Lixisenatide
ADLYXIN
What it isShort-acting GLP-1 receptor agonist; type 2 diabetes.
Why this oneIts short action targets postprandial glucose more than fasting, which complements basal insulin.
What limits itDaily injection with GI intolerance, and no cardiovascular benefit demonstrated, unlike the long-acting agents.
FDA-approved for
- type 2 diabetes (2016)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Type 2 diabetes mellitus (adjunct to diet/exercise) | Naive to basal insulin/GLP-1, on a GLP-1 RA, or <30 units basal insulin/day | 15 units SC QD | titrate to fasting plasma glucose goal | 60 units/day (20 mcg lixisenatide) |
| Type 2 diabetes mellitus | On 30–60 units basal insulin/day | 30 units SC QD | titrate to fasting plasma glucose goal | 60 units/day (20 mcg lixisenatide) |
Titration Adjust by 2–4 units weekly based on fasting plasma glucose
Renal Mild–moderate: no dose adjustment, monitor; not recommended in end-stage renal disease (eGFR <15)
Hepatic Undefined
Fixed-ratio combination pen with insulin glargine; max 60 units/day
Instructions
- Inject SC once daily within 1 hr before the first meal
- Rotate injection sites (abdomen, thigh, upper arm)
- Do not give IV or via pump; do not dilute or mix
- Discontinue basal insulin or GLP-1 RA before initiating
- Never exceed 60 units/day
Contraindications
- During episodes of hypoglycemia
Cautions
- Anaphylaxis / serious hypersensitivity
- Acute pancreatitis
- Never share pen between patients
- Hypo-/hyperglycemia with insulin regimen changes
- Overdose from medication errors (two drugs in one pen)
- Hypoglycemia
- Acute kidney injury from volume depletion
- Severe GI reactions (avoid in severe gastroparesis)
- Immunogenicity
- Hypokalemia
- Fluid retention/heart failure with PPAR-gamma agonists
- Acute gallbladder disease
- Pulmonary aspiration under anesthesia/deep sedation
Adverse reactions
- Hypoglycemia
- Nausea
- Nasopharyngitis
- Diarrhea
- Upper respiratory tract infection
- Headache
Pregnancy Possible fetal risk (animal visceral/skeletal defects with lixisenatide); use only if benefit justifies risk
Lactation No human data on either component; weigh benefits against potential risk
⚠ BOXED WARNING
- Thyroid C-cell tumors in rodents
Classes and tags
Clinical profile
Mechanism of action: Lixisenatide ballicule
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Memory aids: mascots and interaction avatars
Tide Pod → GLP-1 agonist