Posology: To improve gastro-intestinal tolerability, the starting dose is 0.6 mg liraglutide daily. After at least one week, the dose should be increased to 1.2 mg. Some patients are expected to benefit from an increase in dose from 1.2 mg to 1.8 mg and based on clinical response, after at least one week, the dose can be increased to 1.8 mg to further improve glycaemic control. Daily doses higher than 1.8 mg are not recommended.
Victoza can be added to existing metformin or to a combination of metformin and thiazolidinedione therapy. The current dose of metformin and thiazolidinedione can be continued unchanged.
Victoza can be added to existing sulfonylurea or to a combination of metformin and sulfonylurea therapy or insulin. When Victoza is added to sulfonylurea therapy or insulin, a reduction in the dose of sulfonylurea or insulin should be considered to reduce the risk of hypoglycaemia (see Precautions).
Self-monitoring of blood glucose is not needed in order to adjust the dose of Victoza. However, when initiating treatment with Victoza in combination with a sulfonylurea or insulin, blood glucose self-monitoring may become necessary to adjust the dose of the sulfonylurea or the insulin.
No dose adjustment is required during Ramadan when Victoza is added to metformin for treatment of type 2 diabetes mellitus (see Pharmacology: Pharmacodynamics: Other clinical data under Actions). It is recommended to finalise dose escalation of Victoza before patients start Ramadan fasting.
Special populations: Elderly patients (>65 years old): No dose adjustment is required based on age (see Pharmacology: Pharmacokinetics under Actions).
Renal impairment: No dose adjustment is required for patients with mild, moderate or severe renal impairment. There is no therapeutic experience in patients with end-stage renal disease, and Victoza is therefore not recommended for use in these patients (see Pharmacology: Pharmacodynamics and Pharmacokinetics under Actions).
Hepatic impairment: No dose adjustment is recommended for patients with mild or moderate hepatic impairment. Victoza is not recommended for use in patients with severe hepatic impairment (see Pharmacology: Pharmacokinetics under Actions).
Paediatric population: The safety and efficacy of Victoza in children and adolescents below age 18 have not been established (see Pharmacology: Pharmacodynamics under Actions). No data are available.
Method of administration: Victoza must not be administered intravenously or intramuscularly.
Victoza is administered once daily at any time, independent of meals, and can be injected subcutaneously in the abdomen, in the thigh or in the upper arm. The injection site and timing can be changed without dose adjustment. However, it is preferable that Victoza is injected around the same time of the day, when the most convenient time of the day has been chosen. For further instructions on administration (see Special precautions for disposal and other handling under Cautions for Usage).