Lixisenatide is given once a day as an injection just under the surface of the skin.
Store unopened packs of lixisenatide in a fridge. Once in use, you can keep the pre-filled pen for up to 14 days at room temperature.
The most common side-effects are sickness and diarrhoea - these usually reduce over time. If at any time you develop severe stomach pain with sickness, speak with a doctor as soon as possible.
|Type of medicine||An antidiabetic injection|
|Used for||Type 2 diabetes mellitus in adults|
|Available as||Subcutaneous injection in the form of a pre-filled pen|
Insulin is a hormone which is made naturally in your body, in the pancreas. It helps to control the levels of sugar (glucose) in your blood. If your body does not make enough insulin, or if it does not use the insulin it makes effectively, this results in the condition called sugar diabetes (diabetes mellitus).
People with diabetes need treatment to control the amount of sugar in their blood. This is because good control of blood sugar levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat but, for other people, medicines are given alongside the changes in diet. Lixisenatide is one of the medicines that are prescribed for people with type 2 diabetes.
Lixisenatide works in three ways. It increases the amount of insulin produced by your body which then reduces the level of sugar in your blood. It also reduces the amount of a substance called glucagon being produced by your pancreas. Glucagon causes your liver to produce more sugar, so by reducing the amount of glucagon in your body, this also helps to reduce the levels of sugar in your blood. Lixisenatide also works on your stomach so that food passes more slowly through it. This means that the sugar from your meals takes longer to get into your blood.
Lixisenatide is given as an injection just under the surface of the skin. It is administered using an injection device called a pre-filled pen. It is used in addition to other antidiabetic medicines.
Before taking lixisenatide
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking lixisenatide it is important that your doctor knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have a problem with your stomach or digestive system.
- If you have any problems with the way your kidneys work.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take lixisenatide
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack as well as any information you are given by your doctor or diabetes clinic. The manufacturer's leaflet will provide you with a full list of the side-effects which you may experience.
- Use lixisenatide exactly as your doctor tells you to. Your doctor or diabetes nurse will show you how to use the pre-filled pen to inject yourself. Lixisenatide should be injected into the skin on your upper arms, thigh, or tummy (abdomen). Try to choose a slightly different injection site for each of your injections as this will help to prevent skin problems and difficulties in injecting.
- Use lixisenatide once a day. You should use it during the hour before you eat a meal (usually before breakfast or the evening meal). Although you can choose which meal to inject before, you should use lixisenatide before the same meal on each day. You will start on a dose of 10 micrograms daily for two weeks, then the dose will be increased to 20 micrograms daily. To make this easy for you, it is likely you will be prescribed a 'treatment initiation pack' which contains a two-week supply of 10 microgram doses (green pre-filled pen) and a two-week supply of 20 micrograms (purple pre-filled pen).
- If you forget to use lixisenatide before your usual meal, use it before your next meal instead. Do not inject lixisenatide after you have eaten.
Getting the most from your treatment
- It is important that you keep your regular doctor's and clinic appointments. This is so that your progress can be monitored. You will need regular check-ups with an eye clinic and a foot clinic as well as with your doctor and diabetes clinic.
- Your doctor may recommend that you test for sugar (glucose) in your blood or urine regularly to check that your diabetes is being controlled. Your doctor or diabetes nurse will show you how to do this.
- If you have been given advice by your doctor about changes to your diet, stopping smoking or taking regular exercise, it is important for you to follow the advice you have been given.
- Make sure you know what it feels like if your blood sugar is low. This is known as hypoglycaemia, or a 'hypo'. Although lixisenatide is unlikely to cause low blood sugar, other medicines that you are taking for diabetes alongside it may. The first signs of hypoglycaemia are feeling shaky or anxious, sweating, looking pale, feeling hungry, having a feeling that your heart is pounding (palpitations), and feeling dizzy. If this happens, eat something containing sugar, such as dextrose tablets, jelly babies or a sugary drink (non-diet), and then follow this up with a snack such as a sandwich or a banana.
- If you are a driver you should take special care, as your ability to concentrate may be affected if your diabetes is not well controlled. You may be advised to check your blood sugar levels before you travel and to have a snack with you on long journeys.
- Do not drink alcohol, as it can affect the control of your blood sugar. Ask your doctor if you need further advice about this.
- If you get unusually thirsty, pass urine more frequently than normal, or feel very tired, you should let your doctor know. These are signs that there is too much sugar in your blood and your treatment may need adjusting.
- Check with your doctor before taking up any new physical exercise, as this will have an effect on your blood sugar levels and you may need to check your blood or urine levels more regularly.
- If you are due to have an operation or dental treatment, you should tell the person carrying out the treatment that you have diabetes and give them a list of the medicines you are taking.
- If you buy any medicines, always check with a pharmacist that they are suitable for you to take. Lixisenatide can interfere with the way some other medicines are absorbed which stops them from working properly. Because of this, some medicines should not be taken during the hour before lixisenatide is given, or during the four hours after it has been given.
- Treatment for diabetes is usually lifelong. Continue with lixisenatide unless you are told otherwise by your doctor
Can lixisenatide cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with lixisenatide. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common lixisenatide side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Feeling or being sick||Stick to simple foods - avoid rich or spicy meals|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Common lixisenatide side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling dizzy or tired||Do not drive or use tools or machines until you feel better|
|Nose and throat infections, urine infections, indigestion, back pain, injection site problems||Let your doctor or diabetes clinic know if any of these become troublesome|
Important: medicines like lixisenatide can cause persistent and severe tummy (abdominal) pain in a few people. If this happens to you, you should speak with your doctor as soon as possible as these can be symptoms of an inflamed pancreas (pancreatitis).
If you experience any other symptoms which you think may be due to the injections, speak with your doctor or pharmacist for further advice.
How to store lixisenatide
- Keep all medicines out of the reach and sight of children.
- Lixisenatide can be kept for 14 days at room temperature, as long as this is below 30°C and it is kept away from direct heat and sunlight. It is however best to store your unopened packs in a refrigerator. Do not freeze lixisenatide.
- The prefilled pens must be discarded 14 days after being first used.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Lyxumia® Solution for Injection; Sanofi, The electronic Medicines Compendium. Dated June 2014.
- British National Formulary; 67th Edition (March 2014) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox