Learning how to inject Victoza in the stomach correctly is essential for effective type 2 diabetes management. Victoza (liraglutide) is a GLP-1 receptor agonist administered once daily via subcutaneous injection to help control blood glucose levels. The abdominal area is the most common and convenient injection site, offering good absorption and easy access for self-administration. Proper injection technique, including site selection, needle insertion, and rotation practices, ensures optimal medication delivery whilst minimising complications such as injection-site reactions or tissue changes. This guide provides step-by-step instructions aligned with UK clinical guidance to help you inject Victoza safely and confidently at home.

What Is Victoza and Why Is It Injected

Victoza (liraglutide) is a prescription medicine used to improve blood sugar control in adults and children aged 10 years and above with type 2 diabetes mellitus. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of a naturally occurring hormone in the body that helps regulate blood glucose levels.

The mechanism of action of Victoza involves several key processes. It stimulates insulin secretion from the pancreas when blood glucose levels are elevated, whilst simultaneously suppressing the release of glucagon, a hormone that raises blood sugar. Additionally, Victoza slows gastric emptying, which helps reduce post-meal glucose spikes. These combined effects make it an effective option for glycaemic control when diet and exercise alone are insufficient.

Why injection is necessary: Victoza must be administered as a subcutaneous injection because it is a protein-based medication that would be broken down by digestive enzymes if taken orally. The subcutaneous route—injecting just beneath the skin—allows the medication to be absorbed gradually into the bloodstream, providing consistent therapeutic effects throughout the day. Victoza is typically administered once daily at any time, with or without food.

Victoza treatment usually starts with a dose of 0.6 mg once daily for at least one week to improve gastrointestinal tolerability. The dose is then increased to 1.2 mg once daily, with a possible further increase to 1.8 mg if needed for better glycaemic control, as directed by your healthcare professional.

Importantly, Victoza is not for use in people with type 1 diabetes or diabetic ketoacidosis, and should not be used alongside other GLP-1 receptor agonists. According to NICE guidance (NG28), GLP-1 receptor agonists like Victoza are recommended as part of a comprehensive diabetes management plan that includes lifestyle modifications.

Preparing Your Victoza Pen for Injection

Proper preparation of your Victoza pen is essential to ensure accurate dosing and reduce the risk of injection-site complications. Before each injection, you should follow a systematic approach to prepare your medication safely.

Initial steps before injection:

• Check the medication: Verify you have the correct medicine, strength, and that it's within the expiry date. New pens should be stored in the refrigerator (2-8°C), while in-use pens can be kept at room temperature (below 30°C) for up to 30 days. Inspect the solution through the pen window—it should be clear and colourless. Do not use the pen if the liquid appears cloudy, discoloured, contains particles, or if the pen has been frozen.

• Gather supplies: You will need your Victoza pen, a new disposable needle (supplied separately), and an alcohol wipe. Always use a new needle for each injection to maintain sterility and ensure proper medication flow.

• Wash your hands thoroughly with soap and water to reduce infection risk.

Attaching the needle and priming the pen:

Remove the pen cap and attach a new needle by pushing it straight onto the pen and twisting until secure. Remove both the outer and inner needle caps, keeping the outer cap for safe disposal later. Before your first use of a new pen, you must prime the pen (flow check) to remove air bubbles and ensure proper function.

To prime, turn the dose selector to the flow check symbol (typically showing flowing drops), hold the pen with the needle pointing upward, and tap the cartridge gently to bring air bubbles to the top. Press and hold the dose button until a drop of medication appears at the needle tip and the dose counter returns to zero. This confirms the pen is ready for use. Once primed, turn the dose selector to your prescribed dose as directed by your healthcare professional.

After use, dispose of the needle safely in an NHS-approved sharps bin, which you can obtain from your GP surgery, pharmacy, or diabetes clinic. When full, return the sharps bin according to your local council's arrangements or to your pharmacy or GP surgery.

How to Inject Victoza in Your Stomach Safely

Injecting Victoza into your stomach (abdomen) is one of the most common and convenient injection sites. The abdominal area provides good subcutaneous tissue for absorption and is easily accessible for self-administration.

Selecting the injection site on your stomach:

The recommended injection area is the front of your abdomen, at least 5 centimetres away from your navel (belly button). Avoid injecting directly into the navel, as this area has less subcutaneous tissue and may be more sensitive. You should also avoid areas with scars, bruises, or skin abnormalities, as these can affect medication absorption.

Step-by-step injection technique:

1. Clean the injection site with an alcohol wipe using a circular motion, and allow the skin to dry completely (approximately 10 seconds) to prevent stinging.

2. Pinch the skin gently between your thumb and forefinger to create a fold of subcutaneous tissue. This technique helps ensure the needle enters the subcutaneous layer rather than muscle. This step may not be necessary if you have sufficient subcutaneous tissue or are using a short needle—follow your healthcare professional's advice.

