BSN Tracker

liraglutide

Brand: Victoza, Saxenda

⚠ BBW Prototype Drug
Drug Class: GLP-1 receptor agonist
Drug Family: antidiabetic
Subclass: once-daily long-acting GLP-1 agonist
Organ Systems: endocrinecardiovascular

Mechanism of Action

Fatty acid-modified GLP-1 analog with 97% sequence homology to human GLP-1, enabling once-daily dosing via albumin binding. Activates GLP-1 receptors in the pancreas (insulin secretion, glucagon suppression), hypothalamus (appetite suppression), heart (cardioprotection), and kidney (natriuresis). Produces significant weight loss.

GLP-1 receptor (GLP-1R)

Indications

  • type 2 diabetes mellitus (Victoza)
  • obesity management — BMI ≥30 or ≥27 with comorbidity (Saxenda)
  • cardiovascular risk reduction in T2DM with established CVD (Victoza)

Contraindications

  • personal or family history of medullary thyroid carcinoma
  • MEN2
  • pregnancy

Adverse Effects

Common

  • nausea
  • diarrhea
  • constipation
  • vomiting
  • injection site reactions

Serious

  • pancreatitis
  • gallbladder disease (cholelithiasis)
  • medullary thyroid carcinoma (rodent data)
  • tachycardia
  • suicidal ideation (Saxenda — weight management dose)

Pharmacokinetics (ADME)

Absorption subcutaneous injection; fatty acid chain allows albumin binding and once-daily dosing
Distribution Vd ~11–17 L; albumin-bound
Metabolism proteolytic catabolism
Excretion renal and fecal as metabolites
Half-life 13 hours
Onset days
Peak 8–12 hours
Duration 24 hours
Protein Binding >98% (albumin)
Vd 11–17 L

Drug Interactions

Drug / Agent Mechanism Severity
oral medications gastric emptying delay reduces Cmax of orally administered drugs moderate
warfarin altered absorption kinetics; monitor INR moderate

Nursing Considerations

  1. Inject subcutaneously in abdomen, thigh, or upper arm once daily at any time, independent of meals.
  2. Titrate dose slowly (0.6 mg → 1.2 mg → 1.8 mg weekly) to minimize GI side effects.
  3. Educate patients that this medication requires refrigeration until opened; after first use, store at room temperature for up to 30 days.
  4. For Saxenda (obesity): assess for depression/suicidal ideation; discontinue if not achieving ≥4% weight loss at 16 weeks.

Clinical Pearls

  • The LEADER trial demonstrated a 13% relative risk reduction in MACE (major adverse cardiovascular events) in T2DM patients with established CVD, establishing liraglutide as the first GLP-1 agonist with proven CV benefit.
  • At the higher dose (3 mg; Saxenda), liraglutide achieves approximately 5–8% average body weight loss independent of glucose lowering — the first FDA-approved injectable weight-loss medication since orlistat.

Safety Profile

Pregnancy contraindicated
Lactation avoid
Renal Adjustment Not required
Hepatic Adjustment Not required
TDM Not required

Concordance Terms

Cross-referenced clinical concepts — click any term to see all content where it appears.

Cardiovascular Risk Reduction In T2DM With Established CVD (Victoza) GLP-1 Receptor Agonist Obesity Management — BMI ≥30 Or ≥27 With Comorbidity (Saxenda) Type 2 Diabetes Mellitus (Victoza)
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