Victoza: Effective GLP-1 Therapy for Type 2 Diabetes Management
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Synonyms | |||
Victoza (liraglutide) is a once-daily injectable prescription medication used to improve blood sugar control in adults with type 2 diabetes, alongside diet and exercise. As a glucagon-like peptide-1 (GLP-1) receptor agonist, it works by stimulating insulin secretion, suppressing glucagon release, and slowing gastric emptying. This comprehensive product card provides detailed, expert-level information for healthcare professionals and informed patients regarding its use, mechanism, benefits, and important safety considerations.
Features
- Active ingredient: Liraglutide
- Drug class: Glucagon-like peptide-1 (GLP-1) receptor agonist
- Administration: Subcutaneous injection
- Available strengths: 6 mg/mL pre-filled pens (delivering 0.6 mg, 1.2 mg, or 1.8 mg per dose)
- Dosing frequency: Once daily, any time of day
- Delivery system: Pre-filled, multi-dose pen with needle
Benefits
- Significantly lowers HbA1c levels through glucose-dependent insulin secretion
- Promotes weight loss by reducing appetite and slowing gastric emptying
- Lowers risk of major adverse cardiovascular events in patients with established cardiovascular disease
- Convenient once-daily dosing regimen supports treatment adherence
- Does not typically cause hypoglycemia when used without sulfonylureas or insulin
- May preserve beta-cell function through GLP-1 receptor activation
Common use
Victoza is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is commonly prescribed when metformin alone provides insufficient glycemic control or when additional glucose-lowering effects are needed. Healthcare providers may consider Victoza particularly for patients who would benefit from weight loss or those with established cardiovascular disease seeking cardiovascular risk reduction. The medication is typically integrated into a comprehensive diabetes management plan that includes nutritional counseling, physical activity, and regular glucose monitoring.
Dosage and direction
The recommended starting dose is 0.6 mg once daily for at least one week to reduce gastrointestinal symptoms. The dose should then be increased to 1.2 mg once daily. If the 1.2 mg dose does not result in acceptable glycemic control, the dose may be increased to 1.8 mg once daily. Administer Victoza by subcutaneous injection in the abdomen, thigh, or upper arm. Rotate injection sites to prevent lipodystrophy. The injection may be administered independently of meals, though consistency in timing is recommended. Patients should receive proper training on injection technique, including priming the pen, dose selection, and safe needle disposal.
Precautions
Patients should be monitored for pancreatitis; discontinue promptly if pancreatitis is suspected. Use with caution in patients with renal impairment or severe gastrointestinal disease. Thyroid C-cell tumors have been observed in rodent studies; relevance to humans is unknown but warrants consideration. Not recommended as first-line therapy for patients with inadequate glycemic control on diet and exercise alone. Regular monitoring of glycemic control, renal function, and potential allergic reactions is advised. Patients should be educated about recognizing symptoms of hypoglycemia, especially when used with other glucose-lowering medications. Use during pregnancy only if potential benefit justifies potential risk to the fetus.
Contraindications
Victoza is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). It should not be used in patients with a history of hypersensitivity to liraglutide or any component of the formulation. Not indicated for use in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis. Contraindicated in patients with severe renal impairment or end-stage renal disease. Should not be used in combination with other GLP-1 receptor agonists.
Possible side effects
Common side effects (≥5%) include nausea, diarrhea, vomiting, decreased appetite, dyspepsia, and constipation. These gastrointestinal effects are typically dose-dependent and often diminish over time. Hypoglycemia may occur when used with sulfonylureas or insulin. Less common but serious adverse reactions include pancreatitis, allergic reactions, renal impairment, and gallbladder disease. Injection site reactions may occur but are generally mild. Patients should report persistent severe abdominal pain, symptoms of allergic reactions, or changes in renal function to their healthcare provider promptly.
Drug interaction
Victoza delays gastric emptying and may impact absorption of concomitantly administered oral medications. Particular attention should be paid to medications with narrow therapeutic indices or those requiring specific absorption timing. Oral contraceptives should be taken at least one hour before or eleven hours after Victoza injection. Use with insulin or sulfonylureas increases risk of hypoglycemia; dose adjustment of these medications may be necessary. No clinically significant interactions have been observed with metformin, digoxin, warfarin, atorvastatin, or other commonly co-administered medications, though careful monitoring is still recommended.
Missed dose
If a dose is missed, it should be administered as soon as possible on the same day. However, if the missed dose is not remembered until the next day, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not administer two doses on the same day to make up for a missed dose. Consistent daily dosing is important for maintaining therapeutic effect, so patients should establish routines to support adherence. Healthcare providers should discuss strategies for managing missed doses during patient education sessions.
Overdose
In clinical trials, doses up to 15 mg once daily have been administered and were associated with severe nausea and vomiting. In case of overdose, appropriate supportive treatment should be initiated according to the patient’s clinical signs and symptoms. Because liraglutide has a long half-life (approximately 13 hours), effects may persist. Blood glucose should be monitored, and symptomatic treatment for nausea and vomiting provided as needed. There is no specific antidote for liraglutide overdose. Hemodialysis is unlikely to be effective due to the high protein binding of liraglutide.
Storage
Unused Victoza pens should be refrigerated at 2°C to 8°C (36°F to 46°F). Do not freeze. Protect from light. After first use, pens may be stored at room temperature (below 30°C/86°F) or refrigerated. The pen in use should be discarded 30 days after first use, even if it still contains medication. Do not use Victoza if it has been frozen or exposed to temperatures above 30°C. Always check the solution before use; it should be clear and colorless. Do not use if particulate matter or discoloration is present. Keep out of reach of children.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Healthcare professionals should refer to the full prescribing information before prescribing Victoza. Patients should use Victoza only as directed by their healthcare provider and should not make changes to their treatment regimen without medical supervision. Individual results may vary, and not all patients will experience the same benefits or side effects. The information presented here is based on current medical knowledge but may not include all possible information about this medication.
Reviews
Clinical trials demonstrate that Victoza significantly reduces HbA1c levels (typically by 0.8% to 1.5%) and promotes weight loss (average 2-3 kg) in patients with type 2 diabetes. The LEAD clinical trial program, involving over 4,000 patients, established its efficacy and safety profile. Many endocrinologists report positive experiences with Victoza, particularly noting its cardiovascular benefits in high-risk patients. Some patients report improved quality of life due to better glucose control and weight management, though gastrointestinal side effects may be challenging initially. Long-term extension studies suggest maintained efficacy with continued use. Real-world evidence supports the cardiovascular benefits observed in clinical trials.