Victoza Liraglutide Injection

1. Indications and Usage
Type 2 Diabetes Mellitus (T2DM):
Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Chronic Weight Management:
Indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m²) with at least one weight-related comorbidity.
(Note: The indication for weight management corresponds to the brand name Saxenda/Wegovy, while T2DM corresponds to Victoza/Victoza).
Limitations of Use:
Not indicated for the treatment of patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis.
2. Dosage and Administration
Route of Administration:
For Subcutaneous Injection ONLY. Administer once daily at any time, independently of meals.
Recommended Dosage (Diabetes – Victoza):
Initial Dose: 0.6 mg once daily for 1 week to reduce gastrointestinal symptoms.
Maintenance Dose: Increase to 1.2 mg once daily. If additional glycemic control is needed, increase to a maximum of 1.8 mg once daily.
Recommended Dosage (Weight Management – Saxenda):
Titration: Escalate dose weekly (0.6 mg → 1.2 mg → 1.8 mg → 2.4 mg → 3.0 mg).
Maintenance Dose: 3.0 mg once daily.
Administration Instructions:
Administer into the abdomen, thigh, or upper arm. If a dose is missed, administer as soon as the patient remembers within 12 hours; otherwise, skip the missed dose and resume the regular schedule.
3. Mechanism of Action
GLP-1 Receptor Agonist:
Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that binds to and activates the human GLP-1 receptor.
Glucose-Dependent Insulin Secretion:
It stimulates insulin secretion in a glucose-dependent manner and suppresses glucagon secretion.
Delayed Gastric Emptying:
It slows gastric emptying, leading to reduced postprandial glucose excursions and increased satiety.
Long Half-Life:
Due to fatty acid side-chain attachment and albumin binding, liraglutide has a long half-life (~13 hours), allowing for once-daily dosing.
4. Safety and Warnings
Risk of Thyroid C-Cell Tumors:
Contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Acute Pancreatitis:
Monitor for signs and symptoms of pancreatitis. Discontinue promptly if suspected.
Hypoglycemia:
Risk is increased when used with insulin secretagogues (e.g., sulfonylureas). Consider reducing the dose of the concomitant medication.
Renal Impairment:
Gastrointestinal adverse reactions may lead to dehydration and subsequent renal impairment or acute kidney injury.
Acute Gallbladder Disease:
Cholelithiasis and cholecystitis have been reported during postmarketing experience.
5. Adverse Reactions
Most Common:
Nausea, hypoglycemia (in T2DM), diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, and fatigue.
(Gastrointestinal events are typically most frequent during dose escalation and tend to diminish over time).
6. Drug Interactions
Oral Medications:
Due to delayed gastric emptying, liraglutide may impact the absorption of concomitantly administered oral medications (e.g., acetaminophen, atorvastatin, griseofulvin, lisinopril, digoxin, oral contraceptives).
Insulin Secretagogues:
Concomitant use increases the risk of hypoglycemia.
7. Pharmaceutical Information
Chemical Composition:
Active Ingredient: Liraglutide (recombinant human GLP-1 analog).
Available Strengths:
18 mg/3 mL (6 mg/mL) for T2DM (Victoza).
18 mg/3 mL (6 mg/mL) for Weight Management (Saxenda).
Storage:
Store in a refrigerator at 2°C to 8°C (36°F to 46°F). Do not freeze. In-use pens may be stored at room temperature (below 30°C/86°F) for up to 30 days.