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Victoza vs Lantus
Introduction
For patients with Type 2 Diabetes or other forms of diabetes, certain drugs that regulate the levels of glucose in the blood can help manage symptoms and prevent complications. Victoza and Lantus are two such medications often prescribed for managing diabetes. They each impact different aspects of insulin production and activity, but both aid in maintaining normal blood sugar levels. Victoza is a glucagon-like peptide-1 (GLP-1) receptor agonist which mimics an intestinal hormone to increase insulin secretion when needed. Lantus on the other hand, is a long acting insulin analog used to control high blood sugar levels throughout the day by providing stable and consistent level of insulin.
Victoza vs Lantus Side By Side
| Attribute | Victoza | Lantus |
|---|---|---|
| Brand Name | Victoza | Lantus |
| Contraindications | Should not be used by individuals with a history of pancreatitis or those who have had thyroid cancer. | Must be used cautiously by those suffering from liver and kidney diseases due to slower insulin metabolism. |
| Cost | $900 to $970 for a 30-day supply | $300 to $375 for a 10ml vial |
| Generic Name | Liraglutide | Insulin Glargine |
| Most Serious Side Effect | Signs of pancreatitis, new or worsening kidney problems, rapid weight gain with shortness of breath, severe gastrointestinal issues, thyroid tumors. | Signs of serious allergic reactions, unusual weight gain, swelling in your hands or feet, shortness of breath, rapid heart rate, severe pain in the upper stomach spreading to your back. |
| Severe Drug Interactions | Not specified, but interactions that affect glucose levels should be avoided. | Not specified, but caution is advised when used with drugs that may affect blood glucose levels. |
| Typical Dose | 0.6–1.8 mg/day | 0.2 units/kg or up to 10 units once daily |
What is Victoza?
Liraglutide (the generic name for Victoza) is a relatively new class of diabetes medication known as GLP-1 receptor agonists, which marked a significant advancement from the first class of long-acting insulin analogs such as Insulin Glargine (generic name for Lantus). Liraglutide was first approved by the FDA in 2010. Victoza works by mimicking the effects of natural hormones in your body to keep blood sugar levels stable throughout the day. It's prescribed mostly for type 2 diabetes and weight management. Unlike other antidiabetic medicines, liraglutide directly affects glucose control with minor influence on overall insulin levels resulting in less risk of hypoglycemia compared to medications like Lantus that primarily increase circulating insulin.
What conditions is Victoza approved to treat?
Victoza and Lantus are both approved for the treatment of different types of diabetes:
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Victoza is used in conjunction with diet and exercise to improve blood sugar control in adults and children aged 10 years old or older with type 2 diabetes. It's also employed to reduce the risk of major cardiovascular events like heart attack, stroke, or death in adults with type 2 diabetes who have known heart disease.
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Lantus, on the other hand, is utilized to treat both Type 1 Diabetes (in adults and children over six) as well as Type 2 Diabetes (in adults). This long-lasting insulin helps regulate blood glucose levels throughout the day.
How does Victoza help with these illnesses?
Victoza helps to manage diabetes by mimicking the function of a hormone known as GLP-1. This hormone, produced in the intestines, is released after meals and stimulates insulin secretion from pancreatic beta cells while simultaneously inhibiting glucagon release from alpha cells. By doing this, Victoza can help regulate blood sugar levels throughout the day, reducing post-meal spikes which are common in people with Type 2 Diabetes.
Insulin and glucagon play crucial roles in controlling glucose metabolism; insulin lowers blood glucose levels by promoting its uptake into body tissues for energy use or storage, whereas glucagon raises blood glucose levels by stimulating liver to convert stored glycogen into glucose. It is thought that individuals with type 2 diabetes have relatively higher amounts of uncontrolled blood sugar due to insufficient production of insulin or reduced sensitivity to it.
Therefore, by emulating GLP-1's actions on both insulin and glucagon release, Victoza can help lower overall blood sugar levels thus managing diabetic symptoms better. Unlike other injectable medications such as Lantus which only provide basal insulin coverage over a prolonged period without adjusting for food intake changes during the day; Victoza aims at providing more comprehensive control over daily fluctuations of glycemic levels.
