Liraglutide

Summary

Liraglutide is an acylated GLP-1 receptor agonist administered once daily by subcutaneous injection. It is approved for type 2 diabetes mellitus (as Victoza) and chronic weight management in adults with obesity or overweight with at least one weight-related comorbidity (as Saxenda). It has also demonstrated cardiovascular risk reduction in T2DM patients with established cardiovascular disease.

Mechanism of Action

Liraglutide is a long-acting GLP-1 analogue that binds and activates the GLP-1 receptor, stimulating glucose-dependent insulin secretion, suppressing glucagon release, slowing gastric emptying, and reducing appetite via central hypothalamic pathways.

Routes of Administration

Goals & Uses

• Non-alcoholic steatohepatitis (NASH)HepaticModerate
• Blood pressure reductionCardiovascularModerate
• Cardiovascular risk reductionCardiovascularHigh
• Appetite suppressionMetabolicHigh
• Weight loss / obesity managementMetabolicHigh
• Glycemic control in type 2 diabetesMetabolicHigh

Contraindications

• Personal or family history of medullary thyroid carcinomaOncologicHigh
• Severe renal impairment / end-stage renal diseaseRenalModerate
• PregnancyPopulationHighPotential fetal risk or insufficient safety data
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)Genetic/EndocrineHigh
• History of pancreatitisGastrointestinalModerate
• Hypersensitivity to liraglutide or excipientsImmunologicHigh

Adverse Effects

• Injection site reactionsLocalCommon
• Thyroid C-cell tumorsOncologicUnknown
• NauseaGastrointestinalCommonFeeling of sickness or urge to vomit
• VomitingGastrointestinalCommonForceful expulsion of stomach contents
• Acute pancreatitisGastrointestinalRare
• DiarrheaGastrointestinalCommonLoose or frequent stools

Drug Interactions

• InsulinModerateMay increase risk of low blood sugar
• Insulin secretagogues (e.g., sulfonylureas)Moderate
• WarfarinLow
• Oral medications with narrow therapeutic indexLow

Population Constraints

• PregnancyReproductive SafetyAbsolute
• LactationReproductiveRelative
• Severe gastroparesisGastrointestinalRelative
• Severe hepatic impairmentOrgan ImpairmentRelative
• Pediatric patients under 12 yearsAgeAbsolute

Regulatory Status

• European UnionApprovedApproved: Type 2 diabetes mellitus in adults (Victoza), Weight management in adults with obesity or overweight with comorbidity (Saxenda)EMA approved Victoza in 2009 and Saxenda in 2015. Similar boxed warning requirements.
• United StatesApprovedApproved: Type 2 diabetes mellitus (Victoza, adjunct to diet and exercise), Chronic weight management in adults with BMI ≥30 or ≥27 with comorbidity (Saxenda), Reduction of major adverse cardiovascular events in adults with T2DM and established CVD (Victoza), Type 2 diabetes mellitus in pediatric patients ≥10 years (Victoza)FDA approved Victoza in 2010 and Saxenda in 2014. Carries boxed warning for thyroid C-cell tumors.
• United KingdomApprovedApproved: Type 2 diabetes mellitus (Victoza), Weight management (Saxenda)Approved by MHRA post-Brexit under inherited EMA approvals. Remains available on NHS with restrictions.

FDA approved Victoza (liraglutide 1.8 mg) for T2DM in 2010 and Saxenda (liraglutide 3.0 mg) for chronic weight management in 2014. EMA approvals followed. Carries a boxed warning regarding risk of thyroid C-cell tumors based on rodent studies.

Evidence & Sources

No sources recorded yet.