What is the typical dosing regimen for Victoza (liraglutide) in the treatment of type 2 diabetes?

Victoza (Liraglutide) Dosing Regimen for Type 2 Diabetes

The recommended dosing regimen for Victoza (liraglutide) in adults with type 2 diabetes starts with 0.6 mg subcutaneously once daily for one week, then increases to 1.2 mg once daily, with further titration to 1.8 mg once daily if additional glycemic control is needed after at least one week at the 1.2 mg dose. 1

Detailed Adult Dosing Protocol

• Initial dose: 0.6 mg subcutaneously once daily for one week

  • This starting dose is intended to reduce gastrointestinal symptoms during initial titration and is not effective for glycemic control 1

• First titration: Increase to 1.2 mg subcutaneously once daily after one week

  • This is the usual maintenance dose for most patients 2

• Second titration: If additional glycemic control is required, increase to 1.8 mg subcutaneously once daily

  • This maximum dose should only be implemented after at least one week at the 1.2 mg dose 1

Pediatric Dosing (Ages 10 and Older)

• Initial dose: 0.6 mg subcutaneously once daily
• Titration: Increase in 0.6 mg increments after at least one week at the current dose
• Maximum dose: 1.8 mg subcutaneously once daily 1

Administration Guidelines

• Inject subcutaneously once daily at any time of day, independently of meals
• Injection sites include abdomen, thigh, or upper arm
• Rotate injection sites within the same region to reduce risk of cutaneous amyloidosis
• When using with insulin, administer as separate injections (never mix) 1

Missed Dose Recommendations

• If a dose is missed, resume the once-daily regimen with the next scheduled dose
• Do not administer an extra dose or increase the dose to make up for a missed dose
• If more than 3 days have elapsed since the last dose, reinitiate at 0.6 mg once daily to mitigate gastrointestinal symptoms 1

Clinical Efficacy

Liraglutide effectively reduces HbA1c by at least 1% in patients with type 2 diabetes without inducing hypoglycemia 2. In the ROOTS study, 66.5% of patients achieved either HbA1c <7% or a decrease of ≥1% after 12 months of treatment 3.

Common Side Effects and Management

• Gastrointestinal effects: Nausea, vomiting, and diarrhea are common, typically mild to moderate, and decrease over time 4, 2
• Management: The gradual dose escalation schedule helps minimize these side effects
• Severe symptoms: If severe gastrointestinal symptoms occur, reduce to the previous tolerable dose 4

Important Precautions

• Thyroid C-cell tumors: Contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 1
• Hypersensitivity: Contraindicated in patients with serious hypersensitivity to liraglutide 1
• Renal impairment: Use with caution in patients with renal impairment; monitor renal function in patients with eGFR 15-29 mL/min/1.73 m²; not recommended with eGFR <15 mL/min/1.73 m² 4
• Hypoglycemia risk: Increased risk when used with insulin, sulfonylureas, or glinides 4
• Gastroparesis: Not recommended in patients with clinically meaningful gastroparesis 4

Treatment Evaluation

The American Diabetes Association recommends evaluating treatment response after 3 months, with effective response defined as ≥5% weight loss or significant HbA1c reduction. Consider discontinuation or alternative approaches if response is insufficient (<5% weight loss after 3 months) or if significant safety/tolerability issues occur 4.