Viktoza - official * instructions for use

Pharmacodynamics

Is analogous to glucagon-like peptide-1 human, which is produced by the method of biotechnology and has 97% similarity with the human. Binds to GLP-1 receptors, which are targets for hormone produced in the body incretin.

The latter stimulates insulin production in response to an increase in blood glucose.
At the same time, the active ingredient of the drug suppresses the production of glucagon. And, conversely, when hypoglycemiareduces insulin secretion, and does not affect glucagon secretion. It reduces weight and reduces the amount of fat mass, dulling the feeling of hunger.

Animal studies with prediabetesallowed to conclude that liraglutide slows down the development of diabetes, stimulates an increase in the number of beta cells. Its action lasts for 24 hours.

Pharmacokinetics

The absorption of the drug is slow, and only after 8–12 hours its maximum concentration in the blood can be traced. Bioavailability is 55%. 98% bound to blood proteins. Within 24 hours, liraglutide does not change in the body. T1 / 2 is 13 hours. His 3 metabolites are eliminated within 6–8 days after injection.

Indications for use

Viktoza is used in type 2 diabetes as:

  • monotherapy,
  • combination therapy with oral hypoglycemic drugs - Glibenclamide, Dibetolong, Metformin,
  • combination therapy with insulinIf treatment with previous combinations of drugs was not effective.

Treatment in all cases is carried out against the backdrop of diet and exercise.

Contraindications

  • type 1 diabetes,
  • hypersensitivity to the drug,
  • pregnancyand breastfeeding,
  • ketoacidosis,
  • severe heart failure
  • colitis,
  • age up to 18 years
  • paresis of the stomach.

Side effects

Victoza can cause:

  • nausea diarrhea, vomiting, abdominal pain,
  • loss of appetite anorexia,
  • hypoglycemic states,
  • headache,
  • reactions at the injection site,
  • respiratory tract infections.

Instructions for use Victose (method and dosage)

Introduced n / a, in the abdomen / thigh 1 time per day, regardless of the meal.

It is preferable to enter at the same time of day. The injection site may vary. The drug should not be administered in / in and / m.

Read treatment with 0.6 mg per day. A week later, the dose is increased to 1.2 mg. If necessary, for the best glycemic control in a week increase to 1.8 mg. A dose above 1.8 mg is undesirable.
Usually used in addition to treatment. Metforminor Metformin+ Thiazolidinedionein previous doses. When combined with sulfonylurea derivatives, the dose of the latter should be reduced, since undesirable hypoglycemia.

Interaction

When taken simultaneously with Paracetamol the dose of the latter does not need to be adjusted.

Does not cause significant changes in pharmacokinetics Atorvastatin.

Dose adjustment Griseofulvina with the simultaneous use of Viktozy is not required.

Also, no correction Dozlizinopriland Digoxin.

Contraceptive effect Ethinyl Estradioland Levonorgestrel when taken simultaneously with Viktoza does not change.

Drug interaction with Insulinand Warfarin not studied

Reviews of Viktose

Reviews of doctors about Viktose boil down to the fact that the drug should be used according to indications and only as prescribed by a doctor. Studies have shown that drugs for the treatment of type 2 diabetes, Byetta and Viktoza, are effective in combating obesity. This point is important because the key task in treating patients with this diagnosis is weight loss.

The drug is intended for treatment. diabetesand the prevention of its complications, a positive effect on the cardiovascular system. It does not just reduce the level of glucose, but restores the physiological insulin production in patients with diabetes. In animal experiments it has been proved that under its influence the structure of beta cells and their function are restored. The use of the drug allows a comprehensive approach to treatment. Type 2 diabetes.

Viktoza for slimming in some patients with diabetes was used as monotherapy. All patients reported persistent loss of appetite. Blood glucose values ​​within a day were within the normal range, during the month the level normalized triglycerides.

The drug was administered at a dose of 0.6 mg once a day for a week, then the dose was increased to 1.2 mg. The duration of treatment is 1 year. The best results were observed in combination therapy with Metformin. During the first month of treatment, some patients lost 8 kg. Doctors want to lose weight from spontaneous taking this drug. Using it is risky. thyroid cancer and occurrence pancreatitis.

Reviews on the forums are more often negative. Most slimmers report a weight loss of 1 kg per month, at best 10 kg in six months. The question is actively discussed, is there any point in interfering with the metabolism for 1 kg per month? Given that dieting and exercise are still required.

"Distort the metabolism ... no."

“I admit that drug treatment is necessary at stage 3-4 of obesity, when the metabolism goes astray, and here? I do not understand…"

“In Israel, this medicine is prescribed ONLY for diabetics with a certain level of sugar. You just won't get the recipe. ”

“There is nothing good about this medicine. For 3 months + 5 kg. But I took it not for weight loss, I am diabetic. ”

Release form and composition

Dosage form - solution for subcutaneous administration: colorless or almost colorless (3 ml * each in glass cartridges which are sealed in a disposable plastic syringe pen for repeated injections, in a cardboard bundle 1, 2 or 3 syringe pens).

* 1 pen (3 ml) contains 10 doses of 1.8 mg each, 15 doses of 1.2 mg each, or 30 doses of 0.6 mg each.

Active ingredient: liraglutid, in 1 ml - 6 mg.

