Lyxumia (lixisenatide) is a once-daily injectable GLP-1 receptor agonist used to improve blood glucose control in adults with type 2 diabetes. Whilst effective at regulating blood sugar levels, Lyxumia pen side effects are an important consideration for patients starting this treatment. The most commonly reported adverse reactions are gastrointestinal, including nausea, vomiting, and diarrhoea, particularly during the initial weeks of therapy. Understanding which side effects are expected and manageable, versus those requiring urgent medical attention, helps patients use Lyxumia safely and effectively. This article provides comprehensive guidance on recognising, managing, and reporting side effects associated with the Lyxumia pen.
Summary: The most common Lyxumia pen side effects are gastrointestinal, with nausea affecting more than 1 in 10 users, alongside vomiting, diarrhoea, headache, and injection site reactions.
- Lyxumia is a GLP-1 receptor agonist administered once daily via pre-filled pen to improve blood glucose control in type 2 diabetes.
- Gastrointestinal side effects (nausea, vomiting, diarrhoea) are most common and typically diminish within the first few weeks of treatment.
- Hypoglycaemia risk increases when Lyxumia is combined with sulfonylureas or insulin, requiring dose adjustments under medical supervision.
- Serious but rare side effects include pancreatitis (severe persistent abdominal pain) and severe allergic reactions requiring immediate medical attention.
- Lyxumia is contraindicated in pregnancy, type 1 diabetes, and should not be used with prandial insulin or in end-stage renal disease.
- Side effects should be reported via the MHRA Yellow Card Scheme, and persistent symptoms warrant review by your diabetes care team.
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What Is Lyxumia and How Does It Work?
Lyxumia (lixisenatide) is a once-daily injectable medication used to improve blood glucose control in adults with type 2 diabetes mellitus. It belongs to a class of medicines called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of naturally occurring incretin hormones in the body. The medication is administered via a pre-filled pen device.
Lyxumia is initiated at 10 micrograms once daily for 14 days, then increased to a maintenance dose of 20 micrograms once daily. The injection should be given within 1 hour before a meal, preferably the same meal each day. It must not be administered after a meal. The mechanism of action involves several complementary pathways that help regulate blood sugar levels. When injected, lixisenatide binds to GLP-1 receptors on pancreatic beta cells, stimulating the release of insulin in response to elevated blood glucose levels. Importantly, this glucose-dependent insulin secretion means that Lyxumia primarily works when blood sugar is high, reducing the risk of hypoglycaemia compared to some other diabetes medications. Additionally, the drug suppresses the inappropriate secretion of glucagon—a hormone that raises blood glucose—and slows gastric emptying, which helps moderate the post-meal rise in blood sugar.
Lyxumia is typically prescribed as an adjunct to diet and exercise when these measures, along with other antidiabetic medications such as metformin, sulfonylureas, or basal insulin, do not provide adequate glycaemic control. The medication is not suitable for treating type 1 diabetes or diabetic ketoacidosis. According to NICE guideline NG28 on type 2 diabetes management, GLP-1 receptor agonists may be considered in specific clinical scenarios, particularly when HbA1c remains elevated despite other therapies and when weight management is a concern. Lyxumia is not recommended for use in combination with prandial (short-acting) insulin, as this has not been studied. Patients should receive proper training on pen injection technique and storage requirements before commencing treatment. Because lixisenatide slows gastric emptying, it may affect the absorption of some oral medicines; patients taking oral contraceptives should take them at least 1 hour before the Lyxumia injection or 11 hours after, and similar timing considerations may apply to other time-critical oral medications.
Common Side Effects of Lyxumia Pen
Like all medications, Lyxumia can cause side effects, although not everyone experiences them. The most frequently reported adverse effects are gastrointestinal in nature, particularly during the initial weeks of treatment as the body adjusts to the medication. Understanding these common reactions can help patients distinguish between expected, manageable effects and those requiring medical attention.
Nausea is the most common side effect, classified as very common (affecting more than 1 in 10 people). This typically occurs after injections and may be more pronounced following meals. Vomiting and diarrhoea are also common (affecting up to 1 in 10 users). These gastrointestinal symptoms usually diminish over time as tolerance develops, often within the first few weeks of treatment. Injecting within 1 hour before the same meal each day and eating smaller, more frequent meals may help reduce these effects.
Other commonly reported side effects include:
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Headache – generally mild and self-limiting
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Dizziness
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Dyspepsia (indigestion) – a burning sensation or discomfort in the upper abdomen
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Decreased appetite
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Injection site reactions – including redness, itching, or mild pain at the injection site
Hypoglycaemia (low blood sugar) can occur, particularly when Lyxumia is used in combination with a sulfonylurea or basal insulin. Symptoms may include trembling, sweating, anxiety, blurred vision, tingling lips, pallor, mood changes, or confusion. Patients should be educated on recognising and treating hypoglycaemia with fast-acting carbohydrates. When Lyxumia is added to a sulfonylurea or insulin, your doctor may reduce the dose of these medicines to lower the risk of hypoglycaemia; any dose adjustments must only be made under medical supervision. The risk of hypoglycaemia is generally lower when Lyxumia is used with metformin alone. Most of these common side effects are mild to moderate in severity and do not require discontinuation of treatment, though patients should discuss persistent or troublesome symptoms with their healthcare provider.
