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Victoza
liraglutide
Black Box Warnings .
Thyroid C-cell Tumor Risk
contraindicated in pts w/ medullary thyroid carcinoma (MTC) hx or family hx, or in pts w/ multiple endocrine neoplasia syndrome type 2 (MEN 2); dose-related and duration-dependent incr. in thyroid C-cell tumor incidence observed in rodents, but human relevance unknown; uncertain value of routine serum calcitonin or thyroid ultrasound monitoring; advise pts of potential MTC risk and thyroid tumor sx (e.g., neck mass, dysphagia, dyspnea, persistent hoarseness)
Adult Dosing .
Dosage forms: INJ (pen): 6 mg per mL
Special Note
- [prescribing info]
- Info: see other injectable liraglutide product for FDA-approved weight management dosing
diabetes mellitus, type 2
- [1.2-1.8 mg SC qd]
- Start: 0.6 mg SC qd x1wk, then 1.2 mg SC qd, then may incr. to 1.8 mg SC qd after at least 1wk; Max: 1.8 mg/day; Info: retitrate from 0.6 mg SC qd if tx interrupted for >3 days
cardiovascular event risk reduction - DM type 2 pts w/ estab. cardiovascular dz
- [1.2-1.8 mg SC qd]
- Start: 0.6 mg SC qd x1wk, then 1.2 mg SC qd, then may incr. to 1.8 mg SC qd after at least 1wk if additional glycemic control needed; Max: 1.8 mg/day; Info: retitrate from 0.6 mg SC qd if tx interrupted for >3 days
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: INJ (pen): 6 mg per mL
diabetes mellitus, type 2
- [10 yo and older]
- Dose: 0.6-1.8 mg SC qd; Start: 0.6 mg SC qd, may incr. by 0.6 mg/day no more frequently than qwk; Max: 1.8 mg/day; Info: retitrate from 0.6 mg SC qd if tx interrupted for >3 days
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- medullary thyroid CA hx
- medullary thyroid CA family hx
- multiple endocrine neoplasia syndrome type 2
- diabetes mellitus, type 1
- caution: hypersensitivity to GLP-1 agonists
- caution: renal impairment
- caution: volume depletion
- caution: GI dz, severe
- caution: gastroparesis, severe
- caution: pancreatitis risk
- caution: pancreatitis hx
- caution: surgery
Drug Interactions .
Overview
liraglutide
GLP-1 agonist
- antidiabetic agent
- decreases gastrointestinal motility
- tachycardia
- caution advised w/ concurrent oral drugs requiring rapid onset; liraglutide delays gastric emptying
Contraindicated
- potassium chloride
- potassium citrate
Avoid/Use Alternative
- desogestrel (contraceptive)
- dienogest (contraceptive)
- drospirenone (contraceptive)
- dulaglutide
- ephedra
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethinyl estradiol (contraceptive)
- ethynodiol (contraceptive)
- exenatide
- levonorgestrel (contraceptive)
- levonorgestrel (post-coital contraceptive)
- liraglutide
- norethindrone (contraceptive)
- norgestimate (contraceptive)
- norgestrel (contraceptive)
- semaglutide
- tirzepatide
- ulipristal (post-coital contraceptive)
Monitor/Modify Tx
- acebutolol
- albuterol
- albuterol inhaled
- alclometasone topical
- aloe
- alogliptin
- alpelisib
- amcinonide topical
- amitriptyline
- amoxapine
- amphetamine
- arformoterol inhaled
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- armodafinil
- arsenic trioxide
- asenapine
- ashwagandha
- asparaginase
- aspirin
- atazanavir
- atomoxetine
- atropine
- benazepril
- benzphetamine
- benztropine
- berberine
- betamethasone
- betamethasone topical
- bismuth subsalicylate
- bortezomib
- brentuximab vedotin
- brexpiprazole
- brigatinib
- bromocriptine
- budesonide
- bumetanide
- caffeine
- caffeine citrate
- calaspargase
- canagliflozin
- cannabis
- capivasertib
- cariprazine
- carvedilol
- cassia cinnamon
- ceritinib
- chloroquine
- chlorothiazide
- chlorthalidone
- chromium
- ciprofloxacin
- clarithromycin
- clobetasol topical
- clocortolone topical
- clomipramine
- clozapine
- cocaine
- colesevelam
- copanlisib
- corticotropin
- cortisone
- dabrafenib
- danazol
- darunavir
- decitabine
- deflazacort
- delafloxacin
- desipramine
- desonide topical
- desoximetasone topical
- dexamethasone
- dexmethylphenidate
- dextroamphetamine
- diazoxide
- dicyclomine
- diethylpropion
- diflorasone topical
- digoxin
- disopyramide
- dobutamine
- dopamine
- doxepin
- dronabinol
- eleuthero
- enfortumab vedotin
- ensartinib
- ephedrine injection
- ephedrine oral
- epinephrine
- epinephrine inhaled
- ertugliflozin
- estradiol (hormone replacement)
- estrogens, conjugated (hormone replacement)
- estrogens, esterified (hormone replacement)
- ethacrynic acid
- ethanol
- ethinyl estradiol (hormone replacement)
