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GREY MATTER NEWS








                                                     ISSUE 1 2022










        Liraglutide 3 mg is the only GLP-1 approved in
        South Africa for weight management    1-7
       I had the will                                                               liraglutide injection 3mg


       to start a business

       from scratch.



       But I still need help

       to lose weight


       and keep it off.




        SARAH, consultant; Age: 43; BMI: 37
        Patient portrayal.
        Your patients with obesity have the will. You can offer them the way.


        BMI=body mass index; GLP-1=glucagon-like peptide-1
        # Shown in animal models. The exact mechanism of action is unknown.
        References: 1. Saxenda ®  Professional Information. 2. Victoza ®  Professional Information. 3. Xultophy ®  Professional Information. 4. TRULICITY Professional Information. 5. BYETTA Professional Information. 6. South African Health Products Regulatory
        Authority (SAHPRA). Registered Health Products [online 2022][cited 2022 January 21]; Available from URL: https://www.sahpra.org.za/registered-health-products/. 7. IMS May 2020.
        Abbreviated professional information
        Proprietary Name: Saxenda ®  Scheduling Status: S4 Qualitative and quantitative composition: One ml of solution contains 6 mg of liraglutide and phenol 0,55 % m/v as the preservative. Therapeutic indications: Adults: Saxenda ®  is indicated
        as an adjunct to a reduced-calorie diet and increased physical activity for medically supervised chronic weight management programme in adult patients with an initial Body Mass Index (BMI) of: • ≥ 30 kg/m 2  (obese), or • ≥ 27 kg/m 2  to < 30 kg/m 2
        (overweight) in the presence of at least one weight related comorbidity such as dysglycaemia (pre-diabetes and type 2 diabetes mellitus), hypertension, dyslipidaemia, or obstructive sleep apnoea. Adolescents: Saxenda ®  can be used as an adjunct
        to a healthy nutrition and physical activity counselling for weight management in adolescent patients from the age of 12 years and above with: • body weight above 60 kg and • obesity (BMI corresponding to ≥ 30 kg/m 2  for adults by international
        cut-off points)*.
         Age (years)       12     12.5   13    13.5   14     14.5  15     15.5   16    16.5   17     17.5  18
         Body mass index    Males  26.02  26.43  26.84  27.25  27.63  27.98  28.30  28.60  28.88  29.14  29.41  29.70  30.00
         30 kg/m 2   Females  26.67  27.24  27.76  28.20  28.57  28.87  29.11  29.29  29.43  29.56  29.69  29.84  30.00
        *IOTF BMI cut-off points for obesity by sex between 12–18 years
        Posology and method of administration: The starting dose is 0,6 mg once daily. The dose should be increased to 3,0 mg once daily in increments of 0,6 mg with at least one week intervals to improve gastrointestinal tolerability.
        If escalation to the next dose step is not tolerated for two consecutive weeks, consider discontinuing treatment. Daily doses higher than 3,0 mg are not recommended. Saxenda® is for subcutaneous use only. It must not be administered
        intravenously or intramuscularly. Saxenda ®  is administered once daily at any time, independent of meals. However, it is preferable that Saxenda ®  is injected around the same time of the day. It should be injected in the abdomen, thigh or
        upper arm. Saxenda ®  should not be used in combination with another GLP-1 receptor agonist. When initiating Saxenda ® , consider reducing the dose of concomitantly administered insulin or insulin secretagogues (such as sulfonylureas)
        to reduce the risk of hypoglycaemia. Saxenda ®  is not recommended for use in children below 12 years of age or in adolescents with a body weight below or equal to 60 kg due to lack of data.  Contraindication:  •  Hypersensitivity  to
        liraglutide  or  to  any  of  the  excipients  listed  under  Composition.  •  Pregnancy  and  lactation.  Special warnings and precautions for use: Saxenda ®  must not be used as a substitute for insulin. There is no clinical experience
        in patients with congestive heart failure New York Heart Association (NYHA) class IV and Saxenda ®  is therefore not recommended for use in these patients. The safety and efficacy of Saxenda ®  have not been established in the following
        patients,  viz:  •  Treated  with  other  products  for  weight  management,  •  With  obesity  secondary  to  endocrinological  or  eating  disorders  or  to  treatment  with  medicinal  products  that  may  cause  weight  gain,  •  With  severe  renal  impairment,
        • With severe hepatic impairment, • With inflammatory bowel disease and diabetic gastroparesis. Use in these patients is not recommended. Acute pancreatitis has been observed with the use of GLP-1 receptor agonists. Patients should be informed
        of the characteristic symptoms of acute pancreatitis. If pancreatitis is suspected, Saxenda ®  should be discontinued; if acute pancreatitis is confirmed, Saxenda ®  should not be restarted. In the absence of other signs and symptoms of acute pancreatitis,
        elevations in pancreatic enzymes alone are not predictive of acute pancreatitis. In clinical trials, a higher rate of cholelithiasis and cholecystitis was observed in patients treated with Saxenda ®  than in patients on placebo. Patients should be informed of
        the characteristic symptoms of cholelithiasis and cholecystitis. In clinical trials in type 2 diabetes, thyroid adverse events, such as goitre have been reported in patients with pre-existing thyroid disease. Saxenda ®  should therefore be used with caution
        in patients with thyroid disease. An increase in heart rate was observed in clinical trials. Heart rate should be monitored at regular intervals consistent with usual clinical practice. Patients should be informed of the symptoms of increased heart rate
        (palpitations or feelings of a racing heartbeat while at rest). For patients who experience a clinically relevant sustained increase in resting heart rate, treatment with Saxenda ®  should be discontinued. Patients treated with Saxenda ®  should be advised
        of the potential risk of dehydration in relation to gastrointestinal side effects and take precautions to avoid fluid depletion. Patients with type 2 diabetes receiving Saxenda ®  in combination with insulin and/or sulphonylurea have an increased risk of
        hypoglycaemia. Fertility, pregnancy and lactation: Saxenda ®  should not be used during pregnancy and lactation. Undesirable effects: Gastrointestinal reactions were the most frequently reported adverse reactions during treatment with Saxenda ® .
        Very common side effects are nausea, vomiting diarrhoea, constipation. Common side effects include: Hypoglycaemia, insomnia, dizziness, dysgeusia, dry mouth, dyspepsia, gastritis, gastro-oesophageal reflux disease, abdominal pain upper, flatulence,
        eructation, abdominal distension, cholelithiasis, injection site reactions, asthenia & fatigue, increased lipase/increased amylase. Uncommon side effects include: dehydration, tachycardia, pancreatitis, cholecystitis, urticaria & malaise. Rare side effects
        include: anaphylactic reaction, acute renal failure & renal impairment. Overdose: With overdose, the patients reported severe nausea, vomiting and diarrhoea, but recovered without complications. Severe hypoglycaemia has also been observed. In
        the event of overdosage, appropriate supportive treatment should be initiated according to the patient’s clinical signs and symptoms. The patient should be observed for clinical signs of dehydration and blood glucose should be monitored. Reg. No.:
        50/21.13/1091. For full prescribing information, refer to the Professional Information approved by the Regulatory Authority.
                                 Novo Nordisk (Pty) Ltd. Reg. No.: 1959/000833/07. 150 Rivonia Road, 10 Marion Street Office Park, Building C1,
                                 Sandton, Johannesburg, 2196, South Africa. Tel: (011) 202 0500. Fax: (011) 807 7989. www.novonordisk.com.   liraglutide injection 3mg
                                                18033T. ZA22SX00005 January 2022.
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