Lixisenatide will be registered in Australia from May 1 as an add-on treatment to achieve glycaemic control with metformin, a sulphonylurea, a basal insulin, or any combination of these, in Type 2 Diabetes Mellitus. It was approved in Europe in February, and is being considered by the FDA.

This new analogue of the incretin hormone, glucagon-like peptide-1 (GLP-1) stimulates receptors to enhance glucose dependant insulin secretion, decrease glucagon secretion, and slow gastric emptying, similar to exenatide (Byetta®, Eli Lilly).

The once daily subcutaneous injection should be initiated at a 10mcg dose, administered up to an hour before breakfast or dinner, and may be increased to 20mcg after 15 days.

Caution should be used when used in combination with both sulphonylurea and insulin because of a risk of hypoglycaemia. Adverse reactions are most commonly nausea, vomiting, diarrhoea, and hypoglycaemia. It is eliminated renally, with a terminal half-life of around three hours.

Sanofi has registered lixisenatide as Lyxumia® simultaneously with two generic labels. The injector pens offering 10mcg or 20mcg doses must be refrigerated.

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