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Indications and Dosage
Subcutaneous
Adjunct to type 2 diabetes mellitus Adult: Initially, 10 mcg once daily for 14 days, given within 1 hour before morning or evening meal. May increase dose to 20 mcg once daily starting on day 15. Missed dose should be given within 1 hour of the next meal.
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Renal Impairment
ESRD: Not recommended.
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Special Precautions
Patient with history of hypersensitivity or pancreatitis, volume depletion, severe gastrointestinal disease (e.g. gastroparesis). Not intended for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis. Renal impairment (including ESRD). Pregnancy and lactation.
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Adverse Reactions
Significant: Antibody formation, acute kidney injury, severe gastroparesis, serious hypersensitivity reactions (e.g. anaphylaxis, angioedema).
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, constipation, dyspepsia, abdominal distention, upper abdominal pain. General disorders and administration site conditions: Inj site pain, pruritus, erythema. Infections and infestations: Influenza, viral infection. Musculoskeletal and connective tissue disorders: Back pain. Nervous system disorders: Headache, dizziness, somnolence. Renal and urinary disorders: Cystitis. Respiratory, thoracic and mediastinal disorder: Upper respiratory tract infection. Potentially Fatal: Acute pancreatitis, including fatal and non-fatal haemorrhagic or necrotising pancreatitis. |
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Monitoring Parameters
Monitor serum glucose, HbA1c, renal function, signs and symptoms of pancreatitis and hypersensitivity.
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Overdosage
Symptoms: Gastrointestinal disorders. Management: Supportive treatment.
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Drug Interactions
Increased risk of hypoglycaemia with sulfonylureas or basal insulin. May reduce the rate of absorption of oral medications (e.g. antibiotics, paracetamol, oral contraceptives).
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Action
Description: Lixisenatide binds to and activates glucagon-like peptide-1 (GLP-1) receptor to stimulate glucagon-dependent insulin secretion, suppress glucagon secretion and slow gastric emptying.
Pharmacokinetics: Absorption: Rapidly absorbed. Time to peak plasma concentration: Approx 1-3.5 hours. Distribution: Volume of distribution: Approx 100 L. Plasma protein binding: Approx 55%. Metabolism: Undergoes proteolytic degradation into smaller peptides and amino acids. Excretion: Mainly via urine. Terminal elimination half-life: Approx 3 hours. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Lixisenatide, CID=90472060, https://pubchem.ncbi.nlm.nih.gov/compound/Lixisenatide (accessed on Jan. 22, 2020) |
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Storage
Store between 2-8°C prior to initial use. Store below 30°C after initial use. Do not freeze. Protect from light.
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MIMS Class
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ATC Classification
A10BJ03 - lixisenatide ; Belongs to the class of glucagon-like peptide-1 (GLP-1) analogues. Used in the treatment of diabetes.
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References
Adlyxin Injection, Solution (Sanofi-Aventis U.S. LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/02/2018. Anon. Lixisenatide. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 02/02/2018. Anon. Lixisenatide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/02/2018. Buckingham R (ed). Lixisenatide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/02/2018. Joint Formulary Committee. Lixisenatide. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/02/2018.
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