What is Lantus?
Lantus, a brand name for insulin glargine, is a long-acting basal insulin analogue. This means it helps to control blood sugar levels over an extended period of time by delaying the absorption of insulin into the bloodstream and reducing its rate of degradation. It's typically administered once daily to help manage type 1 and type 2 diabetes. Lantus was first approved by the FDA in 2000.
Unlike Victoza (liraglutide), which is not an insulin but rather a glucagon-like peptide-1 receptor agonist that increases insulin secretion and decreases glucose production in the liver, Lantus does not cause weight loss or risk hypoglycemia when used alone. Its action profile makes it different from other insulins; specifically, it provides continuous steady-state levels without any pronounced peak effect, reducing the chances of nocturnal hypoglycemia (a common side-effect with some other types of long-acting insulins). The stable level of background insulin provided by Lantus can be beneficial for patients who require better glycemic control over prolonged periods.
What conditions is Lantus approved to treat?
Lantus is an FDA-approved medication that has been proven to be effective in managing the following conditions:
- Type 1 Diabetes, where it can substitute for the body's inability to produce sufficient insulin.
- Type 2 Diabetes, aiding patients whose bodies cannot use insulin properly. It works by providing a steady and consistent level of insulin over a 24-hour period, which helps control blood sugar levels throughout the day and night.
How does Lantus help with these illnesses?
Insulin is a hormone that plays several vital roles in the body's metabolism, especially in controlling blood glucose levels. Lantus, also known as insulin glargine, works by mimicking the basal insulin release of a healthy pancreas to help control blood sugar levels throughout the day and night. It has a long duration of action—up to 24 hours—which can provide consistent insulin activity to manage diabetes effectively. Its mechanism differs from Victoza (liraglutide), which primarily stimulates the release of insulin when there are high blood sugar levels. Since it does not significantly affect digestion speed like some other medications for type 2 diabetes, Lantus may be prescribed when a patient does not respond well to other medications or alongside them for better glycemic control.
How effective are both Victoza and Lantus?
Both liraglutide (Victoza) and insulin glargine (Lantus) have been significantly successful in managing type 2 diabetes, with their initial FDA approvals being just a few years apart. As they act on different aspects of glucose metabolism, they may be prescribed under different circumstances. The effectiveness of Victoza and Lantus in controlling blood sugar levels was directly studied in several clinical trials; both drugs showed similar efficacy in managing symptoms of diabetes as well as promising safety profiles. In these studies, there were no significant differences between the groups receiving Victoza or Lantus when it came to overall glycemic control.
A review from 2010 demonstrated that Victoza is effective at reducing HbA1c levels and fasting plasma glucose starting from the first week of treatment, its side effect profile is manageable compared to other antidiabetic medications, and it can even promote weight loss—a valuable benefit for many individuals with type 2 diabetes. Further research has also shown that Victoza reduces cardiovascular risk factors beyond just improving blood sugar control.
Numerous reviews indicate that Lantus is highly effective at lowering HbA1c levels similarly to other basal insulins but offers improved predictability and less hypoglycemia risk—especially nocturnal hypoglycemia—which can greatly improve patients' quality of life. Despite this, medical professionals often consider other treatment options before resorting to insulin therapy due to concerns about potential weight gain or hypoglycemia associated with insulin use.
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At what dose is Victoza typically prescribed?
Subcutaneous injections of Victoza range from 0.6–1.8 mg/day, but research suggests that a starting dose of 0.6 mg/day is adequate for the treatment of type 2 diabetes in most adults. This can be increased to a maximum dose of 1.8 mg/day if there is no response after one week or more. In contrast, Lantus dosage usually begins at around 0.2 units/kg once daily, and should not exceed an amount that causes hypoglycemia (low blood sugar). The exact dosing varies depending on individual patient needs and should always be determined by the treating physician.
At what dose is Lantus typically prescribed?
