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VICTOZA, The Best Type II Diabetes Treatment, including its Known Side Effects & Uses

By Jemima Faith

VictozaLiraglutide (Victoza) refers to an expensive drug used to improve the control of blood sugar in adults having type 2 diabetes. The drug is more popular than other comparable drugs.  Victoza currently has no generic alternatives. It is usually covered by most Medicare and insurance plans, but some pharmacy coupon prices may be lower.

Victoza is used to help lower blood sugar levels along together with diet, exercise, and some other selected diabetes medicines. Victoza isn't recommended as the first therapy patients should try if they haven't adequately controlled their diabetes with diet and exercise alone.

It also belongs to a particular class of medicines known as glucagon-like peptide-1 (GLP-1) receptor agonists, which acts by helping the pancreas make more insulin after eating a meal.

Controlling the sugar levels of blood is very important in order to prevent or reduce the long term complications of diabetes, and Victoza also offers certain patients with type 2 diabetes. That is, treatment option for controlling their blood glucose levels.

Uses of Victoza

Looking at the uses of Victoza, Liraglutide can be used either alone or with other medications, and alongside a proper diet and exercise program for controlling high blood sugar levels. Other uses of Victoza are that it is used in people with type 2 diabetes. Controlling high blood sugar can help to prevent kidney damage, nerve problems, blindness, loss of limbs, and sexual malfunction problems. Proper control of diabetes can also lessen the risk of a heart attack or stroke.

Liraglutide is somehow similar to a natural hormone in your body (incretin). It causes the release of insulin in response to high sugar levels (such as after a meal) and decreasing the amount of sugar that the liver makes.

Uses of Victoza in Specific Populations

 Studies on Victoza has not been done in patients having type 2 diabetes who are under 18 years of age and is not recommended for use in pediatric patients.

Victoza can slow gastric emptying. It has not been studied in patients with pre-existing gastro paresis.

Most women having pre-existing diabetes will need insulin in time of pregnancy. Since its discovery, Insulin has been the treatment of choice for diabetes in pregnancy. Many new insulin types have been developed and not all of these have been studied in cases of pregnancy in randomized controlled trials. Insulin types that have been studied in pregnancy include the human insulin and NPH (N) and newer analog insulin lispro (Humalog), aspart (Novolog) and detemir (Levemir). All these three analog insulin has been found to be very safe and effective as the human insulin found in pregnancy.  If you have to use a different type of insulin, speak to your doctor about changing the type of insulin that you have been using to one that has been studied for use in pregnancy.

Oral drugs have not always been safe and effective in pregnancy for women with pre-existing diabetes. If you find out that you are pregnant while you are currently taking an oral medication, it is always advised to contact your health care provider so that you may start insulin and/or put off your oral medication.  Some oral medications such as glyburide and metformin are always safe in the first trimester, so these medications should not be stopped until you achieved good diabetes control with insulin.  However, high blood glucose levels in the first trimester are not always good for the baby.

There exist other new injectable types of medications such as pramlintide and the GLP-1.  There are many types/brands of GLP1 agonists, including exenatide.These have not been studied in pregnancy and they are not known to be safe or effective. Always endeavor to contact your health care provider if you are taking these medications. Preferably you should stop taking Victoza when you are planning to get pregnant.

 

Victoza in Pregnancy and Breastfeeding

Victoza (Liraglutide) as earlier mentioned is a medication that is used to treat type 2 diabetes In situations where the condition is not controlled with insulin therapy, diet and some exercise. Patients having doubts about using Victoza during pregnancy or about Victoza and breastfeeding should always speak with their physician if they want to become pregnant, or as soon as they realise they are pregnant, or before nursing an infant.

Victoza is classified as an FDA (food and drug administration) pregnancy category C drug because of the simple fact that sufficient research has not been carried to determine the side effects of Victoza on an unborn baby.  With respect to a laboratory test performed on some pregnant bunnies and vermin, serious irregularities and malformations were being observed. Some female rats that were given Victoza before breeding, experienced a greater number of embryonic deaths compared to those that were not given the drug, even though the medication appeared to have no effect on mating males.  Still on the laboratory test, Victoza were also given to the nursing animals, which resulted in lower body weights of their offspring with noticeable behavioral differences in young males.

