liraglutide (Rx)

Brand and Other Names:Victoza, Saxenda
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

SC solution multidose pen

  • 18mg/3mL (Victoza); delivers doses of 0.6mg, 1.2mg, or 1.8mg
  • 18mg/3mL (Saxenda); delivers doses of 0.6mg, 1.2mg, 1.8mg, 2.4mg, or 3mg

Type 2 Diabetes Mellitus

Victoza only

0.6 mg SC qDay for 1 week initially, THEN increase to 1.2 mg qDay

If glycemic control not achieved, can increase to 1.8 mg qDay

Initial dose of 0.6 mg SC qDay is only to decrease GI adverse effects and does not provide glycemic control

Indications

  • As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
  • To reduce the risk of major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease

Obesity

Saxenda only

Adjunctive therapy to a reduced-calorie diet and increased physical activity for chronic weight management in adults with a body mass index (BMI) of ≥30 kg/m2 (obese) or a BMI of ≥27 kg/m2 (overweight) who have at least 1 weight-related condition (eg, hypertension, type 2 diabetes, dyslipidemia)

Initiate at 0.6 mg SC qDay for 1 week; increase by 0.6 mg/day in weekly intervals until a dose of 3 mg/day achieved

If patients do not tolerate an increased dose during dose escalation, consider delaying dose escalation for ~1 additional week

Discontinue if a patient cannot tolerate the 3-mg dose, as efficacy has not been established at lower doses (eg, 0.6, 1.2, 1.8, 2.4 mg)

Evaluate change in body weight 16 weeks after initiating Saxenda

Discontinue Saxenda if the patient has not lost at least 4% of baseline body weight

Dosage Modifications

Saxenda

  • Initiating Saxenda in patients taking insulin or insulin secretagogues (eg, sulfonylureas)
    • Consider reducing dose of the insulin secretagogue (eg, by one-half) or insulin to reduce the risk for hypoglycemia, and monitor blood glucose
    • Conversely, if discontinuing Saxenda in patients with type 2 diabetes, monitor for an increase in blood glucose
  • Renal impairment
    • Mild-to-severe, including patients with end-stage renal disease (ESRD): Limited experience
    • There have been postmarketing reports of acute renal failure and worsening of chronic renal failure with liraglutide, which may sometimes require hemodialysis; use with caution in these patients
  • Hepatic impairment
    • Mild-to-severe: Use caution; limited experience

Victoza

  • Renal impairment
    • Mild-to-severe: No dosage adjustment necessary
    • Patients with ESRD: Limited experience; there have been postmarketing reports of acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis; use caution in patients who experience dehydration
  • Hepatic impairment
    • Mild-to-severe: Limited experience; no dosage adjustment necessary

Dosing Considerations

Saxenda slows gastric emptying; has not been studied in patients with pre-existing gastroparesis

Limitations of use for Victoza

  • Not for treatment of type 1 diabetes mellitus or diabetic ketoacidosis (not effective for these conditions)
  • Not studied in combination with prandial insulin

Limitations of use for Saxenda

  • Not indicated for the treatment of type 2 diabetes mellitus
  • Saxenda and Victoza both contain liraglutide, and therefore should not be used together or in combination with any other GLP-1 receptor agonist
  • Safety and effectiveness in combination with other products intended for weight loss, including prescription drugs, OTCs, and herbal products, have not been established

Dosage Forms & Strengths

SC solution multidose pen

  • 18mg/3mL (Victoza); delivers doses of 0.6mg, 1.2mg, or 1.8mg
  • 18mg/3mL (Saxenda); delivers doses of 0.6mg, 1.2mg, 1.8mg, 2.4mg, or 3mg

Type 2 Diabetes Mellitus

Victoza only

Indicated as an adjunct to diet and exercise to improve glycemic control in patients aged ≥10 years with type 2 diabetes mellitus

<10 years: Safety and efficacy not studied

≥10 years

  • Victoza only
  • Indicated as an adjunct to diet and exercise to improve glycemic control in patients aged ≥10 years with type 2 diabetes mellitus
  • 0.6 mg SC qDay
  • After at least 1 week at 0.6 mg qDay, may increase dose to 1.2 mg/day if additional glycemic control required
  • If additional glycemic control required, may increase to 1.8 mg qDay after at least 1 week after 1.2 mg qDay dose

