Onglyza vs Victoza

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Introduction

For patients with type 2 diabetes, certain drugs that alter the level of sugar in your blood can help in controlling blood glucose levels and managing symptoms. Onglyza and Victoza are two such drugs that are prescribed for this condition. They each impact different mechanisms in the body, but both have glucose-lowering effects in patients with type 2 diabetes. Onglyza is a DPP-4 inhibitor (dipeptidyl peptidase-4 inhibitor), which works by increasing the production of insulin (a hormone that regulates blood sugar) and reducing the amount of glucose made by the liver. On the other hand, Victoza falls under a class of medication called GLP-1 receptor agonists (glucagon-like peptide 1 receptor agonists). It mimics incretin hormones like GLP-1 to stimulate insulin secretion when needed and inhibit glucagon release from your liver thereby improving overall glycemic control.

What is Onglyza?

Saxagliptin (the generic name for Onglyza) is a member of the class of drugs known as DPP-4 inhibitors, which have made significant advances from the original classes of diabetes medications. Saxagliptin was first approved by the FDA in 2009. Onglyza works by increasing levels of incretin hormones that help control blood sugar by increasing insulin release, especially after meals, and decreasing the amount of glucose produced and released by the liver. It is prescribed primarily for type-2 diabetes treatment.

Liraglutide (Victoza), on other hand, belongs to a different class called GLP-1 receptor agonists or incretin mimetics with its approval coming a year later than Onglyza in 2010. Unlike Onglyza which increases incretins indirectly through inhibition of their breakdown enzyme DPP-4, Victoza directly increases insulin release due to its structure being similar to natural GLP-1 hormone hence mimicking its function more effectively leading to stronger glycemic control but at expense of potentially more side effects like gastrointestinal disturbances.

What conditions is Onglyza approved to treat?

Onglyza has been approved for the treatment of different variations of type 2 diabetes:

Adult onset diabetes, otherwise known as Type 2 Diabetes Mellitus (T2DM)
Management of blood sugar levels in conjunction with diet and exercise
It is often used in combination with other antidiabetic drugs to effectively manage T2DM when single drug therapy does not provide adequate glycemic control.

How does Onglyza help with these illnesses?

Onglyza aids in managing type 2 diabetes by increasing the amount of incretins available in the body. Incretins are a group of hormones that signal your pancreas to release insulin after eating, an important process for regulating blood sugar levels. Onglyza works by blocking the enzyme responsible for breaking down these incretins, so their levels can be maintained higher for longer periods of time. Insulin is a hormone that allows cells to take up glucose from the bloodstream and use it as energy, helping to keep blood sugar levels stable. Individuals with type 2 diabetes have trouble producing or using insulin effectively leading to high blood sugar levels. Therefore, by increasing incretin levels which subsequently increases insulin production and decreases glucagon secretion (a hormone that raises blood glucose level), Onglyza can help manage high blood sugar associated with type 2 diabetes and maintain overall metabolic balance.

What is Victoza?

Victoza, whose generic name is liraglutide, belongs to a class of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists. It works by mimicking the function of GLP-1, a hormone in the body that slows down gastric emptying and causes insulin release when glucose levels are high. The FDA approved Victoza for use in 2010.

Unlike Onglyza which falls under the category of dipeptidyl peptidase-4 inhibitors and primarily acts on the pancreas to stimulate insulin secretion and reduce glucose production, Victoza goes above this action by not only stimulating insulin but also suppressing glucagon - both necessary actions for controlling blood sugar levels. In cases where patients do not respond well to "typical" DPP-4 inhibitor drugs like Onglyza, they might find more success with GLP-1 receptor agonists such as Victoza.

It's important to note that while Victoza has been found effective in managing type 2 diabetes and weight loss due its appetite-suppressing effects; it may cause side effects including nausea, diarrhea, vomiting and decreased appetite.

What conditions is Victoza approved to treat?

Victoza is a medication that has received approval from the FDA for the treatment of:

Type 2 diabetes, by improving blood sugar control in conjunction with diet and exercise
Reducing the risk of major cardiovascular events such as heart attack or stroke in adults with type 2 diabetes and established cardiovascular disease.

How does Victoza help with these illnesses?

Victoza, also known as Liraglutide, is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the management of type 2 diabetes. This hormone plays an essential role in glycemic regulation by enhancing glucose-dependent insulin secretion. It also slows gastric emptying and helps to reduce food intake by making patients feel fuller longer, which can aid in weight loss - a beneficial factor often needed in managing type 2 diabetes. Victoza's actions on GLP-1 receptors may play significant roles in its usage as an antidiabetic drug. Since it does not significantly affect DPP4 activity like Onglyza or other DPP4 inhibitors do, it may be prescribed when a patient does not respond well to these types of medications or may even be combined with them for better blood sugar control.

