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Living with diabetes can be managed by proper medication. However, you may have questions regarding the medications available to you. Here, we will take a closer look at two medications, Ozempic and Saxenda, so that you can see how these medications can impact your health. A CLOSER LOOK AT DIABETES Diabetes can be divided into two categories, type 1 diabetes (T1D) and type 2 diabetes (T2D). Type 1 diabetes is an autoimmune disorder and is commonly diagnosed in children. Individuals with T1D require lifelong insulin treatment to manage their diabetes. Type 2 diabetes is diagnosed later in life due to genetics, lifestyle, and other risk factors. Unlike T1D, there are numerous treatment options other than insulin therapy to manage type 2 diabetes. GLP-1 RECEPTOR AGONISTS A common drug class used to treat type 2 diabetes is glucagon-like peptide 1 (GLP-1) receptor agonists. GLP-1 receptor agonists work by lowering blood glucose and slowing gastric emptying. Benefits of using a GLP-1 receptor agonist include: weight loss, atherosclerotic cardiovascular disease (ASCVD) benefits, lowering A1C values, and chronic kidney disease (CKD) benefits with little risk of hypoglycemia. Common GLP-1 receptor agonist side effects include nausea, vomiting, diarrhea, weight loss, and injection site reactions. GLP-1 receptor agonists should not be used in patients with a personal or a family history of medullary thyroid cancer.

The Medicines and Healthcare products Regulatory Agency (MHRA) has warned the public to avoid buying pre-filled weight loss pens without a prescription. The warning came after 369 fake Ozempic injections have been seized since January 2023. However, Saxenda pens were obtained by members of the public in the UK through "non-legitimate routes". The health regulator has urged the public to buy the pens after consulting a healthcare professional and with a prescription. Dr Alison Cave, MHRA Chief Safety Officer shared her opinion on the matter, she said: "Buying products such as Ozempic or Saxenda without a prescription, from illegally trading suppliers, significantly increases the risk of receiving something which is either fake or not licensed for use in the UK.

With Novo Nordisk's patent protection for liraglutide now expired, the UK is set to welcome the first wave of generic weight loss medicines. The British Generic Manufacturers Association (BGMA), the trade body for off-patent medicines, believes these generic versions could "provide could provide much-needed capacity to meet growing demand and alleviate shortages." Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, is primarily used to treat type 2 diabetes and obesity. Novo Nordisk markets liraglutide under the brand names Victoza (for type 2 diabetes and Saxenda (for weight loss). In a statement released on 20 November 2024, the BGMA confirmed that "liraglutide's patent protection was no longer in force, marking the first time generic versions of diabetes and weight loss treatments can be available in the UK." The BGMA anticipates that at least four companies will obtain UK marketing authorisations for generics targeting type 2 diabetes and obesity. However, it remains uncertain how many will launch immediately.

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Victoza (liraglutide) 6mg/mL pre-filled injection pens, previously used in the treatment of type 2 diabetes mellitus (T2DM), have been out of stock in the UK since August 2023. Novo Nordisk has confirmed to The Pharmaceutical Journal that the product has now been discontinued as part of their broader strategy to consolidate their portfolio. The Danish pharmaceutical company said that they are in close dialogue with the Department of Health and Social Care (DHSC), which is expected to release guidance outlining timelines, alternative treatments, and recommended next steps for healthcare professionals. However, the company clarified that they have no plans to discontinue Saxenda (liraglutide) pre-filled injection pens, though this product has also faced supply restrictions in the UK since shortages began. The DHSC initially announced a national shortage of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including Victoza, in June 2023. At that time, prescribers were advised to limit use of these drugs for their licensed indications and to avoid initiating new GLP-1 RA therapies for T2DM patients during the shortage.

Following a comprehensive review, the Medicines and Healthcare products Regulatory Agency (MHRA) has concluded that current evidence does not support a causal link between Glucagon-Like Peptide-1 (GLP-1) receptor agonists and suicidal behaviour, suicidal ideation, self-injury, or depression. GLP-1 receptor agonists , which contain active ingredients such as exenatide, lixisenatide, liraglutide, dulaglutide, and semaglutide, are commonly used to treat type 2 diabetes and obesity. In July 2023, concerns were raised about the safety of these receptor agonists after post-marketing reports suggested a potential risk of suicidal thoughts and self-harm associated with these medications. As a result, safety reviews were initiated by the Market Authorisation Holders (MAHs), evaluating the UK post-marketing data to assess the potential risks of these drugs. These reviews also examined the risk of depression in the interest of patient safety following reports of these side effects.