Obesity

Saxenda only

Adjunctive therapy to a reduced-calorie diet and increased physical activity for chronic weight management in adolescents aged ≥12 years with weight >60 kg and an initial body mass index (BMI) corresponding to ≥30 kg/m2 for adults (obese) by international cutoffs

Initiate at 0.6 mg SC qDay for 1 week; increase by 0.6 mg/day in weekly intervals until a dose of 3 mg/day achieved

Recommended maintenance dose is 3 mg/day; if unable to tolerate, may reduce to 2.4 mg/day; discontinue if 2.4 mg not tolerated

If pediatric patients do not tolerate an increased dose during dose escalation, may lower dose to previous level; dose escalation for pediatric patients may take up to 8 weeks

Evaluate change in BMI after 12 weeks on maintenance dose

Discontinue Saxenda if the patient has not reduced BMI by at least 1% from baseline, since it is unlikely that the patient will achieve and sustain clinically meaningful weight loss with continued treatment

Dosage Modifications

Victoza

  • Renal impairment
    • Mild-to-severe: No dosage adjustment necessary
    • Patients with ESRD: Limited experience; there have been postmarketing reports of acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis; use caution in patients who experience dehydration
  • Hepatic impairment
    • Mild-to-severe: Use caution; limited experience

Saxenda

  • Renal impairment
    • Mild-to-severe, including patients with end-stage renal disease (ESRD): Limited experience
    • There have been postmarketing reports of acute renal failure and worsening of chronic renal failure with liraglutide, which may sometimes require hemodialysis; use with caution in these patients
  • Hepatic impairment
    • Mild-to-severe: Use caution; limited experience

Dosing Considerations

Saxenda slows gastric emptying; has not been studied in patients with pre-existing gastroparesis

Limitations of use for Victoza

  • Not for treatment of type 1 diabetes mellitus or diabetic ketoacidosis (not effective for these conditions)
  • Has not been studied in combination with prandial insulin
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Interactions

Interaction Checker

and liraglutide

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                Monitor Closely (111)

                • acarbose

                  liraglutide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • aripiprazole

                  aripiprazole, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • asenapine

                  asenapine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • atazanavir

                  atazanavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • atorvastatin

                  liraglutide will decrease the level or effect of atorvastatin by Other (see comment). Use Caution/Monitor. Based on pharmacokinetic studies liraglutide decreased atorvastatin Cmax by 38% and median Tmax delayed from 1h to 3h with liraglutide and the AUC did not change.

                • azilsartan

                  azilsartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • bazedoxifene/conjugated estrogens

                  bazedoxifene/conjugated estrogens decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Estrogens may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • benazepril

                  benazepril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • betamethasone

                  betamethasone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • candesartan

                  candesartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • captopril

                  captopril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • chlorothiazide

                  chlorothiazide decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.

                • chlorpromazine

                  chlorpromazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

                • chlorpropamide

                  liraglutide, chlorpropamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

                • chlorthalidone

                  chlorthalidone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.

                • cinnamon

                  cinnamon increases effects of liraglutide by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.

                • clozapine

                  clozapine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • conjugated estrogens

                  conjugated estrogens decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Estrogens may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • conjugated estrogens, vaginal

                  conjugated estrogens, vaginal decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Estrogens may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • cortisone

                  cortisone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • darunavir

                  darunavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • desogestrel

                  desogestrel decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • dexamethasone

                  dexamethasone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • drospirenone

                  drospirenone decreases effects of liraglutide by passive renal tubular reabsorption due to increased pH. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • enalapril

                  enalapril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • eprosartan

                  eprosartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • estradiol

                  estradiol decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Estradiol may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • estradiol combos

                  estradiol combos decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • estrogens conjugated synthetic

                  estrogens conjugated synthetic decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Estrogens may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • estrogens esterified

                  estrogens esterified decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Estrogens may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • estropipate

                  estropipate decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Estropipate may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • ethinylestradiol

                  ethinylestradiol decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • etonogestrel

                  etonogestrel decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Etonogestrel may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • fludrocortisone

                  fludrocortisone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • fluphenazine

                  fluphenazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

                • fosamprenavir

                  fosamprenavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • fosinopril

                  fosinopril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • glimepiride

                  liraglutide, glimepiride. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

                • glipizide

                  liraglutide, glipizide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

                • glyburide

                  liraglutide, glyburide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

                • hydrochlorothiazide

                  hydrochlorothiazide decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.