Lantus is typically initiated at a dose of 0.2 units/kg or up to 10 units once daily, depending on the patient's insulin needs and blood sugar control. This amount can then be adjusted upwards in increments of 1-2 units every few days based on individual metabolic needs, blood glucose monitoring results and glycemic control goal. Maximum dosage differs from person to person but should not exceed what you require for a full day's worth of background (basal) insulin coverage. The injection time must remain consistent each day; ideally at bedtime to ensure optimal absorption and action over a 24-hour period.
What are the most common side effects for Victoza?
Common side effects of Victoza include:
- Nausea
- Diarrhea
- Vomiting
- Decreased appetite
- Indigestion
- Constipation
- Abdominal discomfort or pain
- Bloating and gas
- Fatigue (general weakness and tiredness)
- Headache, dizziness, insomnia.
Meanwhile, the typical side effects for Lantus are slightly different:
- Low blood sugar (hypoglycemia)
- Weight gain
- Skin reactions at the injection site such as redness, swelling or itching.
It is important to remember that these medications should be used under a healthcare provider's supervision. Each individual may react differently to medication; some may experience multiple side effects while others face none. Always consult your healthcare provider if you encounter any adverse symptoms after using these drugs.
Are there any potential serious side effects for Victoza?
While Victoza and Lantus are both used in the management of diabetes, they can have different side effects. For Victoza, rare but serious side effects may include:
- Signs of pancreatitis: severe pain in your upper stomach spreading to your back, nausea and vomiting, loss of appetite
- New or worsening kidney problems: little or no urination; painful or difficult urination; swelling in your feet or ankles
- Rapid weight gain with shortness of breath
- Severe gastrointestinal issues: constant feeling of nausea leading to significant weight loss; severe constipation causing abdominal discomfort
- Thyroid tumors: lump or swelling in neck accompanied by hoarseness
For Lantus these might be:
- Low blood sugar (hypoglycemia): sudden sweating, shaking, fast heartbeat, hunger blurred vision dizziness tingling hands/feet.
- Allergic reactions like itching rash over whole body trouble breathing chest tightness wheezing low potassium levels which could cause muscle cramps irregular heartbeats fluttering in chest increased thirst/urination numbness/tingling/pain/cold feeling extremities.
In case you experience any unusual symptoms while taking either medication it's recommended that you speak to a healthcare professional immediately.
What are the most common side effects for Lantus?
Common side effects of Lantus, a long-acting insulin used to manage blood sugar levels in those with type 1 and type 2 diabetes, include:
- Injection site reactions (redness, swelling, or itching)
- Headache
- Weight gain
- Mild rash or redness on the skin
- Swelling in your hands and feet
- Back pain or joint pain
- Nausea, stomach discomfort It's important to note that while these side effects can occur they are usually mild and manageable. However, more serious symptoms like low potassium level (causing muscle weakness), abnormal heart rhythms or severe allergic reaction do require immediate medical attention.
Are there any potential serious side effects for Lantus?
While Lantus is typically well-tolerated by patients, it can sometimes cause severe side effects. These could include:
- Signs of serious allergic reactions: hives, itching, rash, trouble breathing or swallowing, swelling in your face or throat
- Unusual weight gain
- Swelling in your hands or feet
- Shortness of breath (even with mild exertion)
- Rapid heart rate
- Severe pain in the upper stomach spreading to your back
- Nausea and vomiting; feeling weak or tired
If you encounter any of these side effects while using Lantus, please stop usage immediately and consult your healthcare provider for further advice.
Contraindications for Victoza and Lantus?
Both Victoza and Lantus, like many other diabetes medications, may cause hypoglycemia (low blood sugar) in some individuals. If you experience symptoms of low blood sugar such as dizziness, confusion, irritability or shakiness, seek immediate medical attention.
Neither Victoza nor Lantus should be used if you are currently taking or have recently taken any medication that can affect your glucose levels or if you have a history of pancreatitis. Always inform your doctor about all the medications you are taking; certain drugs might require an adjustment period to prevent dangerous interactions with Victoza and Lantus.
