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Liraglutide

A10B - Blood glucose lowering drugs, excl. insulins ATC A10BX07 Protein approved 2009 Parenteral Natural product Black-box warning

JFDA label: Saxenda 6mg/ml Solution For Injection in PFP

⚠ Black-Box Warning
  • Thyroid C-cell tumor risk:

Mechanism of Action

Agonist of Glucagon-like peptide 1 receptor — Glucagon-like peptide 1 receptor agonist

TargetActionGene / class
Glucagon-like peptide 1 receptor efficacy AGONIST GLP1R

Indications

Approved

  • Chronic weight management (Saxenda)
  • Diabetes mellitus, type 2 (Victoza)

Class profile

mechanismClassGLP-1 receptor agonist (long-acting, daily)
insulinSecretagogue0
weightEffectLoss
hypoglycemiaRiskNone (when used alone)
renalContraindicated0
cardioProtective1
renalProtective0
sourceADA-EASD2023/Maruthur2016

Contraindications

Source: Lexicomp

  • Additional contraindications (not in US labeling): Pregnancy (Saxenda, Victoza) Absolute
  • Prior serious hypersensitivity to liraglutide or any component of the formulation Absolute
  • breastfeeding Absolute
  • history of or family history of MTC Absolute
  • patients with multiple endocrine neoplasia syndrome type 2 (MEN2) Absolute
  • pregnancy (Saxenda) Absolute

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Cardiac disorders (2)

Very Common Increased heart rate

Common Tachycardia

Nervous system disorders (3)

Very Common Headache

Common dizziness · Fatigue

Hepatobiliary disorders (1)

Common Hyperbilirubinemia

Renal and urinary disorders (1)

Common Urinary tract infection

Immune system disorders (1)

Common Antibody development

Metabolism and nutrition disorders (1)

Very Common Hypoglycemia

Gastrointestinal disorders (20)

Very Common constipation · diarrhea · Gastrointestinal disease · Nausea · vomiting

Common abdominal distension · abdominal pain · cholecystitis · cholelithiasis · Decreased appetite · dyspepsia · eructation · flatulence · gastroenteritis · gastroesophageal reflux disease · increased amylase · increased serum lipase · upper abdominal pain · viral gastroenteritis · xerostomia

Musculoskeletal and connective tissue disorders (2)

Common Back pain · Weakness

Infections and infestations (1)

Very Common Infection

General disorders and administration site conditions (1)

Common Injection site reactions

Other (1)

Common Incidence reported in monotherapy trials unless otherwise specified

Respiratory, thoracic and mediastinal disorders (2)

Very Common Upper respiratory tract infection

Common Nasopharyngitis

Dosing

Source: Lexicomp

Chronic weight management (Saxenda): SubQ: Initial: 0.6 mg once daily for one week; increase by 0.6 mg daily at weekly intervals to a target dose of 3 mg once daily. If the patient cannot tolerate an increased dose during dose escalation, consider delaying dose escalation for one additional week. If the 3 mg daily dose is not tolerated, discontinue use as efficacy has not been established at lower doses. Note: Evaluate change in body weight 16 weeks after initiation of therapy; discontinue if at least 4% of baseline body weight loss has not been achieved. Diabetes mellitus, type 2 (Victoza): SubQ: Initial: 0.6 mg once daily for 1 week; then increase to 1.2 mg once daily; if optimal glycemic response not achieved, may increase further to 1.8 mg once daily. Note: Initial dose is intended to reduce GI symptoms; does not provide effective glycemic control. Concomitant use with insulin and/or insulin secretagogues (eg, sulfonylurea): Reduced dose of insulin and/or insulin secretagogues may be needed Missed doses: In the event of a missed dose, the once daily regimen can be resumed with the next scheduled dose (an extra dose or an increase in the next dose should not be attempted); if >3 days have passed since the last liraglutide dose, reinitiate therapy at 0.6 mg/day to avoid GI symptoms and titrate according to prescriber discretion.
Refer to adult dosing.
No dosage adjustment necessary; use with caution when initiating therapy and with dose escalation. There is limited data in patients with ESRD.
No dosage adjustment necessary; use with caution due to limited experience.