 Also, an increase in the number of solemn birth defects and prolonged pregnancies was reported as well. Although it is important to remember the fact that animals often respond differently to medications than humans, women who are pregnant or plan to become pregnant should always avoid class C medications except the benefits to the mother greatly overshadow any potential risks to the fetus.

Built on these studies, women who are expectant, nursing, or plan to become pregnant should seek alternative treatment options.

 

Side Effects Victoza in Pregnancy

Some of the major Victoza side effects that pregnant women may experience while using Victoza are always totally different from the typical side effects of Victoza experienced by non-pregnant patients. For instance, pregnant women may tend to experience severe constipation as this is both a side effect of the pregnancy and the medication.

They may also have an increase inNausea, though this is usually only temporary. Finally, since pregnancy causes an increased response to certain irritations, women may tend to experience increased redness and swelling at the injection spot occurring as Victoza side effects. Also, women who are pregnant should only put this drug into use if the benefits clearly outweigh the risks in order to avoid these side effects.

 

Victoza and Breastfeeding

In this situation, there have been no major studies on humans who nursed their babies while taking this medication, but numerous studies in animals have revealed that Victoza does pass into the breast milk of lab rats.

Also, since it has not yet been determined whether the amount of the drug that passes through is being destroyed in the digestive tract of infants, it is still unknown if human infants may be affected. Also, Victoza has been known to cause thyroid tumors in baby lab rats, and it is also possible that the same symptoms may appear in human babies. It is because of all these that the manufacturer recommends that women who must take Victoza should avoid breastfeeding.

 

Non Diabetic Uses of Victoza

Victoza slows down food, leaving the stomach. GLP-1 is usually released from the small intestine when we eat. This usually acts by slowing down the process of food, leaving the stomach, which always helps to control our blood sugar after meals.

Victoza also helps to prevent the liver from producing too much sugar.

 Other uses of Victoza are that it helps the pancreas to produce more insulin when the blood sugar levels are high. Victoza performs this by helping important cells to work the way they should. These cells are known as beta cells and they help control blood sugar by making insulin and then releasing it.

Weight lost

Looking at the loss of weight as other uses of Victoza, Liraglutide, which is available in about 1.8mg and about 1.2 mg. The corporation has currently filed with the FDA seeking authorization for a 3.0 mg dosage of Victoza. After studies had found major weight loss benefits (in conjunction with diet and exercise.)

In clinical trials, liraglutide helped those who took it to lose 5 to 10 percent of their body mass, according to more research published in the International Journal of Obesity. And while this study looked only at people having diabetes, a previous study published in the Lancet tested the drug in non-diabetics and found similarly impressive weight loss.

In a particular period, Novo Nordisk filed two submissions for liraglutide, a new drug application (NDA) with the FDA, and a Marketing Authorization Application (MAA) with the European Medicines Agency, with respect to Drug Discovery & Development.

But it may appear that some folks may not need to wait for a long time. Novo Nordisk has also made the unusual move for an initial agreement of high-dose liraglutide. And sometimes others may not wait at all; while the studies warn against using liraglutide "off-label it seems certain that patients will seek to use Victoza for that purpose.

Liraglutide works by representing a hormone known as GLP-1, which happens to slow digestion and stimulates the body's natural production of insulin. Victoza always has been very successful for Novo Nordisk, with sales jumping from about 58% in 2012, and ascending up to an additional 14% in the third quarter of 2013.

Experts are projecting the fact that liraglutide would have blockbuster potential as a weight loss application because the weight loss market is so large.

 

The study carried out in non-diabetics, tested four different doses of liraglutide: (2.4 mg, 1.8 mg, 1.8 mg, and 3.0 mg) against placebo and another drug, Orlistat and found that people who take the highest dosage of liraglutide will lose an average of almost 16 pounds. People taking lower doses also will lose weight, between 10 pounds with about 1.2 mg and also 13 pounds at about 2.4 mg.

