What is the recommended dosing and administration schedule for Liraglutide (Glucagon-like peptide-1 receptor agonist) 18 mg/3ml solution for weight management?

Liraglutide Dosing for Weight Management

For weight management, liraglutide (18 mg/3ml) should be administered as a daily subcutaneous injection with a gradual dose titration starting at 0.6 mg daily for the first week, followed by weekly increments of 0.6 mg until reaching the target maintenance dose of 3.0 mg daily after 4 weeks. 1, 2

Detailed Dosing Schedule

• Week 1: 0.6 mg daily 1, 2
• Week 2: 1.2 mg daily 1, 2
• Week 3: 1.8 mg daily 1, 2
• Week 4: 2.4 mg daily 1, 2
• Week 5 and beyond: 3.0 mg daily (maintenance dose) 1, 2

Administration Guidelines

• Administer as a subcutaneous injection once daily at any time of day, independent of meals 2, 3
• Use the 18 mg/3ml solution pen device specifically approved for weight management 2
• Injections can be administered in the abdomen, thigh, or upper arm 2
• No specific timing requirements; can be administered at the same time each day for consistency 2, 3

Missed Dose Management

• If 1-2 consecutive doses are missed: Resume at the current dose if the medication has been well-tolerated 1
• If more than 2 consecutive doses are missed: Clinical judgment is required 1
  • For patients who previously tolerated the medication well: Resume at the same dose 1
  • For patients with previous tolerability issues: Consider lowering to the previous tolerable dose 1
• If 3 or more consecutive doses are missed: Consider restarting the titration schedule 1

Dose Adjustment for Side Effects

• If gastrointestinal side effects occur (nausea, vomiting): Reduce to the previous tolerable dose 1, 2
• Some patients may achieve satisfactory results at submaximal doses (less than 3.0 mg) and can continue at that dose long-term 1

Monitoring and Evaluation

• Evaluate weight loss response after 16 weeks at the 3.0 mg dose 2
• Consider discontinuation if patient has not lost at least 4% of baseline body weight 2
• No daily blood glucose monitoring required unless used with sulfonylureas 3

Important Precautions

• Gradual dose titration is essential to minimize gastrointestinal side effects 1, 2
• Should not be used with other GLP-1 receptor agonists or dipeptidyl peptidase-4 inhibitors 1
• Use caution when combining with insulin or insulin secretagogues due to potential hypoglycemia risk 1
• May delay gastric emptying, potentially affecting absorption of other medications 1

Common Side Effects

• Gastrointestinal effects: nausea (40%), vomiting (16%), diarrhea 1, 2, 4
• These side effects typically diminish over time with continued use 2, 3

This dosing regimen has been shown to produce 5-8% weight loss in clinical trials when used as an adjunct to lifestyle modifications in patients with BMI ≥30 kg/m² or BMI ≥27 kg/m² with at least one weight-related comorbidity 2, 4, 5.