Restarting Victoza After 8 Days of Missed Doses
After missing 8 days of Victoza 1.8 mg, you must restart the titration schedule beginning at 0.6 mg daily, as missing 3 or more consecutive doses requires restarting from the initial dose to minimize gastrointestinal side effects and maintain tolerability. 1
Why Restart Titration is Necessary
When 3 or more consecutive doses of liraglutide are missed, the body loses its adaptation to the medication, particularly regarding gastrointestinal tolerance 1. Jumping directly back to 1.8 mg after an 8-day gap would likely cause significant nausea, vomiting, and diarrhea that could be severe enough to require discontinuation 2, 3, 4.
The gastrointestinal adverse events with GLP-1 receptor agonists are dose-dependent and most pronounced during the initial treatment phase 3, 4. Slow dose titration is the most effective approach to minimize these symptoms 2.
Specific Restart Protocol
Week 1 (Days 1-7): Start with 0.6 mg subcutaneously once daily 2, 3
Week 2 (Days 8-14): Increase to 1.2 mg once daily 2, 3
- This is the usual maintenance dose for many patients 3
- Continue monitoring gastrointestinal symptoms 2
Week 3 onwards: Increase to 1.8 mg once daily (your previous dose) 2, 3
- This is the maximal approved dose for type 2 diabetes 3
- Only advance if the 1.2 mg dose is well-tolerated 2
Administration Guidelines
- Inject subcutaneously once daily at any time of day, independent of meals 2
- Rotate injection sites within the abdomen, thigh, or upper arm 2
- If nausea persists at any dose level, maintain that dose longer before advancing rather than discontinuing therapy 2
Important Medication Interactions During Restart
If you are taking insulin or sulfonylureas, these doses may need reduction when restarting Victoza to prevent hypoglycemia 2. Monitor glucose levels more frequently during the titration period 2.
Do not use Victoza with other GLP-1 receptor agonists or DPP-4 inhibitors 2.
What to Expect
Gastrointestinal symptoms (nausea, vomiting) may occur during the initial phase but usually diminish with time and rarely require medication interruption 3, 5. These symptoms typically subside within several days 5. The slow titration schedule minimizes these effects while allowing your body to readapt to the medication 2, 3.