Auxiliary components: hydrochloric acid / sodium hydroxide q.s., sodium hydrogen phosphate dihydrate, phenol, propylene glycol, water for injection.

Pharmacokinetics

After subcutaneous administration, absorption of liraglutide is slow, Tmax (time to reach maximum concentration) in plasma is 8–12 hours. Cmax (maximum concentration) in plasma after administration of a single dose of 0.6 mg is 9.4 nmol / l. At a dose of 1.8 mg, the average Css (equilibrium concentration) in plasma reaches approximately 34 nmol / l. Exposure of the substance increases in proportion to the dose. The intraindividual coefficient of variation for AUC (the area under the concentration-time curve) after the introduction of liraglutide in a single dose is 11%. Absolute bioavailability is about 55%.

Seeming vd (volume of distribution) of liraglutide in tissues with the subcutaneous route of administration is 11–17 l, the value of the average Vd after intravenous administration - 0.07 l / kg. There is a significant binding of liraglutide to plasma proteins (> 98%).

Liraglutide metabolism occurs like large proteins, without participation of any specific organ as a pathway for excretion. For 24 hours after administration of a single dose, the unchanged substance remains the main component of the plasma. Two metabolites were found in plasma (≤ 9 and ≤ 5% of the total dose).

Unchanged liraglutide after administration of a dose of 3 H-liraglutide in the urine or feces is not defined. By the kidneys or through the intestine only a small part of the substance-related metabolites is excreted (6 and 5%, respectively). After subcutaneous administration of a single dose of liraglutide, the average clearance from the body is approximately 1.2 l / h with elimination T1/2 about 13 hours.

Instructions for use Viktoza: method and dosage

Viktozu must be administered subcutaneously in the stomach, shoulder or thigh 1 time per day, regardless of meals. The place and time of the injection can be changed without dose adjustment, however, it is desirable to administer the drug at about the same time of day, most convenient for the patient.

To improve gastrointestinal tolerance, it is recommended to begin treatment with a daily dose of 0.6 mg. After a minimum of one week, the dose is increased to 1.2 mg. If necessary, in order to achieve the best glycemic control, taking into account the clinical efficacy of Viktoza, an increase in the dose to 1.8 mg is possible at least one week later. The use of higher doses is not recommended.

The drug can be prescribed in addition to the treatment with metformin or combination therapy with metformin in combination with thiazolidinedione. Doses of the latter with no need to adjust.

Victose can be added to existing sulfonylurea therapy or combination therapy with metformin in combination with sulfonylurea derivatives. In this case, to minimize the risk of unwanted hypoglycemia, the dose of sulfonylurea derivatives should be reduced.

Also Victoza can be added to basal insulin, but to reduce the risk of hypoglycemia, it is necessary to reduce the insulin dose.

In case of missing a dose:

  • if no more than 12 hours have passed, you need to enter the missed dose as soon as possible,
  • if more than 12 hours have passed, the next dose must be administered the next day at the scheduled time, i.e. you do not need to compensate for the missed dose with an additional or double dose.

Guidance on the use of the drug

Each pen is designed for individual use.

The drug should be injected with needles up to 8 mm in length and up to 32G in thickness (not included in the kit, therefore, purchased separately). Syringe pens are combined with disposable injection needles NovoTvist and NovoFayn.

Viktoza should not be injected if the solution looks different than a clear, almost colorless or colorless liquid.

You can not enter the drug if it has undergone freezing.

Do not store the syringe pen with a needle attached. After each injection, it must be discarded. This measure helps prevent leakage, contamination and infection of the drug, and also guarantees the accuracy of dosing.

Pharmacological properties:

Pharmacodynamics
Liraglutide has a long 24-hour action and improves glycemic control by reducing fasting blood glucose concentrations and after eating in patients with type 2 diabetes.
Glucose-dependent insulin secretion
With increasing blood glucose concentration, liraglutide increases insulin secretion. When phased glucose is administered, insulin secretion after administration of a single dose of liraglutide in patients with type 2 diabetes increases to a level comparable to that in healthy subjects (Fig. 1).