                • hydrocortisone

                  hydrocortisone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • iloperidone

                  iloperidone, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • indapamide

                  indapamide decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.

                • indinavir

                  indinavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • insulin aspart

                  liraglutide, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin aspart protamine/insulin aspart

                  liraglutide, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin degludec

                  liraglutide, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin degludec/insulin aspart

                  liraglutide, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin detemir

                  liraglutide, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin glargine

                  liraglutide, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin glulisine

                  liraglutide, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin inhaled

                  liraglutide, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin isophane human/insulin regular human

                  liraglutide, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin lispro

                  liraglutide, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin lispro protamine/insulin lispro

                  liraglutide, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin NPH

                  liraglutide, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • insulin regular human

                  liraglutide, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

                • irbesartan

                  irbesartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • levonorgestrel oral

                  levonorgestrel oral decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • lisinopril

                  lisinopril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • lopinavir

                  lopinavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • losartan

                  losartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • lurasidone

                  lurasidone, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • medroxyprogesterone

                  medroxyprogesterone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Medroxyprogesterone may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • mestranol

                  mestranol decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • metformin

                  liraglutide, metformin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • methyclothiazide

                  methyclothiazide decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.

                • methylprednisolone

                  methylprednisolone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • methyltestosterone

                  methyltestosterone increases effects of liraglutide by pharmacodynamic synergism. Use Caution/Monitor. It is important to monitor all patients with type 2 diabetes on antidiabetic agents receiving androgens for changes in glycemic control. Potential for hypoglycemia.

                • metolazone

                  metolazone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Thiazide diuretics can decrease insulin sensitivity thereby leading to glucose intolerance and hyperglycemia. Monitor glycemic control especially when initiating, discontinuing, or increasing thiazide diuretic dose.

                • miglitol

                  liraglutide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • moexipril

                  moexipril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • nateglinide

                  liraglutide, nateglinide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • nelfinavir

                  nelfinavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • norethindrone acetate

                  norethindrone acetate decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • norgestimate

                  norgestimate decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Oral contraceptives may decrease hypoglycemic effects of antidiabetics by impairing glucose tolerance. Monitor for glycemic control in diabetic patients.

                • olanzapine

                  olanzapine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • olmesartan

                  olmesartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • paliperidone

                  paliperidone, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • pegvisomant

                  pegvisomant increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Pegvisomant may increase glucose tolerance. Dosage reductions of antidiabetic agents may be needed to avoid potential hypoglycemia.

                • perindopril

                  perindopril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • perphenazine

                  perphenazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

                • pioglitazone

                  liraglutide, pioglitazone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • pramlintide

                  liraglutide, pramlintide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • prednisolone

                  prednisolone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • prednisone

                  prednisone decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • prochlorperazine

                  prochlorperazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

                • promethazine

                  promethazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

                • quetiapine

                  quetiapine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • quinapril

                  quinapril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • ramipril

                  ramipril increases effects of liraglutide by unknown mechanism. Use Caution/Monitor. ACE inhibitors may increase hypoglycemic effect. Monitor glycemic control especially during the first month of treatment with an ACE inhibitor. .

                • repaglinide

                  liraglutide, repaglinide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • risperidone

                  risperidone, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                • ritonavir

                  ritonavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • rosiglitazone

                  liraglutide, rosiglitazone. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • sacubitril/valsartan

                  sacubitril/valsartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • saquinavir

                  saquinavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • saxagliptin

                  liraglutide, saxagliptin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • sitagliptin

                  liraglutide, sitagliptin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.

                • somapacitan

                  somapacitan decreases effects of liraglutide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .

                • somatropin

                  somatropin decreases effects of liraglutide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Somatropin may potentially diminish hypoglycemic effects of antidiabetic agent. May consider modifying therapy.

