Victoza dosage, forms, and strengths

Victoza is a brand-name prescription drug that helps reduce blood sugar in people with Type 2 diabetes mellitus as well as reduce the risk of cardiovascular events in people with both Type 2 diabetes and heart disease. Liraglutide, the active ingredient in Victoza, belongs to a family of diabetes drugs called glucagon-like peptide-1 receptor agonists or GLP-1 agonists. These drugs increase the amount of insulin produced immediately after a meal, inhibit the body’s ability to manufacture glucose after eating, and slow down the rate that food is moved through the digestive system. Victoza is administered as a subcutaneous injection once daily without respect to time or food.

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Victoza forms and strengths

Victoza is injected under the skin (subcutaneously)using an injection pen. Injections are typically given at home and are either self-administered or administered by a caregiver.

• Injection pen: 18milligrams (mg) per 3 milliliter (mL) pen (6 mg/mL)

Victoza dosage for adults

Victoza is prescribed as an adjunct to diet and exercise to control blood sugar in patients ten years or older who are diagnosed with Type 2 diabetes. In addition, it is prescribed to adults with both Type 2 diabetes and cardiovascular disease to reduce the risk of serious cardiovascular events such as heart attack or stroke. Victoza is not an approved treatment for Type 1 diabetes.

The American Diabetes Association considers metformin to be the first-line therapy for controlling blood sugar in people with type 2 diabetes. Most patients will begin treatment with metformin alone and continue on metformin monotherapy until they are no longer achieving A1c goals. However, in patients with an A1c level that is 1.5%-2% above goal, initial therapy may also include a second-line treatment such as Victoza. Second-line treatments may be used as initial therapy in people who can’t take metformin. In most cases, they are added later. 

The U.S. Food and Drug Administration has approved high-dose liraglutide injections along with diet and exercise for weight loss in people diagnosed with obesity. However, high-dose liraglutide is sold as a separate brand name drug called Saxenda, another Novo Nordisk product.

Source: Epocrates

Victoza dosage for Type 2 diabetes mellitus

Liraglutide, the active ingredient in Victoza, helps patients with Type 2 diabetes maintain glycemic control by increasing the body’s removal of glucose from the bloodstream after a meal. Liraglutide also decreases the body’s production of glucagon, a hormone that stimulates the liver to manufacture and secrete glucose into the bloodstream. Finally, liraglutide slows down the speed that food is released from the stomach into the intestines, which in turn slows down the release of glucose into the bloodstream after a meal. This increases feelings of fullness and also helps prevent spikes in blood sugar after eating.

As a GLP-1 receptor agonist, liraglutide’s basic mechanism of action is to mimic an incretin hormone called GLP-1. The incretin hormones GLP-1 and GIP are small protein-like molecules (peptides) secreted by the gut after a meal. Once in the bloodstream, they signal the pancreas to produce insulin, the hormone that stimulates cells to absorb glucose from out of the bloodstream. Type 2 diabetes diminishes the incretin effect, but insulin-producing cells are still sensitive to GLP-1. Drugs like Victoza mimic GLP-1, causing a significant rise in insulin after eating resulting in more stable blood sugar 

Victoza injections are taken once daily. They can be taken at any time during the day with or without food. Patients will begin therapy using 0.6 mg injected under the skin once daily. The dose may be increased to 1.2 mg daily if blood sugar control is not achieved after one week on the starting dose. Pediatric patients may increase the dose to 1.8 mg daily after at least one week of treatment with 1.2 mg daily if blood sugar control is still not achieved. If patients go more than three days without a dose, they should restart the dosing procedure at 0.6 mg and increase the dose following the same guidelines. Restarting at the initial dose will avoid GI symptoms associated with restarting treatment.

• Standard dosage for Type 2 diabetes in adults: 1.2–1.8 mg subcutaneous injection taken once daily

Victoza dosage for cardiovascular event risk reduction

Victoza is also FDA approved to treat patients diagnosed with both Type 2 diabetes and cardiovascular disease to reduce the risk of cardiovascular events such as heart attack, stroke, or cardiovascular death. Dosages and administration are the same as for the treatment of type 2 diabetes.

