Learning how to inject Victoza correctly is essential for effective type 2 diabetes management. Victoza (liraglutide) is a once-daily GLP-1 receptor agonist administered subcutaneously to improve blood glucose control alongside diet and exercise. Proper injection technique ensures optimal medication delivery, minimises discomfort, and reduces the risk of complications such as injection site reactions. This comprehensive guide covers everything you need to know about preparing your Victoza pen, selecting injection sites, performing the injection safely, and troubleshooting common problems. Whether you're new to Victoza or seeking to refine your technique, understanding these steps will help you manage your diabetes confidently and safely.

What Is Victoza and How Does It Work?

Victoza (liraglutide) is a prescription medicine used to improve blood sugar control in adults with type 2 diabetes mellitus. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. Victoza is administered as a once-daily subcutaneous injection and is typically used alongside diet and exercise modifications to achieve optimal glycaemic control.

The medication works by mimicking the action of GLP-1, a naturally occurring hormone in the body that helps regulate blood glucose levels. When you inject Victoza, it stimulates insulin secretion from the pancreas in response to elevated blood sugar levels, particularly after meals. Importantly, this insulin release is glucose-dependent, meaning it occurs primarily when blood sugar is raised, which reduces the risk of hypoglycaemia compared to some other diabetes medications.

Victoza also slows gastric emptying, which means food moves more slowly from your stomach into your small intestine. This helps prevent rapid spikes in blood glucose after eating and can contribute to feelings of fullness, potentially supporting weight management. Additionally, liraglutide suppresses the release of glucagon, a hormone that raises blood sugar levels, further contributing to improved glycaemic control.

According to NICE guidance (NG28), GLP-1 receptor agonists like Victoza may be considered for people with type 2 diabetes who have not achieved adequate control with oral medications or who require additional therapy. The medication has been shown in clinical trials to reduce HbA1c levels effectively whilst also potentially leading to weight loss, which is particularly valuable for many individuals with type 2 diabetes who are overweight or obese.

It's important to note that Victoza is not indicated for people with type 1 diabetes or diabetic ketoacidosis and is not a substitute for insulin.

Preparing Your Victoza Pen for Injection

Proper preparation of your Victoza pen is essential to ensure you receive the correct dose safely and effectively. Before each injection, you should gather all necessary supplies: your Victoza pen, a new disposable needle (these are prescribed separately), and an alcohol wipe if recommended by your healthcare professional.

Before first use of each new pen, you must perform a flow check to ensure your pen is working correctly. Remove the pen cap and attach a new needle by removing the protective tab, screwing the needle straight onto the pen, and then removing both the outer and inner needle caps. Turn the dose selector to the flow check symbol (typically showing flowing drops). Hold the pen with the needle pointing upwards and press the dose button fully until the dose counter returns to zero. You should see a drop of Victoza appear at the needle tip. If no drop appears, repeat this process up to six times. If you still don't see a drop, do not use the pen and contact your pharmacist or healthcare professional.

Always check that the Victoza solution is clear and colourless; do not use it if it appears cloudy, coloured, or contains particles. Check the expiry date on the pen label and do not use if it has passed.

Store your unused Victoza pens in the refrigerator between 2°C and 8°C, but never freeze them. Once you start using a pen, you can keep it at room temperature (below 30°C) or in the refrigerator for up to one month, after which you should discard it even if solution remains. Always keep the pen cap on when not in use to protect the medicine from light. Allow the pen to reach room temperature before injecting, as cold injections may be more uncomfortable.

After each injection, always remove the needle and dispose of it in an approved sharps bin. Never store your pen with a needle attached as this can lead to leakage, contamination or air entering the cartridge. You can obtain sharps bins from your GP, pharmacist or through your local council's clinical waste services. Never dispose of needles in household waste.

Step-by-Step Guide to Injecting Victoza Safely

Administering your Victoza injection correctly ensures optimal medication delivery and minimises discomfort. Follow these steps carefully each time you inject:

Step 1: Wash your hands thoroughly with soap and water to reduce infection risk.

Step 2: Prepare the injection site by cleaning it with an alcohol wipe if advised by your healthcare professional, and allow the skin to dry completely.

Step 3: Attach a new needle to your pen (as described in the previous section). Always use a new needle for each injection to maintain sterility and ensure proper medication flow.

Step 4: Select your dose by turning the dose selector until the correct dose appears in the dose counter window. Victoza is typically started at 0.6 mg daily for at least one week, then increased to 1.2 mg daily. Some patients may benefit from a further increase to 1.8 mg daily after at least one week at 1.2 mg, as directed by their doctor.

Step 5: Insert the needle into your skin at a 90-degree angle using a quick, dart-like motion. You don't need to pinch the skin unless you're very thin or injecting into an area with less subcutaneous fat. Victoza must only be injected subcutaneously (under the skin) – never inject into a vein or muscle.

Step 6: Inject the medication by pressing the dose button fully until the dose counter shows '0'. Keep the button pressed down and count slowly to six before withdrawing the needle. This ensures the full dose is delivered.

Step 7: Remove the needle by carefully placing the outer needle cap back on, then unscrewing the needle from the pen. You may see a small drop of blood, which is normal—apply gentle pressure with a clean tissue if needed.

Step 8: Dispose of the needle safely in a sharps container immediately after use. Never recap needles without using the outer cap, as this increases the risk of needle-stick injuries. Replace the pen cap and store the pen appropriately.

