• Obesity

Obesity:

Indications for SAXENDA:

Adjunct to reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial BMI of ≥30kg/m2 (obese), or ≥27kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, T2DM, dyslipidemia).

Limitations of Use:

Not indicated for type 2 diabetes. Not been studied in patients taking insulin. Do not use with Victoza, other GLP-1 receptor agonists, or insulin. Safety and efficacy with concomitant other weight loss products (including prescription or OTC drugs, herbal preps) has not been established.

Adult:

Give by SC inj into abdomen, thigh, or upper arm once daily. Escalate dose with the following escalation schedule (to mitigate risk of GI effects): Week 1: 0.6mg daily; Week 2: 1.2mg daily; Week 3: 1.8mg daily; Week 4: 2.4mg daily; Week 5 and onward: 3mg daily (recommended dose). Delay dose escalation 1 week if increased dose not tolerated; discontinue if 3mg not tolerated. If >3 days elapsed since last dose, reinitiate at 0.6mg/day, then follow dose escalation schedule. Evaluate response after 16 weeks. Discontinue if ≥4% weight loss is not achieved.

Children:

Not recommended.

Contraindications:

History (personal or family) of medullary thyroid carcinoma (MTC). Multiple endocrine neoplasia syndrome type 2 (MEN 2). Pregnancy.

Boxed Warning:

Risk of thyroid C-cell tumors.

Warnings/Precautions:

Risk of thyroid C-cell tumors; inform patients of potential risk and symptoms. Monitor for signs/symptoms of pancreatitis; discontinue if suspected; do not restart if confirmed. Risk of acute gallbladder disease. History of suicidal attempts or ideation: avoid. Monitor for emergence or worsening depression, suicidal thinking or behavior; discontinue if occurs. Monitor blood glucose prior to and during treatment in type 2 diabetics. Monitor heart rate periodically; discontinue if sustained increases. History of anaphylaxis or angioedema with other GLP-1 receptor agonist. Discontinue if hypersensitivity reactions occur. Renal impairment: caution with initiating or escalating doses. Hepatic impairment: use with caution (limited data). Gastroparesis: not studied. Nursing mothers.

Pharmacologic Class:

Glucagon-like peptide-1 (GLP-1) receptor agonist.

Interactions:

Risk of hypoglycemia with concomitant insulin secretagogues (eg, sulfonylureas); consider reducing their doses by ½. May affect absorption of other oral drugs (delayed gastric emptying).

Adverse Reactions:

Nausea, hypoglycemia, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase; hypersensitivity reactions.

REMS:

YES

Generic Availability:

NO

How Supplied:

Multi-dose, pre-filled pen (3mL)—3, 5

Pricing for SAXENDA

five 3ml pens of 3mg/0.5ml carton (Qty: 1)
Appx. price $1244
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