CHF and arrhythmias:
Indications for: VICTOZA
As an adjunct to diet and exercise, to improve glycemic control in patients with type 2 diabetes mellitus (T2DM). To reduce the risk of major adverse CV events (eg, CV death, non-fatal MI/stroke) in adults with T2DM and established CV disease.
Limitations of Use:
Not for treating type 1 diabetes. Should not be coadministered with other liraglutide-containing products.
Give by SC inj in abdomen, thigh, or upper arm once daily. Rotate inj sites. Initially 0.6mg/day for 1 week, then increase to 1.2mg/day; may increase to 1.8mg/day after ≥1 week if additional control is required. If >3 days elapsed since last dose, reinitiate at 0.6mg/day, then titrate.
Major CV events: <18yrs: not established. Glycemic control in T2DM:<10yrs: not established. Give by SC inj in abdomen, thigh, or upper arm once daily. Rotate inj sites. ≥10yrs: initially 0.6mg/day; after ≥1 week, may increase to 1.2mg/day if additional control is required; may further increase to 1.8mg/day after ≥1 week if needed. If >3 days elapsed since last dose, reinitiate at 0.6mg/day, then titrate.
History (personal or family) of medullary thyroid carcinoma. Multiple endocrine neoplasia syndrome type 2.
Risk of thyroid C-cell tumors.
Risk of thyroid C-cell tumors; inform patients of potential risk and symptoms. Discontinue if pancreatitis is suspected; do not restart if confirmed. History of pancreatitis: limited data. Do not reuse or share pens between patients, even if the needle is changed. Higher risk of hypoglycemia in pediatrics ≥10yrs old (regardless of insulin and/or metformin use). History of anaphylaxis or angioedema with other GLP-1 receptor agonist. Discontinue if hypersensitivity reactions occur. Acute gallbladder disease (eg, cholelithiasis, cholecystitis). Perform gallbladder studies and clinical follow-up if cholelithiasis is suspected. Renal impairment: caution with initiating or escalating doses. Hepatic impairment: use with caution (limited data). Dehydration. Gastroparesis: not studied. Pregnancy. Nursing mothers.
Glucagon-like peptide-1 (GLP-1) receptor agonist.
Concomitant insulin; administer as separate injections not adjacent to each other. Adults: increased risk of hypoglycemia with sulfonylureas or insulin (consider reducing dose of these). May affect absorption of concomitant oral drugs (delayed gastric emptying); caution.
Nausea, diarrhea, headache, vomiting, decreased appetite, dyspepsia, constipation, immunogenicity reactions (eg, urticaria); hypoglycemia (esp. in children); rare: pancreatitis, papillary thyroid carcinoma, hypersensitivity reactions.
Half-life: ~13 hours.
Generic Drug Availability:
Multi-dose, pre-filled pens (3mL)—2, 3