What is liraglutide

Participants in the liraglutide group experienced symptomatic hypoglycemia more frequently than the placebo group 5. It is important to note that it is uncommon for patients without diabetes who are not taking other medications known to cause hypoglycemia to develop hypoglycemia from liraglutide alone. Overall, the SCALE maintenance trial showed that liraglutide could be useful in maintaining weight loss in patients that are able to lose clinical significant weight through intensive lifestyle modifications.

The dosing regimen was similar to prior trials and both groups received counseling on lifestyle modifications. Patients meeting exclusion criteria of SCALE maintenance trial and those with a personal or family history of multiple endocrine neoplasia 2 MEN 2 or familial medullary thyroid carcinoma MTC were excluded. Patients randomized to liraglutide had a significantly greater reduction in the mean body weight 8. There was a significant improvement in the fasting lipid profile in the liraglutide treated group as well.

The incidence of neoplasms was similar in both groups and no clinically relevant differences in mental health assessments were noted. At week , 1. Of the participants screened for eligibility, were randomized in a ratio to liraglutide 3. Dosing regimen followed standard protocol and all participants were encouraged to follow lifestyle interventions throughout the duration of the trial.

Patients in the liraglutide 3. Also the proportion of patients achieving the target HbA1c below 7. Similar to previous trials, gastrointestinal side effects were the most common AEs in the liraglutide 3. Notably, hypoglycemic episodes, as per the American Diabetes Association classification 22 , were more frequent in the liraglutide 3. The rate of gallbladder related adverse events was low across groups as well but it was higher with liraglutide 3.

No cases of acute pancreatitis or MTC were reported in the liraglutide 3. The SCALE diabetes trial highlighted that liraglutide is an effective weight loss agent in patients with type 2 diabetes, who form a large subset of individuals that can benefit from pharmacotherapy for obesity.

Dosing followed standard protocol and both groups received counseling on lifestyle modifications. Individuals with diabetes were excluded. Secondary outcomes included changes in body weight and glycemic control. Patients randomized to liraglutide 3. Liraglutide 3. Similar to previous trials most of the adverse events in the liraglutide group were gastrointestinal and occurred more frequently with liraglutide compared with placebo.

Overall, liraglutide 3. Gastrointestinal intolerability is common and in clinical trials was noted to be the most common reason for drug discontinuation in patients with adverse events.

Patients starting liraglutide should be cautioned about the risks of acute pancreatitis, acute gallbladder disease, serious hypoglycemia, heart rate increase, hypersensitivity reactions and suicidal behavior.

Over the last decade, the US FDA has mandated that pharmaceutical companies demonstrate that any new drug for diabetes does not increase the risk of cardiovascular events. In this context, the cardiovascular effects of liraglutide added to standard therapy in patients with type 2 diabetes were recently reported In a large, multicenter, double blind trial, patients with type 2 diabetes and high cardiovascular risk were randomized to receive liraglutide 1.

The primary composite outcome was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The primary outcome occurred in significantly fewer patients in the liraglutide group There were fewer deaths overall HR 0. Importantly, there was no signal for increased hospitalization for heart failure in the liraglutide group and adverse events were similar to those seen in prior trials. This seminal study was performed using the dose approved for type 2 diabetes treatment 1.

These studies would further help to inform the clinical applicability of liraglutide for weight management. If findings are consistent in this patient population, liraglutide would be the first medication approved for weight management to demonstrate a cardiovascular, and possibly mortality, benefit.

Liraglutide may be a particularly effective choice among obese patients with type 2 diabetes, and can be considered for those at high risk for cardiovascular disease given a beneficial signal in cardiovascular outcomes seen in the 1. Further studies of pharmacological combination therapies may be warranted. Additional important considerations in the application of liraglutide to clinical weight management in the context of currently available agents include its high cost, injectable delivery system, and requirement for dose titration.

In addition to its injectable delivery, the dose must be titrated up on a weekly basis starting from 0. Liraglutide has been shown to be effective at inducing and sustaining weight loss in a population of obese patients including those with hypertension, dyslipidemia, type 2 diabetes and obstructive sleep apnea.