Pancreatic beta cell function
Liraglutide improved the function of the beta cells of the pancreas, as evidenced by the first and second phases of the insulin response and the maximum secretory activity of the beta cells. Pharmacodynamic studies of patients with type 2 diabetes showed recovery of the first phase of insulin secretion (intravenous insulin), improvement of the second phase of insulin secretion (hyperglycemic clamp) and maximum secretion of insulin (arginine stimulation test).
During the 52-week treatment with Viktoz®, there was an improvement in pancreatic beta-cell function, as evidenced by an estimate of the homeostatic model of pancreatic beta-cell function (HOMA-index) and the ratio of insulin to proinsulin.
Glucagon secretion:
Lyraglutide, by stimulating insulin secretion and suppressing glucagon secretion, reduces the concentration of glucose in the blood. Lyraglutide does not suppress the glucagon response to low glucose concentrations. In addition, a lower endogenous glucose production was observed in the background of liraglutide.
Gastric emptying:
Lyraglutide causes a slight delay in gastric emptying, thus reducing the intensity of postprandial glucose in the blood.
Body weight, body composition and energy consumption:
In subjects with increased body weight, included in long-term clinical trials of liraglutide, the latter caused a significant decrease in body weight. Scanning using computed tomography (CT) and dual-energy X-ray absorptiometry (DEDA) methods showed that the loss of body weight was primarily due to the loss of patients' adipose tissue. These results are explained by the fact that during therapy with liraglutide, patients have decreased hunger and energy consumption.
Electrophysiology of the heart (EFc):
The effect of liraglutide on the repolarization process in the heart was tested in the study of EFS. The use of liraglutide in an equilibrium concentration in a daily dose of up to 1.8 mg does not produce prolongation of EFS.
Clinical efficacy
3992 patients with type 2 diabetes were randomized in 5 double-blind clinical safety and efficacy trials carried out to assess the effect of Victoz ® on glycemic control. Therapy with Viktoz ® caused a clinically and statistically significant improvement in HbA1s, fasting glucose and postprandial glucose compared with placebo.
Glycemic control
The drug Viktoza ® in the form of monotherapy for 52 weeks caused a statistically significant (p ®, while in patients participating in clinical studies of the combined use of the drug Viktoza ®, the average HbA1s decreased by 1.1-2.5%.
During 26-week combination therapy with metformin, sulfonylurea or metformin and thiazolidinedione, Viktoz® caused statistically significant (p® and metformin, the addition of insulin detemir provided greater efficacy compared to therapy with Victoz® and metformin after 26 weeks of treatment (reduction in HbA1c by 0.52%).
It was proved that the effectiveness of the drug Viktoza ® at a dose of 0.6 mg in combination with sulfonylurea or metformin is superior to placebo, but at the same time lower than that of 1.2 mg and 1.8 mg.
The ratio of patients who have achieved a decrease in HbA1s
Against the background of monotherapy with Viktoz ® during the 52-week study, the number of patients who achieved the HbA index1s ® in combination with metformin, sulfonylurea derivatives, or a combination of metformin with thiazolidinedione, the number of patients who have reached HbA1s ≤ 6.5%, statistically significant (p ≤ 0.0001) increased in relation to the number of patients who received therapy alone, without the addition of the preparation Viktoza ®, hypoglycemic drugs.
In groups of patients who did not achieve adequate glycemic control on therapy with Victoza® and Metformin, the percentage of patients who reached the target HbA1s (® managed to achieve HbA1s ® as a monotherapy, and in combination with one or two oral hypoglycemic agents. This decrease was observed during the first two weeks from the start of treatment.
Postprandial glycemia
The use of the drug Viktoza ® for three days of taking standard food helped to reduce the concentration of postprandial glucose by 31-49 mg% (1.68-2.71 mmol / l).
Body mass
52-week monotherapy with Viktoza ® was associated with sustained weight loss.
During the entire period of the clinical study, sustained weight loss was also associated with the use of Viktoza ® in combination with metformin and in combination with a combination of metformin with sulfonylureas or a combination of metformin with thiazolidinedione.
A decrease in body weight in patients receiving Viktoz ® in combination with metformin was also observed after adding insulin detemir.
The greatest weight loss was observed in patients who had an increased body mass index (BMI) at the starting point of the study.
Monotherapy with the drug Viktoz ® for 52 weeks caused a decrease in the average waist volume of 3.0-3.6 cm.
A decrease in body weight was observed in all patients who received treatment with Viktoz®, regardless of whether or not they experienced a side reaction in the form of nausea.
The drug Viktoza ® in combination therapy with metformin reduced the volume of subcutaneous fat by 13-17%.
Non-alcoholic steatohepatosis
Lyraglutide reduces the severity of steatohepatosis in patients with type 2 diabetes.
Blood pressure indicators
Long-term clinical studies have shown that Victoza ® reduces systolic blood pressure by an average of 2.3-6.7 mm Hg. in the first two weeks of treatment. A decrease in systolic blood pressure occurred before the onset of weight loss.
Other clinical data
In a comparative study of the efficacy and safety of the drug Viktoz ® (at doses of 1.2 mg and 1.8 mg) and the dipeptidyl peptidase-4 inhibitor sitagliptin at a dose of 100 mg in patients who did not achieve adequate control on metformin therapy, after 26 weeks of treatment, the best reduction was shown HbA indicator1s with the use of the drug Viktoza ® in both doses compared with sitagliptin (-1.24%, -1.50% compared with -0.90%, p ® compared with sitagliptin (43.7% and 56.0% for compared with 22.0%, p ® was significantly higher compared with patients receiving sitagliptin (-2.9 kg and -3.4 kg, compared with -1.0 kg, p ®, nausea was more frequent. However nausea was transient. The incidence of mild hypoglycemia was slightly different when treated with Victoza ® and sitagliptin (0.178 and 0.161, compared to 0.106 cases / patient per year). Reduction in HbA1s and the advantage of Victoza® compared to sitagliptin was observed after the 26th week of treatment with Victoz® (1.2 mg and 1.8 mg) and was confirmed after the 52nd week of treatment (-1.29% and -1.51% compared to -0.88%, p ®, which led to an additional and statistically significant decrease in the HbA index1s at the 78th week of treatment (0.24% and 0.45%, 95 Cl: from 0.41 to 0.07 and from -0.67 to 0.23).
In a comparative study of the efficacy and safety of the drug Viktoza ® (at a dose of 1.8 mg) and exenatide (at a dose of 10 µg twice a day) in patients who did not achieve adequate control on therapy with metformin and / or sulfonylurea derivatives, after 26 weeks of use Viktoza ® marked a greater decrease in HbA1s compared with exenatide (-1.12% compared with -0.79%, p ® compared with exenatide (54.2% compared with 43.4%, p = 0.0015). Both therapies showed an average loss body weight of approximately 3 kg. The number of patients who reported nausea was lower in the group of patients receiving Viktoza® compared with exenatide. The incidence of mild hypoglycemia was significantly lower in the group of patients receiving Viktoza® compared to exenatide ( 1,932 versus 2,600 cases / patient per year, p = 0.01. After 26 weeks of exenatide use, patients would transferred to Viktoz ®, which resulted in an additional decrease in HbA1s at the 40th week of treatment (-0.32%, p ® for 52 weeks improved insulin sensitivity compared to that of sulfonylurea preparations, which was revealed using the homeostatic HOMA-IR insulin resistance assessment model.

