Generic Name

Liraglutide

---

Classification

FDA Approved Indications

• Type 2 diabetes mellitus (Victoza)
• Chronic weight management in adults with obesity or overweight with comorbidities (Saxenda)

Mechanism of Action

Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that enhances glucose-dependent insulin secretion, suppresses glucagon secretion, delays gastric emptying, and promotes satiety, leading to reduced blood glucose levels and weight loss.

Dosage and Administration

Adult: Victoza: 0.6 mg daily, can be increased to 1.2 mg or 1.8 mg based on response; Saxenda: 0.6 mg daily, titrated up to 3.0 mg daily.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; no specific dosing adjustments, monitor renal and hepatic function.

Renal Impairment: Use with caution; no specific dose adjustment recommended but monitor renal function.

Hepatic Impairment: Use with caution; limited data available.

Pharmacokinetics

Absorption: Slowly absorbed after subcutaneous injection.

Distribution: Wide distribution; bound minimally to plasma proteins (~50%).

Metabolism: Metabolized via proteolytic degradation to small peptides and amino acids.

Excretion: Excreted primarily via urine as metabolites.

Half Life: Approx. 13 hours, allowing once-daily dosing.

Contraindications

• Personal or family history of medullary thyroid carcinoma
• Multiple endocrine neoplasia syndrome type 2

Precautions

• History of pancreatitis
• Renal impairment
• Hepatic impairment
• Pregnancy and lactation (use only if clearly needed)

Adverse Reactions - Common

• Nausea (Common)
• Diarrhea (Common)
• Vomiting (Common)
• Upper respiratory infection (Common)

Adverse Reactions - Serious

• Pancreatitis (Serious, rare)
• Thyroid C-cell tumors (Serious, animal studies; human relevance unknown)
• Hypoglycemia (with concomitant insulin or secretagogues) (Serious)

Drug-Drug Interactions

• Insulin, sulfonylureas (risk of hypoglycemia)
• Other medications affecting gastrointestinal motility

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication exactly as prescribed, preferably at the same time each day.
• Report symptoms of pancreatitis (severe abdominal pain, nausea, vomiting).
• Be aware of the possible gastrointestinal side effects when initiating therapy.
• Use contraception if applicable, as safety in pregnancy is not established.
• Maintain a healthy diet and exercise program.

Special Considerations

Black Box Warnings:

• Thyroid C-cell tumors observed in rodents; human risk unknown.

Genetic Factors: Limited data; no established genetic considerations.

Lab Test Interference: No known interference.

Overdose Management

Signs/Symptoms: Severe nausea, vomiting, hypoglycemia, or pancreatitis symptoms.

Treatment: Supportive care; monitor vital signs and laboratory parameters; symptomatic management.

Storage and Handling

Storage: Store in a refrigerator (36°F to 46°F / 2°C to 8°C); do not freeze.

Stability: Stable for 21 days at room temperature (up to 86°F / 30°C).