• Standard dosage for cardiovascular risk reduction in adults: 1.2–1.8 mg subcutaneous injection taken once daily.

Victoza dosage for children

Victoza is approved for use in pediatric patients as young as 10 years of age diagnosed with Type 2 diabetes. Dosages and administration are the same as they are with adults

• Standard dosage for children ages 10 and older: 1.2–1.8 mg subcutaneous injection taken once daily

Victoza pediatric dosage chart

Source: Epocrates

Victoza dosage restrictions

Victoza has no dosage restrictions based on age organ function. Liraglutide is not eliminated by the liver or kidneys, so people with liver impairment or renal impairment will not require dosage reductions.

However, Victoza is contraindicated in any person with hypersensitivity to the drug, a history of medullary thyroid carcinoma (MTC), or history of multiple endocrine neoplasia syndrome type 2 (MEN 2). Other medical conditions may require close monitoring for side effects. These include people at risk for pancreatitis, a history of severe gastrointestinal disease, or a history of severe gastroparesis. 

How to take Victoza

Victoza is taken as a daily, self-administered subcutaneous injection. People taking Victoza can take it at any time of day without any regard to meals.

• Follow the instructions given by a healthcare provider when taking this medicine.

• This medicine should come with a medication guide that includes illustrated instructions on how to use the Victoza pen. If the medication guide is missing, ask a pharmacist for a copy.

• A healthcare provider will demonstrate how to self-administer Victoza injections.

• Wash your hands with soap and water before each injection.

• For most people, subcutaneous injections will be self-injected into the stomach, thighs, or upper arm. Use a different body area each time you give yourself a shot. Keep track of where each shot is given to ensure different areas of the body are used for injections.

• Each Victoza prefilled pen has enough medicine for more than one injection. Except for the first use of the pen, you will need to attach a needle to the pen before each injection and detach and dispose of that needle after each injection.

• The pen can be used for up to 30 days after the first use of the pen.

• Never use the pen injector if it looks damaged or has medicine that is discolored or has particles in it. 

• Never mix Victoza with insulin or any other injection. Always administer Victoza as a separate injection.

• Victoza may be injected in the same body region as other injections, but never adjacent to other injections.

• Store the Victoza pen at room temperature (59ºF to 86ºF) or in the refrigerator (36°F to 46°F) protected from heat or sunlight.

• If the Victoza pen is exposed to temperatures higher than 86ºF, the pen and its contents should be disposed of.

Giving an injection

• Clean the injection site with an alcohol wipe. Make sure the skin has dried before giving the injection.

• Pull off the protective tab, outer needle cap, and inner needle cap, but don’t throw the outer needle cap away.

• If the pen has been used and the needle is missing, follow the instructions to put on a new needle.

• For the first use, turn the dose selector until the mark lines up with the correct dose. Once set, this does not need to be repeated for future injections.

• Holding the pen with the needle pointing up, follow the instructions to remove air bubbles from the syringe.

• Insert the needle into the injection site.

• Press and hold the dose button until 0 mg lines up with the pointer.

• Continue to press the dose button with the needle in the skin to a count of six.

• Continue to press down on the dose button while the needle is removed from the skin.

• The injection is finished. Carefully cover the needle with the outer needle cap.

• Rotate the needle to remove it from the pen and discard it in a sharps disposal container.

• When all the medicine has been used from the injector, it, too, should be discarded in a sharps disposal container.

• Inspect the injection site. If there’s blood, press a cotton ball or gauze strip to the site but do not rub the injection site.

Victoza dosage FAQs

What happens if I miss a dose of Victoza?

If a dose of Victoza is missed, skip the missed dose and return to the regular dosing schedule. Never take extra medicine to make up for a missed dose. If Victoza doses are missed for three days or more, it is recommended to restart therapy at 0.6 mg daily to avoid GI symptoms associated with restarting therapy. However, always consult your healthcare provider on how to restart treatment. 

How long can you take Victoza?

