GLP-1 receptor agonist medications like Victoza and Ozempic are getting a lot of attention lately due to their ability to promote weight loss.
However, we can’t forget what these medications are meant to do, which is to treat type 2 diabetes.
If you’re prescribed Victoza, you’ll want to become aware of the potential adverse effects (both rare and common), along with other precautions to take to minimize side effects from Victoza.
What is Victoza?
Victoza is a brand name for the medication liraglutide, a GLP-1 receptor agonist meant to treat type 2 diabetes.
Victoza isn’t meant to treat type 1 diabetes and shouldn’t be used to treat diabetic ketoacidosis (DKA), a condition that primarily impacts patients with type 1 diabetes.
The Food and Drug Administration (FDA) approved Victoza in 2010 for use in people ten years of age and older.
Victoza is meant to be injected once daily (compared to weekly injections for some other types of GLP-1 drugs) and comes in prefilled injection pens.
Victoza pens can administer doses of 0.6 milligrams, 1.2 milligrams, or 1.8 milligrams, with typical doses being 1.2 and 1.8 milligrams.
What are the side effects of Victoza?
Victoza comes with side effects like any medication. Many of the more common side effects are considered minor.
Here are some of the more common Victoza side effects to be aware of:
- Nausea
- Diarrhea
- Vomiting
- Decreased appetite
- Indigestion
- Constipation
- Weight loss (from side effects related to slowed stomach emptying and reduced appetite)
How long do the side effects of Victoza last?
The side effects of Victoza will generally wear off or reduce in intensity as you get used to taking it.
It’s typical for the side effects to last a few weeks after you start taking it, but it will depend on your dosing schedule and your sensitivity.
You might experience an increase in side effects when your dose is increased, but once you get to your maintenance dose, the side effects should reduce in intensity.
There is a chance that you might experience side effects even after you’ve been taking Victoza for a while.
If that’s the case, you might need to try another medication if the side effects interfere with your quality of life.
How to reduce the side effects of Victoza
Follow your healthcare provider’s dosing schedule. If you’re taking Victoza for the first time, your healthcare provider will likely suggest following a gradual schedule to help you get used to Victoza and minimize any side effects.
According to the manufacturer, the recommended dosing schedule is:
- Start 0.6 milligrams for at least a week to establish tolerance
- Maintain a dose of 1.2 milligrams for at least a week
- Increase up to 1.8 milligrams as needed
As you can see, the guidelines only specify to follow a dose for at least a week – that means you might need to do a more gradual dose-increasing plan, such as staying on the previous dose for several weeks before increasing, to reduce the side effects of Victoza.
Are there any long-term side effects of taking Victoza?
More rarely, Victoza might cause rare but serious side effects. Some potential rare side effects include:
Pancreatitis
Inflammation of your pancreas (pancreatitis) can occur when taking GLP-1 receptor agonists like Victoza.
Watch out for signs of pancreatitis, like severe abdominal pain (with or without vomiting), and notify your healthcare provider immediately if you experience these symptoms while taking Victoza.
There are some concerns regarding Victoza (and drugs like it) and pancreatic cancer risk. The theory is that because Victoza stimulates your pancreas to release insulin, pancreatic cells might replicate abnormally and result in cancer.
However, studies don’t show an association between Victoza and pancreatic cancer at this time.
Gallbladder problems
There is a chance that you might develop gallbladder disease when taking Victoza. Gallbladder disease encompasses several conditions, including:
- Cholecystitis (inflammation of the gallbladder)
- Gallstones
- Chronic acalculous gallbladder disease (when the natural movements that help your gallbladder empty do not work well)
- Gangrene or abscesses
- Growths of tissue in the gallbladder
- Sclerosing cholangitis
- Tumors of the gallbladder and bile ducts
Some signs of gallbladder disease include upper right abdominal pain often radiating to your back, fever, nausea and vomiting, and the yellowing of the whites of your eyes (jaundice).
In some studies, around 3.1% of participants taking Victoza developed gallbladder disease (gallbladder inflammation and gallstones) compared to 1.9% of patients taking a placebo.
Kidney problems (kidney failure)
If you already have kidney problems, some of the more common side effects of Victoza, like diarrhea, nausea, and vomiting, can cause dehydration which can worsen your kidney problems.
Otherwise, Victoza is generally considered safe even if you have kidney disease since it isn’t cleared by your kidneys.
However, your primary care provider or nephrologist can offer specific recommendations based on your kidney health and function.
Thyroid cancer risk
In animal studies, the active ingredient of Victoza caused thyroid cancer in some mice and rats. It’s unknown if taking these medications will increase your risk of thyroid cancer, but due to the animal studies, Victoza and other medications in the same class have a black box warning from the FDA regarding the risk of thyroid tumors.
You should avoid taking Victoza if you or anyone in your family have had medullary thyroid carcinoma (MTC), a type of thyroid cancer. You also shouldn’t take Victoza if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
The main sign of thyroid cancer is developing a lump or swelling in your neck or throat. If this occurs, you should stop taking Victoza immediately and notify your healthcare provider.