There are also more serious safety concerns; currently the FDA is investigating the entire class of GLP-1 drugs to see if they are capable to raise the risk of pancreatitis. Victoza also has a warning that indicates animal studies that found it caused thyroid tumors, both cancerousand benign, in rats, and that it's "not known" if it could also carry the same risk for humans.

Also, with the non-diabetic uses of Victoza, there is the fact that liraglutide is administered always as a daily injection, which may likely prove a barrier for many people, especially given the availability of oral weight loss drugs like Qsymia and Belviq.

 

General Side Effects of Victoza

Some major Victoza side effects may include:

Inflammation of the pancreas (pancreatitis); if this happens, stop using Victoza and quickly contact your health care provider immediately. Also do same, if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may also feel some pains from your abdomen to your back.

Low blood sugar (hypoglycemia) can also occur as side effects Victoza. You may have a high risk of getting low blood sugar if you use Victoza with another medicine that can cause low blood sugar, such medicine may include sulfonylurea or insulin: dizziness or blurred vision, irritability or changing of mood, slurred speech, hunger, confusion or drowsiness, weakness, headache, and feeling jittery May occur as Signs and symptoms of low blood sugar.

Another side effect of Victoza includes kidney problems (kidney failure). Diarrhea, nausea, and vomiting may cause a loss of fluids (dehydration), which can easily result in kidney problems to get worse In people having kidney problems. In this case, stop using Victoza and get medical help instantly if you have any symptoms of a serious allergic reaction.

Some common side effects of Victoza

Some liraglutide side effects may not need any medical attention. As the body gets used to the medicine with time, these side effects Victoza may happen to disappear. Your health care provider may be able to help you prevent or reduce these side effects of Victoza, but always check with them if any of the following Victoza side effects continue.

Abdominal or stomach cramps, discomfort, or pain, acid or sour stomach, back pain, belching, body aches or pain, constipation, decreased appetite, heartburn, indigestion, loss of voice, pain or tenderness around the eyes and cheekbones, sneezing, discoloration of the skin, stuffy nose, swollen mouth and tongue, unpleasant taste, Bleeding, blistering, coldness, , feeling of pressure, hives, infection, ulceration, inflammation, itching, numbness, pain, rash, scarring, soreness, stinging, tenderness, swelling, lumps, tingling,  or warmth that  is felt at the injection site

Some of the side effects that may likely affect the health practitioner includes: Gastrointestinal, Chronic Weight Management: Very common (10% or more): Nausea (39.3%), diarrhea (20.9%), constipation (19.4%), vomiting (15.7%),

Common (1% to 10%): Dyspepsia, abdominal pain, upper abdominal pain, reflux disease, abdominal distension, eructation, increased lipase, flatulence, gastroenteritis, viral gastroenteritis uncommon (0.1% to 1%): Acute pancreatitis, acute gallbladder disease

Chronic Weight Management:

With respect to other laboratory tests, the proportion of patients reporting nausea declined. Most gastrointestinal events were mild or moderate and did not lead to discontinuation.

Acute pancreatitis occurred in 0.3% (9/3291) of liraglutide-treated patients and 0.1% (1/1843) of placebo patients in situations of clinical trials. Three additional cases did occur in liraglutide patients, 2 in other patients who prematurely withdrew from the trial and 1 during an off-treatment follow-up period.

Severe gallbladder disease was also reported more frequently in cases of liraglutide-treated patients (1.5% against 0.5%) during clinical trials. Substantial or rapid weight loss can raise the risk of cholelithiasis, but even after looking for the degree of weight loss, the frequency of acute gallbladder disease was greater in liraglutide-treated patients.

 

Type 2 Diabetes Mellitus

There have also been post marketing reports of acute hemorrhagic or necrotizing pancreatitis, including mortalities. During clinical trials, some 13 cases of pancreatitis were received among liraglutide treated patients, 9 acute and 4 chronic cases compared with 1 case in the comparator (glimepiride) group.  It was proven that some patients could have other risk factors for pancreatitis, which may include, alcohol abuse.

