Victoza

Victoza contains the active ingredient liraglutide and belongs to the class of GLP-1 receptor agonists. It is used once daily as a subcutaneous injection to treat type 2 diabetes mellitus in adults.

Liraglutide mimics the body's own incretin hormone GLP-1, which is released after eating. It stimulates insulin release, inhibits glucagon release, and slows gastric emptying.

Victoza is manufactured by Novo Nordisk. A cardiovascular protective effect was demonstrated in the LEADER trial.

Liraglutide acts as a GLP-1 receptor agonist:

Glucose-dependent insulin stimulation:

• Promotes insulin release only when blood sugar is elevated
• Hypoglycemia is possible even when used alone

Glucagon inhibition:

• Reduces glucagon release from the pancreas
• Less sugar released from the liver

Gastric emptying:

• Slowing of gastric emptying
• Flatter blood sugar spikes after meals

Satiety:

• Acts on the satiety center in the brain
• Supports weight loss

Victoza is suitable for:

• Adults with type 2 diabetes in combination with oral antidiabetic drugs
• Patients in whom metformin alone is not sufficient
• Diabetes patients with increased cardiovascular risk
• Overweight patients (additional weight reduction)

Not suitable:

• Type 1 diabetes
• Diabetic ketoacidosis
• Personal/family history of medullary thyroid carcinoma
• MEN 2 syndrome
• Pregnancy and breastfeeding

Prefilled pen for subcutaneous injection:

• 0.6 mg once daily (starting dose, at least 1 week)
• 1.2 mg once daily (therapeutic dose)
• 1.8 mg once daily (maximum dose, if needed)

Dose escalation:

• Week 1: 0.6 mg/day (adjustment phase, not yet fully effective)
• From week 2: 1.2 mg/day
• If needed, after at least 1 week: 1.8 mg/day

Use:

• Once daily, at any time of day
• Preferably at the same time each day
• Subcutaneous injection into the abdomen, thigh, or upper arm
• Rotate the injection site

Important information:

• Store the pen in the refrigerator (2-8 °C); once in use, max. 30 days at room temperature
• Put the pen cap back on (protection from light)
• Do not freeze
• If you miss a dose: inject it within 12 hours; after that, skip it

Victoza must not be used in cases of:

• Hypersensitivity to liraglutide
• Type 1 diabetes

Caution in cases of:

• History of pancreatitis
• Severe renal impairment
• Severe hepatic impairment
• Inflammatory bowel disease
• Diabetic gastroparesis

Pregnancy/breastfeeding: Victoza must not be used during pregnancy. Victoza should not be used during breastfeeding. If you wish to become pregnant or if you become pregnant, treatment with Victoza must be stopped.

Very common (>10%):

• Nausea
• Diarrhea

Common (1-10%):

• Vomiting
• Constipation
• Headache
• Decreased appetite
• Abdominal pain
• Injection site reactions

Uncommon:

• Pancreatitis
• Gallstones
• Allergic reactions
• Increased heart rate

Note: Gastrointestinal side effects occur mainly at the beginning and usually improve within a few weeks. Slow dose escalation is important.

Insulin and sulfonylureas: Increased risk of hypoglycemia. A dose reduction may be necessary.

Oral medications: Delayed gastric emptying can affect the absorption of other medications.

Warfarin: Monitor INR more frequently at the start.