liraglutide, Victoza

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GENERIC NAME: liraglutide


DRUG CLASS AND MECHANISM: Liraglutide is an injectable drug that reduces the level of sugar (glucose) in the blood. It is used for treating type 2 diabetes and is similar to exenatide (Byetta). Liraglutide belongs in a class of drugs called incretin mimetics because these drugs mimic the effects of incretins. Incretins, such as human-glucagon-like peptide-1 (GLP-1), are hormones that are produced and released into the blood by the intestine in response to food. GLP-1 increases the secretion of insulin from the pancreas, slows absorption of glucose from the gut, and reduces the action of glucagon. (Glucagon is a hormone that increases glucose production by the liver.) All three of these actions reduce levels of glucose in the blood. In addition, GLP-1 reduces appetite. Liraglutide is a synthetic (man-made) hormone that resembles and acts like GLP-1. In studies, liraglutide treated patients achieved lower blood glucose levels and experienced weight loss. Liraglutide was approved by the FDA in January 2010.



PREPARATIONS: Multiple dose pre-filled pen: 18 mg in 3 ml (6 mg/ml)

STORAGE: Liraglutide should be refrigerated between 2-8 C (36-46 F) prior to first use. After the first use it can be stored at room temperature 15-30 C (59-86 F) or refrigerated at 2-8 C (36-46 F).

PRESCRIBED FOR: Liraglutide is used with diet and exercise to improve control of blood sugar in adults with type 2 diabetes mellitus. Liraglutide should not be used for treating diabetic ketoacidosis or type 1 diabetes and should not be used as the first agent for treating diabetes after failure of diet and exercise.

DOSING: Liraglutide is injected under the skin of the abdomen, thigh, or upper arm. Each pre-fiilled pen can deliver 0.6, 1.2, and 1.8 mg doses. The initial dose is 0.6 mg daily for one week. The initial dose helps the body to build a tolerance to stomach related side effects. It is not effective for controlling blood glucose. After one week the dose is increased to 1.2 mg daily. The maximum dose is 1.8 mg daily.

DRUG INTERACTIONS: Liraglutide slows down transit of food and drugs through the intestine and, therefore, may reduce the absorption of drugs that are taken orally. Although liraglutide did not significantly affect the absorption of oral dugs tested in studies, it is still prudent to separate administration of liraglutide and oral medications. Combining liraglutide with insulin or drugs that stimulate release of insulin (for example, glyburide [Micronase, Diabeta, Glynase, Prestab]) may increase the occurrence of low blood sugar (hypoglycemia). The dose of insulin or the insulin release stimulating drug should be reduced.

PREGNANCY: There are no adequate studies of liraglutide in pregnant women. Most experts agree that insulin is the drug of choice in pregnant women with diabetes.

NURSING MOTHERS: There are no adequate studies of liraglutide in nursing mothers, and it is not known whether liraglutide is excreted in human breast milk.

SIDE EFFECTS: The most common side effects of liraglutide are nausea, vomiting, diarrhea, constipation, upper respiratory tract infection, and headache. Patients also may experience flu like symptoms, dizziness, sinusitis, back pain, and reactions at the injection site.

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