Some patients may benefit from an increase in dosage to 1.8 mg once daily after at least one week. Max. 1.8 mg/day. When added to insulin, consider reducing the insulin dose to lower the risk of hypoglycemia; self-monitoring of blood glucose levels is necessary. Gradually reduce the insulin dose. When added to a sulfonylurea derivative (only in adults), consider reducing the sulfonylurea dose to lower the risk of hypoglycemia; self-monitoring of blood glucose levels is necessary. For elderly patients (> 65 years), renal and liver function impairment: No dose adjustment is needed for elderly patients, mild to severe renal impairment, and mild to moderate liver impairment. Use in end-stage renal disease or severe liver impairment is not recommended.
Saxenda: Starting dose s.c. 0.6 mg once daily, increase in steps of 0.6 mg with intervals of at least one week to a maintenance dose of 3.0 mg once daily, max. 3.0 mg/day. Consider discontinuing treatment if the increase to the next dose step is not tolerated for two consecutive weeks.Gastrointestinal disorders occur more frequently at the beginning of treatment and usually decrease within a few days or weeks. Gastrointestinal disorders may occur more frequently in elderly patients (? 65 years) and individuals with mild or moderate renal insufficiency (creatinine clearance ? 30 ml/min). Common (1-10%): nasopharyngitis, bronchitis. Hypoglycemia (very common when combined with a sulfonylurea derivative). Decreased appetite, vomiting, dyspepsia, gastritis, gastroesophageal reflux, abdominal pain, flatulence, abdominal distension, constipation. Toothache, headache, dizziness, fatigue. Increased heart rate. Injection site reaction, rash. Increased serum lipase and amylase. Rarely (0.1-1%): dehydration. Cholelithiasis, cholecystitis. Urticaria, itching. Malaise, acute renal failure, renal insufficiency. Common (110%): hypoglycemia. Dry mouth, dysgeusia, dyspepsia, gastritis, gastroesophageal reflux, abdominal pain, flatulence, belching, abdominal distension.
Liraglutide is made by attaching a C-16 fatty acid (palmitic acid) with a glutamic acid spacer on the remaining lysine residue at position 26 of the peptide precursor. Liraglutide was granted FDA approval on January 25, 2010.
Saxenda, a formulation of liraglutide intended for weight loss, is indicated as an adjunct to diet and exercise for chronic weight management in adult patients who are obese (BMI ≥ 30 kg/m²), or who are overweight (BMI ≥ 27 kg/m²) and have at least one weight-related comorbidity. It is also indicated for chronic weight management in pediatric patients ≥ 12 years old who weigh ≥ 60 kg and have an initial BMI corresponding to obesity based on international cut-offs.
Victoza, a formulation of liraglutide used in diabetes, is indicated as an adjunct to diet and exercise to improve glycemic control in patients ≥ 10 years old with type 2 diabetes mellitus. It is also indicated to reduce the risk of major adverse cardiovascular events in adult patients with type 2 diabetes and established cardiovascular disease.
# Liraglutide Overview