Serious Side Effects and When to Seek Medical Help
Whilst most people tolerate Lyxumia well, there are several serious but rare side effects that require immediate medical attention. Patients and carers should be aware of these warning signs and know when to contact their GP or seek emergency care.
Pancreatitis (inflammation of the pancreas) is a recognised risk with GLP-1 receptor agonists. Symptoms include severe and persistent abdominal pain that may radiate to the back, often accompanied by nausea and vomiting. This pain typically does not resolve with simple analgesia and may worsen after eating. If pancreatitis is suspected, patients should seek immediate medical attention. Lyxumia must be discontinued if acute pancreatitis is confirmed, and should not be restarted.
Severe allergic reactions (anaphylaxis) are extremely rare but constitute a medical emergency. Warning signs include:
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Difficulty breathing or swallowing
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Swelling of the face, lips, tongue, or throat
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Severe skin rash, itching, or hives
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Rapid heartbeat and dizziness
Patients experiencing these symptoms should call 999 immediately or attend the nearest A&E department.
Severe hypoglycaemia requiring assistance from another person is uncommon with Lyxumia alone but can occur when combined with sulfonylureas or insulin. If a patient becomes confused, loses consciousness, or experiences seizures due to low blood sugar, emergency services should be contacted.
Other serious effects requiring prompt GP contact include:
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Persistent vomiting or diarrhoea leading to dehydration – severe gastrointestinal symptoms can cause dehydration and may lead to acute kidney injury; maintaining hydration is essential
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Severe abdominal pain of any kind
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Signs of kidney problems (reduced urination, swelling of ankles, unusual tiredness)
Patients should not hesitate to seek medical advice if they experience any symptoms that cause significant concern, even if not listed here. Suspected side effects should be reported via the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or through the Yellow Card app.
Managing Side Effects While Using Lyxumia
Effective management of side effects can significantly improve treatment adherence and quality of life for patients using Lyxumia. Several practical strategies can help minimise adverse effects whilst maintaining the therapeutic benefits of the medication.
For gastrointestinal symptoms, which are the most common side effects, several approaches may prove helpful. Injecting within 1 hour before the same meal each day, as recommended, can help reduce post-injection nausea. Eating smaller, more frequent meals rather than large portions may ease digestive discomfort. Avoiding fatty, spicy, or heavily processed foods during the initial treatment period can also reduce nausea and indigestion. Staying well-hydrated is important, particularly if experiencing vomiting or diarrhoea, to prevent dehydration. If nausea is severe, patients should consult their GP, who may recommend anti-emetic medication. If gastrointestinal side effects are not tolerated during the initial 14-day period on 10 micrograms, your doctor may consider extending this period before stepping up to the 20-microgram maintenance dose. Once on 20 micrograms, there is no standard lower maintenance dose; persistent adverse effects should prompt a treatment review with your healthcare team.
If you miss a dose, skip the missed dose and take your next scheduled dose within 1 hour before your next meal. Do not take an extra dose to make up for the missed one.
Managing injection site reactions involves proper injection technique and site rotation. Patients should inject into different areas of the abdomen or thigh with each dose, avoiding the same spot repeatedly. The injection site should be clean and dry, and the pen should be at room temperature before injection. Allowing alcohol swabs to dry completely before injecting can reduce stinging. If persistent redness, swelling, or pain develops at injection sites, this should be reported to a healthcare professional.
Preventing hypoglycaemia requires careful blood glucose monitoring, particularly when Lyxumia is combined with sulfonylureas or insulin. Patients should:
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Monitor blood glucose as advised by their diabetes team
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Carry fast-acting glucose tablets or sugary drinks
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Wear medical identification indicating diabetes
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Inform family members about recognising and treating low blood sugar
Your doctor may reduce the dose of your sulfonylurea or insulin when starting Lyxumia to lower the risk of hypoglycaemia; any dose adjustments must only be made under medical supervision.
Important interaction advice: Because Lyxumia slows gastric emptying, it can affect the absorption of some oral medicines. If you take a combined or progestogen-only oral contraceptive pill, take it at least 1 hour before your Lyxumia injection or 11 hours after. Discuss timing with your GP or pharmacist if you take other time-critical oral medicines.
