Victoza (liraglutide) is a once-daily injectable medication used to improve blood sugar control in adults with type 2 diabetes mellitus. As a glucagon-like peptide-1 (GLP-1) receptor agonist, Victoza works by stimulating insulin secretion, slowing gastric emptying, and suppressing glucagon release. Proper injection technique, dosage management, and understanding potential side effects are essential for safe and effective use. This guide explains how to use Victoza correctly, including step-by-step injection instructions, storage requirements, and important safety information aligned with UK clinical guidance from NICE and the MHRA.

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 to help manage blood glucose levels.

The active ingredient, liraglutide, works by mimicking the action of a naturally occurring hormone called GLP-1. This hormone is released by the intestines after eating and plays several important roles in glucose regulation. Victoza stimulates insulin secretion from the pancreas when blood sugar levels are elevated, helping to lower glucose after meals. Importantly, this effect is glucose-dependent, meaning insulin release decreases as blood sugar normalises, which reduces the risk of hypoglycaemia (low blood sugar) compared to some other diabetes medications.

Additionally, Victoza slows gastric emptying, which means food moves more slowly from the stomach into the small intestine. This helps to reduce post-meal blood sugar spikes and can promote a feeling of fullness. The medication also suppresses glucagon secretion—a hormone that raises blood sugar—when glucose levels are high. Together, these mechanisms help improve overall glycaemic control. Treatment with Victoza is often associated with modest weight loss, although it is not licensed for weight management.

Victoza is licensed in the UK for use in adults with type 2 diabetes and may be prescribed as monotherapy when metformin is inappropriate, or in combination with other glucose-lowering medications including insulin. According to NICE guidance (NG28), GLP-1 receptor agonists like Victoza should only be considered in specific circumstances, such as when a person has a BMI of 35 kg/m² or higher (adjusted for ethnicity) or weight-related complications, and when other glucose-lowering therapies have not been effective. Victoza should not be used in combination with DPP-4 inhibitors. It is not suitable for treating type 1 diabetes or diabetic ketoacidosis.

How to Use Victoza: Step-by-Step Injection Guide

Victoza is supplied in a pre-filled, multi-dose pen designed for ease of use. Before your first injection, your healthcare professional should demonstrate the correct technique. Always read the patient information leaflet provided with your pen.

Preparation steps:

• Wash your hands thoroughly with soap and water.

• Check the Victoza pen label to ensure it is the correct medication and has not expired.

• Attach a new needle to the pen for each injection. Remove both the outer and inner needle caps.

• Prime the pen before first use of each new pen. Turn the dose selector to the flow check symbol, hold the pen with the needle pointing upwards, and press the dose button until a drop of Victoza appears at the needle tip. This ensures the pen is working correctly.

Injection technique:

• Select your injection site: abdomen (tummy), thigh, or upper arm. If using the upper arm, another person should give the injection. Rotate sites to reduce the risk of lipodystrophy (changes in fat tissue under the skin).

• Pinch the skin gently and insert the needle at a 90-degree angle using a quick, dart-like motion.

• Press and hold the dose button until the dose counter returns to 0. Keep the needle in the skin and count slowly to six to ensure the full dose is delivered.

• Withdraw the needle and dispose of it safely in a sharps container. Never reuse needles, as this increases infection risk and can damage the pen.

• Replace the pen cap (without the needle attached) and store the pen as directed.

• Never share your pen with anyone else, even if you change the needle, as this poses a risk of infection transmission.

If you are unsure about any step, contact your GP, practice nurse, or diabetes specialist team for further guidance.

Dosage and When to Take Victoza

The starting dose of Victoza is 0.6 mg once daily for at least one week. This initial lower dose is intended to help your body adjust to the medication and reduces the likelihood of gastrointestinal side effects such as nausea. It is not intended for glycaemic control. After one week, your doctor will usually increase the dose to 1.2 mg once daily. Depending on your blood sugar control and tolerability, the dose may be further increased to a maximum of 1.8 mg once daily after at least another week.

Victoza should be injected once a day at any time, with or without food. However, it is important to use it at approximately the same time each day to maintain consistent blood levels and establish a routine. Many patients find it helpful to link their injection to a daily activity, such as before breakfast or before bed, to aid adherence.

If you miss a dose, take it as soon as you remember on the same day. If more than 12 hours have passed since your usual injection time, skip the missed dose and resume your normal schedule the next day. Do not take a double dose to make up for a forgotten injection, as this may increase the risk of side effects.

If you are also taking a sulphonylurea medication or insulin, your doctor may reduce the doses of these medications when starting Victoza to reduce the risk of hypoglycaemia (low blood sugar).

According to NICE guidance, treatment with Victoza should only be continued if you have a beneficial response after 6 months, defined as a reduction in HbA1c of at least 11 mmol/mol (1.0%) and weight loss of at least 3% of initial body weight. Your healthcare team will review your progress regularly to determine if treatment should continue.

Dosage adjustments should only be made under the guidance of your healthcare professional. Regular monitoring of blood glucose, HbA1c, and kidney function is recommended. Always attend your diabetes review appointments and report any concerns to your healthcare team promptly.

Storage and Handling of Your Victoza Pen

Proper storage of your Victoza pen is essential to maintain the medication's effectiveness and safety. Before first use, store the pen in a refrigerator at 2°C to 8°C. Do not freeze Victoza, and do not use the pen if it has been frozen. Keep the pen in its original carton to protect it from light.

