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Victoza: 7 things you should know

Victoza: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Jul 29, 2020.

1. How it works
  • Victoza is a brand (trade) name for liraglutide.
  • Liraglutide mimics the actions of GLP-1, a naturally occurring hormone that helps to regulate blood glucose levels. By binding to and activating the GLP-1 receptor, it stimulates insulin secretion and lowers glucagon secretion when blood glucose levels are high. It also causes a slowing down in how fast the stomach empties.
  • Victoza belongs to the class of medicines called GLP-1 receptor agonists. It may also be called an incretin mimetic.
2. Upsides
  • Victoza may be used in the treatment of type 2 diabetes in adults and children aged 10 years and older alongside diet modification and increased exercise.
  • Victoza may also be given to reduce the risk of future cardiovascular events, such as a heart attack or stroke, in adults with type 2 diabetes who also have heart disease.
  • Victoza is effective at reducing blood glucose levels and it also reduces body weight.
  • The dosage of Victoza does not need to be adjusted in people with kidney or liver disease; however, kidney function should be monitored.
3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Common side effects of Victoza include hypoglycemia (low blood sugar levels), nausea, diarrhea, headache, blocked nose, vomiting, decreased appetite, dyspepsia, upper respiratory tract infection, constipation, and back pain.
  • Victoza needs to be given by injection under the skin (subcutaneous). However, self-administration is easy to learn for most people.
  • The dosage of Victoza needs to be increased slowly over a couple of weeks, starting with 0.6 mg/day and increasing at weekly intervals by 0.6mg to reach 1.2mg or 1.8mg if necessary and tolerated. Victoza is only effective at dosages greater than or equal to 1.2mg.
  • Victoza does not take the place of insulin and is not effective in people with type 1 diabetes or for the treatment of diabetic ketoacidosis. Victoza may increase the risk of developing diabetic ketoacidosis.
  • Animal studies have reported thyroid C-cell tumors in rats given liraglutide. Cases of thyroid-C-cell tumors have been reported in people taking Victoza outside of a clinical trial, but there is not enough data to establish or exclude a causal relationship with Victoza. Victoza should not be used in people with a history of thyroid cancer or those with Multiple Endocrine Neoplasia syndrome type 2.
  • Victoza may increase the risk of pancreatitis. If this occurs, Victoza should be discontinued and not restarted. There have also been reports of kidney damage, which may require hemodialysis, in people treated with GLP-1 receptor agonists (RA), such as Victoza. Anaphylaxis and angioedema have also been reported with GLP-1 RAs and the initial administration of Victoza should preferably be done in a medical facility.
  • Victoza has not been adequately studied in pregnant women and should not be used unless the perceived benefits outweigh the risks of uncontrolled diabetes, which include preeclampsia, spontaneous abortions, and preterm delivery.
  • Victoza is given by injection subcutaneously (under the skin), once daily.
  • There is no generic version of Victoza.

Notes: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. For a complete list of all side effects, click here. 4. Bottom Line

  • Victoza lowers blood sugar levels by mimicking the effects of GLP-1, a naturally occurring hormone that stimulates insulin secretion and lowers glucagon secretion from the liver. It is given once daily by subcutaneous injection and may be used in conjunction with other medications for the treatment of type 2 diabetes. Common side effects include low blood sugar levels, nausea, diarrhea, and headache and it may increase the risk of diabetic ketoacidosis.
5. Tips
  • Ask your doctor or nurse to show you how to self-administer Victoza before you first do it yourself. Victoza should be injected just under the skin into the abdomen, thigh, or upper arm. Change injection sites each day so that you are not injecting into the same bit of skin every day. Always inspect the injection and do not use Victoza if it contains particles or discoloration is seen.
  • If you also need to self-administer insulin, administer the insulin at a different site to Victoza, at least 15cm apart. Never mix insulin with Victoza and never share your injection with another person. Taking Victoza with insulin (as well as other medications such as sulfonylureas that also lower blood sugar levels) increases your risk of hypoglycemia (low blood sugar levels) so monitor yourself for symptoms of low blood sugar which include sweating, shaking, dizziness, a fast heartbeat, and mood changes.
  • Report any symptoms of a possible thyroid tumor (such as a lump in the neck, shortness of breath, difficulty swallowing, or persistent hoarseness) to your doctor immediately.
  • If you develop persistent, severe, abdominal pain, which may radiate to the back or be accompanied by vomiting, ring your doctor immediately as Victoza can increase your risk of developing pancreatitis.
  • If you are a woman, use adequate contraception to ensure you do not become pregnant while taking Victoza. For a planned pregnancy, it is recommended Victoza is discontinued at least two months before conception. Tell your doctor if you inadvertently become pregnant while taking Victoza.
6. Response and Effectiveness
  • Trials have reported that Victoza significantly improves HbA1c values and fasting plasma glucose levels more than placebo (a pretend medication).
  • Only dosages of at least 1.2 mg/day are effective at lowering blood glucose levels.
  • In comparative trials, Victoza 1.8mg and 1.2mg lowered HbA1c levels significantly more than glimepiride 8mg/day. The number of trial participants who discontinued therapy because it was ineffective was 3.6% taking Victoza 1.8mg, 6% taking Victoza 1.2mg, and 10.1% taking glimepiride 8mg. Fasting plasma glucose levels decreased by an average of 26 from baseline in the Victoza 1.8mg group, 15 from baseline in the Victoza 1.2mg group, and 5 from baseline in the glimepiride 8mg group.
7. Interactions

Medicines that interact with Victoza may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Victoza. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Victoza include:

  • acetazolamide
  • anticonvulsants such as phenytoin
  • antidepressants such as tricyclic antidepressants (such as amitriptyline, nortriptyline) or monoamine oxidase inhibitors (MAOI) (eg, selegiline, isocarboxazid, and phenelzine)
  • antipsychotics, such as aripiprazole
  • beta-blockers, such as atenolol, labetalol, and metoprolol, may enhance the hypoglycemic effects
  • bexarotene
  • ciprofloxacin
  • corticosteroids, such as prednisone or cortisone
  • diuretics, such as bumetanide, HCTZ, and bendroflumethiazide
  • HIV medications, such as amprenavir, atazanavir, and fosamprenavir
  • hormones, such as ethinylestradiol and hydroxyprogesterone
  • insulin (may increase risk of hypoglycemia)
  • isoniazid
  • other medications that affect blood sugar levels or are used for diabetes, such as glimepiride, or metformin.

Victoza may also enhance the toxic effects of alcohol, causing flushing.

Also, because Victoza causes a delay in gastric emptying, it may impact the absorption of any medication taken orally. However, in clinical trials, this did not appear to change the effects of other medications.

Note that this list is not all-inclusive and includes only common medications that may interact with Victoza. You should refer to the prescribing information for Victoza for a complete list of interactions.

References
  • Victoza (liraglutide) [Package Insert] 09/2019 Novo Nordisk https:// /pro/victoza.html
  • Victoza (liraglutide injection 1.2mg/1.8mg) https://www.victoza.com/
Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Victoza only for the indication prescribed.

Copyright 1996-2020 . Revision date: July 29, 2020.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

More about Victoza (liraglutide)
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  • Dosage Information
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  • En Español
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  • Drug class: incretin mimetics
  • FDA Alerts (2)
  • FDA Approval History
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