Indications: diabetes mellitus

Cautions: discontinue if symptoms of acute pancreatitis (persistent, severe abdominal pain)

Contra-indications: ketoacidosis; inflammatory bowel disease; diabetic gastroparesis

Hepatic impairment: avoid—limited experience

Renal impairment: avoid if eGFR less than 60 ml/minute/1.73 m2—limited experience

Pregnancy: avoid—toxicity in animal studies.

Breast-feeding: avoid—no information available.

Side Effects: gastro-intestinal disturbances including nausea, vomiting, constipation, diarrhoea, dyspepsia, abdominal pain and distension, flatulence, gastritis, gastro-oesophageal reflux disease, decreased appetite; headache, dizziness, fatigue; fever, bronchitis, nasopharyngitis; hypoglycaemia; injection site reactions; also reported acute pancreatitis, thyroid neoplasm, goitre, increased blood calcitonin, angioedema.

Dose: By subcutaneous injection, adult over 18 years, initially 0.6 mg once daily, increased after at least 1 week to 1.2 mg once daily, further increased if necessary after an interval of at least 1 week to max. 1.8 mg once daily Maintenance.