Liraglutide

FDA label

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Titration Increase only after at least 1 week at the current dose (0.6 -> 1.2 -> 1.8 mg; pediatric in 0.6 mg increments).

Renal No adjustment needed

Hepatic No adjustment needed (use with caution; limited experience)

Instructions

• Inject subcutaneously once daily at any time of day, independent of meals, in the abdomen, thigh, or upper arm.
• Rotate injection sites within the same region to reduce cutaneous amyloidosis.
• When used with insulin, administer as separate injections — never mix.
• The 0.6 mg dose is for titration only and is not effective for glycemic control.
• If more than 3 days have elapsed since the last dose, reinitiate at 0.6 mg QD and retitrate.

Contraindications

• Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

Cautions

• Acute pancreatitis — discontinue if suspected
• Hypoglycemia when combined with insulin secretagogues or insulin (reduce their dose)
• Acute kidney injury from volume depletion (nausea/vomiting/diarrhea/dehydration)
• Severe gastrointestinal reactions; not recommended in severe gastroparesis
• Serious hypersensitivity reactions incl. anaphylaxis and angioedema
• Acute gallbladder disease (cholelithiasis/cholecystitis)
• Pulmonary aspiration under general anesthesia/deep sedation (delayed gastric emptying)
• Never share a pen between patients

Adverse reactions

• Nausea
• Diarrhea
• Vomiting
• Decreased appetite
• Dyspepsia
• Constipation
• Headache
• Small mean heart-rate increase

Pregnancy Animal studies show fetal harm (early embryonic deaths, major malformations); use in pregnancy only if the potential benefit justifies the risk.

Lactation No data on presence in human milk; present in milk of lactating rats.