Pharmacokinetics
Absorption
Liraglutide absorption after subcutaneous administration occurs slowly, the time to reach the maximum plasma concentration - 8-12 hours after a dose. Maximum concentration (Cmaxa) Liraglutide in plasma after subcutaneous injection in a single dose of 0.6 mg is 9.4 nmol / L. With the introduction of liraglutide in a dose of 1.8 mg, the average index of its equilibrium concentration in plasma (AUC?/24) reaches approximately 34 nmol / l. The exposure of liraglutid increases in proportion to the dose administered. After the introduction of liraglutide in a single dose, the intrapopulation coefficient of variation of the area under the concentration-time curve AUC is 11%. The absolute bioavailability of liraglutide after subcutaneous administration is approximately 55%.
Distribution
The apparent volume of distribution of liraglutide in the tissues after subcutaneous administration is 11-17 liters. The average volume of distribution of liraglutide after intravenous administration is 0.07 l / kg. Lyraglutide is largely bound to plasma proteins (> 98%).
Metabolism
For 24 hours after the administration of a single dose of a radioactive isotope of 3 H-liraglutide to healthy volunteers, the main component of plasma remained unchanged liraglutide. Two plasma metabolites were detected (≤ 9% and ≤ 5% of the total radioactivity level in the blood plasma). Lyraglutide is metabolized endogenously, like large proteins, without involving any specific organ as a route of excretion.
Removal
After dosing with 3 H-liraglutide, unchanged liraglutide was not detected in urine or feces. Only an insignificant part of the administered radioactivity in the form of metabolites associated with liraglutide (6% and 5%, respectively) was excreted by the kidneys or through the intestines. Radioactive substances are excreted by the kidneys or through the intestines, mainly during the first 6-8 days after the dose, and are three metabolites. The average clearance from the body after subcutaneous administration of liraglutide in a single dose is approximately 1.2 l / h with an elimination half-life of approximately 13 hours.
Special patient groups
Elderly age:
Data from pharmacokinetic studies in the group of healthy volunteers and analysis of the pharmacokinetic data obtained in the patient population (from 18 to 80 years) indicate that age does not have a clinically significant effect on the pharmacokinetic properties of liraglutide.
Floor: Population pharmacokinetic analysis of data obtained in a study of the effect of liraglutide in female and male patients, and data from pharmacokinetic studies in the group of healthy volunteers indicate that sex does not have a clinically significant effect on the pharmacokinetic properties of liraglutide.
Ethnicity: A population-based pharmacokinetic analysis of data obtained in a study of the effect of liraglutide in subjects of the white, black, Asian, and Latin American racial groups suggests that ethnicity does not have a clinically significant effect on the pharmacokinetic properties of liraglutide.
Obesity: Population pharmacokinetic data analysis suggests that body mass index (BMI) does not have a clinically significant effect on the pharmacokinetic properties of liraglutide.
Liver failure:
The pharmacokinetic properties of liraglutide were investigated in a clinical trial of a single dose of the drug in subjects with varying degrees of liver failure. Patients with mild hepatic insufficiency (according to Child Pugh classification, severity of disease 5–6 points) and severe hepatic insufficiency (according to Child Pugh classification, disease severity> 9 points) were included in the study. The exposure of liraglutide in the group of patients with impaired liver function was no higher than that in the group of healthy subjects, which indicates that hepatic insufficiency does not have a clinically significant effect on the pharmacokinetics of liraglutide.
Renal failure:
The pharmacokinetics of liraglutide was studied in patients with varying degrees of renal failure in a single dose study. Subjects with varying degrees of renal failure were included in this study: from light (creatinine clearance score 50-80 ml / min) to severe (creatinine clearance clearance in children was not evaluated.
Preclinical safety data
The results of preclinical toxicological studies with the introduction of repeated doses of the drug, including genotoxicity, showed that the use of liraglutide does not pose a threat to human health.
Tumors of C-cells of the thyroid gland of rats and mice were identified during two-year studies of the carcinogenicity of the drug in rodents and did not lead to a lethal outcome. Non-toxic dose (NOAEL) in rats has not been established. The appearance of such tumors in monkeys treated with liraglutide for 20 months was not observed. The results obtained in rodent studies are related to the fact that rodents are particularly sensitive to the GLP-1 receptor-mediated non-genotoxic specific mechanism. The significance of the data obtained for humans is low, but cannot be completely excluded. The appearance of any other tumors associated with the therapy, was not observed.
In animal studies there was no direct adverse effect of the drug on fertility, but there was a slight increase in the frequency of early fetal death in the treatment with the highest dose of the drug. The administration of Viktoza ® to rats in the middle of the gestation period caused their mother’s weight loss and embryo growth with an effect on the ribs that was not fully studied, and in the group of rabbits - deviations in the skeletal structure. The growth of newborns in the group of rats during treatment with Viktoz® decreased, and this decrease was sustainably maintained after the end of breastfeeding in the group of models receiving high doses of liraglutide. It is not known what caused such a decrease in the growth of newborn rats - a decrease in their consumption of mother's milk due to the direct effect of GLP-1, or insufficient production of breast milk by the mothers of rats due to a decrease in their calorie intake.

