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GLP-1 ANALOG DOSING



Drug Dosage form Typical dosage range Maximum Dose Food Generic/Price Storage Other
Albiglutide

(Tanzeum™)
Single-dose pen
  • 30 mg dose
  • 50 mg dose
  • Comes in cartons of 1 and 4
Type 2 diabetes
  • Starting: 30 mg once a week
  • Maintenance: 30 - 50 mg once a week
  • See precautions for dosing in kidney and liver disease
50 mg once a week May be given without regard to food NO/$$$$ REFRIGERATED PENS (UNMIXED)
  • Good until expiration date if refrigerated

ROOM TEMPERATURE PENS (UNMIXED)
  • Good for 4 weeks

MIXED PENS
  • Dose should be administered within 8 hours
Other
  • Inject subcutaneously in thigh, abdomen, or upper arm
  • Pen comes with powder and diluent inside. Patient must follow instructions to allow them to mix inside the pen.
  • After mixing, patient must wait to inject for 15 minutes (30 mg pen) or 30 minutes (50 mg pen)
  • If adding to insulin or sulfonylurea, consider lowering dose of these drugs when initiating to prevent hypoglycemia
Missed doses
  • If dose is missed, patient should administer ASAP within 3 days of missed dose. Resume dosing on usual day of administration.
  • If 3 days have passed, patient should administer next dose on day of their next regularly scheduled dose

Drug Dosage form Typical dosage range Maximum Dose Food Generic/Price Storage Other
Dulaglutide

(Trulicity™)
Single-dose pen
  • 0.75 mg dose
  • 1.5 mg dose
  • Comes in carton with 4 pens
Prefilled syringe
  • 0.75 mg dose
  • 1.5 mg dose
  • Comes in carton with 4 syringes
Type 2 diabetes
  • Starting: 0.75 mg once a week
  • Maintenance: 0.75 - 1.5 mg once a week
  • See precautions for dosing in kidney and liver disease
1.5 mg once a week May be given without regard to food NO/$$$$ REFRIGERATED PENS AND SYRINGES
  • Good until expiration date if refrigerated

ROOM TEMPERATURE PENS AND SYRINGES
  • Good for 14 days
Other
  • Inject subcutaneously in thigh, abdomen, or upper arm
  • If adding to insulin or sulfonylurea, consider lowering dose of these drugs when initiating to prevent hypoglycemia
Missed doses
  • If a dose is missed, administer as soon as possible if there are at least 3 days until the next scheduled dose
  • If less than 3 days remain before the next scheduled dose, skip the missed dose and administer the next dose on the regularly scheduled day
  • In each case, patients can then resume their regular once weekly dosing schedule
  • The day of weekly administration can be changed if necessary as long as the last dose was administered 3 or more days before

Drug Dosage form Typical dosage range Maximum Dose Food Generic/Price Storage Other
Exenatide

(Byetta®)
5 mcg dose
  • 1.2ml prefilled syringe with 60 doses
10 mcg dose
  • 2.4ml prefilled syringe with 60 doses
Type 2 diabetes
  • Starting: 5mcg twice a day
  • Maintenance: 5 - 10mcg twice a day
  • Increase dose at intervals of ≥ 4 weeks
  • See precautions for dosing in kidney and liver disease
10mcg twice a day Give within the 60-minute time period before the morning and evening meal NO/$$$$ UNPUNCTURED PENS
  • Keep refrigerated
  • Good until expiration date on product

PUNCTURED PENS
  • Keep at temperature below 77° F (25°C)
  • Good for 30 days
  • Do not freeze
  • To limit GI side effects, the recommended starting dose is 5mcg twice a day
  • Inject subcutaneously in thigh, abdomen, or upper arm

Drug Dosage form Typical dosage range Maximum Dose Food Generic/Price Storage Other
Exenatide

(Bydureon®)
Single-dose pen
  • Each pen contains 2 mg
  • Comes in carton of 4 pens
Dosing tray
  • Each dosing tray comes with a syringe, needle, and vial
  • Each vial has a 2 mg dose
  • Comes in carton of 4 trays
Type 2 diabetes
  • Dosing: 2 mg once a week
  • See precautions for dosing in kidney and liver disease
2 mg once a week May be given without regard to food NO/$$$$ REFRIGERATED PENS/TRAYS
  • Good until expiration date

ROOM TEMPERATURE PENS/TRAYS
  • Good for 4 weeks

MIXED DOSE FROM TRAY
  • Use immediately
Other
  • Tray requires patient to mix the drug. After suspension, the mixture should be white to off-white and cloudy.
  • Inject subcutaneously in abdomen, thigh, or upper arm
Missed doses
  • Administer missed dose as soon as possible, provided the next regularly scheduled dose is due at least 3 days later. Thereafter, patients can resume their usual dosing schedule of once a week.
  • If a dose is missed and the next regularly scheduled dose is due 1 or 2 days later, the patient should not administer the missed dose and instead resume Bydureon with the next regularly scheduled dose.
  • Do not take 2 doses within 3 days of each other

Drug Dosage form Typical dosage range Maximum Dose Food Generic/Price Storage Other
Liraglutide

(Victoza®)
Pen - 3ml
  • Pen can be dialed to all 3 doses
  • For 1.8 mg dose has 10 doses
  • For 1.2 mg dose has 15 doses
  • For 0.6 mg dose has 30 doses
  • Comes in packages of 2 or 3 pens
Type 2 diabetes
  • Starting: 0.6 mg once daily for 1 week
  • Maintenance: 1.2 - 1.8 mg once daily
  • See precautions for dosing in kidney and liver disease
1.8 mg once daily May be given without regard to food NO/$$$$ UNPUNCTURED PENS
  • Keep refrigerated
  • Good until expiration date if refrigerated
  • Do not freeze

PUNCTURED PENS
  • Keep at room temperature or refrigerate
  • Good for 30 days
  • Do not freeze
  • Inject subcutaneously in thigh, abdomen, or upper arm
  • To limit GI side effects, the recommended starting dose is 0.6 mg once daily
  • 0.6 mg dose is not effective for blood sugar control
  • If adding to insulin or sulfonylurea, consider lowering dose of these drugs when initiating to prevent hypoglycemia
  • It is acceptable to inject Victoza and insulin in the same body region but the injections should not be adjacent to each other
  • If > 3 days have elapsed since last dose, reinitiate at 0.6 mg dose



Drug Dosage form Typical dosage range Generic/Price
Xultophy®

liraglutide + insulin degludec
Insulin degludec - Liraglutide
  • 100 units of insulin and 3.6 mg of liraglutide/ml
  • Comes in 3 ml pens sold in packages of 5
Type 2 diabetes
  • Dosing is based on units of insulin
  • Starting: 16 units once daily
  • Max: 50 units once daily
  • Adjust dose up or down every 3 - 4 days by two units
  • Pen may be dialed in one-unit increments to deliver a dose between 10 and 50 units
  • Store unused pens in refrigerator
  • After first use, pens may be stored at room temperature for 21 days
NO/$$$



  • PRICING

    • $ = 0 - $50
    • $$ = $51 - $100
    • $$$ = $101 - $150
    • $$$$ = > $151

    • Pricing based on one month of therapy at typical doses
    • Pricing based on survey of GoodRX.com®, HEB®, and Costco®, [accessed 12/2014]
    • Pricing may vary by region and availability



  • References:
  • 1 - Manufacturer's Package Insert for each drug listed