Victoza 6 mg/ml Injection

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Indications of Victoza 6 mg/ml

Victoza 6 mg/ml is a glucagon-like peptide 1 (GLP-1) receptor agonist indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in: Adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obese), or 27 ... Read moreVictoza 6 mg/ml is a glucagon-like peptide 1 (GLP-1) receptor agonist indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in: Adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obese), or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g. hypertension, type 2 diabetes mellitus, or dyslipidemia). Pediatric patients aged 12 years and older with body weight above 60 kg and an initial BMI corresponding to 30 kg/m2 for adults (obese) by international cut-offs.

Theropeutic Class

GLP-1 receptor agonists

Pharmacology

Victoza 6 mg/ml is an acylated analog of human glucagon-like peptide 1 (GLP-1), an endogenous incretin hormone and acts as a GLP-1 receptor agonist. Activation of GLP-1 receptor stimulates insulin secretion and suppression of glucagon secretion in a glucose-dependent manner. It also delays gastric emptying thus reduces the rate of postprandial glucose present in the circulation. It has lowering effects of fasting, premeal and postprandial glucose; with a decrease in HbA1c by approx 1%.

Dosage of Victoza 6 mg/ml

Inject Victoza 6 mg/ml subcutaneously in the abdomen, thigh, or upper arm once daily at any time of day, without regard to the timing of meals. The recommended dose of Victoza 6 mg/ml is 3 mg daily. Initiate at 0.6 mg per day for one week. In weekly intervals, increase the dose until a dose of 3 mg is reached. If pediatric patients do not tolerate an increased dose during dose escalation, the dose may also be lowered to the previous level. Dose escalation for pediatric patients may take up to 8 weeks. Pediatric patients who do not tolerate 3 mg daily may have their dose reduced to 2.4 mg daily. Adult patients with type 2 diabetes should monitor blood glucose prior to starting Victoza 6 mg/ml and during Victoza 6 mg/ml treatment.Pediatric Use: The safety and effectiveness of Victoza 6 mg/ml as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management have been established in pediatric patients aged 12 years and older with body weight above 60 kg.

Administration of Victoza 6 mg/ml

Inspect visually prior to each injection. Only use if solution is clear, colorless, and contains no particles. Inject Victoza 6 mg/ml subcutaneously in the abdomen, thigh or upper arm. No dose adjustment is needed if changing the injection site and/or timing. When using Victoza 6 mg/ml with insulin, administer as separate injections. Never mix. It is acceptable to inject Victoza 6 mg/ml and insulin in the same body region but the injections should not be adjacent to each other.

Interaction of Victoza 6 mg/ml

Victoza 6 mg/ml causes a delay of gastric emptying and thereby has the potential to impact the absorption of concomitantly administered oral medications. In clinical pharmacology trials, Victoza 6 mg/ml did not affect the absorption of the tested orally administered medications to any clinically relevant degree. Nonetheless, monitor for potential consequences of delayed absorption of oral medications concomitantly administered with Victoza 6 mg/ml.

Contraindications

Personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type-2. Hypersensitivity to Victoza 6 mg/ml or any excipients in Victoza 6 mg/ml. Pregnancy

Side Effects of Victoza 6 mg/ml

Most common adverse reactions, reported in greater than or equal to 5% are: nausea, diarrhea, constipation, vomiting, injection site reactions, headache, hypoglycemia, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, upper abdominal pain, pyrexia, and gastroenteritis

Pregnancy & Lactation

Pregnancy category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Precautions & Warnings

Acute Pancreatitis: Discontinue promptly if pancreatitis is suspected. Do not restart if pancreatitis is confirmed.Acute Gallbladder Disease: If cholelithiasis or cholecystitis are suspected, gallbladder studies are indicated.Hypoglycemia: This can occur in adults when Victoza 6 mg/ml is used with an insulin secretagogue (e.g. a sulfonylurea) or insulin. The risk may be lowered by a reduction in the dose of concomitantly administered insulin secretagogues or insulin. In the pediatric clinical trial, patients did not have type 2 diabetes. Hypoglycemia occurred in Victoza 6 mg/ml-treated pediatric patients. Inform all patients of the risk of hypoglycemia and educate them on the signs and symptoms of hypoglycemia.Heart Rate Increase: Monitor heart rate at regular intervals.Renal Impairment: Has been reported postmarketing, usually in association with nausea, vomiting, diarrhea, or dehydration which may sometimes require hemodialysis. Use caution when initiating or escalating doses of Victoza 6 mg/ml in patients with renal impairment.Hypersensitivity Reactions: Postmarketing reports of serious hypersensitivity reactions (e.g., anaphylactic reactions and angioedema). Discontinue Victoza 6 mg/ml and other suspect medications and promptly seek medical advice.Suicidal Behavior and Ideation: Monitor for depression or suicidal thoughts. Discontinue Victoza 6 mg/ml if symptoms develop.

Overdose Effects of Victoza 6 mg/ml

Overdoses have been reported in clinical trials and post-marketing use of Victoza 6 mg/ml. Effects have included severe nausea, severe vomiting and severe hypoglycemia. In the event of overdosage, appropriate supportive treatment should be initiated according to the patient’s clinical signs and symptoms.

Storage Conditions

Store between 2-8°C. Do not freeze. After initial use, it can be stored between 15-30°C for 30 days. Protect from heat and light.

Drug Classes

GLP-1 receptor agonists

Mode Of Action

Victoza 6 mg/ml is an acylated human glucagon-like peptide-1 (GLP-1) receptor agonist with 97% amino acid sequence homology to endogenous human GLP-1(7-37). Like endogenous GLP-1, Victoza 6 mg/ml binds to and activates the GLP-1 receptor, a cell-surface receptor coupled to adenylyl cyclase activation through the stimulatory G-protein, Gs. Endogenous GLP-1 has a half-life of 1.5-2 minutes due to degradation by the ubiquitous endogenous enzymes, dipeptidyl peptidase 4 (DPP-4) and neutral endopeptidases (NEP). Unlike native GLP-1, Victoza 6 mg/ml is stable against metabolic degradation by both peptidases and has a plasma half-life of 13 hours after subcutaneous administration. The pharmacokinetic profile of Victoza 6 mg/ml, which makes it suitable for once-daily administration, is a result of self-association that delays absorption, plasma protein binding, and stability against metabolic degradation by DPP-4 and NEP.

Pregnancy

Victoza 6 mg/ml is contraindicated during pregnancy because weight loss offers no potential benefit to a pregnant woman and may result in fetal harm. There are no available data with Victoza 6 mg/ml in pregnant women to inform a drug-associated risk for major birth defects and miscarriage. Victoza 6 mg/ml should not be used during pregnancy. If a patient wishes to become pregnant, or pregnancy occurs, treatment with Victoza 6 mg/ml should be discontinued.There are no data on the presence of Victoza 6 mg/ml in human milk, the effects on the breastfed infant, or effects on milk production. Victoza 6 mg/ml was present in the milk of lactating rats. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Victoza 6 mg/ml and any potential adverse effects on the breastfed infant from Victoza 6 mg/ml or from the underlying maternal condition.
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