Victoza has been associated with thyroid tumors in animal studies so it is not recommended for people who have had thyroid cancer. On the other hand, Lantus must be used cautiously by those suffering from liver and kidney diseases because its action may be prolonged due to slower insulin metabolism.
How much do Victoza and Lantus cost?
For the brand name versions of these drugs:
- The price of Victoza (liraglutide) ranges from $900 to $970 for a 30-day supply of 1.8mg/day, which works out to approximately $30-$32 per day.
- The price of Lantus (insulin glargine) ranges from about $300 to $375 for a 10ml vial, which can last up to one month based on the dosage (usually between 0.2 -0.6 units/kg/day), equating roughly to around $10-$12 per day.
Thus, if you are on an average dose range for insulin glargine and liraglutide, then brand-name Lantus is likely less expensive on a per-day treatment basis compared with Victoza. Please remember that cost should not be your primary consideration in determining which medication is right for you.
There aren't any generic versions available yet for either Victoza or Lantus as they're biologics and more complex than traditional small-molecule drugs. However, there's an alternative lower-cost biosimilar version called Basaglar available in place of Lantus and it typically costs between $250 and $300 per pen pack containing five KwikPens at most pharmacies.
Popularity of Victoza and Lantus
Liraglutide, known by the brand name Victoza, was prescribed to about 1.8 million people in the USA in 2020. Liraglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 RA) and accounted for nearly 30% of GLP-1 RA prescriptions last year. It has seen an upward trend since its approval by FDA in 2010.
Insulin glargine, sold under the brand name Lantus among others, was prescribed to around 4 million people in the USA during that same period. As part of long-acting insulin analogs, it represents approximately one third of total insulin prescriptions handed out over this timeframe. Despite newer drugs entering this market segment such as ultra-long acting insulins like Tresiba and Toujeo; Insulin Glargine's prescription number remained relatively steady over the past decade.
Conclusion
Both Victoza (liraglutide) and Lantus (insulin glargine) have been widely used in managing diabetes, and their effectiveness has been backed by numerous clinical studies. Occasionally, these medications may be combined for better glucose control, but this is subject to careful consideration from a healthcare professional due to potential interactions between the two drugs. Their mechanisms of action differ: Victoza mimics an intestinal hormone that stimulates insulin secretion when blood sugar levels are high; Lantus is a long-acting form of insulin that regulates the metabolism of sugar.
Victoza can lead to weight loss while improving blood glucose control which makes it advantageous in diabetic patients who are overweight or obese, whereas Lantus primarily focuses on controlling blood sugar levels with neutral effect on weight.
Although both medications come as injectables, they do not yet have generic versions available which could represent significant cost factors for patients paying out-of-pocket. Both Victoza and Lantus require some time before their full effects become noticeable.
Side effects vary somewhat between the two drugs with nausea being more common with Victoza than Lantus. However, both are generally well-tolerated after a brief adjustment period at the onset of treatment. For both medications, it's recommended that users monitor their blood glucose levels regularly and seek medical help immediately if hypoglycemic symptoms occur.
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Refrences
- Scott, L. J. (2014, November 4). Liraglutide: A Review of Its Use in Adult Patients with Type 2 Diabetes Mellitus. Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40265-014-0321-6
- Usui, R., Sakuramachi, Y., Seino, Y., Murotani, K., Kuwata, H., Tatsuoka, H., … Yabe, D. (2017, December 13). Retrospective analysis of liraglutide and basal insulin combination therapy in Japanese type 2 diabetes patients: The association between remaining β‐cell function and the achievement of the glycated hemoglobin target 1 year after initiation. Journal of Diabetes Investigation. Wiley.http://doi.org/10.1111/jdi.12773
- Lee, P. H., Stockton, M. D., & Franks, A. S. (2011, April). Acute Pancreatitis Associated with Liraglutide. Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1345/aph.1p714
- Gross, B. (2012, December 2). Clinical Pearls for Initiating and Utilizing Liraglutide in Patients With Type 2 Diabetes. Journal of Pharmacy Practice. SAGE Publications.http://doi.org/10.1177/0897190012465985