Warnings & Precautions

Source: Lexicomp

Antibody formation

Use may be associated with the development of anti-liraglutide antibodies. Antibody formation was not associated with a loss of efficacy; however, patients with the highest titers of anti-liraglutide antibodies had no reduction in HbA1C.

Cardiovascular effects

Increased resting heart rate has been observed in placebo controlled trials; monitoring is recommended. Discontinue use in patients who experience a sustained increase in resting heart rates.

Gallbladder disease

Use of GLP-1 agonists may increase risk of gallbladder and bile duct disease (Faillie 2016). Cholelithiasis and cholecystitis have been reported in patients treated with liraglutide with the majority of patients requiring requiring hospitalization or cholecystectomy; gallbladder studies and further clinical assessment are indicated if cholelithiasis is suspected.

GI symptoms

Most common reactions are gastrointestinal related; these symptoms may be dose-related and may decrease in frequency/severity with gradual titration and continued use.

Hypersensitivity reactions

Serious hypersensitivity reactions, including anaphylactic reactions and angioedema, have been reported with use; permanently discontinue therapy in the event of a hypersensitivity reaction. Use with caution in patients with a history of anaphylaxis or angioedema to other GLP-1 receptor agonists; potential for cross-sensitivity is unknown.

Pancreatitis

Cases of acute and chronic pancreatitis (including fatal and nonfatal, hemorrhagic or necrotizing pancreatitis) have been reported; monitor for signs and symptoms of pancreatitis (eg, persistent severe abdominal pain which may radiate to the back and which may or may not be accompanied by vomiting). If pancreatitis is suspected, discontinue use. Do not resume unless an alternative etiology of pancreatitis is confirmed. It is not known if liraglutide increases risk for development of pancreatitis in patients with a history of pancreatitis.

Psychiatric effects

Suicidal behavior, with one case of attempted suicide, has been reported in patients treated for obesity; monitor for new or worsening depression, suicidal thoughts or behavior, or unusual changes in mood or behavior. Discontinue use if suicidal thoughts or behaviors occur. Avoid use in patients with history of suicidal attempts or active suicidal ideation.

Renal effects

Acute renal failure and chronic renal failure exacerbation (including severe cases requiring hemodialysis) have been reported; some cases have been reported in patients with no known preexisting renal disease. Reports primarily occurred in patients with nausea, vomiting, diarrhea, or dehydration. Renal dysfunction was usually reversible with appropriate corrective measures, including discontinuation of liraglutide. Risk may be increased in patients receiving concomitant medications affecting renal function and/or hydration status.

Thyroid tumors

[US Boxed Warning] Dose-dependent and treatment duration-dependent thyroid C-cell tumors have developed in animal studies with liraglutide therapy; it is unknown whether liraglutide will cause thyroid C-cell tumors, including MTC, in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Patients should be counseled on the potential risk of MTC with the use of liraglutide and informed of symptoms of thyroid tumors (eg, neck mass, dysphagia, dyspnea, persistent hoarseness). Use is contraindicated in patients with a personal or a family history of MTC and in patients with multiple endocrine neoplasia syndrome type 2 (MEN2). Cases of MTC in humans have been reported in patients treated with liraglutide. Consultation with an endocrinologist is recommended in patients who develop elevated calcitonin concentrations or have thyroid nodules detected during imaging studies or physical exam. Routine monitoring of serum calcitonin or using thyroid ultrasound monitoring is of uncertain value for early detection of MTC in patients treated with liraglutide. Disease-related concerns:

Gastroparesis

Slows gastric emptying; has not been studied in patients with preexisting gastroparesis.

Hepatic impairment

Use with caution in patients with hepatic impairment; limited experience.

