Home Drug Guide Lixisenatide

Drug Guide

Generic Name

Lixisenatide

Brand Names Adlyxin

Classification

Therapeutic: Antidiabetic agent

Pharmacological: Glucagon-like peptide-1 (GLP-1) receptor agonist

FDA Approved Indications

  • Type 2 diabetes mellitus to improve glycemic control

Mechanism of Action

Lixisenatide is a GLP-1 receptor agonist that enhances glucose-dependent insulin secretion, suppresses elevated glucagon secretion, and slows gastric emptying, which helps to lower blood glucose levels.

Dosage and Administration

Adult: 10 mcg once daily within 1 hour before the first meal. May increase to 20 mcg once daily if additional glycemic control is needed.

Pediatric: Not approved for pediatric use.

Geriatric: Use with caution; consider renal function and risk of gastrointestinal side effects.

Renal Impairment: No dosage adjustment needed for mild impairment; use caution in severe impairment.

Hepatic Impairment: No specific dosing recommendations available.

Pharmacokinetics

Absorption: Rapid absorption with peak plasma concentrations in approximately 1.5 hours.

Distribution: Wide distribution; protein binding is minimal.

Metabolism: Metabolized mainly via dipeptidyl peptidase-4 (DPP-4) enzymes and other proteolytic pathways.

Excretion: Primarily excreted via the kidneys.

Half Life: Approximately 3 hours.

Contraindications

  • Hypersensitivity to lixisenatide or other components.
  • Personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2.

Precautions

  • Risk of pancreatitis; monitor for symptoms.
  • Use with caution in patients with renal impairment.
  • Potential for gastrointestinal symptoms; start at lower doses in sensitive patients.

Adverse Reactions - Common

  • Nausea (Often)
  • Vomiting (Less common)
  • Diarrhea (Less common)
  • Headache (Less common)

Adverse Reactions - Serious

  • Pancreatitis (Rare)
  • Hypoglycemia (especially when combined with insulin or sulfonylureas) (Uncommon)

Drug-Drug Interactions

  • Insulin or sulfonylureas (risk of hypoglycemia)

Drug-Food Interactions

  • No significant interactions generally reported

Drug-Herb Interactions

  • Limited data; use caution with herbal products that affect glucose levels.

Nursing Implications

Assessment: Monitor blood glucose levels regularly, assess for symptoms of pancreatitis, renal function.

Diagnoses:

  • Risk for hypoglycemia
  • Impaired tissue perfusion related to hypoglycemia

Implementation: Administer once daily before the first meal; educate patients on gastrointestinal side effects and pancreatitis symptoms.

Evaluation: Assess blood glucose control, monitor for side effects, verify weight and hydration status.

Patient/Family Teaching

  • Take lixisenatide exactly as prescribed, preferably before the first meal.
  • Recognize symptoms of pancreatitis (severe abdominal pain, nausea, vomiting).
  • Report any signs of hypoglycemia, especially if using insulin or other hypoglycemics.
  • Maintain regular blood glucose monitoring.

Special Considerations

Black Box Warnings:

  • Thyroid C-cell tumors, including medullary thyroid carcinoma, have been observed in rodent studies; use only if the benefits outweigh the risks.

Genetic Factors: Patients with a personal or family history of medullary thyroid carcinoma or MEN 2 should not use.

Lab Test Interference: No known significant interference.

Overdose Management

Signs/Symptoms: Symptoms of hypoglycemia or gastrointestinal disturbances.

Treatment: Discontinue lixisenatide, manage hypoglycemia with glucose as needed, supportive care.

Storage and Handling

Storage: Store refrigerated at 2°C to 8°C (36°F to 46°F).

Stability: Unopened vials can be kept at room temperature up to 14 days; opened vials should be used promptly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.