Identification

Name
Liraglutide
Accession Number
DB06655
Description

Victoza contains liraglutide, a synthetic analog of human glucagon-like peptide-1(GLP-1) and acts as a GLP-1 receptor agonistLabel,1. Liraglutide is 97% homologous to native human GLP-1 by substituting arginine for lysine at position 341. Liraglutide is made by attaching a C-16 fatty acid (palmitic acid) with a glutamic acid spacer on the remaining lysine residue at position 26 of the peptide precursor1. Liraglutide was granted FDA approval on Januray 25, 20104.

Type
Biotech
Groups
Approved
Biologic Classification
Protein Based Therapies
Hormones
Protein Chemical Formula
C172H265N43O51
Protein Average Weight
3751.2 Da
Sequences
>Liraglutide Sequence (gamma-E-palmitoyl at E21)
HAEGTFTSDVSSYLEGQAAKEEFIAWLVRGRG
Download FASTA Format
Synonyms
  • Arg34Lys26-(N-ε-(γ-Glu(N-α-hexadecanoyl)))-GLP-1[7-37]
  • Liraglutida
  • Liraglutide
  • Liraglutide (genetical recombination)
  • Liraglutide (rDNA origin)
  • Liraglutide recombinant
  • Liraglutidum
  • N²⁶-(hexadecanoyl-gamma-glutamyle)-[34-arginine]GLP-1-(7-37)-peptide
  • N²⁶-(N-Hexadecanoyl-L-gamma-glutamyl)-[34-L-arginine]glucagon-like peptide 1-(7-37)-peptide
External IDs
  • NN 2211
  • NN-2211
  • NN-9924
  • NN2211
  • NN9924
  • NNC 90-1170
  • NNC-90-1170

Pharmacology

Pharmacology
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Indication

Liraglutide is indicated in combination with diet and exercise to improve glycemic control in patients 10 years and older with type 2 diabetes mellitusLabel,5. It is also indicated to reduce the risk of major adverse cardiovascular events in patients with type 2 diabetes mellitus as well as cardiovascular diseaseLabel.

Associated Conditions
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

Liraglutide is a once-daily GLP-1 derivative for the treatment of type 2 diabetesLabel,2. The prolonged action of liraglutide is achieved by attaching a fatty acid molecule at position 26 of the GLP-1 molecule, enabling it to bind reversibly to albumin within the subcutaneous tissue and bloodstream and be released slowly over timeLabel,2,3. Binding with albumin results in slower degradation and reduced elimination of liraglutide from the circulation by the kidneys compared to GLP-12,3. The effect of liraglutide is the increased secretion of insulin and decreased secretion of glucagon in response to glucose as well as slower gastric emptyingLabel. Liraglutide also does not adversely affect glucagon secretion in response to low blood sugarLabel,2.

Mechanism of action

Liraglutide is an acylated synthetic glucagon-like peptide-1 analogLabel,1,2. Liraglutide is an agonist of the glucagon-like peptide-1 receptor which is coupled to adenylate cyclaseLabel. The increase in cyclic AMP stimulates the glucose dependant release of insulin, inhibits the glucose dependant release of glucagon, and slows gastric emptying to increase control of blood sugarLabel,3.

TargetActionsOrganism
AGlucagon-like peptide 1 receptor
agonist
Humans
Absorption

Bioavailability of liraglutide after subcutaneous injection is approximately 55%Label and maximum concentrations are reached after 11.7 hours1.

Volume of distribution

13LLabel.

Protein binding

>98%Label.

Metabolism

Liraglutide is less sensitive to metabolism than the endogenous GLP-1 and so is more slowly metabolized by dipeptidyl peptidase-4 and neutral endopeptidase to various smaller polypeptides which have not all been structurally determined1. A portion of Liraglutide may be completely metabolized to carbon dioxide and water1.

Route of elimination

6% excreted in urine and 5% excreted in feces1.

Half-life

Terminal half life of 13 hours1.

Clearance

1.2L/hLabel.