Viktoza: how to accept, what to replace, contraindications


Viktoza is a drug for the treatment of type 2 diabetes with the main active ingredient liraglutide. The drug is produced by the company Novo Nordisk, which from the positive side has established itself in the market of pharmacological services.

If a person was prescribed the drug Viktoza for the treatment of diabetes mellitus, then the following information will allow him to get maximum information about contraindications, side effects and dosage of the drug. Victosis is used not only to reduce blood sugar levels, but also to reduce body weight. It is an effective drug that meets all modern safety requirements.

Viktoza: instructions for use

How the drug works

Liraglutide causes the pancreas to produce insulin after each meal. The effect of the substance is also aimed at reduced glycogen production in the liver. This allows you to reduce the level of glucose in the blood, but hypoglycemia does not threaten a person.
The use of the drug makes it possible to reduce appetite, and also slows down the processes of digestion. Displays the drug and the kidneys, and the liver. The withdrawal period is from 6 to 8 days.

When to take it

Victoza is prescribed to patients with type 2 diabetes. This is the only indication that can be found in the official instructions.
However, many people independently inject themselves with a drug, which allows them to struggle with excess weight, as it allows them to control their appetite. In parallel, these people decrease blood sugar levels, if it was elevated (a similar situation is often observed in obesity). If you combine the use of the drug with a low-carb diet, you can achieve good results.

When the drug can not be used

There are certain contraindications to the use of Viktoza:

  • Individual intolerance to the components that make up the drug.
  • Type 1 diabetes.
  • Developing diabetic ketoacidosis and diabetic coma.
  • Renal and hepatic insufficiency of the severe course.
  • Heart failure 3 or 4 functional class.
  • Previously diagnosed medullary thyroid cancer in the family history.
  • Age under 18 years.

What you need to pay special attention

In diabetic neuropathy, the patient may develop gastroparesis, which is characterized by a violation of the transition of food from the stomach to the intestine. With this complication, the use of the drug is prohibited.
During treatment, you should regularly take a blood test for pancreatic amylase. If the indicators deteriorate from time to time, then you need to abandon the use of Viktozy. Otherwise, the patient may develop pancreatitis.
Without the appointment of a doctor, it is impossible to replace Victoza with insulin injections.

Injection put 1 time per day. It is best to do this at the same time.
Practitioners recommend putting injections 1-3 hours before the upcoming hearty meal.
The starting dose is 0.6 mg per day. If the patient feels satisfactory, then it is increased and after 7 days it should be 1.2 mg. In the future, it can be increased to 1.8 mg.
If a person's sugar level is normal, and he uses Viktoza for weight loss, then 3 mg of the drug can be administered per day. However, you should also start with small doses. This will allow the body to adapt to therapy.

As an adverse event, patients often complain of diarrhea and constipation, nausea and vomiting, and pruritus. As a rule, they develop in the early stages of treatment, and after a few weeks or days pass by themselves.
Headaches and chest pains are also possible. At the same time, the appetite is getting worse, but it does not disappear completely.
The most formidable side effect is acute pancreatitis.

Period of childbearing and breastfeeding

Pregnant and lactating women do not prescribe the drug.

Interaction with other drugs

Since liraglutide affects the absorption processes in the stomach and intestines, its use may adversely affect other treatments. It is known that Victoza can be used in a complex treatment regimen with insulin injections Levemir. However, before starting therapy, you need to get medical advice.

Overdose is indicated by nausea and vomiting, as well as severe diarrhea. With timely treatment for medical care, it is possible to completely arrest the symptoms of overdose. The use of high doses of Viktoza does not lead to hypoglycemia. Treatment depends on the symptoms that occur in the patient.

The drug is released in the form of a solution for subcutaneous administration at a dosage of 6 mg / ml. The solution has almost no color. You can also find the drug in 3 ml cartridges made of glass. They are sealed with a rubber or polyisoprene disc, and on the other side of the cartridge is a piston. The cartridge is sealed in a syringe pen. In the carton can be from 1 to 3 syringe pens.

How to store, shelf life

Observe storage conditions strictly. All of them are indicated in the instructions for use.If the cartridge began to be used, then its shelf life is limited to a month.

The basis of the drug - liraglutid. The excipients are sodium hydrophosphate dihydrate, propylene glycol, hydrochloric acid, sodium hydroxide, water for injection.

Analogues of the drug Viktoza, characterized by low cost, no. By drugs that have a similar effect include Byetta (exenatide), Liksumiya (lixisinatide) and Trulicity (dulaglutid). However, these tools are expensive.

Liraglutide, as a hypoglycemic substance, has virtually no effect on blood glucose levels. However, it weakens the appetite, promotes rapid saturation and prevents overeating.

