About This Calculator

This Victoza (liraglutide) Dose Calculator is designed for healthcare professionals to quickly determine standard dosing schedules and estimate pen supply duration. It simplifies treatment planning by outlining the recommended titration pathway for new patients or those escalating their current dose, ensuring adherence to prescribing guidelines for glycemic control.

Outputs Explained

The tool provides two key outputs based on your selections:

• Recommended Titration Schedule: This section details the step-by-step weekly dosing adjustments. It outlines the induction phase, starting with the initial 0.6 mg dose, and the subsequent increases to 1.2 mg and the maximum 1.8 mg dose, where clinically appropriate.
• Pen & Supply Information: This output calculates how many days a single 18 mg / 3 mL Victoza pen will last based on a specified daily maintenance dose (0.6 mg, 1.2 mg, or 1.8 mg). This helps in managing prescriptions and patient expectations.

How to Use the Calculator

To use the tool effectively, follow these two simple steps:

1. Select Patient’s Current Treatment Status: Choose from the dropdown menu whether the patient is new to Victoza (“Initiating Therapy”), currently taking the 0.6 mg or 1.2 mg dose, or has already reached the maximum maintenance dose. This determines the titration recommendation.
2. Select Daily Dose for Supply Calculation: Choose the target daily dose (0.6 mg, 1.2 mg, or 1.8 mg) to calculate how long one pen will last at that specific dose.

Dosing Overview

The standard dosing for Victoza follows a gradual titration schedule to improve gastrointestinal tolerability. This administration protocol is crucial for patient adherence.

• Initiation Dose: Therapy begins at 0.6 mg injected subcutaneously once daily for at least one week. This dose is sub-therapeutic and intended for acclimatization.
• Titration Dose 1: After one week at 0.6 mg, the dose should be increased to 1.2 mg once daily.
• Titration Dose 2 (Optional): If further glycemic control is needed after at least one week on the 1.2 mg dose, it can be increased to the maximum dose of 1.8 mg once daily.
• Pediatric Dosing: The dosing and titration schedule for pediatric patients (10 years and older) is the same as for adults.

Switching and Re-initiation

Special considerations are needed if therapy is interrupted. The goal is to mitigate the risk of gastrointestinal side effects upon restarting.

• Re-initiation After Interruption: If more than 3 days have passed since the last dose of Victoza, therapy should be re-initiated at the starting dose of 0.6 mg once daily to reduce the likelihood of GI symptoms. The patient should then follow the standard titration schedule as if they were a new user.
• Switching from other GLP-1 RAs: Consult specific prescribing information when transitioning a patient from another GLP-1 receptor agonist to Victoza. A washout period may be necessary.

Missed Dose Instructions

If a patient misses a scheduled dose of Victoza, the following guidance should be provided:

• General Rule: Skip the missed dose and resume the regular once-daily dosing schedule with the next planned dose.
• Do Not Double Dose: Patients should be instructed not to take an extra dose or increase the next dose to make up for the missed one.
• Prolonged Interruption: As noted above, if doses are missed for more than 3 consecutive days, re-initiation at 0.6 mg/day is recommended.

Safety Alerts

Victoza is associated with important safety information that must be considered before and during therapy.

• Contraindications: Victoza is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• Common Adverse Reactions: The most frequently reported side effects include nausea, diarrhea, vomiting, decreased appetite, and constipation. These are often dose-dependent and decrease over time for most patients.

Frequently Asked Questions

References

• Victoza (liraglutide) Injection Prescribing Information. U.S. Food and Drug Administration. Revised: 08/2023. Available at: FDA.gov.
• Victoza HCP Website. Novo Nordisk. Accessed October 2023. Available at: novomedlink.com.
• American Diabetes Association. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2023. Diabetes Care 2023; 46 (Suppl. 1): S140–S157. Available at: doi.org.
• Liraglutide. In: Drugs@FDA: FDA-Approved Drugs. U.S. Food and Drug Administration. Accessed October 2023. Available at: accessdata.fda.gov.