Adverse Effects
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Toxicity

There is no clinical significance of race or ethnicity on the safety or efficacy of liraglutideLabel. Geriatric patients do not experience clinically significant differences in pharmacokinetics though patients at an especially advanced age may be more susceptible to adverse effectsLabel. Female patients have reduced clearance of liraglutide but no dose adjustment is necessaryLabel. The risk and benefit of liraglutide in pregnancy must be weighed before prescribingLabel. In animal studies, liraglutide is associated with an increased risk of embryonic death and fetal abnormalities though an HbA1c > 7 is also associated with a 20-25% risk of birth defectsLabel. In animal studies, liraglutide is present in the milk of lactating rats at half the plasma concentration of the mother but these results may not translate to humansLabel. Because it is not known if liraglutide is present in breast milk and the effects on infants are also unknown, the risk and benefit of liraglutide in breastfeeding must be considered before prescribingLabel. Liraglutide was shown to be safe and effective in patients up to 160kg in weight but has not been studied in patients at a higher weightLabel. A patient's weight significantly affects the pharmacokinetics of liraglutideLabel. Liraglutide has not been investigated for use in pediatric patientsLabel. No dosage adjustments are necessary in patients with renal impairment but studies have not been performed in patients with end stage renal diseaseLabel. There are no recommendations on dosage adjustment in patients with hepatic impairment, though caution should still be exercised when prescribing to this populationLabel.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AcarboseThe risk or severity of hypoglycemia can be increased when Acarbose is combined with Liraglutide.
AcebutololThe therapeutic efficacy of Liraglutide can be increased when used in combination with Acebutolol.
AcetazolamideThe therapeutic efficacy of Liraglutide can be increased when used in combination with Acetazolamide.
AcetohexamideLiraglutide may increase the hypoglycemic activities of Acetohexamide.
Acetyl sulfisoxazoleThe therapeutic efficacy of Liraglutide can be increased when used in combination with Acetyl sulfisoxazole.
Acetylsalicylic acidThe risk or severity of hypoglycemia can be increased when Acetylsalicylic acid is combined with Liraglutide.
AlbiglutideThe risk or severity of hypoglycemia can be increased when Liraglutide is combined with Albiglutide.
AlclometasoneThe risk or severity of hyperglycemia can be increased when Alclometasone is combined with Liraglutide.
AlogliptinThe risk or severity of hypoglycemia can be increased when Alogliptin is combined with Liraglutide.
AmcinonideThe risk or severity of hyperglycemia can be increased when Amcinonide is combined with Liraglutide.
Interactions
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Food Interactions
  • Take with or without food.

Products

Products
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
SaxendaInjection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag
SaxendaInjection, solution6 mg/1mLSubcutaneousNovo Nordisk2014-12-31Not applicableUS flag
SaxendaSolution6 mgSubcutaneousNovo Nordisk2015-05-27Not applicableCanada flag
SaxendaInjection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag
SaxendaInjection, solution6 mg/1mLSubcutaneousA-S Medication Solutions2014-12-31Not applicableUS flag
SaxendaInjection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag
VictozaInjection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag
VictozaInjection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag
VictozaInjection6 mg/1mLSubcutaneousA-S Medication Solutions2010-01-25Not applicableUS flag
VictozaSolution6 mgSubcutaneousNovo Nordisk2010-05-27Not applicableCanada flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
XultophyLiraglutide (3.6 mg/ml) + Insulin degludec (100 U/ml)Injection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag
XultophyLiraglutide (3.6 mg/ml) + Insulin degludec (100 U/ml)Injection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag
XultophyLiraglutide (3.6 mg) + Insulin degludec (100 unit)SolutionSubcutaneousNovo Nordisk2018-06-06Not applicableCanada flag
XultophyLiraglutide (3.6 mg/ml) + Insulin degludec (100 U/ml)Injection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag
Xultophy 100/3.6Liraglutide (3.6 mg/1mL) + Insulin degludec (100 [iU]/1mL)Injection, solutionSubcutaneousNovo Nordisk2016-11-21Not applicableUS flag
XULTOPHY 100U/ML+3.6MG/ML ENJEKSİYONLUK ÇÖZELTİ İÇEREN KULLANIMA HAZIR KALEM, 1 ADETLiraglutide (3.6 mg/mL) + Insulin degludec (100 U/mL)InjectionSubcutaneousNOVO NORDİSK SAĞLIK ÜRÜNLERİ TİC. LTD. ŞTİ.2020-08-14Not applicableTurkey flag
XULTOPHY 100U/ML+3.6MG/ML ENJEKSİYONLUK ÇÖZELTİ İÇEREN KULLANIMA HAZIR KALEM, 10 ADETLiraglutide (3.6 mg/mL) + Insulin degludec (100 U/mL)InjectionSubcutaneousNOVO NORDİSK SAĞLIK ÜRÜNLERİ TİC. LTD. ŞTİ.2020-08-14Not applicableTurkey flag
XULTOPHY 100U/ML+3.6MG/ML ENJEKSİYONLUK ÇÖZELTİ İÇEREN KULLANIMA HAZIR KALEM, 3 ADETLiraglutide (3.6 mg/mL) + Insulin degludec (100 U/mL)InjectionSubcutaneousNOVO NORDİSK SAĞLIK ÜRÜNLERİ TİC. LTD. ŞTİ.2020-08-14Not applicableTurkey flag
XULTOPHY 100U/ML+3.6MG/ML ENJEKSİYONLUK ÇÖZELTİ İÇEREN KULLANIMA HAZIR KALEM, 5 ADETLiraglutide (3.6 mg/mL) + Insulin degludec (100 U/mL)InjectionSubcutaneousNOVO NORDİSK SAĞLIK ÜRÜNLERİ TİC. LTD. ŞTİ.2020-08-14Not applicableTurkey flag
Xultophy Pre-filled PenLiraglutide (3.6 mg/ml) + Insulin degludec (100 U/ml)Injection, solutionSubcutaneousNovo Nordisk2016-09-08Not applicableEU flag

