As adjunct to diet and exercise, to improve glycemic control in type 2 diabetes. Limitations of use: not recommended as first-line treatment for patients inadequately controlled on diet and exercise. Not a substitute for insulin. Not for treating type 1 diabetes or ketoacidosis. Not studied in combination with prandial insulin or with a history of pancreatitis.
Give by SC inj in abdomen, thigh, or upper arm once daily. Initially 0.6mg/day for 1 week, then 1.2mg/day; may increase to 1.8mg/day. If >3 days elapsed since last dose, reinitiate at 0.6mg/day, then titrate. Renal impairment: caution with initiating or escalating doses.
<18yrs: not recommended.
Glucagon-like peptide-1 [GLP-1] receptor agonist.
History (personal or family) of medullary thyroid carcinoma. Multiple endocrine neoplasia syndrome type 2.
Inform patients of thyroid cancer risk and symptoms. Discontinue if pancreatitis is suspected; do not restart if confirmed. History of pancreatitis: consider other antidiabetic therapies. Renal or hepatic dysfunction. Gastroparesis. Pregnancy (Cat.C). Nursing mothers: not recommended.
Concomitant insulin (insufficient data); administer as separate injections not adjacent to each other. Hypoglycemia with sulfonylureas or insulin (consider reducing their doses). May affect absorption of other drugs (delayed gastric emptying). Monitor digoxin.
Headache, nausea, diarrhea, antibody formation, immunogenicity reactions (eg, urticaria), constipation; rare: pancreatitis (discontinue if occurs), papillary thyroid carcinoma, anaphylactic reactions and angioedema (discontinue if occurs).
Multi-dose, pre-filled pen (3mL)—2, 3