After first use, the Victoza pen can be stored either in the refrigerator (2°C to 8°C) or at room temperature (below 30°C) for up to 30 days. Many patients find room temperature storage more convenient, as it can make injections more comfortable. Always keep the pen cap on when not in use to protect the medication from light and contamination.

It's helpful to write the date of first use on the pen label or carton to track the 30-day in-use period. Discard the pen 30 days after first use, even if it still contains solution.

Important handling precautions:

• Remove the needle after each injection and dispose of it safely in a sharps bin. Never store the pen with a needle attached, as this can lead to leakage, air bubbles, or contamination.

• Keep Victoza out of sight and reach of children.

• Do not use the pen after the expiry date printed on the label.

• Inspect the solution before each use. Victoza should be clear and colourless. Do not use if the solution appears cloudy, discoloured, or contains particles.

• Protect the pen from excessive heat and direct sunlight.

• Do not store the pen in the car or other locations where temperature cannot be controlled.

If you are travelling, particularly abroad, plan ahead to ensure proper storage. Insulated medication travel cases can help maintain appropriate temperatures. If you have any concerns about whether your pen has been stored correctly, contact your pharmacist or diabetes team before using it. Dispose of used pens and needles according to local regulations—your pharmacist can provide a sharps container and advise on safe disposal.

Common Side Effects and What to Watch For

Like all medicines, Victoza can cause side effects, although not everyone experiences them. The most common side effects are gastrointestinal and typically improve over time as your body adjusts to the medication.

Very common side effects (affecting more than 1 in 10 people) include:

• Nausea – often most noticeable when starting treatment or increasing the dose. Eating smaller, more frequent meals may help.

• Diarrhoea – usually mild and temporary.

• Vomiting – if persistent or severe, contact your healthcare team.

Common side effects (affecting up to 1 in 10 people) include:

• Headache

• Indigestion or upper abdominal discomfort

• Constipation

• Decreased appetite

• Injection site reactions – such as redness, itching, or bruising. These are usually mild and resolve quickly. Rotating injection sites can help minimise reactions.

• Hypoglycaemia (low blood sugar) – particularly when Victoza is used in combination with a sulphonylurea or insulin. Symptoms include trembling, sweating, confusion, rapid heartbeat, and hunger. Always carry a fast-acting source of glucose (such as glucose tablets or sugary drink) if you are at risk.

It's important to stay well-hydrated, especially if you experience vomiting or diarrhoea. Prolonged gastrointestinal symptoms can lead to dehydration and potentially affect kidney function. Contact your doctor if you cannot keep fluids down.

When to seek medical advice:

Contact your GP or diabetes team if side effects are persistent, severe, or affecting your quality of life. Seek urgent medical attention if you experience:

• Severe, persistent abdominal pain that may radiate to the back, possibly with vomiting – these could be signs of pancreatitis (inflammation of the pancreas), a rare but serious side effect.

• Signs of a severe allergic reaction – such as swelling of the face, lips, tongue, or throat, difficulty breathing, or severe rash.

• Symptoms of gallbladder problems – such as sudden, severe pain in the upper right abdomen, fever, yellowing of the skin or eyes (jaundice).

• Unexplained neck swelling, hoarseness, or difficulty swallowing – report these to your doctor as thyroid-related adverse events have been reported.

Report any side effects to your healthcare professional and via the MHRA Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

Important Safety Information Before Using Victoza

Before starting Victoza, inform your doctor about your complete medical history and all medications you are taking, including over-the-counter medicines and herbal supplements. Certain conditions and medications may affect whether Victoza is suitable for you.

Do not use Victoza if you:

• Are allergic to liraglutide or any other ingredients in Victoza

• Have type 1 diabetes or diabetic ketoacidosis

• Are under 18 years of age (safety and efficacy not established)

Use with caution and discuss with your doctor if you have:

• Kidney problems – no dose adjustment is generally needed, but Victoza is not recommended in end-stage renal disease

• Liver problems – no dose adjustment is generally needed, but there is limited experience in severe hepatic impairment

• A history of pancreatitis (inflammation of the pancreas) – if pancreatitis is suspected during treatment, Victoza should be discontinued and not restarted unless another cause is identified

• Inflammatory bowel disease or severe gastrointestinal disease, including diabetic gastroparesis – Victoza is not recommended in these conditions as there is limited experience

• Heart failure – particularly if you have severe heart failure (NYHA class IV)

Pregnancy and breastfeeding:

Victoza is not recommended during pregnancy. If you are planning to become pregnant or discover you are pregnant, contact your doctor immediately. Alternative diabetes treatments, such as insulin, are typically recommended during pregnancy. It is not known whether liraglutide passes into breast milk, so Victoza should not be used while breastfeeding.

Drug interactions:

Victoza generally does not have clinically significant effects on the absorption of oral medications. However, if you take warfarin or other coumarin derivatives, more frequent monitoring of INR (International Normalised Ratio) is recommended when starting Victoza. If you experience severe vomiting or diarrhoea while taking oral contraceptives, you may need to use additional contraceptive methods temporarily.

Do not use Victoza with another GLP-1 receptor agonist. According to NICE guidance, Victoza should not be used in combination with DPP-4 inhibitors.

Monitoring:

Regular monitoring of blood glucose, HbA1c, and kidney function is recommended. NICE guidance suggests reviewing treatment effectiveness and tolerability at regular intervals. Always attend your diabetes review appointments and report any concerns to your healthcare team promptly.

Frequently Asked Questions