Drug Guide
Albiglutide
Classification
Therapeutic: Anti-diabetic agent, glucagon-like peptide-1 (GLP-1) receptor agonist
Pharmacological: Peptide, GLP-1 receptor agonist
FDA Approved Indications
- Type 2 diabetes mellitus to improve glycemic control
Mechanism of Action
Albiglutide mimics endogenous GLP-1, enhancing glucose-dependent insulin secretion, suppressing glucagon secretion, slowing gastric emptying, and reducing appetite, thereby improving blood glucose control.
Dosage and Administration
Adult: Initially, 30 mg subcutaneously once weekly. Dose may be increased to 50 mg based on glycemic response.
Pediatric: Not approved for pediatric use.
Geriatric: Use with caution; monitor renal function and hydration status.
Renal Impairment: Adjust dose based on tolerance and response; no specific dosage adjustment needed, but cautious use recommended.
Hepatic Impairment: No specific dose adjustments; use with caution.
Pharmacokinetics
Absorption: Rapid absorption after subcutaneous injection.
Distribution: Wide distribution; approx. 69% bound to plasma proteins.
Metabolism: Degraded by proteolytic enzymes; not a substrate for cytochrome P450 enzymes.
Excretion: Metabolites excreted primarily in urine; parent drug not excreted unchanged.
Half Life: Approximately 5 days, allowing once-weekly dosing.
Contraindications
- Personal or family history of medullary thyroid carcinoma
- Multiple endocrine neoplasia syndrome type 2
Precautions
- Use with caution in patients with renal impairment, pancreatitis, or gastrointestinal disease. Monitor for signs of pancreatitis, hypersensitivity reactions, and hypoglycemia.
Adverse Reactions - Common
- Nausea (Occasional to common)
- Vomiting (Less common)
- Diarrhea (Less common)
- Injection site reactions (Less common)
Adverse Reactions - Serious
- Pancreatitis (Rare)
- Thyroid tumors, including medullary thyroid carcinoma (Rare, based on animal studies)
- Hypersensitivity reactions (Rare)
Drug-Drug Interactions
- Other antidiabetic agents, especially insulin or sulfonylureas (risk of hypoglycemia)
Drug-Food Interactions
- No significant interactions reported
Drug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood glucose levels regularly. Assess for symptoms of pancreatitis (abdominal pain, nausea).
Diagnoses:
- Impaired glucose regulation
- Risk for hypoglycemia
Implementation: Inject subcutaneously once weekly, rotate injection sites. Educate patient on injection technique and adherence.
Evaluation: Monitor glycemic control (A1C levels) and adverse effects.
Patient/Family Teaching
- Use medication exactly as prescribed.
- Recognize symptoms of pancreatitis and hypersensitivity.
- Maintain regular follow-up appointments.
- Report any gastrointestinal symptoms or allergic reactions.
Special Considerations
Black Box Warnings:
- Thyroid C-cell tumors (medullary thyroid carcinoma in animals)
Genetic Factors: Patients with a history of medullary thyroid carcinoma or MEN 2 should not use this medication.
Lab Test Interference: No significant interference reported.
Overdose Management
Signs/Symptoms: Nausea, vomiting, diarrhea, hypoglycemia in some cases.
Treatment: Supportive care; notify healthcare provider. No specific antidote.
Storage and Handling
Storage: Store in the refrigerator (2°C to 8°C). Do not freeze.
Stability: Stable at room temperature for up to 14 days; protected from light.