                • telmisartan

                  telmisartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • thioridazine

                  thioridazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

                • tipranavir

                  tipranavir decreases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

                • tolazamide

                  liraglutide, tolazamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

                • tolbutamide

                  liraglutide, tolbutamide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

                • triamcinolone acetonide injectable suspension

                  triamcinolone acetonide injectable suspension decreases effects of liraglutide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully. .

                • trifluoperazine

                  trifluoperazine, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Phenothiazines may increase or decrease glucose levels, monitor therapy closely when these agents are concurrently administered.

                • valsartan

                  valsartan increases effects of liraglutide by Other (see comment). Use Caution/Monitor. Comment: Angiotensin II receptor antagonists may enhance hypoglycemic effects of antidiabetic agents by improving insulin sensitivity. Monitor patients for changes in glycemic control.

                • ziprasidone

                  ziprasidone, liraglutide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

                Minor (4)

                • acetaminophen

                  liraglutide decreases levels of acetaminophen by unspecified interaction mechanism. Minor/Significance Unknown.

                • acetaminophen IV

                  liraglutide decreases levels of acetaminophen IV by unspecified interaction mechanism. Minor/Significance Unknown.

                • digoxin

                  liraglutide decreases levels of digoxin by unspecified interaction mechanism. Minor/Significance Unknown.

                • lovastatin

                  liraglutide decreases levels of lovastatin by unspecified interaction mechanism. Minor/Significance Unknown.

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                Adverse Effects

                >10% (Victoza)

                Nausea (26%)

                Diarrhea (17%)

                Vomiting (11%)

                >10% (Saxenda)

                Nausea (39.3%)

                Hypoglycemia in T2DM (23%)

                Diarrhea (20.9%)

                Constipation (19.4%)

                Vomiting (15.7%)

                Headache (13.6%)

                1-10% (Victoza)

                Constipation (10%)

                Headache (9%)

                Antiliraglutide antibodies (7%)

                Injection-site reactions (2%)

                1-10% (Saxenda)

                Decreased appetite (10%)

                Dyspepsia (9.6%)

                Fatigue (7.5%)

                Dizziness (6.9%)

                Abdominal pain (5.4%)

                Increased lipase (5.3%)

                Upper abdominal pain (5.1%)

                Gastroesophageal reflux disease (4.7%)

                Gastroenteritis (4.7%)

                Abdominal distension (4.5%)

                Eructation (4.5%)

                Urinary tract infection (4.3%)

                Flatulence (4%)

                Viral gastroenteritis (2.8%)

                Injection site erythema (2.5%)

                Injection site reaction (2.5%)

                Insomnia (2.4%)

                Dry mouth (2.3%)

                Asthenia (2.1%)

                Anxiety (2%)

                <1% (Victoza)

                Urticaria

                Upper respiratory tract infection

                UTI

                Dizziness

                Sinusitis

                Nasopharyngitis

                Back pain

                Hypertension

                Hypoglycemia (mostly in combination therapy)

                Pancreatitis

                Papillary thyroid carcinoma

                Thyroid C-cell hyperplasia

                Postmarketing Reports

                Dehydration resulting from nausea, vomiting, and diarrhea

                Increased serum creatinine, acute renal failure, and worsening chronic renal failure, sometimes requiring hemodialysis

                Hypersensitivity reactions (anaphylactic and angioedema)

                Allergic reactions: Rash, pruritus

                Acute pancreatitis, including fatal and nonfatal hemorrhagic or necrotizing pancreatitis

                Breast cancer

                Colorectal neoplasms

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                Warnings

                Black Box Warnings

                Risk of thyroid C-cell tumors

                • Causes thyroid C-cell tumors in rodents; human risk could not be determined
                • Contraindicated in patients with personal or family history of medullary thyroid carcinoma (MTC) or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2)
                • Routine monitoring of serum calcitonin or using thyroid ultrasound monitoring is of uncertain value for early detection of MTC in patients treated with liraglutide
                • Counsel patients regarding the potential risk of MTC with therapy

                Contraindications

                Hypersensitivity to liraglutide or its components

                Patients with a personal or family history of medullary thyroid carcinoma (MTC) or patients with multiple endocrine neoplasia syndrome type 2 (MEN 2)

