Cochin Cardiac Club

Health Blog by Dr.Uday Nair


What is Liraglutide?

  • Liraglutide is a injectable diabetes medicine that helps control blood sugar levels.
  • Liraglutide is used to treat type 2 diabetes(non-insulin dependent)and is similar to exenatide(Byetta).
  • Liraglutide is a once-daily human GLP-1 analogue.Liraglutide works by stimulating the release of insulin only when glucose levels become too high,and by inhibiting appetite.

  • GLP-1 lowers blood glucose in type 2 diabetes patients with the unique advantage that glucose-lowering ceases when blood glucose gets into the normal range, as both effects on insulin and glucagon release are glucose-dependent. Thus, it is possible to treat effectively without simultaneously running a risk of inducing hypoglycaemia. GLP-1 has a positive impact on beta cell function. Also, in contrast to most other antidiabetic treatments, liraglutide also leads to weight loss, an important problem during current treatment of type 2 diabetes.Liraglutide also has a beneficial impact on systolic blood pressure, a key cardiovascular risk factor in type 2 diabetes.
  • Liraglutide is a derivative of human GLP-1 (97% homology)designed to be protected against DPPIV degradation and elimination by the kidneys resulting in a prolonged half-life and thus sustained action of more than 24 hours.This is primarily due to its binding to serum albumin.

What are the side effects and risks of Liraglutide?

The most frequent side effects reported with Liraglutide(Victoza) are gastrointestinal. Nausea, vomiting, diarrhoea, abdominal pain and heartburn have been reported. These effects are more frequent when starting on treatment. Hypoglycaemia may occur when combined with a sulphonylurea. Headache and runny nose may occur.
There have been reports of acute pancreatitis associated with the use of liraglutide. Patients developing severe, persistent abdominal pain that might be caused by pancreatitis, should seek prompt medical attention. If pancreatitis is suspected, liraglutide should be discontinued and not started again until the presence of pancreatitis has been excluded.
Liraglutide can cause thyroid tumors that occur more frequently at higher doses and with longer duration of treatment. Since liraglutide is a synthetic protein patients may develop antibodies to liraglutide. Liraglutide antibodies may reduce the effectiveness of liraglutide.
Who can have liraglutide?

You should be able to have liraglutide (at a dose of 1.2 mg once a day) when given with two other drugs for diabetes (that is, with a type of drug called metformin and either a type of drug known as a sulphonylurea or a thiazolidinedione), if your blood glucose level isn’t under control and:

  • you have a high body mass index (BMI 35 kg/m2 or higher) and problems associated with high body weight or
  • your BMI is under 35 kg/m2 and losing weight would help other weight-related health problems, or taking insulin would greatly affect your ability to work.
You should be able to have liraglutide (at a dose of 1.2 mg once a day) when given with one other drug for diabetes (that is, with either metformin or a sulphonylurea) if:
  • you cannot take either metformin or a sulphonylurea for medical reasons, or you had to stop taking one of these drugs because you had a bad reaction to it, and
  • you cannot take both thiazolidinediones and dipeptidyl peptidase-4 (DPP-4) inhibitors for medical reasons, or you had to stop taking both of these types of drugs because you had a bad reaction to them.
You should be able to carry on taking liraglutide in these circumstances as long as it has helped to improve your diabetes sufficiently (that is, reduced your blood glucose levels, and helped you lose weight if needed) after 6 months of treatment.

How should I take Liraglutide?

Liraglutide comes in a prefilled injection pen.

Liraglutide is injected under the skin. Your doctor will show you the best places on your body to inject liraglutide. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and injection pens.
Liraglutide is usually given once per day. Your doctor may occasionally change your dose to make sure you get the best results. Your dose needs may change if you become ill, have a fever or infection, or if you have surgery or a medical emergency.
You may use liraglutide at any time of the day, with or without a meal.
Do not use liraglutide if it has changed colors or has particles in it. Call your doctor for a new prescription.
Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office. Visit your doctor regularly.
Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, confusion, irritability, drowsiness, weakness, dizziness, tremors, sweating, and fast heartbeat. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency.
Storing unopened injection pens: Store in the refrigerator. Do not store near the refrigerator's cooling element.
Storing after your first use: You may keep "in-use" injection pens in the refrigerator or at room temperature. Protect the pens from moisture, heat, and sunlight. Use within 30 days. Remove the needle before storing an injection pen, and keep the cap on the pen when not in use.
Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.
Do not freeze liraglutide, and throw away the medication if it has become frozen.

Liraglutide is injected under the skin of the abdomen, thigh, or upper arm. Each pre-filled pen can deliver 0.6, 1.2, and 1.8 mg doses. The initial dose is 0.6 mg daily for one week. The initial dose helps the body to build a tolerance to stomach related side effects. It is not effective for controlling blood glucose. After one week the dose is increased to 1.2 mg daily. The maximum dose is 1.8 mg daily.

What special precautions should I follow?

Before using liraglutide injection,

  • tell your doctor and pharmacist if you are allergic to liraglutide, any other medications, or any of the ingredients in liraglutide injection. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. It is especially important to tell your doctor about all the medications you take by mouth because liraglutide may change the way your body absorbs these medications. Also be sure to mention insulin or oral medications for diabetes especially sulfonylureas, including chlorpropamide (Diabinese), glimepiride (Amaryl, in Avandaryl, in Duetact), glipizide (Glucotrol, in Metaglip), glyburide (DiaBeta, in Glucovance, Glycron, Glynase, Micronase), tolazamide, and tolbutamide. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor if you drink or have ever drunk large amounts of alcohol and if you have or have ever had pancreatitis (inflammation of the pancreas); severe stomach problems, including gastroparesis (slowed movement of food from the stomach to the small intestine) or problems digesting food; a high level of triglycerides (fats) in the blood; gallstones (solid deposits that form in the gallbladder); or kidney or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using liraglutide injection, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are using liraglutide injection.
  • ask your doctor what to do if you get sick, develop an infection or fever, experience unusual stress, or are injured. These conditions can affect your blood sugar and the amount of liraglutide you may need.

Please Note- Liraglutide is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar level.

1 comment:

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