancreatic glucagon secretion.

How should I take this medication? 

Diabetes Mellitus Type 2
Injection: Inject 0.6mg subcutaneously once daily for 1 week; increase the dose by 0.6mg at weekly intervals to a target dose of 1.8mg once daily to achieve maximum efficacy for glycemic control.  If you cannot tolerate an increase in dose, consider either delaying the dose escalation for another week.

*Risk of hypoglycemia is higher in pediatric patients, monitor blood glucose close, especially during dose titration.

How Do You Use Liraglutide, Victoza:  Inject 0.6mg subcutaneously once daily for 1 week; increase the dose by 0.6mg at weekly intervals to a target dose of 1.8mg once daily.  If you cannot tolerate an increase in dose, consider either delaying the dose escalation for another week.  Some individuals may use a tolerated dose of less then 1.8mg daily if blood sugar control is being achieved.  Make sure to inject subcutaneously in the upper arm, thigh, or abdomen.  Administer without regard to meals or time of day.  Make sure to change the pen needle with each use.  Always inspect the pen to make sure the solution is clear and free of particulate matter.  Never share your pen with another person or inject in the same exact body region as insulin.  In the case that you miss a dose, you can resume your daily injection on the next scheduled dose (never attempt to increase the dose).  If you miss more than 3 days, reinitiate scheduled therapy at 0.6mg daily to avoid gastrointestinal symptoms and titrate accordingly.  

What should I watch for while using this medication? 

Do not use in patients with prior serious hypersensitivity to liraglutide or any components of its formulation

Do not use in patients with multiple endocrine neoplasia syndrome

Do not use during pregnancy and breastfeeding

Use with caution in patients with hepatic and renal impairment

Avoid using in patients with history of suicidal attempts or active suicidal ideation

What if I miss a dose?

If you miss a dose of this medicine, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

If you miss a dose of this medicine for 3 days or more, call your doctor to talk about how to restart your treatment.

How should I store this medication?

Victoza that is new and unused should be stored in the refrigerator at 36°F to 46°F (2°C to 8°C). If pens are stored outside of the refrigerator (by mistake) prior to first use, it should be used or thrown away within 30 days. Do not freeze,

After first use, store your pen for up to 30 days at room temperature of 59°F to 86°F (15°C to 30°C) or in a refrigerator at 36°F to 46°F (2°C to 8°C).

What are the possible side effects of using this medication?

Well tolerated, most side effects are transient and mild to moderate in nature.  The most common side effects include:

>10%:

Cardiovascular: Increased heart rate (>10 bpm from baseline: 34%; >20 bpm from baseline: 5%)

Central Nervous System: Headache (14%)

Endocrine and Metabolic: Hypoglycemia (obesity patients with type 2 diabetics: combination therapy with sulfonylurea: 44%; monotherapy: 16%; nondiabetic patients: 2% to 3%)

Gastrointestinal: Nausea (39%), diarrhea (21%), constipation (19%), vomiting (16%)

Local: Injection site reaction (3% to 14%)

Note this is not a complete list of side effects for VICTOZA (Liraglutide), only common ones.