Regardless of the indication for which it is necessary to resort to the use of liraglutide, the active ingredient must be administered parenterally and, more precisely, subcutaneously.
Medicines based on liraglutide for the treatment of diabetes can only be dispensed on presentation of a restrictive repeatable prescription - RRL (drugs sold to the public only on prescription from hospitals or specialists). Their cost is very high, but since they are medicines classified as class A drugs, they can be dispensed at the expense of the National Health Service (SSN).
Medicines based on liraglutide for the treatment of obesity and overweight, on the other hand, require a repeatable medical prescription (RR) to be sold. Being classified as class C drugs, their cost is fully borne by the citizen.
Examples of Medicines containing Liraglutide
- Saxenda® (treatment of obesity)
- Victoza® (treatment of type 2 diabetes)
- Xultophy® (treatment of type 2 diabetes, in combination with insulin degludec)
Note: this article will mainly consider indications, warnings, interactions, posology, side effects, use in pregnancy and during lactation and contraindications of liraglutide as a single active ingredient and not as an active ingredient associated with insulin degludec (Xultophy® ).
they are not enough to control blood sugar and you cannot take metformin (another antidiabetic drug);- Body mass index (BMI) equal to or greater than 30 kg / m² (obesity);
- Body mass index (BMI) of 27 kg / m² and less than 30 kg / m² (overweight) and weight-related health problems (such as diabetes, high blood pressure, abnormal blood fat levels or obstructive sleep apnea) .
When liraglutide is administered to combat obesity and overweight, its intake should only be continued if you lose at least 5% of your body weight after 12 weeks with a daily dosage of 3 mg / day. In any case, it is always advisable to consult your doctor.
In addition, liraglutide can be used as an adjunct to healthy nutrition and exercise in adolescents aged 12 years and over with:
- Obesity;
- Body weight over 60 kg.
In these cases, the use of liraglutide can only be continued if the patient has lost at least 4% of their BMI after 12 weeks on a dosage of 3 mg per day or at the maximum tolerated dose. However, it is necessary to consult your doctor before continuing.
;During treatment with liraglutide, however, you should tell your doctor if:
- Symptoms of inflammation and gallbladder stones appear such as severe abdominal pain that can worsen to reach the back or right shoulder.
- You have thyroid pathologies, enlargement of this gland and / or nodules;
- You suffer from cardiac arrhythmias;
- You are dehydrated (which can occur especially at the start of treatment with liraglutide).
Please Note
The use of liraglutide for the treatment of diabetes in children and adolescents less than 18 years of age is not recommended, as there are no studies regarding the use of the active substance in this category of patients.
Regarding the use of liraglutide in the treatment of obesity and overweight, its safety and efficacy have not been studied in children less than 12 years of age.
However, for more information on warnings and precautions for the use of a given liraglutide-based medicine, refer to its package leaflet.
. However, it should be noted that liraglutide can be administered in combination with the above-mentioned drugs, however, it may be necessary to adjust the doses administered.However, before starting treatment with liraglutide, you should tell your doctor if you are taking, or have recently been taking, any medications or products of any kind - even if not listed above - including medications without " medical prescription obligation (SOP), over-the-counter medicines (OTC), herbal and phytotherapeutic products and homeopathic products.
experiencing undesirable effects that differ in type and intensity, or not showing them at all.
The doctor should be alerted immediately if:
- Symptoms of pancreatitis appear, such as: severe and persistent pain in the abdomen that can reach the back, nausea and vomiting.
- Serious allergic reactions (anaphylaxis) occur which can manifest themselves with symptoms such as breathing problems, angioedema, tachycardia.
- Bowel obstruction occurs (a severe form of constipation with additional symptoms such as stomach pain, bloating, vomiting, etc.).
Very common and common side effects
Among the very common and common side effects that can arise during therapy with liraglutide we find:
- Gastrointestinal disturbances such as nausea, vomiting, diarrhea or constipation. They appear at the beginning of treatment, but tend to disappear after a few days.
- Digestive problems, stomach pain, gastritis, heartburn, bloating, flatulence, belching;
- Dry mouth
- Changes in the sense of taste
- Sleep disorders;
- Dizziness
- Gallstones;
- Increase in pancreatic enzyme levels;
- Hypoglycaemia which can manifest itself with:
- Cold sweats;
- Cold pale skin
- Headache;
- Rapid heartbeat;
- Nausea;
- Increased feeling of hunger;
- Changes in vision
- Drowsiness;
- Weakness;
- Nervousness;
- Anxiety;
- Confusion;
- Difficulty concentrating
- Tremor.
- Reactions at the injection site.