The higher rates of discontinuation for liraglutide compared with some other obesity medications due to adverse effects may limit its use in some patient populations.

Also, liraglutide is an injectable medication with a high monthly cost. However, it offers the unique benefit of improved glycemic control and its relatively few contraindications as compared with other weight loss agents make it an attractive option for patients, especially with comorbid type 2 diabetes or cardiovascular disease.

For now, liraglutide remains another important option in the physician's toolkit to combat the growing obesity epidemic in the United States and abroad. Mehta and Dr. Neeland declare no conflict of interest. Mehta, A. National Center for Biotechnology Information , U. Journal List Obes Sci Pract v. Obes Sci Pract. Published online Dec Mehta , 1 S. Marso , 3 and I. Neeland 2. Author information Article notes Copyright and License information Disclaimer.

Neeland, Email: ude. Corresponding author. This article has been cited by other articles in PMC. Summary Objective To review the efficacy, safety, and clinical applicability of liraglutide for weight management from phase III clinical trials.

Conclusions Liraglutide helps to induce and sustain weight loss in patients with obesity. Open in a separate window. Figure 1. Liraglutide efficacy and safety in phase III clinical trials Five large scale randomized multicenter phase III trials have been conducted to evaluate the efficacy of liraglutide as a weight loss agent 3 , 4 , 5 , 6 , 7 , 8. Safety outcomes Overall, liraglutide 3. Liraglutide and cardiovascular outcomes — LEADER trial Over the last decade, the US FDA has mandated that pharmaceutical companies demonstrate that any new drug for diabetes does not increase the risk of cardiovascular events.

Figure 2. Figure 3. Conclusion Liraglutide has been shown to be effective at inducing and sustaining weight loss in a population of obese patients including those with hypertension, dyslipidemia, type 2 diabetes and obstructive sleep apnea. Funding Dr. Conflict of interest Dr. Notes Mehta, A. References 1. Always remove the needle right after you inject your dose. Dispose of needles in a puncture-resistant container. Ask your doctor or pharmacist how to dispose of the puncture resistant container.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Inject the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not inject a double dose to make up for a missed one.

If you forget to use liraglutide injection for 3 or more days, call your doctor. Liraglutide injection may cause other side effects. Call your doctor if you have any unusual problems while using this medication. Keep this medication in the container it came in and out of reach of children. Store it away from light and heat. Do not freeze. Keep the cap on the liraglutide pen when it is not in use. Make a note of the date you first use a liraglutide pen, and dispose of the pen after 30 days, even if there is some solution left in the pen.

It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.

However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at If you are using liraglutide Victoza injection for treatment of diabetes, your blood sugar and glycosylated hemoglobin HbA1c should be checked regularly to determine your response to this medication.

Your doctor will also tell you how to check your response to liraglutide injection by measuring your blood sugar levels at home. Follow these directions carefully. If you are using liraglutide Saxenda injection for weight management, your heart rate and weight will be checked regularly during treatment. Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.

You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Liraglutide Injection pronounced as lir'' a gloo' tide. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow?

What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication? Brand names. Talk to your doctor about the risks of using liraglutide injection. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient. Other uses for this medicine. 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. 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 tell your doctor about other incretin mimetics such as albiglutide Tanzeum; no longer available in the US dulaglutide Trulicity , exenatide Bydureon, Byetta , lixisenatide Adlyxin, in Soliqua , or semaglutide Ozempic ; insulin; or oral medications for diabetes, such as sulfonylureas, including chlorpropamide, glimepiride Amaryl, in Duetact , glipizide Glucotrol , glyburide DiaBeta, Glynase , tolazamide, and tolbutamide.

Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Also tell your doctor if you have recently had diarrhea, nausea, or vomiting or if you cannot drink liquids by mouth, which may cause dehydration loss of a large amount of body fluids.

If you are pregnant you should not use liraglutide injection Saxenda for weight loss. If you become pregnant while using liraglutide injection Victoza , call your doctor. These conditions can affect your blood sugar and the amount of liraglutide you may need.