Lixisenatide

ESRD: Not recommended.

CrCl (mL/min)	Dosage
<30	Not recommended.

Patient with history of pancreatitis; severe gastrointestinal disease (including severe gastroparesis). Not indicated for use in patients with type 1 diabetes mellitus, diabetic ketoacidosis, or for aesthetic weight loss. Patients undergoing surgical and endoscopic procedures. Renal impairment. Pregnancy and lactation.

Significant: Severe gastrointestinal disease, hypoglycaemia; risk of dehydration, suicidal thoughts or actions; anti-lixisenatide antibodies development; risk of gallbladder and bile duct disease (including cholelithiasis and cholecystitis).
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, dyspepsia.
General disorders and administration site conditions: Inj site pruritus.
Infections and infestations: Influenza, viral infection.
Musculoskeletal and connective tissue disorders: Back pain.
Nervous system disorders: Headache, dizziness, somnolence.
Renal and urinary disorders: Cystitis.
Respiratory, thoracic and mediastinal disorders: URTI.
Potentially Fatal: Acute pancreatitis (including haemorrhagic and necrotising pancreatitis); serious hypersensitivity reactions (including anaphylaxis and angioedema).

Ensure adequate fluid intake.

Monitor plasma glucose, renal function; HbA_1c (twice yearly in patients with stable glycaemic control or quarterly in patients who have not met the treatment goal). Monitor for signs and symptoms of pancreatitis.

Symptoms: Increased incidence of gastrointestinal disorders. Management: Symptomatic and supportive treatment.

Increased risk of hypoglycaemia with sulfonylurea or basal insulin. May alter the rate of absorption of drugs with narrow therapeutic ratio, antibiotics, and drugs with gastro-resistant formulation. May delay the absorption of paracetamol.

Description:
Mechanism of Action: Lixisenatide is a synthetic, selective short-acting glucagon-like peptide-1 (GLP-1) receptor agonist antidiabetic agent. It acts on the same receptor as endogenous hormone incretin resulting in increased glucose-dependent insulin secretion and decreased inappropriate glucagon secretion. Additionally, it delays gastric emptying thereby decreasing the rate at which the meal-derived glucose appears in the circulation.
Pharmacokinetics:
Absorption: Rapidly absorbed. Time to peak plasma concentration: 1-3.5 hours.
Distribution: Plasma protein binding: Approx 55%.
Metabolism: Undergoes proteolytic degradation.
Excretion: Via urine. Elimination half-life: Approx 3 hours.

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 90472060, Lixisenatide. https://pubchem.ncbi.nlm.nih.gov/compound/Lixisenatide. Accessed Nov. 25, 2024.

Store between 2-8°C before initial use. Store below 30°C after initial use. Do not freeze. Protect from light.

Antidiabetic Agents

A10BJ03 - lixisenatide ; Belongs to the class of glucagon-like peptide-1 (GLP-1) analogues. Used in the treatment of diabetes.

Anon. Lixisenatide. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 07/11/2024.

Brayfield A, Cadart C (eds). Lixisenatide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/11/2024.

GLP-1 Receptor Agonists: Reminder of the Potential Side Effects and to Be Aware of the Potential for Misuse. Medicines & Healthcare products Regulatory Agency. https://www.gov.uk/drug-safety-update. Accessed 07/11/2024.

Joint Formulary Committee. Lixisenatide. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/11/2024.

Lixisenatide. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 07/11/2024.

Lyxumia 20 mcg Solution for Injection (Sanofi). MHRA. https://products.mhra.gov.uk. Accessed 07/11/2024.