Description: Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist
“ALERT: US Boxed 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 types 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.”
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Liraglutide is a long-acting analog of human glucagon-like peptide-1 (GLP-1) (an incretin hormone). Liraglutide works in multiple 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 slows 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.
Officially indicated for chronic weight management as and an adjunct to a reduced-calorie diet and increased physical activity.
- 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 a history of suicidal attempts or active suicidal ideation
Injection: Inject 0.6mg subcutaneously once daily for 1 week; increase the dose by 0.6mg at weekly intervals to a target dose of 3mg 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 than 3mg daily if the weight loss goal is being achieved.
Points To Consider
- Injectable administration
- Potential exists for misuse in inappropriate patient populations (i.e. anorexia nervosa or bulimia)
Pharmacist Tips On Using
How Do You Use Liraglutide, Saxenda: Inject 0.6mg subcutaneously once daily for 1 week; increase the dose by 0.6mg at weekly intervals to a target dose of 3mg 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 than 3mg daily if the weight loss goal 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.
Is Liraglutide, Saxenda Safe to Use During Pregnancy: Any medication used for weight loss is not recommended at conception and during pregnancy. Hence, Saxenda/Liraglutide is contraindicated in pregnant women (lack of potential benefit and possible fetal harm).
- Well tolerated, most side effects are transient and mild to moderate in nature. The most common side effects include:
- 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%)