6.1.2.6. GLP-1 agonists
Please see the NHSGGC Diabetes Guidelines for further information.
Restrictions:
Restricted to initiation by clinicians, either in primary care or the acute setting, experienced in the treatment of diabetes as part of a triple therapy in patients with inadequate glycaemic control on two oral anti-diabetic drugs.
Prescribing Notes:
- Dulaglutide is a biological medicine. Biological medicines must be prescribed and dispensed by brand name; the manufacturer advises to record the brand name and batch number after each administration.
Restrictions:
Restricted to initiation by clinicians, either in primary care or the acute setting, experienced in the treatment of diabetes for the following indications:
- as a third-line antidiabetic agent in combination with metformin and a sulphonylurea or metformin and a thiazolidinedione
- in combination with basal insulin, with or without metformin. when this regimen alone, with diet and exercise, does not provide adequate glycaemic control.
Prescribing Notes:
- Liraglutide is a biological medicine. Biological medicines must be prescribed and dispensed by brand name; the manufacturer advises to record the brand name and batch number after each administration.
For use in the management of obesity, see section 4.5.2
Restrictions:
Use in the treatment of type 2 diabetes mellitus (T2DM) is restricted to initiation by clinicians, either in primary care or the acute setting, experienced in the treatment of diabetes for use in addition to other oral anti-diabetic medicines, or as an add-on to basal insulin, as an alternative glucagon-like peptide-1 receptor agonist option.
Prescribing Notes:
- Semaglutide is a biological medicine. Biological medicines must be prescribed and dispensed by brand name; the manufacturer advises to record the brand name and batch number after each administration.
Restrictions:
Restricted to initiation by clinicians, either in primary care or the acute setting, experienced in the treatment of diabetes in accordance with the prescribing notes below.
Prescribing Notes:
The once-weekly preparation (Bydureon Bcise®)is restricted to third line treatment of type-2 diabetes mellitus in combination with other agents.
Restrictions:
Restricted to initiation by Consultant Diabetologists for use in patients who are uncontrolled on basal insulin analogues (glycosylated haemoglobin [HbA1c] >7.5% [59mmol/mol]) and for whom a GLP-1 receptor agonist is appropriate as an add-on intensification therapy to basal insulin to obtain glucose control.
Prescribing Notes:
Liraglutide is a biological medicine. Biological medicines must be prescribed and dispensed by brand name; the manufacturer advises to record the brand name and batch number after each administration.
Restrictions:
Restricted to initiation by Consultant Diabetologists for use in patients who are uncontrolled on basal insulin analogues (glycosylated haemoglobin [HbA1c] >7.5% [59mmol/mol]) and for whom a GLP-1 receptor agonist is appropriate as an add-on intensification therapy to basal insulin analogues.
Prescribing Notes:
Lixisenatide is a biological medicine. Biological medicines must be prescribed and dispensed by brand name; the manufacturer advises to record the brand name and batch number after each administration.
Restrictions:
Use in the treatment of type 2 diabetes mellitus (T2DM) is restricted to initiation by clinicians, either in primary care or the acute setting, experienced in the treatment of diabetes for use in addition to other anti-diabetic medicines, or as an add-on to basal insulin.
Prescribing Notes:
- Semaglutide is a biological medicine. Biological medicines must be prescribed and dispensed by brand name; the manufacturer advises to record the brand name and batch number after each administration.