Za Pharmacy

Drugs, Supplies and Delivery

Liraglutide (Victoza® Injection)

Liraglutide, marketed as Victoza®, is a glucagon-like peptide-1 (GLP-1) receptor agonist administered via subcutaneous injection. It is widely used for the management of type 2 diabetes mellitus (T2DM) and has demonstrated cardiovascular benefits in high-risk patients. This article synthesizes evidence from the British National Formulary (BNF)Lippincott Textbook of Pharmacology, and Lange Basic & Clinical Pharmacology to detail its pharmacology, clinical applications, and safety profile.

Liraglutide mimics endogenous GLP-1, a hormone that enhances glucose-dependent insulin secretion and suppresses glucagon release. Key mechanisms include:

  • Insulin Secretion: Binds to pancreatic β-cell GLP-1 receptors, activating cyclic AMP (cAMP) to stimulate insulin release in response to elevated blood glucose (Lippincott).
  • Glucagon Suppression: Reduces inappropriate glucagon secretion from α-cells, lowering hepatic glucose output.
  • Gastric Emptying: Slows gastric motility, reducing postprandial glucose spikes and promoting satiety (Lange).
  • Cardiovascular Protection: Reduces major adverse cardiovascular events (MACE) in patients with T2DM and established cardiovascular disease, as shown in the LEADER trial (BNF).
  1. Type 2 Diabetes Mellitus:
    • Adjunctive therapy to diet, exercise, and other glucose-lowering agents (e.g., metformin, insulin) when glycemic targets are unmet.
    • Preferred for patients with cardiovascular disease due to proven MACE reduction (BNF).
  2. Weight Management (Off-Label):
    • Promotes weight loss via appetite suppression (higher doses approved as Saxenda® for obesity).
  • Administration: Subcutaneous injection (abdomen, thigh, or upper arm) once daily.
  • Titration:
    • Initial: 0.6 mg daily for 1 week to minimize gastrointestinal (GI) side effects.
    • Maintenance: Increase to 1.2 mg or 1.8 mg daily based on tolerance and glycemic response (BNF).
  • Special Populations:
    • Renal Impairment: No dose adjustment for mild-to-moderate impairment; use caution in severe impairment (eGFR <30 mL/min/1.73m²).
    • Hepatic Impairment: No adjustment required.

Elderly: Monitor closely for hypoglycemia and GI effects

  • Gastrointestinal: Nausea (20–40%), vomiting, diarrhea (most frequent during dose escalation).
  • Headache, dizziness.

Serious:

  • Pancreatitis: Monitor for severe abdominal pain; discontinue if confirmed.
  • Thyroid C-Cell Tumors: Contraindicated in personal/family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia type 2 (MEN 2).
  • Acute Kidney Injury: Linked to dehydration from GI adverse effects (BNF).
  • Hypoglycemia: Risk increases with concurrent insulin or sulfonylureas (Lippincott).
  • Contraindications:
    • Personal/family history of MTC or MEN 2.

Hypersensitivity to liraglutide or GLP-1 agonists

    • Renal function, pancreatic enzymes, and HbA1c.
    • Thyroid nodules (via palpation or imaging).

Unopened vials/pens: Refrigerate (2–8°C).

In-use: Store at room temperature (<30°C) for up to 28 days

    • Pregnancy: Category C; avoid unless benefits outweigh risks.
    • Lactation: Discontinue due to insufficient safety data (Lange).
  • Oral Medications: Delayed absorption of drugs requiring rapid GI uptake (e.g., antibiotics, oral contraceptives). Administer 1 hour before liraglutide.
  • Insulin/Sulfonylureas: Increased hypoglycemia risk; consider dose reduction.
  • ACE Inhibitors/Diuretics: May exacerbate dehydration and renal impairment (BNF).
  • Generic: Liraglutide.
  • Brand Names: Victoza® (for T2DM), Saxenda® (for obesity).

Book Now

Order Your Medications with Ease

We provide fast and secure prescription reservations—place your order now and pick it up from the nearest pharmacy!