Victoza (liraglutide) is a glucagon-like peptide-1 (GLP-1) receptor agonist indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is also approved to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease. Administered via subcutaneous injection once daily, Victoza works by enhancing glucose-dependent insulin secretion, suppressing inappropriate glucagon release, and delaying gastric emptying. This comprehensive product card provides detailed information for healthcare professionals and patients considering this therapy.

Features

• Active ingredient: Liraglutide
• Strength: 6 mg/mL solution for injection
• Administration: Subcutaneous, once daily at any time of day
• Delivery system: Prefilled, multi-dose pen (3 mL)
• Needle: 32G, 4mm (included or sold separately depending on region)
• Storage: Refrigerate at 2°C to 8°C prior to first use; after first use, may be stored at room temperature (below 30°C) for 30 days
• Manufacturer: Novo Nordisk

Benefits

• Significantly reduces HbA1c levels through multiple glucose-dependent mechanisms of action
• Promotes weight loss rather than weight gain commonly associated with some diabetes medications
• Demonstrates cardiovascular risk reduction in patients with established cardiovascular disease
• Low risk of hypoglycemia when used without insulin or sulfonylureas
• Convenient once-daily dosing regimen without regard to meals
• May preserve beta-cell function through GLP-1 receptor agonism

Common use

Victoza is primarily prescribed for adults with type 2 diabetes mellitus to improve glycemic control when diet and exercise alone provide insufficient management. It is frequently used in combination with other antidiabetic agents, including metformin, sulfonylureas, or basal insulin, though dosage adjustments of concomitant therapies may be necessary. The medication is particularly valuable for patients who have not achieved target glucose levels with oral antidiabetic drugs alone and for those with established cardiovascular disease who would benefit from its cardioprotective effects. Clinical studies have demonstrated its efficacy across various patient demographics and stages of type 2 diabetes.

Dosage and direction

The recommended starting dose is 0.6 mg once daily for at least one week to reduce gastrointestinal symptoms. The dose should then be increased to 1.2 mg once daily. If the 1.2 mg dose does not result in acceptable glycemic control, the dose may be increased to 1.8 mg once daily. Administer subcutaneously in the abdomen, thigh, or upper arm; rotate injection sites to prevent lipodystrophy. Victoza should be injected at any time of day, independently of meals, but preferably at the same time each day. If a dose is missed, it should be administered as soon as possible on the same day, but two doses should not be administered on the same day. Proper injection technique should be demonstrated to all patients, including priming the pen before first use.

Precautions

Pancreatitis: Discontinue promptly if pancreatitis is suspected; do not restart if pancreatitis is confirmed. Thyroid C-cell tumors: In rodents, liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors; it is unknown whether Victoza causes thyroid C-cell tumors in humans. Hypoglycemia: Risk increases when used with insulin secretagogues or insulin; consider lowering the dose of these concomitant agents. Renal impairment: Use with caution in patients with renal impairment and monitor renal function; experience in severe renal impairment is limited. Hepatic impairment: Use with caution in patients with hepatic impairment. Gastrointestinal disease: Not recommended in patients with severe gastrointestinal disease. Hypersensitivity reactions: Serious reactions have been reported; discontinue and treat promptly. Never share the Victoza pen between patients, even with needle change.

Contraindications

Victoza is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). It is also contraindicated in patients with a history of hypersensitivity to liraglutide or any product components. The safety and effectiveness of Victoza have not been established in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis, and it is not indicated for these uses. Victoza is not recommended during pregnancy unless the potential benefit justifies the potential risk to the fetus.

Possible side effects

The most common adverse reactions (≥5%) are nausea, diarrhea, vomiting, decreased appetite, dyspepsia, and constipation. These gastrointestinal effects are typically dose-dependent and often diminish over time. Hypoglycemia is common when used with sulfonylureas or insulin. Other reported side effects include injection site reactions, fatigue, dizziness, abdominal pain, and increased lipase. Serious but less common side effects include pancreatitis, allergic reactions, renal impairment, and gallbladder disease. Patients should be monitored for signs and symptoms of these conditions and advised to report persistent severe abdominal pain, skin reactions, or changes in urinary output.

Drug interaction

Victoza delays gastric emptying and may impact the absorption of orally administered medications. Particular attention should be paid to drugs with a narrow therapeutic index or those requiring rapid gastrointestinal absorption, such as antibiotics, oral contraceptives, and warfarin; these may need to be taken at least one hour before Victoza injection. When used concomitantly with insulin or insulin secretagogues, the risk of hypoglycemia increases, necessitating dose reduction of these agents. No clinically significant interactions have been observed with metformin, digoxin, atorvastatin, griseofulvin, or lisinopril. However, close monitoring is recommended when initiating or adjusting Victoza therapy with other medications.

Missed dose

If a dose of Victoza is missed, it should be administered as soon as the patient remembers, on the same day. However, if the missed dose is not remembered until the following day, the missed dose should be skipped, and the next dose should be taken at the regular time. Patients should never administer two doses on the same day to make up for a missed dose. Consistent daily administration is important for maintaining stable glycemic control, but occasional missed doses are unlikely to significantly impact long-term management. Patients should be advised to establish a routine to minimize missed doses and to contact their healthcare provider if multiple doses are missed.

Overdose

In clinical trials, doses up to 15 mg once daily (approximately 8 times the maximum recommended dose) have been administered for two weeks with no unexpected adverse reactions. The most likely symptoms of overdose are severe nausea, vomiting, and hypoglycemia. In case of suspected overdose, appropriate supportive treatment should be initiated based on the patient’s clinical presentation. Blood glucose should be monitored, and hypoglycemia should be treated with oral carbohydrates or intravenous glucose as appropriate. Given the prolonged action of GLP-1 receptor agonists, extended monitoring may be necessary. Hemodialysis is unlikely to be effective due to the high protein binding of liraglutide.

Storage

Before first use: Store refrigerated at 2°C to 8°C; do not freeze. Protect from light. After first use: Store at room temperature below 30°C or refrigerated. The pen in use should be discarded 30 days after first use, even if some solution remains. Always remove the needle after each injection and store the pen without a needle attached. Do not use Victoza if it has been frozen, exposed to excessive heat, or if the solution appears cloudy, discolored, or contains particles. Keep out of reach of children and pets.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Individual patient responses to Victoza may vary. Healthcare providers should exercise professional judgment when prescribing this medication, considering the patient’s complete medical history, current medications, and specific health circumstances. Patients should not initiate, adjust, or discontinue Victoza without consulting their healthcare provider. Full prescribing information, including boxed warnings, should be reviewed before administration. The content here reflects information available as of the last update and may not include the most recent findings or regulatory changes.

Reviews

Clinical trials demonstrate that Victoza significantly reduces HbA1c (typically by 0.8% to 1.5%) and body weight (1-3 kg) while showing cardiovascular benefits in high-risk patients. Many patients report improved quality of life due to better glucose control and weight management, though gastrointestinal side effects during the initiation period are commonly noted. Healthcare providers appreciate its once-daily dosing and the flexibility of administration time. Long-term real-world evidence supports the sustained efficacy and safety profile observed in clinical trials, with particular praise for its cardiovascular protective effects in appropriate patient populations.