liraglutide

Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the management of type 2 diabetes mellitus and obesity. It is a synthetic, long-acting analogue of GLP-1 that resists rapid degradation, allowing once-daily subcutaneous injections. By activating the GLP-1 receptor, liraglutide enhances glucose-dependent insulin secretion, suppresses inappropriate glucagon release, slows gastric emptying, and promotes satiety, contributing to improved glycemic control and weight loss in many patients.

Indications and dosing vary by condition. For adults with type 2 diabetes, initiation typically begins at 0.6 mg once daily for one week, then increases to 1.2 mg daily and may be titrated to 1.8 mg as tolerated to improve glycemic outcomes. It can be used as monotherapy or alongside other antidiabetic agents, including metformin. For obesity, the recommended dose is 3 mg once daily, given in addition to diet and exercise, and continued based on clinical response and tolerability.

Pharmacokinetics and safety considerations. Liraglutide is administered by subcutaneous injection with a terminal half-life of about 13 hours, supporting daily dosing. It is metabolized by proteolysis and is not significantly processed by cytochrome P450 enzymes. Contraindications include personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. The most common adverse effects are nausea, diarrhea, vomiting, and decreased appetite; hypoglycemia risk increases when combined with insulin or sulfonylureas. Pancreatitis and gallbladder disease have been observed in some patients. It is not recommended during pregnancy.

Regulatory status. Liraglutide was approved for type 2 diabetes management in 2010 (Victoza) and for chronic weight management in 2014 (Saxenda). It is marketed by Novo Nordisk and has been evaluated in cardiovascular outcomes trials.