📋 Indications & Clinical Dosage
*Type 2 diabetes mellitus in combination with metformin or a sulfonylurea, or both, or in combination with basal insulin and/or metformin and pioglitazone when dual therapy with these drugs fails to achieve adequate glycaemic control:*
BY SC INJ: Adult: Initially 0.6 mg once daily for at least 1 week, then increased to 1.2 mg once daily for at least 1 week, then increased if necessary up to 1.8 mg once daily
💊 Mode of Administration
Administered once daily at any time of day, can be injected SC in the abdomen, thigh, or upper arm. Rotate sites to minimize injection site reactions.
⛔ Contraindications
Diabetic gastroparesis, ketoacidosis, inflammatory bowel disease, moderate to severe congestive heart failure, hepatic impairment, severe renal impairment.
⚠️ Precautions & Warnings
Mild congestive heart failure, history of pancreatitis, thyroid disease, hepatic impairment, renal impairment. Ensure adequate hydration. Dose of concomitant insulin or sulfonylurea may need to be reduced.
🔄 Drug Interactions
Warfarin, insulin
⚠️ Adverse Reactions / Side Effects
Abdominal pain and distension, headache, hypoglycaemia, injection site reactions,
Bronchitis, constipation, decreased appetite, nausea, diarrhoea, dizziness, dyspepsia, flatulence, gastritis, GI disturbances, GORD, malaise, nasopharyngitis, tachycardia, vomiting, goiter. Rare: Acute renal failure, increased blood calcitonin, thyroid neoplasm, acute pancreatitis (Discontinue)
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Contraindicated or not recommended.
🧪 Compatibility & Storage Stability
Stability & Storage: Store in refrigeration at 2oC-8oC, after initial use store in refrigerator or at room temperature of 15oC-30oC. Do not freeze. Protect from heat and light. Pen should be discarded 30 days after initial use.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.