Liraglutide is a Glucagon-like-Peptide (GLP-1) compound which is long-acting, being administered by once-daily injection. It was recently licensed for use in people who have diabetes. It is the second drug within this class of drugs for the treatment of type 2 diabetes.
Liraglutide was developed by Novo Nordisk, a large pharmaceutical company which manufactures a range of insulins including Human Mixtard, Insulin NovoMix30, Novorapid and Insulin Detemir.
Liraglutide has a similar action to Exenatide (Byetta) which increases the activity of Glucagon-like-peptide–1. This is a hormone which stimulates secretion of insulin from the pancreas. Liraglutide also slows the rate at which your stomach empties itself of food which makes you less hungry. This influences intake of food and leads to loss of weight.
Byetta is derived from a chemical called Exendin-4 which shares some similarity with Human GLP-1. Liraglutide is derived from Human GLP-1. In practical terms the main difference for patients between the two compounds is that Exenatide is injected twice daily whereas Liraglutide is injected once a day.
Yes, as with Byetta, Victoza has been shown to be effective in reducing blood glucose concentrations. Many patients also lose weight.
The main advantage of Liraglutide is it’s once daily administration. It is not associated with weight gain and the incidence of hypoglycaemia is negligible.
The most frequent side effects reported with 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.
Victoza is available in a pre-filled pen which contains 18 mg of liraglutide in 3ml of solution. Each ml contains 6mg of Liraglutide. The starting dose is 0.6mg daily administered by subcutaneous injection. After one week this dose is increased to 1.2mg daily. Some patients may benefit from a further increase to 1.8mg daily at the discretion of their doctor or diabetes nurse specialist.
Victoza may be added to Metformin or thiazolidenediones. It may also be added to sulphonylureas however the dose may need to be adjusted to avoid the risk of hypoglycaemia.
Close monitoring of blood glucose concentration is usually not required for patients on Liraglutide.
It does not matter what time you inject, however it is best that you inject at about the same time each day. You do not have to inject at mealtimes.
Victoza can be injected subcutaneously into the abdomen, thigh or upper arm.
The 1.2mg dose of Victoza is likely to cost between 75 and 80 pounds a month.
Dr Nishan Wijenaike
West Suffolk Diabetes Service
Bury St Edmunds