How effective are both Onglyza and Victoza?

Both saxagliptin (Onglyza) and liraglutide (Victoza) are effective medications used in managing type 2 diabetes, with their approvals by the FDA only a year apart. They act differently on glucose metabolism, thus they might be prescribed based on different patient needs. In a direct comparison study conducted in 2010, both drugs showed similar efficacy in lowering HbA1c levels - a key marker for long-term blood sugar control.

A meta-analysis performed in 2013 demonstrated that saxagliptin is effective at reducing HbA1c levels from the start of treatment, it exhibits fewer gastrointestinal side effects compared to other antidiabetic agents and is well-tolerated even in elderly populations. Further research revealed that Onglyza has become one of the most widely-used DPP-4 inhibitors due to its once-daily dosing convenience and overall safety profile.

On the other hand, a review and meta-analysis conducted in 2016 indicated that liraglutide seems to offer additional benefits beyond glycemic control such as weight reduction which could be advantageous considering weight management issues common among diabetic patients. Victoza is typically considered when metformin monotherapy fails or isn't tolerated by patients despite being an injectable medication demonstrating its significant role within this patient population.

Nonetheless, while there's robust data supporting both drugs' efficacy as standalone treatments; more studies need to explore if combining either drug with existing therapies would have synergistic effects leading to improved outcomes. The unique mechanisms of action may make each an optimal choice depending upon individual patient requirements including those who desire minimal GI disturbances or seek added weight loss benefits respectively.

abstract image of a researcher studying a bottle of drug.

At what dose is Onglyza typically prescribed?

Dosages of Onglyza for adults with type 2 diabetes are typically around 5 mg/day, but this can be reduced to 2.5 mg/day if the patient has kidney issues or other related conditions. In contrast, Victoza is administered by injection rather than orally and its starting dose is usually 0.6 mg per day. This dosage may be increased by your healthcare professional after a week or so to improve glycemic control if needed, up to a maximum of 1.8mg/day. However, in both cases, it's important that you follow your doctor’s advice on how much and how often you should take these medications.

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At what dose is Victoza typically prescribed?

Victoza treatment is generally started at a dosage of 0.6 mg per day, injected subcutaneously without regard to meals. After one week, the dose can be increased to 1.2 mg/day if needed. If blood glucose control remains unsatisfactory after at least one week of treatment with this maximum dosage, it may then be escalated up to the maximum recommended daily dose of 1.8 mg which should only be initiated under direct medical supervision and carefully observed for any adverse effects or reactions.

What are the most common side effects for Onglyza?

Common side effects of Onglyza include:

Headache
Upper respiratory tract infection
Urinary Tract Infection (UTI)
Nasopharyngitis, a type of common cold

On the other hand, Victoza may cause side effects like:

Nausea
Diarrhea
Vomiting
Decreased appetite.

More serious but rare side effects for both drugs can include pancreatitis. It's important to disclose your complete medical history with your doctor before starting either medication.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Onglyza?

While Onglyza and Victoza are both effective treatments for type 2 diabetes, they can cause different side effects:

Signs of a serious allergic reaction: With either drug, you could experience hives or itching; trouble breathing; swelling of your face, lips, tongue or throat.
Pancreatitis (inflammation in your pancreas): Symptoms include severe stomach pain that won't go away and may move to your back, with or without vomiting.
Changes in vision: Blurred vision is a common symptom of high blood sugar levels. If you start experiencing blurred vision after starting these medications, contact your doctor immediately.
Fast heart rate: Both drugs can potentially affect the heartbeat. However, rapid heart rate is more commonly associated with Victoza.
Kidney problems (sometimes requiring dialysis). Symptoms include nausea or vomiting; feeling tired or weak; loss of appetite; increased thirst; swelling in the feet or legs; changes in urination (quantity/color); confusion/stupor/coma
Thyroid tumors/cancer with Victoza: Get medical help right away if you have a lump/swelling in the neck area/front of neck/throat/hoarse voice/trouble swallowing/breathing Remember to always discuss potential side effects with your healthcare provider before starting any new medication regimen.

What are the most common side effects for Victoza?

Victoza, unlike Onglyza, may cause the following side effects:

Nausea and vomiting
Diarrhea or constipation
Headache and dizziness
Loss of appetite leading to weight loss
Fatigue
Fast heartbeat at times
Injection site reactions like redness, swelling, and itching.

It's important to note that while these symptoms are generally mild and temporary, they can occasionally be severe. If you experience persistent or troubling side effects while taking Victoza, it is crucial to seek medical attention promptly.