Retinopathy
According to Victoza’s manufacturer, patients taking Victoza experienced diabetic retinopathy complications compared to patients taking a placebo.
However, the risk for complications is highest in patients who have already had retinopathy compared to those who didn’t have a history of retinopathy.
Diabetic retinopathy is a condition where high blood sugar levels damage the blood vessels in your eyes, leading to vision changes.
If left untreated, especially if your blood sugar levels are very high for a long period, retinopathy can progress to loss of sight (blindness).
Symptoms of diabetic retinopathy include:
- Spots or dark strings floating in your vision (floaters)
- Blurred vision
- Fluctuating vision
- Dark or empty areas in your vision
- Vision loss
If you have diabetes, you should receive yearly eye exams from a provider experienced in treating patients with diabetes.
During these eye exams, your eye doctor will be able to tell if the blood vessels in your eyes are being negatively impacted by diabetes.
Keep in mind that rapid changes in blood sugar levels, including a reduction in blood sugar, can cause vision changes.
It’s better to go “slow and steady” when adding new diabetes medications like Victoza to prevent vision changes or problems from rapid blood sugar reduction.
Hypoglycemia
Victoza shouldn’t cause low blood sugar on its own, but it might cause low blood sugar if you take it along with other diabetes medications that can cause low blood sugar, like sulfonylureas or insulin.
Symptoms of low blood sugar to watch out for while taking Victoza include:
- Fast heartbeat
- Shaking
- Sweating
- Nervousness or anxiety
- Irritability or confusion
- Dizziness
- Hunger
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Who should not take Victoza?
People with type 1 diabetes
Victoza isn’t meant to treat patients with type 1 diabetes, only type 2. The reason Victoza doesn’t work if you have type 1 is that it stimulates your pancreas to make insulin in response to your blood sugar levels rising.
The issue is that the beta cells of your pancreas (the ones that produce insulin) are destroyed in an autoimmune response with type 1, so there isn’t enough (or any) insulin to be released.
This is why patients with type 1 diabetes inject insulin and rarely rely on other medications, which are primarily geared toward treating type 2 diabetes.
Patients under the age of ten
The United States Food and Drug Administration has only approved Victoza for people aged 10 and up.
Children under the age of 10 aren’t good candidates for taking Victoza since it’s unclear if it’s safe for them.
History of thyroid problems
You shouldn’t take Victoza if you have a history of multiple endocrine neoplasia type 2 (MEN2), a type of genetic condition that causes tumors to grow in your endocrine system (thyroid, parathyroid, and adrenal glands).
You might also need to avoid Victoza if you have a personal or family history of thyroid tumors or other thyroid issues.
Drug sensitivity or allergy
If you’re allergic to any of the ingredients in Victoza or are sensitive to it, you shouldn’t take it. You might not know if you’re sensitive until you try taking Victoza for the first time, which is why it’s important to document any unusual side effects or symptoms to your healthcare provider as you begin taking Victoza.
Gastroparesis
Gastroparesis is a condition that causes delayed stomach emptying. This is a complication of uncontrolled diabetes as chronic high blood glucose levels damage the nerves that control your stomach emptying.
Victoza causes delayed stomach emptying, which can worsen gastroparesis symptoms such as:
- Vomiting
- Nausea
- Abdominal bloating
- Abdominal pain
- A feeling of fullness after eating just a few bites
- Vomiting undigested food eaten hours prior
- Acid reflux
- Changes in blood sugar levels
- Lack of appetite
- Weight loss and malnutrition
Pregnant or breastfeeding women
It isn’t clear if Victoza is safe for unborn babies, so you shouldn’t take Victoza if you’re pregnant or planning to become pregnant.
If you’re taking Victoza and want to become pregnant, it’s recommended to wait until two months after your last dose of Victoza before you begin trying (per the manufacturer’s recommendations).
It’s also unclear if Victoza is safe to take while breastfeeding (medication can pass from the breast milk to the infant), so you should avoid it while nursing.
What are the side effects of stopping Victoza?
The main side effect that is likely to happen when you stop taking Victoza is a rise in blood sugar, especially if you don’t replace Victoza with another type of diabetes medication.
Otherwise, the only symptoms you might notice are a reduction in any side effects you experienced from taking Victoza, such as nausea and a loss of appetite.
Weight gain might also occur if you stop Victoza, especially if you experienced weight loss from Victoza due to a reduction in appetite from taking it.
Conclusion
Victoza is a medication used to treat type 2 diabetes. It’s a non-insulin injectable medication that is injected daily and is in a class of medications called GLP-1 receptor agonists.
The most common side effects of Victoza are gastrointestinal-related, such as nausea, vomiting, diarrhea, and indigestion, among others.
More rarely, Victoza can cause worsening kidney problems (due to dehydration), gallbladder disease, pancreatitis, thyroid tumors, and retinopathy.
You shouldn’t take Victoza if you have type 1 diabetes, are pregnant or planning to become pregnant, are breastfeeding, have a history of MEN2 (a type of genetic disorder) or thyroid problems, are younger than ten years old, or are allergic or sensitive to Victoza.
Your healthcare provider might also recommend avoiding Victoza based on your personal health history.