GLP-1a, GIPa: Inc glucose dependent insulin secretion, decrease glucagon, slow gastric emptying (satiety)

Question 1

Liraglutide*

brand, dosing frequency, max dose

Answer 1

• Victoza*
• Saxenda* (for weight loss)
• SC daily
• max: 1.8 mg
• pen needles not provided (Victoza)*

Question 2

Dulaglutide*

Answer 2

• Trulicity*
• .75 mg SC weekly, can increase to 1.5 mg SC weekly

Question 3

Semaglutide*

Answer 3

• Ozempic* SC weekly, max 2 mg
  - increase complications with
  diabetic retinopathy
• Rybelsus* oral daily, max 14 mg
  - take dose at least 30
  minutes before first
  food/drink/med of the day
• Wegovy* for weight loss

Question 4

Exenatide

Answer 4

Byetta
- SC BID
- max 10 mcg BID
- CrCl < 30: not recommended*
- the only GLP-1 with no risk of thyroid C-cell carcinoma
- give dose within 60 min of meals*
- pen needles not provided*

Question 5

Exenatide ER

Answer 5

Bydureon BCise
- SC weekly*
- eGFR < 45: not recommended*
- serious injection site reactions (abscess, cellulitis, necrosis) with or without SC nodules

Question 6

The only dual GLP-1 & GIP agonist: Tirzepatide

Answer 6

Mounjaro, “twincretin”
- SC weekly
- max: 15 mg weekly
- increases complications with diabetic retinopathy
- increased heart rate