The cons of Victoza include:

The high cost of the drug.

The presence of side effects.

The need for injection.

For some patients, the fact that they will have to give themselves self-shots is decisive for refusing treatment. Though the syringe pen allows to put injections practically without causing pain.

How to enter the drug?

The drug can be administered in the thigh and shoulder, and in the stomach. It is best to put injections 2 or 3 hours before the next meal (when a person plans to use its maximum volumes), for example, before lunch. Although many people transmit it in the evening. Viktoza will reduce appetite, which increases closer to the night.

How much injection is the pen?

The higher the dosage of the drug, which introduces a man, the faster he will run out of a syringe pen. One such device contains 18 mg of liraglutide.

A pen may be enough for the following number of doses:

If a person injects 0.6 mg of the drug per day, then one pen will be enough for him for 20 injections.

When the daily dose is 1.2 mg, the pen is enough for 15 doses.

If a person uses 1.8 mg of the drug per day, the number of doses will be 10.

When the daily dose is 3.0 mg, the pen is enough for 6 doses.

For severe obesity, it is recommended to inject 3.0 mg of the drug per day, even if the human blood sugar level is within the normal range.

Patients with diabetes are shown to use up to 1.8 mg of the drug per day. However, therapy should begin with 0.6 mg Viktozy. The first time to increase the dosage should be no earlier than 7 days.

Sometimes, in order to save some patients, they inject themselves with one injection of Viktoz, and then take a break for several days. It is not known what can threaten such experiments. With the help of the drug, you can develop the habit of consuming food in small portions and eating properly. When this happens, you can refuse to receive it.

During the course of therapy, it is imperative to monitor the state of the pancreas, donating blood for amylase. If any deviations are observed, then it is necessary to refuse reception of Viktozy.

What needles are suitable for the syringe pens? Where do they sell?

The pen can be used with NovoFine and NovoTvist needles manufactured by Novo Nordisk. The same company is engaged in the release of the drug Viktoza. They can be purchased at the pharmacy and ordered online. The price of the needles is not high. You can also check with the seller about the possibility of using needles from other manufacturers.

It is recommended to use one needle for one injection. After it is used, it should be discarded. Do not leave the needle in the pen, as this can cause a leakage of the drug, and also carries the risk of contamination of the needle and further infection of soft tissues.

Byetta or Viktoza - what to choose?

Exenatide byte is a drug that has a similar effect as Victoza. You need to enter it 2 times a day: in the morning and evening hours. Of course, this creates certain inconveniences. Viktoza is more expensive than Baeta, but it is also more comfortable to use the drug.

Abroad in the sale can be found a drug called Bydueron. The injection should be placed only once every seven days. However, drug reviews vary. There is evidence that its use may trigger the development of thyroid cancer. If this information is confirmed, it will be removed from sale. In Russia, this drug is produced under the name Byeta Long, but it is problematic to buy it.

A similar effect with the drug Byetta has the drug Trulicity with the main active ingredient dulaglutid. It is enough to enter it once a week to achieve a therapeutic effect. It is sold not only in European countries, but also in Russia. Feedback in a foreign language about this drug is more positive. It lowers blood sugar and suppresses appetite. In this case, the injection will need to be done only 1 time in 7 days, which is very convenient.

Drug administration causes nausea and diarrhea. To eat with such side effects just do not want. It should be noted that official medicine does not recognize the drug Trulysity as a means to combat obesity. Also, after setting the first injection, you need to be ready to call an ambulance. It can not be excluded that the drug provokes an attack of acute pancreatitis or a serious allergic reaction.

Viktoza for weight loss

People use the drug Viktoza for weight loss. It is not aimed at burning kilocalories, but suppresses appetite, which allows you to eat less and lose weight faster. Sometimes you can find reviews that Viktoza provokes disgust for food, but does not force a person to completely refuse it.

Course taking the drug Viktoza designed to teach a person to eat properly, to break the habit of overeating. After giving up on injections, useful skills should be maintained. It is not recommended to use Viktoz injections for a long time to lose weight.

Viktoza or Saksenda - what to choose?

Liraglutide was originally created as a substance for the treatment of diabetes. In the future, manufacturers realized that it can be used as a drug for weight loss. After all, there are a lot of people suffering from obesity, much more than diabetics. Therefore, the US Department of Health (FDA) conducted a series of studies on this subject and allowed the use of liraglutide as a drug for weight loss. At the same time it is produced under the brand name of Saxend.

Therefore, Viktoza and Saksenda are a drug with the same active ingredient, but they have different names. Liraglutide can be used for people with a BMI of 30 kg / m2 and more than 27-30 kg / m2 if they have impaired metabolic processes, hypertension, impaired glucose tolerance, or prediabetes. Such people are recommended to administer 0.6 mg of the drug per day during the first week. Then every 7 days the dose is increased by 0.6 mg. It is necessary to bring it up to 3.0 mg per day. While patients with diabetes mellitus shown no more than 1.8 mg liraglutide per day.

The side effects of drugs Saxenda and Victoza are similar. However, in people who use the drug for weight loss, they can appear much more intense, since the daily dose of the drug is higher. They need to be attentive to their health, as there is a risk of developing pancreatitis. To get the drug Saxenda harder than the drug Viktoza.

Is it possible to combine treatment with alcohol?

If you refer to the official instructions, then it does not contain any information about the use of alcohol during treatment with the drug Viktoza. Therefore, a person may, at its discretion, consume alcoholic beverages. However, in order not to provoke the development of serious side effects, you need to refuse to take large doses of alcohol. After all, all liquids containing alcohol, by themselves, increase the risk of developing pancreatitis, and taking this drug Viktoza doubles these risks.

About the doctor: From 2010 to 2016 practicing physician of the therapeutic hospital of the central medical and sanitary unit No. 21, the city of Elektrostal. Since 2016 he has been working in the diagnostic center №3.

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Composition and release form

They warn that not everyone can use the medicine "Viktoza", reviews. Weight loss is indicated here only to persons with diabetes grade II, all other people should use it with extreme caution, since a strong decrease in blood sugar can cause hypoglycemia.

The drug is produced in Denmark by Novo Nordisk A / S in the form of a solution. 1 ml contains about 6 ml of liraglutide. Substance is colorless and odorless. Auxiliary components of the drug are sodium hydroxide, propylene glycol, sodium hydrogen phosphate dihydrate, phenol, distilled water.

The solution "Viktoza" is placed in a glass cartridge, which, in turn, is sealed in a syringe pen for repeated injections. Packed in a cardboard box, where in addition to the instructions can be from 1 to 3 syringes-pens. Each such syringe is designed for thirty doses of 0.6 mg, fifteen injections of 1.2 mg and ten subcutaneous injections of 1.8 mg.

The shelf life of a sealed product is 30 months. Do not use the drug after the date indicated on the package. The solution should be stored in a refrigerator at a temperature of 2-8 ° C. It can not be frozen. The shelf life of the pen used is one month.

Is the drug effective for weight loss?

They say that the use of the drug "Viktoza" contributes to the discharge of extra kilograms, reviews. Weight loss here is due to the normalization of blood sugar levels and decreased appetite.

The effect of the drug was investigated by European scientists in overweight people. The experiment involved 564 people. The subjects were divided into three groups, and all of them were under the control of specialists. Patients had to adhere to proper nutrition, reduce the caloric content of their diet and devote time to physical activity. In this case, the first group of opponents took a placebo, the second - "Xenical", and people from the third category - "Viktosu."

The experimental results showed that of those taking a placebo, only 30% were able to reduce their weight. In the group that consumed "Xenical", about 44% of the thinner patients were observed. The effectiveness of the participants in the third group was 75%.

This indicator characterizes a good result of weight loss in people who used the drug "Viktoza". Instructions for use (reviews of some patients note headaches and nausea during the periods of treatment with this tool) recommends it to patients with diabetes mellitus grade II. The drug reduces appetite, improves the general well-being of such patients, stabilizes sugar levels. Lost as a result of the use of this tool, the patients managed to maintain a sufficiently long period even after the withdrawal of Victoza.

The people who used this remedy noted a decrease in weight from 7 to 10 kg in one month. But despite this, "Viktoza" is a very serious drug that can cause the most unexpected consequences, therefore, before using it, you must consult a specialist and a full examination of the body.

If the idea to lose weight with "Viktoza" does not give rest, then in addition to the solution, an additional set of measures should be applied for successful weight loss.

Additional measures to help lose weight with "Viktoza"

It should be borne in mind that when using the “Viktoza” product (reviews of some women note a stable weight loss of up to 5 kg per month, but they did not always feel good), additional measures should be taken to increase the weight loss.

First of all, you should follow the drinking regime and drink at least 1.5 liters of pure non-carbonated water daily. Drinks include unsweetened green tea, chicory, mineral water and ginger tea.

During the use of the drug should not forget about physical activity, which must be devoted daily from 30 minutes to an hour. This may be exercise, exercise at the gym, hoop, jump rope, cycling and skiing, swimming, fitness. Even the most ordinary walking will speed up the process of losing weight.

When losing weight with "Viktoza" should adhere to proper nutrition. The menu should be balanced and low-calorie. High-fat foods should be excluded, as well as salted, smoked and fried foods. It is necessary to abandon the sweet, flour and spicy. Such a diet allows you to gradually lose weight and prevent the appearance of extra pounds in the future.

All of the above activities most beneficial effect on health, improve health and accelerate the process of losing weight.

Pharmachologic effect

Possesses the drug "Viktoza" hypoglycemic properties. Reviews (weight loss in diabetics when using this tool occurs gradually, without jumps) note tangible results in reducing weight (up to 15 kg per month) and improving overall well-being.

The active ingredient of the drug is 97% similar to the human glucagon-like peptide - GLP-1. It is obtained by biotechnological method. This component binds to the GLP-1 receptors, which represent the target for incretin produced in the human body.

It is incretin that increases insulin production in response to an increase in blood glucose. Also, the action of liraglutide in the composition of the drug inhibits the production of glucagon. Despite this, in the presence of hypoglycemia, the active substance lowers insulin production and does not affect the production of glucagon.

They note the effective effect on patients with diabetes mellitus type II drug "Viktoza" reviews of doctors. Weight loss occurs due to the normalization of the functions of the pancreas, lowering blood sugar levels and reducing appetite. The drug increases the production of beta cells. Another impact of this tool slows the development of diabetes. The effect after the introduction of the drug into the body is observed throughout the day.

