liraglutide/insulin degludec

Action and Spectrum

Actions and Spectrum:

liraglutide/insulin degludec are two different medications used in the management of diabetes.

liraglutide:

• liraglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA).
• It is administered by injection, typically once a day.
• Mechanism of action: Liraglutide stimulates insulin secretion and lowers glucagon secretion, helping to control blood sugar levels.
• Liraglutide promotes weight loss and may have cardiovascular benefits.
• Common side effects include nausea, vomiting, and diarrhea.

insulin degludec:

• insulin degludec is a long-acting insulin analog.
• It is administered by injection, usually once a day, but it can sometimes be taken less frequently.
• Mechanism of action: insulin degludec provides a steady release of insulin over an extended period, helping to regulate blood sugar levels throughout the day and night.
• It is often used in combination with short-acting insulins.
• Common side effects may include hypoglycemia (low blood sugar) and injection site reactions.

Both liraglutide and insulin degludec are valuable tools in diabetes management, but they work through different mechanisms and have distinct profiles in terms of dosing, side effects, and patient suitability.

Drug Interaction

Adverse Reaction

Frequency Defined

>1-10%

Headache (9.1%)

Nasopharyngitis (9.6 %)

Nausea (7.8%)

Increased lipase (6.7%)

Diarrhea (7.5%)

Mildly elevated serum bilirubin concentrations (4%)

Upper respiratory tract infection (5.7%)

<1%

Cholecystitis (0.2%)

Cholelithiasis (0.3%)

Frequency Not Defined

Lipodystrophy at injection site

Weight gain

Immunogenicity

Hypoglycemia

Increased pulse 2-3 bpm

Peripheral edema

Systemic allergy

Black Box Warning

Black Box Warning:

None

Contraindication / Caution

Contraindication / Caution:

liraglutide:

Contraindications:

• Hypersensitivity to liraglutide or any of its components.
• Personal or family history of medullary thyroid carcinoma (MTC).
• Multiple endocrine neoplasia syndrome type 2 (MEN 2).

Cautions:

• Acute pancreatitis: Use with caution and discontinue if pancreatitis is suspected.
• Thyroid tumors: Monitor for signs of thyroid tumors and discontinue if MTC is confirmed.
• Gastrointestinal disorders: Caution in patients with a history of gastrointestinal disease.

Insulin Degludec:

Contraindications:

• Hypersensitivity to insulin degludec or any of its components.

Cautions:

• Hypoglycemia: Dose adjustments may be needed to prevent low blood sugar.
• Hypokalemia: Monitor potassium levels, as insulin may lower them.
• Adjustments in insulin dose may be needed during illness or changes in physical activity.

Pregnancy / Lactation

Pregnancy consideration:

Pregnancy category: N/A

Lactation: Excretion into human milk is unknown

Pregnancy Categories:     

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.

Category N: There is no data available for the drug under this category.

Pharmacology

Adminstartion

Patient Information Leaflet

Patient information leaflet

Generic Name: liraglutide/insulin degludec

Why do we use liraglutide/insulin degludec?

The combination of liraglutide and insulin degludec is employed in managing type 2 diabetes, offering various advantages:

• Effective Blood Sugar Management: This combination addresses blood sugar control comprehensively. Liraglutide, acting as a GLP-1 receptor agonist, stimulates insulin production and reduces glucagon secretion. Simultaneously, insulin degludec, with its extended action, maintains consistent blood sugar levels throughout the day.
• Facilitates Weight Control: Liraglutide often leads to weight loss in diabetic patients. This is particularly beneficial for individuals struggling with weight gain due to their diabetes treatment. It complements insulin therapy, which can sometimes result in weight gain.
• Mitigates Hypoglycemia Risk: By combining liraglutide with insulin degludec, there’s a reduced likelihood of experiencing hypoglycemia (low blood sugar). Liraglutide, as a standalone medication, tends not to induce low blood sugar.
• Enhanced Convenience: Insulin degludec’s prolonged duration of action allows for once-daily dosing, improving convenience for patients. Liraglutide is also administered once daily, simplifying treatment regimens.
• Elevated A1c Control: The combination of these medications often leads to superior A1c control. A1c reflects average blood sugar levels over time and is a crucial metric in diabetes management.
• Cardiovascular Benefits: Clinical trials have demonstrated cardiovascular benefits associated with liraglutide. This is particularly valuable for individuals with diabetes who face an elevated risk of heart disease.