                Saxenda only: Pregnancy

                Cautions

                Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed; studied in a limited number of patients with a history of pancreatitis; unknown if patients with a history of pancreatitis are at higher risk for development of pancreatitis

                Acute gallbladder disease reported; if cholelithiasis is suspected, gallbladder studies and follow-up appropriately

                May cause dose-dependent and treatment-duration-dependent thyroid C-cell tumors (adenomas and/or carcinomas) at clinically relevant exposures in both genders of rats and mice; if serum calcitonin is elevated, evaluate further; patients with thyroid nodules noted on physical examination or neck imaging should also be further evaluated

                Renal Impairment reported in association with nausea, vomiting, diarrhea, or dehydration, which may sometimes require hemodialysis; altered renal function has been reversed in many of reported cases with supportive treatment and discontinuation of potentially causative agents; use caution when initiating or escalating doses of in these patients

                There have been postmarketing reports of serious hypersensitivity reactions (eg, anaphylactic reactions, angioedema)

                Never share pen between patients even if needle is changed

                Saxenda only

                • Resting heart rate may increase by 2-3 bpm; up to 10-20 bpm increases also reported
                • Suicidal ideation; monitor for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior; discontinue in patients who experience suicidal thoughts or behaviors; avoid in patients with a history of suicidal attempts or active suicidal ideation

                Drug interactions overview

                • May cause a delay of gastric emptying, and thereby has the potential to impact the absorption of concomitantly administered oral medications; exercise caution when oral medications are concomitantly administered with liraglutide
                • Risk for Hypoglycemia with Concomitant Use of Antidiabetic Therapy
                  • Risk for hypoglycemia is increased when Saxenda is used in combination with insulin secretagogues (ie, sulfonylureas) or insulin in patients with type 2 DM
                  • In patients with type 2 diabetes, monitor blood glucose prior to starting therapy and during treatment
                  • Therefore, patients may require a lower dose of sulfonylurea (or other concomitantly administered insulin secretagogues) or insulin in this setting
                  • Victoza only: In pediatric patients ≥10 years, the risk of hypoglycemia was higher regardless of concomitant antidiabetic therapies
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                Pregnancy & Lactation

                Pregnancy

                Victoza

                • Based on animal reproduction studies, there may be risks to the fetus from exposure during pregnancy
                • Use during pregnancy only if the potential benefit justifies the potential risk to the fetus
                • Animal data
                  • Animal reproduction studies identified increased adverse developmental outcomes from exposure during pregnancy
                  • Liraglutide exposure was associated with early embryonic deaths and an imbalance in some fetal abnormalities in pregnant rats administered liraglutide during organogenesis at doses that approximate clinical exposures at the maximum recommended human dose (MRHD) of 1.8 mg/day
                  • In pregnant rabbits administered liraglutide during organogenesis, decreased fetal weight and an increased incidence of major fetal abnormalities were seen at exposures below the human exposures at the MRHD

                Saxenda

                • Contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm
                • There are no available data in pregnant women to inform a drug associated risk for major birth defects and miscarriage
                • If patient wishes to become pregnant, or pregnancy occurs, discontinue treatment
                • A minimum weight gain, and no weight loss, recommended for all pregnant women, including those who are already overweight or obese, due to necessary weight gain that occurs in maternal tissues during pregnancy

                Clinical considerations

                • Disease-associated maternal and/or embryo/fetal risk
                • Poorly controlled diabetes in pregnancy increases maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications
                • Poorly controlled diabetes increases fetal risk for major birth defects, still birth, and macrosomia related morbidity

                Lactation

                There are no data on the presence of drug in human milk, the effects on the breastfed infant, or the effects on milk production

                Present in milk of lactating rats

                Pregnancy Categories

                A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

                B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

                C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

                D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

                X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

                NA: Information not available.