Metabolic

  • ·         Chronic Weight Management:
  • ·         Very common (10% or more): Hypoglycemia in type 2 diabetes (23%)
  • ·         Common (1% to 10%): Decreased appetite
  • ·         Very common (10% or more): Hypoglycemia (when used in combination with a sulfonylurea)
  • ·         Uncommon (0.1% to 1%): Dehydration

 

Chronic Weight Management:

In patients with type 2 diabetes mellitus receiving this drug for chronic weight management, severe hypoglycemia occurred in 0.7% (3/422) of liraglutide-treated cases, each of these patients were also receiving a sulfonylurea. Amid all the other patients receiving this drug in combination with a sulfonylurea, occurred in 43.6% (48/110) of patients. The amount of sulfonylurea had been reduced by 50% at the beginning of the trial. Among patients who are not taking a symptomatic hypoglycemia occurred in 15.7% (49/312) of patients.

Major incidents of hypoglycemia have not really been reported in clinical trials in which liraglutide were used as monotherapy, nevertheless, when used in combination with a sulfonylurea, hypoglycemia was very commonly reported.

Very common (10% or more): Headache (up to 13.6%), Common (1% to 10%): Dizziness

Dosage of Victoza

Victoza always comes as a pre-filled pen to be vaccinated under the skin of the thigh, stomach, or upper arm. Every pen can deliver a 0.6 milligram (mg), 1.8 milligram, or 1.2 milligram dose.

The initial dosage of Victoza is always 0.6 mg a day for one week. After a week, the dose is usually augmented to 1.2 mg a day. The maximum dosage of Victoza is normally 1.8 mg a day.

Victoza is usually injected once a day irrespective of whether food has been taken or not. Any injection should try to be administered at around the same time each day.

The instructions on your prescription label should be followed very carefully when taking this medicine. The drug should not be taken more of less than is prescribed.

The solution of Victoza should always be well verified before injecting it. If it's colored, cloudy, or contains any solid particles, don't take it. Also, don't take the drug if the expiration date has passed. Needles or pens should not be reused. You will be told how to dispose of your needles by your doctor.

Victoza Overdose

Overdose can also occur when looking at the dosage of Victoza. If you suspect an overdose, you should immediately contact a poison control center or emergency room. You can as well get in touch with a poison control center.

Missed Dose of Victoza

In case you miss a dosage of Victoza, you have to inject it as soon as you remember.

However, if it's almost or already time for your next dose, the missed dose should be skipped and continue with your regular dosing schedule. Never inject more medication to make up for a missed dose.

Victoza should be administered as separate injections. When using it with insulin.it should Never be mixed.

Victoza and insulin can be injected in the same body region, but the injections should not be adjacent to each other.

 Victoza can be taken once-daily at any time of the day, irrespective of meals.

Victoza should be initiated with a dose of about 0.6 mg each day for a week. The 0.6 mg dose will be a starting dose intended to reduce gastrointestinal symptoms during initial titration, and is not always effective for glycemic control. After about one week at 0.6 mg per day, the dose must be augmented to 1.2 mg. If the 1.2 mg dose does not result in acceptable glycemic control, the dose can as well be improved to 1.8 mg. If you happen to be missed a dose, resume the once-daily regimen as prescribed with the next scheduled dose. An extra dose should not be administered to make up for the missed dose.

If more than 3 days have passed since the last Victoza dose, reinitiate Victoza at about 0.6 mg to mitigate any gastrointestinal symptoms related to reinitiating cure. Upon reinitiating, Victoza should be titrated at the discretion of the prescriber.

When Victoza is being initiated, consider reducing the dose of concomitantly administered insulin secretagogues (such as sulfonylureas) to reduce the risk of hypoglycemia.

A disclaimer: Remember that this article serves and should only be used as a guide. It is not intended to replace your pharmacist or health care provider’s advice and prescription.

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