Like most other diabetes medications, Victoza is intended for long-term treatment. Unfortunately, diabetes is a progressive disorder, so Victoza may eventually need to be stopped in favor of other diabetes medications.

How do I stop taking Victoza?

Do not stop taking Victoza or any other diabetes medication except under the medical advice of a healthcare professional. If no other diabetes medications are being taken, stopping Victoza could cause glucose levels to rise to harmful levels. 

People may need to stop taking Victoza for a variety of reasons. Some patients have trouble with common adverse reactions such as low blood sugar (hypoglycemia), upper abdominal pain (dyspepsia), hoarseness, or constipation. Other people may experience serious side effects such as allergic reactions, thyroid c-cell tumors, medullary thyroid carcinoma, gallbladder stones, or acute pancreatitis (swollen pancreas). 

Medical science, though, offers a wide range of diabetes medications that keep blood sugar under control. These include biguanides, sulfonylureas, meglitinides, glitazones, alpha-glucosidase inhibitors, dopamine-2 agonists, thiazolidinediones, and insulin. Another family of diabetes medications works similarly to GLP-1 receptor agonists. Called DPP-4 inhibitors, these medications increase insulin production by blocking the enzyme that breaks down GLP-1 in the bloodstream. DPP-4 inhibitors are very similar to GLP-1 agonists like Victoza since their effects are triggered by blood sugar levels. Therefore GLP-1 agonists and DDP-4 inhibitors both have a lower risk of hypoglycemia compared to other classes of diabetes medications.

Can you overdose on Victoza?

Overdoses have been observed in both clinical trials and clinical use of Victoza. Taking too much Victoza can cause symptoms such as severe nausea, severe vomiting, and severe hypoglycemia. Call a healthcare provider immediately if too much Victoza has been taken. 

What interacts with Victoza?

Like all drugs, Victoza might cause problems when combined with other drugs. For this reason, keep a list of all prescription drugs, over-the-counter medications, and supplements being taken. To avoid potential drug interactions, always share this list with healthcare providers when getting a prescription.

For Victoza, the most significant drug interactions involve combining Victoza with drugs that can harm the kidneys. Examples of such drugs include aminoglycoside antibiotics, some antiviral drugs, many chemotherapy drugs, among others. While Victoza does not directly harm the kidneys, patients should be monitored when using Victoza with other drugs that can harm the kidneys.

Victoza is commonly combined with other diabetes medications. However, the combination can cause blood sugar to fall too low, particularly when Victoza is combined with insulin or certain drugs that stimulate insulin secretion such as sulfonylureas. Furthermore, many medications can enhance the ability of Victoza to lower blood sugar, thus dosage adjustments may be required. ACE inhibitors (e.g. lisinopril) are a common class of drugs that can have this effect.

Finally, as a general problem, Victoza slows gastric emptying, so it could affect the absorption of drugs taken orally. This may be problematic for medications that required an immediate onset. It may also be problematic for medications that require a minimum concentration to be effective. One important example is the progestin-only oral contraceptives (“mini pill”). These contraceptives should be taken at least 1 hour before injecting Victoza.

Is it safe to take Victoza during pregnancy?

Pregnant women should seek medical advice about the potential risks and benefits of taking Victoza while pregnant. In Animal studies, a risk to the fetus has been established after mothers are given liraglutide, but animal studies are not always predictive of human response to drugs. There is not adequate human data to determine the safety of Victoza use during pregnancy, so it is generally better to use a safer diabetic medication such as insulin if possible.

There are no studies of Victoza’s presence in milk or effects on a nursing infant. Again, breastfeeding women should seek medical advice from a healthcare professional about taking Victoza. Alternative treatments may be preferable.

Related resources for Victoza dosages:

• Glucagon-like peptide-1 receptor agonists, StatPearls

• Incretin hormones: Their role in health and disease, Diabetes, Obesity, & Metabolism

• Practice Guideline Resources, American Diabetes Association

• Saxenda prescribing information, U.S. National Library of Medicine

• Victoza, Epocrates

• Victoza prescribing information, U.S. National Library of Medicine