Try to use Victoza at the same time each day to establish a routine. Never share your Victoza pen or needles with anyone else, even if the needle has been changed, as this could transmit infections.

Choosing and Rotating Injection Sites

Selecting appropriate injection sites and rotating them regularly is crucial for maintaining healthy skin and ensuring consistent medication absorption. Victoza should be injected subcutaneously (under the skin) into areas with adequate fatty tissue.

Approved injection sites include:

• The abdomen (stomach area) – away from your navel (belly button)

• The front of your thighs – on the top or outer areas

• The upper arms – on the outer back area (you may need assistance to inject here to ensure subcutaneous delivery)

The abdomen typically provides the most consistent absorption and is often the preferred site for many patients. However, all three sites are equally suitable, and you can inject Victoza at any time of day, with or without food, making it convenient to fit into your daily routine.

Site rotation is essential to prevent lipohypertrophy (lumpy skin) or lipoatrophy (skin indentations), conditions that can affect insulin absorption and cause discomfort. Develop a systematic rotation pattern—for example, if you inject in your abdomen, divide it into quadrants and rotate through them, moving at least 1–2 cm from your previous injection site each time. Keep a mental note or use a diary to track where you last injected.

Avoid injecting into areas that are:

• Bruised, tender, red, or hard

• Scarred or damaged

• Close to your navel

• Directly over a vein you can see

If you notice any changes in your injection sites, such as lumps, dimples, or persistent redness, inform your diabetes nurse or GP. They can assess whether your injection technique needs adjustment or if the site requires time to heal before being used again.

Common Injection Problems and How to Solve Them

Even with careful technique, you may occasionally encounter problems when injecting Victoza. Understanding how to address these issues helps ensure you receive your medication safely and effectively.

Blocked or damaged needles: If you press the dose button but it feels unusually difficult or the dose counter doesn't return to zero, the needle may be blocked. Remove the needle, attach a new one, and perform a flow check before attempting to inject again. Never try to clear a blocked needle, as this could cause injury.

Incomplete dose delivery: If you remove the needle before counting to six, you may not have received your full dose. Do not attempt to inject the remaining amount. Simply take your next dose at the usual time the following day. If this happens repeatedly, discuss your injection technique with your healthcare team.

Injection site reactions: Mild redness, itching, or slight swelling at the injection site is relatively common, particularly when starting Victoza. These reactions typically resolve within a few days. Ensure you're rotating sites properly and not injecting into the same spot repeatedly. If reactions persist or worsen, contact your GP or diabetes nurse.

Bruising or bleeding: Small amounts of bleeding or bruising can occur if you hit a small blood vessel. Apply gentle pressure with a clean tissue. This doesn't affect medication absorption. To minimise bruising, ensure you're inserting the needle at the correct angle and not moving it once inserted.

Pen malfunctions: If your dose selector won't turn, the pen may be empty or damaged. Check the medication level in the cartridge window. If the pen appears damaged or isn't working correctly despite having medication remaining, don't attempt to use it—contact your pharmacy for a replacement. For persistent device issues, you can also contact the manufacturer, Novo Nordisk, for support.

Forgetting a dose: If you miss a dose and remember within 12 hours of when you should have taken it, inject it as soon as possible. If more than 12 hours have passed, skip the missed dose and resume your normal schedule the next day. Never inject a double dose to make up for a forgotten one.

When to Contact Your Healthcare Team

Whilst Victoza is generally well-tolerated, certain situations require prompt medical attention. Understanding when to seek help ensures your safety and optimal diabetes management.

Call 999 or go to A&E immediately if you experience:

• Signs of a severe allergic reaction (anaphylaxis), including widespread rash, itching, difficulty breathing, swelling of your face, lips, tongue, or throat, or feeling faint.

Contact your GP or diabetes team urgently if you experience:

• Severe or persistent abdominal pain, particularly if accompanied by vomiting, as this could indicate pancreatitis—a rare but serious side effect. Pancreatitis typically causes severe pain in the upper abdomen that may radiate to your back.

• Severe upper-right abdominal pain, possibly with fever or yellowing of the skin/eyes, which could indicate gallbladder problems such as gallstones or inflammation.

• Persistent nausea and vomiting that prevents you from eating or drinking, as this can lead to dehydration and may affect kidney function. Signs of dehydration include increased thirst, reduced urination, and dizziness.

• Symptoms of hypoglycaemia (low blood sugar), particularly if you're taking Victoza alongside a sulphonylurea or insulin. Symptoms include trembling, sweating, confusion, rapid heartbeat, and feeling very hungry. Whilst Victoza alone rarely causes hypoglycaemia, the risk increases when combined with other diabetes medications.

Seek routine advice from your healthcare team if:

• You're experiencing persistent injection site problems despite proper technique

• You're having difficulty managing common side effects like nausea or diarrhoea

• You're unsure about your injection technique or need a refresher

• You're planning pregnancy or have become pregnant, as Victoza is not recommended during pregnancy

• You develop any new symptoms or have concerns about your diabetes control

For urgent but non-life-threatening concerns outside of normal GP hours, contact NHS 111 for advice.

Regular follow-up appointments are essential for monitoring your HbA1c levels, assessing treatment effectiveness, and adjusting your dose if needed. The NHS recommends that people with type 2 diabetes have their diabetes control reviewed at least annually, though you may need more frequent monitoring when starting or adjusting Victoza.

If you experience any side effects, you can report them directly to the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk. By reporting side effects, you can help provide more information on the safety of this medicine.

Frequently Asked Questions