Absorption of the drug occurs in slow motion, only after 8-12 hours the maximum concentration of the active substance in the blood is observed.

The bioavailability of the drug is 55%. 98% of it is bound to blood proteins. During the day, liraglutide remains in the body unchanged. The half-life of the drug is 13 hours.

Indications and Contraindications

The drug "Viktoza" (instructions and reviews draw attention to the need to consult a doctor before using this drug) is prescribed for type II diabetes. In this case, the solution can be used both in monotherapy and in complex treatment with hypoglycemic oral agents, such as Dibetolong, Glibenclamide and Metformin. More "Viktoza" can be used in complex treatment with insulin, if the use of previous combinations of medicines has failed.

In all of the above cases, therapy must be accompanied by a therapeutic diet and exercise.

The drug is prohibited to use in diabetes mellitus type I, as well as if there is hypersensitivity to the constituent components of the drug. You can not use the drug during pregnancy and while breastfeeding. Contraindications to the use of ketoacidosis, colitis, heart failure and paresis of the gastric organ. It is not recommended to appoint Vicosa for persons under the age of 18 years.

Drug "Viktoza": instructions for use

The drug is administered once a day, subcutaneously, in the abdomen, shoulder or thigh area, regardless of the meal.It is recommended to inject the drug "Viktoza" (instructions for use describes in detail how to use this medication) at the same time. The drug can not be used for intramuscular and especially for intravenous administration.

The initial daily dosage of this agent should not exceed 0.6 mg. Gradually, during the week, it is increased to 1.2 mg. If necessary, over the next seven days, gradually increase the dose to 1.8 mg. A daily dose of 1.8 mg is the maximum allowable.

Doctors advise solution "Victoza" supplement treatment with metformin. It is recommended to use it in conjunction with metformin and thiazolidinedione. The dose of the latest drugs can not be changed.

The drug is used in the treatment of sulfonylureas and in the complex therapy of metformin with sulfonylurea. In the latter case, the content of sulfonylureas is reduced to prevent the occurrence of unwanted hypoglycemia.

It does not require the selection of the dose depending on the age of the patient. With caution "Viktosu" should apply to persons of the age group of 75 years.

The use of the drug without dose adjustment in patients with mild to moderate renal insufficiency is acceptable. In severe pathologies of renal function, this remedy is contraindicated. Also, you can not enter the drug for people with kidney disease of varying severity.

Side effects

The drug "Viktoza" (reviews indicate that the tool is quite expensive, but it works effectively and the result is worth the money) when used can provoke nausea, gag reflex, diarrhea and pain in the intestinal area. Loss of appetite and anorexia are occasionally observed during drug administration. Improper use of the drug can cause a hypoglycemic condition, headache.

There is a possibility of a certain discomfort at the injection site. In some cases, the drug provokes infectious diseases of the upper respiratory tract.

Caution should be taken when pancreatitis medication, as it may be exacerbated. In some cases, there are failures in the thyroid gland. The tool can cause the occurrence of goiter and other neoplasms.

If the above symptoms occur, the use of "Viktozy" should be discontinued.

Medicine "Viktoza": reviews of patients and doctors

All doctors, without exception, consider this drug serious and recommend using it strictly according to indications, that is, in the presence of type II diabetes. Only in this case, the treatment with this tool will give a good result, because here overweight plays a crucial role.

Used for the purpose means prevents the development of diabetes and its complications. Effectively lowers glucose and restores natural insulin production. "Viktoza" suppresses appetite and dulls the feeling of hunger. Some patients managed to lose up to 8 kg per month. Doctors warn that the drug should not be prescribed for yourself and lose weight spontaneously with it. It can cause thyroid cancer and provoke the appearance of acute pancreatitis uncontrolled use of the drug "Viktoza".

Reviews have grown thin there are very different. Negatives show a slight weight loss, 1-3 kg per month. They note deterioration in health, metabolic disorders, headaches and indigestion. They do not see the need to acquire it anymore, because you still need to follow a diet and pay attention to fitness. As a rule, these persons used the drug without a doctor's prescription and not having direct indications.

Positively note the effect of the drug "Victoza" reviews of patients with type II diabetes. These people point to a large weight loss, 8-15 kg per month. Such results were achieved not only by the effect of the drug on the body, but also by proper nutrition and exercise. Patients point to lightness throughout the body, improved cardiovascular function, decreased appetite and loss of unwanted pounds. These people were satisfied with the effectiveness of the solution "Viktoza."

Recommends to apply the preparation "Viktoza" strictly according to the doctor's prescription. Both analogues and this medicine cannot be prescribed for oneself, without examination, since the consequences can be very sad. If the drug "Viktoza" did not fit and caused side effects, then it can be replaced with similar drugs, such as "Saxenda" and "Byetta". The first is similar to "Viktoza" on the active substance and properties. It costs about 27 000 rubles. The second has another active ingredient, but is similar in its effects on the body and indications. Its price is around 4,500 rubles.

Cost of medication

The drug "Viktoza" refers to expensive medicines (reviews of doctors note the need for a complete examination of the body before using this drug). Its cost in a syringe pen 3 ml number 2 varies in the region of 7-10 thousand rubles. The drug is sold in conventional pharmacies and is available only on prescription.

“Viktoza” solution is indispensable for people with type II diabetes, but all other people should use it strictly as prescribed.

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