Lifestyle modifications including regular meal timing, consistent carbohydrate intake, and avoiding excessive alcohol consumption can help stabilise blood glucose levels and reduce side effects. Patients should maintain regular contact with their diabetes care team, attending scheduled reviews and reporting any persistent or concerning symptoms. The healthcare team can provide individualised advice and may adjust treatment if side effects significantly impact daily life.
Who Should Avoid Lyxumia Pen?
Lyxumia is not suitable for everyone, and certain individuals should not use this medication due to contraindications or increased risk of adverse effects. Healthcare professionals conduct thorough assessments before prescribing Lyxumia to ensure patient safety.
Absolute contraindications include hypersensitivity to lixisenatide or any of the excipients in the formulation. Lyxumia is not indicated for type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis, as it is not a substitute for insulin in these conditions. Lyxumia is not recommended for use in combination with prandial (short-acting) insulin, as this has not been studied.
Pregnancy and breastfeeding represent important considerations. There is limited data on the use of Lyxumia during pregnancy, and animal studies have shown potential reproductive toxicity. Lyxumia should not be used during pregnancy. Women who are pregnant or planning pregnancy should discuss alternative diabetes management strategies with their healthcare team, as insulin is generally the preferred treatment during pregnancy. It is unknown whether lixisenatide is excreted in human breast milk, so breastfeeding whilst using Lyxumia is not recommended. Women of childbearing potential should discuss the need for effective contraception with their healthcare provider.
Caution is advised in several clinical situations:
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Severe renal impairment – Lyxumia is not recommended in end-stage renal disease. It should be used with caution in patients with severe renal impairment (estimated glomerular filtration rate below 30 mL/min/1.73 m²). Renal function should be monitored, particularly if severe gastrointestinal symptoms occur, as dehydration can lead to acute kidney injury.
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Severe gastrointestinal disease – patients with gastroparesis or other severe gastrointestinal conditions may experience worsening symptoms due to delayed gastric emptying
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History of pancreatitis – caution is warranted; patients should be informed of the characteristic symptoms of acute pancreatitis
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Elderly patients (over 75 years) – limited clinical experience exists in this age group
Paediatric use is not recommended, as safety and efficacy have not been established in children and adolescents under 18 years of age.
Before starting Lyxumia, patients should provide their healthcare provider with a complete medical history, including all current medications, to identify potential contraindications or drug interactions (particularly time-critical oral medicines affected by delayed gastric emptying) that may affect treatment suitability.
Frequently Asked Questions
How long do Lyxumia pen side effects typically last?
Most gastrointestinal side effects from Lyxumia, such as nausea and vomiting, typically diminish within the first few weeks of treatment as your body adjusts to the medication. If side effects persist beyond this initial period or become troublesome, you should discuss them with your healthcare provider, who may consider extending the 10-microgram dose period or reviewing your treatment plan.
Can Lyxumia cause low blood sugar on its own?
Lyxumia alone has a low risk of causing hypoglycaemia because it works in a glucose-dependent manner, primarily stimulating insulin release when blood sugar is elevated. However, the risk of low blood sugar increases significantly when Lyxumia is combined with sulfonylureas or insulin, which is why your doctor may reduce the dose of these medications when starting Lyxumia.
What should I do if I experience severe stomach pain whilst using the Lyxumia pen?
Severe and persistent abdominal pain, especially if it radiates to your back and is accompanied by nausea or vomiting, may indicate pancreatitis and requires immediate medical attention. Contact your GP urgently or attend A&E, as Lyxumia must be discontinued if acute pancreatitis is confirmed and should not be restarted.
Is it safe to take the contraceptive pill with Lyxumia?
Yes, but timing is crucial because Lyxumia slows gastric emptying, which can affect oral medication absorption. You should take your combined or progestogen-only contraceptive pill at least 1 hour before your Lyxumia injection or 11 hours after to ensure reliable contraceptive protection.
What are the differences between Lyxumia side effects and other GLP-1 medications like Ozempic?
Lyxumia and other GLP-1 receptor agonists share similar side effect profiles, particularly gastrointestinal symptoms like nausea and vomiting. However, Lyxumia is taken once daily before a meal and has a shorter duration of action compared to weekly GLP-1 agonists like semaglutide (Ozempic), which may influence the frequency and intensity of side effects experienced by individual patients.
How do I report side effects from my Lyxumia pen to UK authorities?
You can report suspected side effects via the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or by downloading the Yellow Card app. Reporting helps regulatory authorities monitor the safety of medicines and contributes to ongoing pharmacovigilance, ensuring that emerging safety concerns are identified and addressed promptly.
The health-related content published on this site is based on credible scientific sources and is periodically reviewed to ensure accuracy and relevance. Although we aim to reflect the most current medical knowledge, the material is meant for general education and awareness only.
The information on this site is not a substitute for professional medical advice. For any health concerns, please speak with a qualified medical professional. By using this information, you acknowledge responsibility for any decisions made and understand we are not liable for any consequences that may result.
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