Uncommon and rare side effects
Among the uncommon and rare side effects that can occur during treatment with liraglutide, we find instead:
- Dehydration (can occur especially at the beginning of treatment due to the appearance of vomiting and diarrhea);
- Allergic reactions, including skin rash;
- Generalized malaise;
- Increased heart rate
- Inflammation of the gallbladder;
- Reduced kidney function or acute renal failure (signs of the latter may be: decreased volume of urine, metallic taste in the mouth and bruising easily).
Overdose
Symptoms such as severe nausea and vomiting may occur in the event of liraglutide overdose. Treatment is symptomatic and supportive. Therefore, in the event of overdosing - whether it is ascertained or presumed to be - it is advisable to notify the doctor immediately or go to the nearest emergency room, taking care to take the package of the medicine taken with you.
and exenatide - belongs to the group of incretin mimetics.
Specific hormones called incretins are produced in the intestine and their levels increase following food intake. There are basically two types of incretins: GLP-1 (Glucagon-like peptide 1) and GIP (Glucose-dependent insulinotropic peptide). GLP-1, in particular, is responsible for blood sugar control, especially after meals.
Liraglutide is a long-acting GLP-1 receptor agonist; therefore, once taken, it binds to it producing the same effect that would be produced if the endogenous substrate GLP-1 (liraglutide ne mima l "action: hence the name of" incretino-mimetics "). Thanks to this mechanism of action, liraglutide causes the release of insulin from the beta cells of the pancreas and suppresses the secretion of glucagon, whose levels are elevated in patients with type 2 diabetes (lower concentrations of glucagon cause a reduction hepatic glucose output). The hypoglycemic mechanism also involves a slight slowing of gastric emptying.
Liraglutide against obesity and overweight
Liraglutide is used in the treatment of obesity and overweight as it is capable of reducing body weight and fat mass through mechanisms - however, not yet well defined - that involve a decrease in appetite, an increase in feelings of fullness and satiety and, consequently, the reduction of the desire to consume food. GLP-1, in fact, is a physiological regulator of appetite and food intake.
. Medicines that contain it as the only active ingredient are in the form of a solution for injection contained in a pre-filled pen.To find out how to use this device correctly, you need to contact your doctor and carefully read the instructions in the package leaflet of the medicine (this information can also be found on the official website of the Italian Medicines Agency - AIFA: Instructions for "use of Saxenda® - Instructions for use of Victoza®).
Without prejudice to the importance of strictly following all the instructions provided by the doctor, below we will report the dosages of liraglutide usually used in therapy for illustrative purposes only. For any doubts, contact your doctor.
Treatment of type 2 diabetes
For the treatment of type 2 diabetes mellitus, the usual starting dose of liraglutide is 0.6 mg per day for at least one week. After that, the doctor may decide to increase the amount of drug administered to 1.2 mg once a day. If deemed necessary, this health professional can further increase the administered dose up to 1.8 mg of liraglutide per day.
Liraglutide can be administered at any time of the day, regardless of meals; however, once a time is established, it is best to inject at the same time each day.
Treatment of obesity and overweight
In the treatment of obesity and overweight, liraglutide can be taken at any time of the day, with or without food and drink. However, it is best to administer the dose at approximately the same time each day.
Adults and adolescents aged 18 years and over
The usual recommended starting dose is 0.6 mg of liraglutide once daily for at least one week. After that, the doctor may decide to increase the amount of active ingredient to be taken, usually, according to the following scheme:
- Week 1: 0.6 mg once daily;
- Week 2: 1.2 mg once daily;
- Week 3: 1.8 mg once daily;
- Week 4: 2.4 mg once daily;
- Week 5 onwards: 3 mg once daily; after that, continue with this dose until treatment is finished.
Liraglutide for the treatment of obesity and overweight should NOT be mixed with other injectable medicines (e.g. insulins) and should NOT be given together with other medicines that contain GLP-1 receptor agonists (incretin mimetics).
Adolescents aged 12 years or older
For adolescents 12 to 18 years of age, the dose of liraglutide to be administered should be gradually increased in a manner similar to that reported above for adult patients. The dose should be increased until reaching 3 mg of active ingredient per day or reaching the maximum tolerated dose. In any case, we reiterate once again the need to follow what is indicated by the doctor.
Forgetfulness of a dose
Regardless of the indication for which liraglutide is being used, if a dose is forgotten and the missed dose is discovered within 12 hours of the time the drug is usually given, the missed dose should be taken as soon as possible. , more than 12 hours have passed, the missed dose should be skipped and the next dose should be taken at the usual scheduled time.
A double dose should NOT be used to make up for a forgotten dose.
and if it can cause harm to the baby, for this reason, the active ingredient should not be given to mothers who are breastfeeding.
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