Renal impairment

Use with caution in patients with renal impairment, particularly during initiation of therapy and dose escalation. Concurrent drug therapy issues:

Drug-drug interactions

Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information. Dosage form specific issues:

Multiple dose injection pens

According to the Centers for Disease Control and Prevention (CDC), pen-shaped injection devices should never be used for more than one person (even when the needle is changed) because of the risk of infection. The injection device should be clearly labeled with individual patient information to ensure that the correct pen is used (CDC 2012). Other warnings/precautions:

Appropriate use

Diabetes mellitus: Victoza is not recommended for first-line therapy in patients inadequately controlled on diet and exercise alone. Do not use in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis; not a substitute for insulin. Saxenda is not indicated for the treatment of type 2 diabetes; concomitant use with insulin is not recommended.

Patient education

Diabetes self-management education (DSME) is essential to maximize the effectiveness of therapy.

Pregnancy & Lactation

Pregnancy

Contraindicated

Use of liraglutide for chronic weight management is contraindicated in pregnant women (lack of potential benefit and possible fetal harm). An increased risk of adverse maternal and fetal outcomes is associated with obesity; however, medications for weight loss therapy are not recommended at conception or during pregnancy (ACOG 156 2015). In women with diabetes, maternal hyperglycemia can be associated with congenital malformations as well as adverse effects in the fetus, neonate, and the mother (ACOG 2005; ADA 2018c; Kitzmiller 2008; Metzger 2007). To prevent adverse outcomes, prior to conception and throughout pregnancy maternal blood glucose and HbA1c should be kept as close to target goals as possible but without causing significant hypoglycemia (ACOG 137 2013; ADA 2018c; Blumer 2013; Kitzmiller 2008). Agents other than liraglutide are currently recommended to treat diabetes in pregnant women (ACOG 137 2013; ADA 2018c; Blumer 2013).

Lactation

It is not known if liraglutide is present in breast milk. According to the manufacturer, the decision to continue or discontinue breastfeeding during therapy should take into account the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

Monitoring

EfficacyHbA1c every 3 months initially, then every 6–12 months when stable; fasting and post-prandial blood glucose; patient-reported hypoglycaemia episodes
ToxicityHypoglycaemia symptoms; eGFR for renally-cleared agents; weight; blood pressure
Clinical pearlIndividualise HbA1c targets based on patient age, comorbidities, and hypoglycaemia risk. Targets of < 7% are appropriate for most patients but < 8% may be safer in frail elderly.
CounselingMonitor blood glucose regularly. Know how to recognise and treat hypoglycaemia. Keep carbohydrate snacks available.

