As a community pharmacist, you will hear about using Saxenda for weight loss. Saxenda (liraglutide) will be a new option to help tackle obesity in adolescents 12 and up, not just in adults. About 30% of Canadian kids age 5 to 17 are overweight or obese. This may lead to adulthood obesity and a higher risk of health conditions, type 2 diabetes, heart disease, sleep apnea, etc. The injectable medication Saxenda has the same active ingredient as the diabetes medication, Victoza. The big difference is that Saxenda is given in higher doses than Victoza, to help reduce hunger. Most patients should try to lose weight by making lifestyle changes first, such as exercising and incorporating more fruits and vegetables into their diet.
Saxenda will be an option for adolescents with obesity when lifestyle changes aren't enough. If you dispense Saxenda for weight loss, watch doses and sigs closely. Adolescents will start on Saxenda 0.6 mg once daily, then increase the dose weekly over 4 to 8 weeks to reach up to 3 mg once daily. This helps reduce side effects, such as nausea, vomiting, and diarrhea. IN THE DISPENSING PHARMACY, use total milliLITERS when entering quantities into the computer, not the number of pens or boxes. For example, put in 15 mL for a box of five 3 mL pens (5 pens × 3 mL/1 pen = 15 mL).
Store Saxenda in the fridge before dispensing, then add a "Use by" label alerting patients that once in use, it's good for up to 30 days at either in the fridge or at room temperature. Keep in mind, Saxenda is very expensive compared to medication like Xenical (orlistat), another weight loss drug. Check that patients get pen needles with Saxenda prescribtion. These aren't included and must be purchased separately. AND Get our note, "7 Diet, a professional guide for weight loss", for more strategies. Also read our notes, "New products to try to lose weight" and "Weight LOSS medications don't always work".
- Saxenda by itself is not enough to keep the weight off. Make sure to still follow your nutritionist's meal and exercise plan.
- Inject under the skin of your stomach, upper leg, or upper arm once daily with or without food.
- Do not share Saxenda with others, even if the needle has been changed. This may put you at risk of infections.
- Take off the needle and properly dispose of it after each shot. Always use a new needle for each shot to prevent an infection.
- Always make sure the medication is clear, colorless, and free of particles before you inject. If it's not, don't use it.
- If the injection hurts you can try letting the pen get to room temperature before you inject. Once it gets to room temperature don't put it back in the fridge.
- Unused pens should be stored in the refrigerator, but the pen in use can be kept at room temperature for up to 30 days.
REFERENCES
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Kelly AS, Auerbach P, Barrientos-Perez M, Gies I, Hale PM, Marcus C, Mastrandrea LD, Prabhu N, Arslanian S; NN8022-4180 Trial Investigators. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity. N Engl J Med. 2020 May 28;382(22):2117-2128. Available at: https://www.nejm.org/doi/10.1056/NEJMoa1916038
Chao AM, Wadden TA, Berkowitz RI. The safety of pharmacologic treatment for pediatric obesity. Expert Opin Drug Saf. 2018 Apr;17(4):379-385. Available at: https://www.tandfonline.com/doi/abs/10.1080/14740338.2018.1437143?journalCode=ieds20
GoodRx. (2022). Saxenda Medicare Coverage and Co-Pay Details. [online] Available at: https://www.goodrx.com/saxenda/medicare-coverage