Victoza Starting Dose, Max Dose, Missed Dose

Victoza is a GLP-1 analog, like Ozempic and Trulicity. It contains Liraglutide and is marketed by two brand names:

• Victoza, and
• Saxenda

Victoza is indicated for the treatment of diabetes type 2 while Saxenda is approved by the FDA for the treatment of obesity.

This is similar to Ozempic and Wegovy. Ozempic is indicated to treat diabetes while Wegovy is approved by the FDA for the management of Obesity.

Although, both Victoza and Saxenda have the same generic drug, Liraglutide, their strength and dose differ [Ref].

Starting Victoza Treatment:

If you are a diabetic and planning to start Victoza injections, always check for the following contraindications first:

• Do you have Type 1 Diabetes?
  •  If Yes, You should not start Victoza treatment. You can not replace insulin with Victoza.
• Do you have a personal or a family history of neck cancer, medullary thyroid cancer, or MEN-II syndrome?
  • If Yes, Avoid Victoza as it has been associated with these cancers. It may result in the reactivation or progression of the disease.
• Are you allergic to Victoza?
  • If you have a history of an allergic reaction before with Victoza, do not use it again.
• Do you have pancreatitis or pancreatic problems?
  • If you have pancreatitis, pancreatic cancer, or type 3c Diabetes, avoid using Victoza as it may increase your risk of developing or exacerbating the disease.
• Do you have gallstones, gallbladder disease, or gastroparesis?
  • Victoza may increase your risk of developing gallstones. It may worsen your symptoms of bloating, abdominal pain, constipation, and abdominal fullness if you have preexisting gastroparesis.
  • Try to avoid Victoza in such situations or monitor for developing any of the above symptoms.

Victoza Starting Dose:

The starting dose of Victoza is 0.6 mg for one week. The injection is administered daily into the skin (as a subcutaneous injection) regardless of meals but preferably at the same time of the day.

Starting Victoza at the lowest dose of 0.6 mg is recommended to reduce the injection-associated gastrointestinal side effects. This dose may not be effective for lowering your blood glucose.

Once you observe that you can tolerate the 0.6 mg injection without any significant side effects, you can then increase the dose to 1.2 mg per day.

If significant side effects, especially related to the stomach are bothering you during the first week of the Victoza starting dose, you may not be able to tolerate higher doses, and it’s better to discontinue it.

Victoza Maximum Dose:

After one week of 0.6 mg, increase the dose of Victoza to the usual maintenance dose of 1.2 mg per day. Monitor your blood glucose levels during the second week.

If your blood glucose is well controlled and you are tolerating Victoza, you can continue the 1.2 mg dose.

If you are not tolerating the 1.2 mg, you may need to discontinue Victoza as lowering the dose may not be helpful in controlling your blood glucose.

However, if you do not develop significant side effects and you are tolerating the dose but have not achieved your glycemic targets, increase the dose to 1.8 mg in the third week.

The maximum dose of Victoza is 1.8 mg per day for the management of diabetes. Do not exceed the 1.8 mg dose.

Victoza Missed Dose:

Victoza is a once-daily subcutaneous injection. It is preferably administered at the same time of the day.

However, if you miss your dose by a few hours, you can still get your dose. If it’s about time for the next scheduled dose, do not administer a double dose.

Do not make up for the missed dose on the next day. This may be associated with severe side effects.

If you have missed three or more days consecutively, you may need to start again from the 0.6 mg starting dose for a week and then titrate up your dose.

Victoza to Ozempic Conversion:

If you are switching from Victoza to Ozempic, you can administer the dose of Ozempic one day after the last dose of Victoza.

You may need to start Ozempic weekly injection from the lowest dose of 0.25 mg and then titrate upwards after 4 weeks.

You can then continue the Ozempic injection every week administering it on the same day every week.

Victoza to Trulicity Conversion:

Trulicity, like Ozempic, is also a once-weekly injection. You can start using Trulicity one day after the last dose of the Victoza injection.

Trulicity can then be continued on the same day each week. The starting dose should be kept at the lowest i.e. 0.75 mg once a week.

The dose can then be titrated up after 4 weeks to 1.5 mg per week.

Ozempic to Victoza Conversion:

If you are on Ozempic, and because for some reason, you want to switch to Victoza, you should keep in mind that your blood glucose may fluctuate during the first two weeks.

Since Ozempic is administered once a week, its effects last for about 5 to 7 days.

After you administer your last dose of weekly Ozempic injection, you can start using Victoza 5 – 7 days after the last dose of Ozempic.

Simply, you can switch to Victoza on the day of the next Ozempic dose. You can then continue Victoza daily at the same time of the day.

The starting dose of Victoza is 0.6 mg per day. However, you can directly start using 1.2 mg if you were on 0.5 mg or 1.0 mg of weekly Ozempic injections.

Trulicity to Victoza Conversion:

If you have been on Trulicity weekly injections, you can switch to Victoza. because the effects of Trulicity may last for a week, you can start Victoza treatment after one week.

Your first dose of Victoza can be administered 5 to 7 days after the last dose of Trulicity injection, preferably after a week, on the day Trulicity was to be administered.

The starting dose of Victoza after switching from Trulicity is 0.6 mg daily. The dose can then be increased to 1.2 mg once a week if there are no significant side effects.

Victoza to DPP-IV (Sitagliptin or Vildagliptin):

You can either use Victoza or take a DPP-IV inhibitor, you can not take the two drugs at a time.

When switching from Victoza to a DPP-IV inhibitor, you can start taking the DPP-IV tablet (Sitagliptin, Vildagliptin, or Linagliptin) one day after the last dose of Victoza.

DPP-IV to Victoza Conversion:

When switching from Linagliptin (Trajenta) or Sitagliptin (Januvia) to Victoza, you can start using Victoza 24 hours after the last dose of Sitagliptin or Linagliptin.

When switching from Vildagliptin (Galvus) to Victoza, you can start using it 12 hours after the last dose of Galvus.

In all the above cases, when switching from Sitagliptin, Vildagliptin, or Linagliptin to Victoza, the dose of Victoza remains the same i.e. 0.6 mg starting dose.

In summary: