Indications and Limitations of Use

Victoza^® (liraglutide) injection 1.2 mg or 1.8 mg is indicated as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes and to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with type 2 diabetes and established cardiovascular disease.

• Victoza^® should not be used in patients with type 1 diabetes
• Victoza^® contains liraglutide and should not be coadministered with other liraglutide-containing products

Important Safety Information cont.

Contraindications

• Victoza^® is contraindicated in patients with a personal or family history of MTC or in patients with MEN 2, and in patients with a serious hypersensitivity reaction to liraglutide or to any of the excipients in Victoza^®. Serious hypersensitivity reactions including anaphylactic reactions and angioedema have been reported with Victoza^®

Warnings and Precautions

• Risk of Thyroid C-cell Tumors: If serum calcitonin is measured and found to be elevated or thyroid nodules are noted on physical examination or neck imaging, the patient should be further evaluated
• Pancreatitis: Acute pancreatitis, including fatal and nonfatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with Victoza^® postmarketing. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, Victoza^® should promptly be discontinued and appropriate management should be initiated. If pancreatitis is confirmed, Victoza^® should not be restarted
• Never Share a Victoza^® Pen Between Patients, even if the needle is changed. Pen-sharing poses a risk for transmission of blood-borne pathogens
• Hypoglycemia: Adult patients receiving Victoza^® in combination with an insulin secretagogue (eg, sulfonylurea) or insulin may have an increased risk of hypoglycemia, including severe hypoglycemia. In pediatric patients 10 years of age and older, the risk of hypoglycemia was higher with Victoza^® regardless of insulin and/or metformin use
• Acute Kidney Injury: Acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis, have been reported postmarketing, usually in association with nausea, vomiting, diarrhea, or dehydration. Use caution when initiating or escalating doses of Victoza^® in patients with renal impairment
• Hypersensitivity Reactions: There have been postmarketing reports of serious hypersensitivity reactions (e.g., anaphylactic reactions and angioedema) in patients treated with Victoza^®. If a hypersensitivity reaction occurs, discontinue Victoza^®; treat promptly per standard of care, and monitor until signs and symptoms resolve. Do not use in patients with a previous hypersensitivity reaction to Victoza^®. Anaphylaxis and angioedema have been reported with other GLP-1 receptor agonists. Use caution in a patient with a history of anaphylaxis or angioedema with another GLP-1 receptor agonist because it is unknown whether such patients will be predisposed to these reactions with Victoza^®
• Acute Gallbladder Disease: Acute events of gallbladder disease such as cholelithiasis or cholecystitis have been reported in GLP-1 receptor agonist trials and postmarketing. In the LEADER trial, 3.1% of Victoza^®-treated patients versus 1.9% of placebo-treated patients reported an acute event of gallbladder disease, such as cholelithiasis or cholecystitis. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated
• Pulmonary Aspiration During General Anesthesia or Deep Sedation: Victoza^® delays gastric emptying. There have been rare postmarketing reports of pulmonary aspiration in patients receiving GLP-1 receptor agonists undergoing elective surgeries or procedures requiring general anesthesia or deep sedation who had residual gastric contents despite reported adherence to preoperative fasting recommendations. Instruct patients to inform healthcare providers prior to any planned surgeries or procedures if they are taking Victoza^®

Adverse Reactions

• The most common adverse reactions (incidence ≥5%) in clinical trials are nausea, diarrhea, vomiting, decreased appetite, dyspepsia, and constipation
• Immunogenicity-related events, including urticaria, were more common among Victoza^®-treated patients (0.8%) than among comparator-treated patients (0.4%) in clinical trials

Drug Interactions

• Victoza^® delays gastric emptying and may impact the absorption of concomitantly administered oral medications. Caution should be exercised when oral medications are concomitantly administered with Victoza^®
• When initiating Victoza^®, consider reducing the dose of concomitantly administered insulin secretagogues (such as sulfonylureas) or insulin to reduce the risk of hypoglycemia

Use in Specific Populations

• The safety and effectiveness of Victoza^® have not been established in pediatric patients less than 10 years of age
• Victoza^® slows gastric emptying. Victoza^® has not been studied in patients with pre-existing gastroparesis
• Victoza^® should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus

Please click here for Victoza^® Prescribing Information, including Boxed Warning.