Categories

ATC Codes
A10AE56 — Insulin degludec and liraglutideA10BJ02 — Liraglutide
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
Not Available
Kingdom
Organic Compounds
Super Class
Organic Acids
Class
Carboxylic Acids and Derivatives
Sub Class
Amino Acids, Peptides, and Analogues
Direct Parent
Peptides
Alternative Parents
Not Available
Substituents
Not Available
Molecular Framework
Not Available
External Descriptors
Not Available

Chemical Identifiers

UNII
839I73S42A
CAS number
204656-20-2

References

General References
  1. Malm-Erjefalt M, Bjornsdottir I, Vanggaard J, Helleberg H, Larsen U, Oosterhuis B, van Lier JJ, Zdravkovic M, Olsen AK: Metabolism and excretion of the once-daily human glucagon-like peptide-1 analog liraglutide in healthy male subjects and its in vitro degradation by dipeptidyl peptidase IV and neutral endopeptidase. Drug Metab Dispos. 2010 Nov;38(11):1944-53. doi: 10.1124/dmd.110.034066. Epub 2010 Aug 13. [PubMed:20709939]
  2. Knudsen B, Jesper Lau: The Discovery and Development of Liraglutide and Semaglutide Frontiers in Endocrinology.
  3. Russell-Jones D: Molecular, pharmacological and clinical aspects of liraglutide, a once-daily human GLP-1 analogue. Mol Cell Endocrinol. 2009 Jan 15;297(1-2):137-40. doi: 10.1016/j.mce.2008.11.018. Epub 2008 Nov 25. [PubMed:19041364]
  4. FDA Drug Approval Package: Liraglutide [Link]
  5. FDA News Release: Liraglutide Indication [Link]
UniProt
P01275
KEGG Drug
D06404
PubChem Substance
347910356
RxNav
475968
ChEBI
71193
ChEMBL
CHEMBL1201866
PharmGKB
PA165958364
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Liraglutide
AHFS Codes
  • 68:20.06 — Incretin Mimetics
FDA label
Download (1.32 MB)
MSDS
Download (569 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4Active Not RecruitingBasic ScienceInsulin Resistance1
4Active Not RecruitingOtherBMI >30 kg/m21
4Active Not RecruitingOtherType 2 Diabetes Mellitus1
4Active Not RecruitingTreatmentBMI >30 kg/m22
4Active Not RecruitingTreatmentBMI >30 kg/m2 / Diabetes Mellitus / Weight Loss1
4Active Not RecruitingTreatmentType 2 Diabetes Mellitus1
4Active Not RecruitingTreatmentType II Diabetes in Subjects BMI 27 to 321
4CompletedBasic ScienceDiabetes / Effects of Liraglutide Administration on Brain Activity / Hunger / Weight Loss1
4CompletedBasic ScienceHealthy Human Male Subjects1
4CompletedBasic ScienceSystolic Hypertension / Type 2 Diabetes Mellitus1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Injection, solutionSubcutaneous
Injection, solutionSubcutaneous6 mg/1mL
SolutionSubcutaneous
InjectionSubcutaneous
InjectionSubcutaneous6 mg/1mL
Injection, solutionParenteral; Subcutaneous
SolutionSubcutaneous6 mg
InjectionSubcutaneous100 IU/ml
Injection, solutionParenteral; Subcutaneous
Injection, solutionSubcutaneous
InjectionSubcutaneous
SolutionSubcutaneous
SolutionSubcutaneous6 mg/1ml
Injection, solution
Injection, solution
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
CA2264243No2004-10-052017-08-22Canada flag
US8672898Yes2014-03-182022-07-02US flag
US8684969Yes2014-04-012026-04-20US flag
US9132239Yes2015-09-152032-08-01US flag
US8920383Yes2014-12-302027-01-17US flag
US7686786No2010-03-302026-08-03US flag
US6899699Yes2005-05-312022-07-01US flag
US9108002Yes2015-08-182026-07-26US flag
USRE41956Yes2010-11-232021-07-21US flag
US9265893Yes2016-02-232033-03-23US flag
US6004297Yes1999-12-212019-07-28US flag
USRE43834No2012-11-272019-01-28US flag
US6458924No2002-10-012017-08-22US flag
US6268343Yes2001-07-312023-02-22US flag
US8846618Yes2014-09-302022-12-27US flag
US8114833Yes2012-02-142026-02-13US flag
US7235627No2007-06-262017-08-22US flag
US7615532Yes2009-11-102029-12-28US flag
US9486588Yes2016-11-082022-07-02US flag
US9457154Yes2016-10-042028-03-27US flag
USRE46363Yes2017-04-112027-02-03US flag
US8937042Yes2015-01-202029-11-05US flag
US9687611Yes2017-06-272027-08-27US flag
US9775953Yes2017-10-032027-01-17US flag
US8579869Yes2013-11-122023-12-30US flag
US7762994Yes2010-07-272024-11-23US flag
US9968659Yes2018-05-152037-07-09US flag
US9861757Yes2018-01-092026-07-20US flag
US9616180Yes2017-04-112026-07-20US flag
US10220155Yes2019-03-052027-01-17US flag
US10357616No2019-07-232026-01-20US flag
US10376652No2019-08-132026-01-20US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
isoelectric point4.9https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/206321Orig1s000ChemR.pdf