3. Insert the needle at a 90-degree angle (straight in) with a quick, dart-like motion. The needle should penetrate fully into the skin fold.

4. Inject the medication by pressing and holding the dose button down completely. Keep the button pressed and count slowly to six before withdrawing the needle. This ensures the full dose is delivered and prevents medication from leaking out.

5. Withdraw the needle at the same angle it was inserted, then release the skin fold.

6. Do not rub the injection site, as this may affect absorption or cause irritation.

After injection: Carefully replace the outer needle cap, unscrew the needle, and dispose of it immediately in a sharps container. Replace the pen cap and store the pen as directed. Never share your Victoza pen with others, even if the needle is changed, as this poses a risk of infection transmission.

Rotating Injection Sites and Best Practices

Site rotation is a critical practice when administering Victoza regularly to prevent complications and maintain optimal medication absorption. Repeatedly injecting in the same spot can lead to lipohypertrophy (fatty lumps under the skin) or lipoatrophy (loss of fatty tissue), both of which can impair absorption of liraglutide and affect blood glucose control.

Why rotation matters:

When you inject into the same area repeatedly, the subcutaneous tissue can become damaged, hardened, or develop lumps. These changes not only make injections more uncomfortable but can also result in unpredictable medication absorption, potentially affecting your diabetes management. Proper rotation helps maintain healthy injection sites and ensures consistent therapeutic effects.

Effective rotation strategies:

• Divide your abdomen into quadrants: Imagine your stomach divided into four sections (upper right, upper left, lower right, lower left), avoiding the area around your navel. Rotate between these quadrants systematically.

• Space injections appropriately: Each new injection should be at least 1–2 centimetres away from the previous injection site. Some patients find it helpful to move in a clockwise pattern around the abdomen.

• Keep a rotation record: Consider keeping a simple diary or using a smartphone app to track which area you used each day, especially when starting treatment.

• Alternative injection sites: Whilst the abdomen is most common, Victoza can also be injected into the thigh (front and outer areas) or upper arm (back of the upper arm, which may require assistance from another person to ensure correct technique). You can rotate between different body areas or stay within one area whilst rotating specific sites.

Additional best practices:

Inspect your injection sites regularly for any signs of redness, swelling, lumps, or skin changes. If you notice any abnormalities, avoid that area and inform your GP or diabetes nurse. Maintain consistent injection timing each day to establish a routine, though the specific time can be flexible. Store your in-use Victoza pen at room temperature (below 30°C) away from direct heat and light, and discard it 30 days after first use, even if medication remains.

Common Side Effects and When to Seek Help

Like all medications, Victoza can cause side effects, though not everyone experiences them. Understanding potential adverse effects and knowing when to seek medical attention is essential for safe medication use.

Common gastrointestinal side effects:

The most frequently reported side effects of Victoza are gastrointestinal in nature, particularly when starting treatment or increasing the dose. These include:

• Nausea (very common, affecting more than 1 in 10 people)

• Diarrhoea (common, affecting up to 1 in 10 people)

• Vomiting (common, affecting up to 1 in 10 people)

• Constipation, abdominal pain, and indigestion (common)

• Reduced appetite (common)

These effects typically diminish over time as your body adjusts to the medication. Eating smaller, more frequent meals and avoiding fatty or spicy foods may help manage these symptoms. If gastrointestinal side effects persist or become severe, consult your healthcare professional, as dose adjustment may be necessary.

Injection-site reactions:

Mild reactions at the injection site, such as redness, itching, or slight swelling, can occur but are usually temporary. Proper injection technique and site rotation typically prevent these issues.

Hypoglycaemia (low blood sugar):

Whilst Victoza alone rarely causes hypoglycaemia, the risk increases when used in combination with other diabetes medications, particularly sulphonylureas or insulin. Symptoms include trembling, sweating, confusion, rapid heartbeat, and hunger. Always carry a fast-acting source of glucose and know how to treat low blood sugar episodes.

When to seek immediate medical attention:

Stop taking Victoza and contact your GP urgently, call 999, or go to A&E if you experience:

• Severe, persistent abdominal pain that may radiate to the back, potentially indicating pancreatitis (inflammation of the pancreas). Do not restart Victoza unless pancreatitis has been ruled out.

• Signs of allergic reaction: difficulty breathing, swelling of the face, lips, tongue, or throat, or severe rash

• Symptoms of thyroid problems: a lump in the neck, persistent hoarseness, difficulty swallowing, or shortness of breath

• Severe or persistent vomiting or diarrhoea, which may lead to dehydration and kidney problems

• Signs of gallbladder problems: yellowing of skin or eyes, fever with abdominal pain, or clay-coloured stools

Regular monitoring by your diabetes care team, including HbA1c checks and kidney function tests, helps ensure safe, effective treatment. Never stop taking Victoza without consulting your healthcare professional, as abrupt discontinuation may affect your blood glucose control.

You can report any suspected side effects to the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or via the Yellow Card app.

Frequently Asked Questions