Chemistry & Properties

2D structure
FormulaC172H265N43O51
Molecular weight3751.26 g/mol
IUPAC name(2S)-5-[[(5S)-5-[[(2S)-2-[[(2S)-2-[[(2S)-5-amino-2-[[2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S,3R)-2-[[(2S)-2-[[(2S,3R)-2-[[2-[[(2S)-2-[[(2S)-2-[[(2S)-2-amino-3-(1H-imidazol-5-yl)propanoyl]amino]propanoyl]amino]-4-carboxybutanoyl]amino]acetyl]amino]-3-hydroxybutanoyl]amino]-3-phenylpropanoyl]amino]-3-hydroxybutanoyl]amino]-3-hydroxypropanoyl]amino]-3-carboxypropanoyl]amino]-3-methylbutanoyl]amino]-3-hydroxypropanoyl]amino]-3-hydroxypropanoyl]amino]-3-(4-hydroxyphenyl)propanoyl]amino]-4-methylpentanoyl]amino]-4-carboxybutanoyl]amino]acetyl]amino]-5-oxopentanoyl]amino]propanoyl]amino]propanoyl]amino]-6-[[(2S)-1-[[(2S)-1-[[(2S,3S)-1-[[(2S)-1-[[(2S)-1-[[(2S)-1-[[(2S)-1-[[(2S)-5-carbamimidamido-1-[[2-[[(2S)-5-carbamimidamido-1-(carboxymethylamino)-1-oxopentan-2-yl]amino]-2-oxoethyl]amino]-1-oxopentan-2-yl]amino]-3-methyl-1-oxobutan-2-yl]amino]-4-methyl-1-oxopentan-2-yl]amino]-3-(1H-indol-3-yl)-1-oxopropan-2-yl]amino]-1-oxopropan-2-yl]amino]-3-methyl-1-oxopentan-2-yl]amino]-1-oxo-3-phenylpropan-2-yl]amino]-4-carboxy-1-oxobutan-2-yl]amino]-6-oxohexyl]amino]-2-(hexadecanoylamino)-5-oxopentanoic acid
CAS204656-20-2
PubChem CID16134956
InChIKeyYSDQQAXHVYUZIW-QCIJIYAXSA-N
SMILESCCCCCCCCCCCCCCCC(=O)N[C@@H](CCC(=O)NCCCC[C@H](NC(=O)[C@H](C)NC(=O)[C@H](C)NC(=O)[C@H](CCC(N)=O)NC(=O)CNC(=O)[C@H](CCC(=O)O)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](Cc1ccc(O)cc1)NC(=O)[C@H](CO)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](CC(=O)O)NC(=O)[C@H](CO)NC(=O)[C@@H](NC(=O)[C@H](Cc1ccccc1)NC(=O)[C@@H](NC(=O)CNC(=O)[C@H](CCC(=O)O)NC(=O)[C@H](C)NC(=O)[C@@H](N)Cc1cnc[nH]1)[C@@H](C)O)[C@@H](C)O)C(C)C)C(=O)N[C@@H](CCC(=O)O)C(=O)N[C@@H](Cc1ccccc1)C(=O)N[C@H](C(=O)N[C@@H](C)C(=O)N[C@@H](Cc1c[nH]c2ccccc12)C(=O)N[C@@H](CC(C)C)C(=O)N[C@H](C(=O)N[C@@H](CCCNC(=N)N)C(=O)NCC(=O)N[C@@H](CCCNC(=N)N)C(=O)NCC(=O)O)C(C)C)[C@@H](C)CC)C(=O)O

Biology & Pharmacokinetics

Pharmacokinetics predicted

Bioavailability70.0%
Half-life3.421 h
Volume of distribution0.24 L/kg
Protein binding40.7%
BBB penetrantNo

Receptor binding (top 1)

TargetActionAffinity
GLP-1 receptor (GLP1R) Agonist pEC50 10.5

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)P-gp (Substrate)

Drug–drug interactions (100+, DDInter)

Interacting drugSeverityManagement
Bexarotene major
Gatifloxacin major
Acetazolamide moderate
Acetohexamide moderate
Alimemazine moderate
Aloe Vera Leaf moderate
Alpelisib moderate
Amprenavir moderate
Aripiprazole moderate
Asenapine moderate
Asparaginase Erwinia chrysanthemi moderate
Asparaginase Escherichia coli moderate
Atazanavir moderate
Bendroflumethiazide moderate
Benzphetamine moderate
Benzthiazide moderate
Betamethasone moderate
Bortezomib moderate
Brentuximab vedotin moderate
Brexpiprazole moderate
Brigatinib moderate
Bumetanide moderate
Calaspargase pegol moderate
Cariprazine moderate
Ceritinib moderate
Chlorothiazide moderate
Chlorpromazine moderate
Chlorpropamide moderate
Chlorthalidone moderate
Chromic chloride moderate
Chromium picolinate moderate
Cinoxacin moderate
Ciprofloxacin moderate
Clarithromycin moderate
Clozapine moderate
Conjugated estrogens moderate
Conjugated estrogens (topical) moderate
Copanlisib moderate
Corticotropin moderate
Dabrafenib moderate

Showing 40 of 100+.

Registered Products (4)

BrandForm / strengthPackAgentCitizen (JOD)
Victoza Pre-filled Pen 6 mg/1 ml 3 ml Khoury Drug Store 96.680
Xultophy Pre-filled Pen 3.6 mg/1 ml, 100 IU/1 ml 3 ml Khoury Drug Store 119.950
Saxenda 6mg/ml Solution For Injection in PFP Injection 6 mg/ml 3 ml pack varies Khoury Drug Store 129.670
Saxenda 6mg/ml Solution For Injection in PFP Injection 6 mg/ml 3 ml pack varies Khoury Drug Store 216.100