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                Pharmacology

                Mechanism of Action

                Incretin mimetic; analogue of human glucagonlike peptide-1 (GLP-1); acts as GLP-1 receptor agonist to increase insulin secretion in the presence of elevated blood glucose; delays gastric emptying to decrease postprandial glucose; also decreases glucagon secretion

                Absorption

                Peak plasma time: 11 hr (Saxenda)

                Peak plasma concentration: 35 ng/mL (Victoza)

                AUC: 960 ng·hr/mL (Victoza)

                Average steady state concentration over 24 hr: 128 ng/mL (at 1.8 mg dose)

                Absolute bioavailability: 55%

                Distribution

                Protein bound: >98%

                Vd: 13 L (Victoza); 20-25 L (Saxenda); 0.07 L/kg (IV)

                Metabolism

                Endogenously metabolized to large proteins without a specific organ route

                Elimination

                Half-life: 13 hr

                Mean apparent clearance: 1.2 L/hr (Victoza); 0.9-1.4 L/hr (Saxenda)

                Excretion (metabolites): 5% feces, 6% urine

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                Administration

                SC Administration

                Administer SC in abdomen, thigh, or upper arm; rotate injection site

                Administer SC qDay at any time, independent of meals

                Must not be administered IV or IM

                Injection site and time of administration can be changed without dose adjustment

                Visually inspect each injection; solution should be used only if it is clear, colorless, and contains no particles

                Missed dose

                • If dose missed, resume the once-daily regimen with the next scheduled dose; do not give an extra dose or a higher dose
                • If missed dose more than 3 days elapsed since the last dose, initiate therapy at 0.6 mg/day to avoid GI symptoms

                Storage

                All formulations

                • Unused pens: Refrigerate at 2-8°C (36-46°F); do not freeze; do not use if frozen
                • Used injectable pens: Store at room temperature (15-30°C [59-86°F]) or refrigerate (2-8°C [36-46°F]); protect from excessive heat and sunlight; discard 30 days after first use
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                Images

                BRAND FORM. UNIT PRICE PILL IMAGE
                Victoza 3-Pak subcutaneous
                -
                0.6 mg/0.1 mL (18 mg/3 mL) injection
                Victoza 2-Pak subcutaneous
                -
                0.6 mg/0.1 mL (18 mg/3 mL) injection

                Copyright © 2010 First DataBank, Inc.

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                Patient Handout

                Patient Education
                liraglutide subcutaneous

                LIRAGLUTIDE (DIABETES) - INJECTION

                (LIR-a-GLOO-tide)

                COMMON BRAND NAME(S): Victoza

                WARNING: This medication has been found to cause a certain type of thyroid tumor (thyroid C-cell tumors) in rats and mice. It is unknown if this medication can cause similar tumors in humans. Talk with your doctor about the benefits and risks of treatment with this medication. This medication should not be used in people with a personal/family history of a certain type of cancer (medullary thyroid carcinoma) or in people with a certain inherited disease (Multiple Endocrine Neoplasia syndrome type 2 or MEN 2). While using this medication, tell your doctor right away if you notice any signs or symptoms of thyroid tumors, including unusual growth or lump in the neck, difficulty swallowing, shortness of breath, persistent hoarseness.

                USES: Liraglutide is used either alone or with other medications, and with a proper diet and exercise program, to control high blood sugar. It is used in people with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Liraglutide is also used in people with type 2 diabetes and heart disease to lower the risk of a heart attack, stroke, or death caused by heart disease.Liraglutide is similar to a natural hormone in your body (incretin). It works by causing insulin release in response to high sugar levels (such as after a meal) and decreasing the amount of sugar your liver makes.Liraglutide is not a substitute for insulin if you require insulin treatment.

                HOW TO USE: Read the Medication Guide and the Pen User Manual provided by your pharmacist before you start using liraglutide and each time you get a refill. Learn all preparation and usage instructions. If you have questions, ask your doctor or pharmacist.Inject this medication under the skin in the thigh, abdomen, or upper arm as directed by your doctor, usually once daily.If you are also using insulin, give liraglutide and insulin as separate injections. Do not mix them. You may inject these medications in the same area of the body, but the injection sites should not be next to each other.The dosage is based on your medical condition and response to treatment. Your doctor will start you on a low dose first to decrease your risk of stomach/abdominal side effects, and gradually increase your dose. If more than 3 days have passed since your last liraglutide dose, ask your doctor if you should restart the medication with the low dose to reduce your chance of side effects. Follow your doctor's instructions carefully.Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. It is important to change the location of the injection site daily to avoid problem areas under the skin.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time each day. Carefully follow the medication treatment plan, meal plan, and exercise program your doctor has recommended.Do not share your pen device with another person, even if the needle is changed. You may give other people a serious infection, or get a serious infection from them. Learn how to store and discard medical supplies safely.Tell your doctor if your condition persists or worsens (such as blood sugar remaining high or increasing).