Targets

Drugtargets
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Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Agonist
General Function
Transmembrane signaling receptor activity
Specific Function
This is a receptor for glucagon-like peptide 1. The activity of this receptor is mediated by G proteins which activate adenylyl cyclase.
Gene Name
GLP1R
Uniprot ID
P43220
Uniprot Name
Glucagon-like peptide 1 receptor
Molecular Weight
53025.22 Da
References
  1. Bock T, Pakkenberg B, Buschard K: The endocrine pancreas in non-diabetic rats after short-term and long-term treatment with the long-acting GLP-1 derivative NN2211. APMIS. 2003 Dec;111(12):1117-24. [PubMed:14678021]
  2. Larsen PJ, Wulff EM, Gotfredsen CF, Brand CL, Sturis J, Vrang N, Knudsen LB, Lykkegaard K: Combination of the insulin sensitizer, pioglitazone, and the long-acting GLP-1 human analog, liraglutide, exerts potent synergistic glucose-lowering efficacy in severely diabetic ZDF rats. Diabetes Obes Metab. 2008 Apr;10(4):301-11. doi: 10.1111/j.1463-1326.2008.00865.x. [PubMed:18333889]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Virus receptor activity
Specific Function
Cell surface glycoprotein receptor involved in the costimulatory signal essential for T-cell receptor (TCR)-mediated T-cell activation. Acts as a positive regulator of T-cell coactivation, by bindi...
Gene Name
DPP4
Uniprot ID
P27487
Uniprot Name
Dipeptidyl peptidase 4
Molecular Weight
88277.935 Da
References
  1. Malm-Erjefalt M, Bjornsdottir I, Vanggaard J, Helleberg H, Larsen U, Oosterhuis B, van Lier JJ, Zdravkovic M, Olsen AK: Metabolism and excretion of the once-daily human glucagon-like peptide-1 analog liraglutide in healthy male subjects and its in vitro degradation by dipeptidyl peptidase IV and neutral endopeptidase. Drug Metab Dispos. 2010 Nov;38(11):1944-53. doi: 10.1124/dmd.110.034066. Epub 2010 Aug 13. [PubMed:20709939]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Zinc ion binding
Specific Function
Thermolysin-like specificity, but is almost confined on acting on polypeptides of up to 30 amino acids (PubMed:15283675, PubMed:8168535). Biologically important in the destruction of opioid peptide...
Gene Name
MME
Uniprot ID
P08473
Uniprot Name
Neprilysin
Molecular Weight
85513.225 Da
References
  1. Malm-Erjefalt M, Bjornsdottir I, Vanggaard J, Helleberg H, Larsen U, Oosterhuis B, van Lier JJ, Zdravkovic M, Olsen AK: Metabolism and excretion of the once-daily human glucagon-like peptide-1 analog liraglutide in healthy male subjects and its in vitro degradation by dipeptidyl peptidase IV and neutral endopeptidase. Drug Metab Dispos. 2010 Nov;38(11):1944-53. doi: 10.1124/dmd.110.034066. Epub 2010 Aug 13. [PubMed:20709939]

Carriers

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Binder
General Function
Toxic substance binding
Specific Function
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloid...
Gene Name
ALB
Uniprot ID
P02768
Uniprot Name
Serum albumin
Molecular Weight
69365.94 Da
References
  1. Knudsen B, Jesper Lau: The Discovery and Development of Liraglutide and Semaglutide Frontiers in Endocrinology.

Drug created on March 19, 2008 16:45 / Updated on April 21, 2021 00:36