- ethionamide
- etonogestrel (contraceptive)
- everolimus
- fenugreek
- flaxseed
- fludrocortisone
- fluocinolone otic
- fluocinolone topical
- fluocinonide topical
- fluoxetine
- flurandrenolide topical
- fluticasone propionate topical
- formoterol inhaled
- fosamprenavir
- fosphenytoin
- furosemide
- garlic
- ginkgo
- ginseng, American
- ginseng, Asian
- glimepiride
- glipizide
- glyburide
- glycopyrrolate
- goserelin
- gymnema
- halcinonide topical
- halobetasol topical
- histrelin
- hoodia
- hydrochlorothiazide
- hydrocortisone
- hydrocortisone topical
- hydroxychloroquine
- hyoscyamine
- iloperidone
- imipramine
- inavolisib
- indapamide
- insulin
- isocarboxazid
- isoniazid
- isoproterenol
- ketamine
- lanreotide
- leuprolide
- levalbuterol inhaled
- levofloxacin
- levomilnacipran
- levothyroxine
- lifileucel
- linagliptin
- linezolid
- liothyronine
- lisdexamfetamine
- lisinopril
- lopinavir/ritonavir
- lorlatinib
- lumateperone
- lurasidone
- lurbinectedin
- lutetium Lu 177 dotatate
- mecasermin
- medroxyprogesterone (contraceptive)
- megestrol
- methamphetamine
- methscopolamine
- methylphenidate
- methylprednisolone
- methyltestosterone
- metolazone
- metreleptin
- milk thistle
- milnacipran
- modafinil
- mometasone topical
- moxifloxacin
- nadolol
- nateglinide
- nelfinavir
- niacin (vitamin B3)
- norelgestromin (contraceptive)
- norepinephrine
- nortriptyline
- octreotide
- ofloxacin
- olanzapine
- olodaterol inhaled
- orphenadrine
- paliperidone
- pasireotide
- pegaspargase
- peginterferon alfa 2a
- pegvisomant
- pentamidine
- phendimetrazine
- phenelzine
- phentermine
- phenylephrine
- phenylephrine ophthalmic
- phenytoin
- pindolol
- pioglitazone
- pramlintide
- prednicarbate topical
- prednisolone
- prednisone
- protriptyline
- pseudoephedrine
- quetiapine
- quinine
- repaglinide
- ribose
- risperidone
- ritonavir
- rosiglitazone
- rotigotine transdermal
- sacrosidase
- salmeterol inhaled
- saxagliptin
- segesterone (contraceptive)
- sirolimus albumin-bound
- sitagliptin
- solriamfetol
- somapacitan
- somatrogon
- somatropin
- sotagliflozin
- sotalol
- spironolactone
- sucralfate
- sunitinib
- temsirolimus
- teprotumumab
- terbutaline
- tesamorelin
- testosterone
- thyroid
- timolol
- tipranavir
- torsemide
- tramadol
- trandolapril
- tranylcypromine
- triamcinolone
- triamcinolone topical
- triamterene
- trimipramine
- triptorelin
- trospium
- turmeric
- vamorolone
- vilanterol inhaled
- viloxazine
- vorinostat
- yohimbe
- ziprasidone
Caution Advised
- acetaminophen
- amoxicillin
- ampicillin
- azithromycin
- barium
- bedaquiline
- cefaclor
- cefadroxil
- cefdinir
- cefixime
- cefpodoxime
- cefprozil
- cefuroxime axetil
- cephalexin
- clindamycin
- cycloserine
- dapsone
- demeclocycline
- dicloxacillin
- doxazosin
- doxycycline
- erythromycin
- fosfomycin
- gepotidacin
- lefamulin
- metoclopramide
- metronidazole
- mexiletine
- minocycline
- omadacycline
- penicillin V
- pivmecillinam
- potassium acid phosphate
- potassium gluconate
- potassium phosphate
- rifabutin
- rifampin
- rifapentine
- sarecycline
- secnidazole
- sulfadiazine
- sulfamethoxazole
- sulfasalazine
- sulopenem
- tedizolid phosphate
- tetracycline
- tinidazole
- trimethoprim
Adverse Reactions .
Serious Reactions
- thyroid C-cell tumor (animal studies)
- medullary thyroid CA risk
- papillary thyroid CA
- hypersensitivity rxn
- anaphylaxis
- angioedema
- acute kidney injury
- GI rxn, severe
- pancreatitis
- cholelithiasis
- cholecystitis
- ileus
- perioperative aspiration
Common Reactions
- hypoglycemia (peds pts)
- nausea
- diarrhea
- headache
- nasopharyngitis
- vomiting
- appetite decr.
- dyspepsia
- URI
- constipation
- back pain
- bilirubin incr.
- injection site rxn
- amylase incr.
- lipase incr.
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available; risk of teratogenicity and decr. fetal wt based on animal data at <1x MRHD
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available, though risk of infant harm not expected based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: unknown; CYP450: unknown
Excretion: urine 6%, feces 5%; Half-life: 13h
Subclass: Diabetes: GLP-1 Agonists ; GLP-1 Agonists, Cardiovascular
Mechanism of Action
activates glucagon-like-peptide-1 (GLP-1) receptor, increasing insulin secretion, decreasing glucagon secretion, and delaying gastric emptying (incretin mimetic)
Formulary .
No Formulary Selected
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