                SIDE EFFECTS: See also Warning section.Nausea, vomiting, stomach upset, decreased appetite, diarrhea, or constipation may occur. Nausea usually lessens as you continue to use liraglutide. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Persistent vomiting/diarrhea may result in a dehydration. Contact your doctor promptly if you notice any symptoms of dehydration, such as unusual dry mouth/thirst, fast heartbeat, or dizziness/lightheadedness.Tell your doctor right away if you have any serious side effects, including: signs of kidney problems (such as change in the amount of urine), mental/mood changes (such as depression, thoughts of suicide).Get medical help right away if you have any very serious side effects, including: signs of pancreatitis or gallbladder disease (such as persistent nausea/vomiting, severe stomach/abdominal pain).Although liraglutide by itself usually does not cause low blood sugar (hypoglycemia), low blood sugar may occur if this drug is prescribed with other diabetes medications. Talk with your doctor or pharmacist about whether the dose(s) of your other diabetes medication(s) needs to be lowered. Drinking large quantities of alcohol, not getting enough calories from food, or doing unusually heavy exercise may also lead to low blood sugar. Symptoms may include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, headache, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, raise your blood sugar quickly by eating a quick source of sugar such as table sugar, honey, candy, or drinking a glass of fruit juice or non-diet soda. Check with your doctor or pharmacist to find out what you should do if you miss a meal.Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your doctor may need to adjust your diabetes medication(s).A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

                PRECAUTIONS: See also Warning section.Before using liraglutide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, disease of the pancreas (pancreatitis), a certain stomach/intestinal disorder (gastroparesis), mental/mood disorders (such as depression, thoughts of suicide).You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.Limit alcohol while using this medication because it can increase your risk of developing low blood sugar.It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because increased stress may require a change in your treatment plan, medications, or blood sugar testing.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Children may be at greater risk for low blood sugar while using this drug.During pregnancy, this medication should be used only when clearly needed. Pregnancy may cause or worsen diabetes. Discuss a plan with your doctor for managing your blood sugar while pregnant. Your doctor may change your diabetes treatment during your pregnancy. Discuss the risks and benefits of different treatments.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

                DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Beta-blocker medications (such as metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness, hunger, or sweating, are unaffected by these drugs.Many drugs can affect your blood sugar, making it harder to control. Examples include corticosteroids (such as prednisone), psychiatric medicines (such as olanzapine), quinolone antibiotics (such as ciprofloxacin), among others. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high or low blood sugar (see also Side Effects section). Your doctor may need to adjust your diabetes medication, exercise program, or diet.Do not use this medication with any other product that contains liraglutide.

                OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe nausea/vomiting.

                NOTES: Do not share this medication with others.Attend a diabetes education program to learn more about how to manage your diabetes with medications, diet, exercise, and regular medical exams. Learn the symptoms of high and low blood sugar and how to treat low blood sugar. Check your blood sugar regularly as directed and share the results with your doctor.Keep all medical appointments. Laboratory and/or medical tests (such as kidney function, fasting blood glucose, hemoglobin A1c) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

                MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.

                STORAGE: Before using the liraglutide pen for the first time, store it in the refrigerator. Do not freeze. After first use, liraglutide can be stored at room temperature or in the refrigerator. Protect from heat and sunlight. Discard 30 days after first use, even if some drug remains in the pen. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

                MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

                Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

                IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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                Formulary

                FormularyPatient Discounts

                Adding plans allows you to compare formulary status to other drugs in the same class.

                To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

                Adding plans allows you to:

                • View the formulary and any restrictions for each plan.
                • Manage and view all your plans together – even plans in different states.
                • Compare formulary status to other drugs in the same class.
                • Access your plan list on any device – mobile or desktop.

                The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

                Tier Description
                1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
                2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
                3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
                4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
                NC NOT COVERED – Drugs that are not covered by the plan.
                Code Definition
                PA Prior Authorization
                Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
                QL Quantity Limits
                Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
                ST Step Therapy
                Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
                OR Other Restrictions
                Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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                Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.