Are there any potential serious side effects for Victoza?

Victoza, like all medications, can have side effects. While most are mild to moderate and go away over time, some may be serious. Keep an eye out for the following:

Symptoms of a severe allergic reaction such as hives; rash; itching; difficulty breathing or swallowing; tightness in the chest; swelling of the mouth, face, lips, throat or tongue
Signs of pancreatitis: persistent severe abdominal pain which might reach through to your back along with nausea and vomiting
Rapid pulse or palpitations
Vision changes including blurred vision
Kidney problems: painful urination, changes in the amount of urine
Mood changes such as depression or suicidal thoughts

If you notice any of these symptoms while taking Victoza, seek immediate medical attention.

Contraindications for Onglyza and Victoza?

Both Onglyza and Victoza, like most diabetes medications, may cause side effects or worsen existing symptoms in some individuals. If you notice an increase in symptoms such as persistent nausea, vomiting, stomach/abdominal pain, fatigue or difficulty breathing please seek immediate medical attention.

Neither Onglyza nor Victoza should be taken if you are taking or have been taking drugs with a known interaction risk without the approval of your healthcare provider. Always disclose to your physician any medications you are currently on; certain drugs will require a period of clearance from the system to prevent dangerous interactions with Onglyza and Victoza.

Particularly for patients with type 2 diabetes and heart disease, there is a potential increased risk of hospitalization due to heart failure when using Onglyza. On the other hand, Victoza has been associated with rare but serious cases of pancreatitis and possible thyroid tumors including cancer. Hence caution must be exercised when choosing between these two medications based on individual health conditions.

How much do Onglyza and Victoza cost?

For the brand name versions of these drugs:

The price for a 30 day supply of Onglyza (5 mg) averages around $410, which works out to about $13.60 per day.
The price for a 30-day supply of Victoza (18mg/3ml) is roughly $800, working out to approximately $26.67/day.

Thus, if you are solely considering cost as a factor in your decision-making process, Onglyza appears to be less expensive on a per-day basis than Victoza. However, it's crucial to remember that cost should not be the primary consideration in determining which medication is best suited for you or your specific medical needs.

As of now, there are no generic versions available for either Onglyza (saxagliptin) or Victoza (liraglutide), thus costs remain relatively high:

Saxagliptin is only available as a branded drug and usually costs around $400-$500 monthly based on dose requirements.
Liraglutide also doesn't yet have a generic alternative and costs can range from approximately $800-$900 monthly depending upon dosage requirements.

These prices may vary depending on location and insurance coverage details. It's recommended that patients discuss with their healthcare provider about these two treatment options taking into consideration efficacy, side effects profile along with the financial aspect before making an informed decision regarding their diabetes management plan.

Popularity of Onglyza and Victoza

Saxagliptin, in generic form as well as its brand name Onglyza, was prescribed to about 1.2 million people in the US in 2018. Saxagliptin is one of several DPP-4 inhibitors used for the treatment of type 2 diabetes and accounted for just under 10% of all DPP-4 inhibitor prescriptions that year.

Liraglutide, which includes the brand version Victoza, was prescribed to almost 2 million patients in the USA during the same period. Liraglutide is a GLP-1 receptor agonist and it accounts for nearly a quarter (24%) of all GLP-1 receptor agonist prescriptions. The use of liraglutide has been generally increasing over recent years due to its effectiveness at lowering blood sugar levels and potential benefits on heart health and weight loss.

Conclusion

Both Onglyza (saxagliptin) and Victoza (liraglutide) have established places in the treatment of type 2 diabetes, being supported by numerous clinical trials that indicate their efficacy over placebo. Sometimes these medications might be combined depending on a patient's unique situation and physician recommendation. However, careful attention must be given as they are contraindicated under certain circumstances due to their different mechanisms of action - with Onglyza primarily inhibiting DPP-4 enzyme to increase insulin production, while Victoza is a GLP-1 receptor agonist that slows digestion and reduces glucose spikes.

Onglyza is often used when metformin alone does not provide adequate control or if it’s contraindicated due to kidney disease. On the other hand, Victoza could be considered as an adjuvant therapy to oral antidiabetic agents or in patients who need significant weight loss benefits which are beyond those typically seen with Onglyza.

Both drugs come in generic forms offering cost savings especially for out-of-pocket payers. Some adjustment time may be needed before you see noticeable effects from either drug.

The side effect profile between these two drugs can differ significantly; while both are usually well-tolerated, Victoza has been associated more commonly with gastrointestinal side effects but also offers potential weight loss advantage. For both medications, patients must monitor their blood sugar levels regularly and seek medical help immediately if they notice any signs of pancreatitis or severe hypoglycemia.