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Pharmacology · GLP-1 receptor agonists

Liraglutide !

A once-daily injected GLP-1 agonist for type 2 diabetes and, at other doses, obesity. It raises insulin after meals and curbs appetite.

Updated 2026-11-01

  • Class: GLP-1 receptor agonists
  • Receptor: GLP-1 receptor (GLP1R)
  • ATC code: A10BJ02
  • WHO Model List of Essential Medicines

No structure with liraglutide bound to the receptor is available; the figure shows native GLP-1, the hormone liraglutide copies almost exactly, bound to the human GLP-1 receptor with its Gs protein.

Target in 3D: GLP-1 receptor (GLP1R). PDB structure 6X18 (RCSB PDB, public domain). View the structure at RCSB PDB

Mechanism of action

Liraglutide is human GLP-1 with one amino-acid change and a fatty acid chain attached. The fatty acid binds albumin and slows absorption, protecting it from DPP-4 and stretching its action to a day. It activates the GLP-1 receptor: glucose-dependent insulin release rises, glucagon falls, the stomach empties more slowly and appetite falls.

  1. Activates the GLP-1 receptor (Gs, cAMP)
  2. Beta cells release more insulin when glucose is high
  3. Glucagon falls and the stomach empties more slowly
  4. Appetite falls: lower glucose and weight

Pharmacokinetics

Absorption
Subcutaneous injection, absorbed slowly.
Distribution
Highly bound to albumin.
Metabolism
Broken down like other proteins, by peptidases; no single organ dominates.
Half-life
Long enough for once-daily injection.

Indications

  • Type 2 diabetes, and to reduce heart attack, stroke and cardiovascular death in those with heart disease Type 2 diabetes mellitus →
  • Chronic weight management in obesity, with a different preparation Obesity →

Adverse effects

Common

  • Nausea, vomiting, diarrhea, constipation, abdominal pain (most common, mostly at the start)
  • Reduced appetite
  • Injection-site reactions
  • Slightly faster heart rate

Contraindications

  • Personal or family history of medullary thyroid carcinoma
  • Multiple endocrine neoplasia type 2 (MEN 2)
  • Serious hypersensitivity to the drug

Key interactions

Insulin or sulfonylureas
Higher risk of hypoglycemia; their dose is often reduced.
Oral drugs in general
Slower gastric emptying can change their absorption.

What is monitored

  • HbA1c and weight
  • Kidney function if vomiting or diarrhea
  • Symptoms of pancreatitis or gallbladder disease
  • Mood in people treated for weight

Administration and safety

  • Subcutaneous injection in the abdomen, thigh or upper arm, rotating sites.
  • Pens are for one person only and are never shared, even with a new needle.
  • The dose is raised step by step to limit nausea.
  • Unopened pens are kept in the refrigerator, not frozen.

Nursing care

  • Before: thyroid history (medullary carcinoma, MEN 2), pancreatitis history, kidney function.
  • During: severe abdominal pain spreading to the back (pancreatitis), vomiting and dehydration.
  • Teach to report a neck lump, hoarseness or trouble swallowing.
  • The anesthesia team is told before surgery or endoscopy.

Pregnancy and breastfeeding

Not used in pregnancy (weight loss is not a goal and animal data showed harm); it is stopped ahead of a planned pregnancy.

Test yourself

Think of the answer, then tap the question to see it.

How is liraglutide protected from DPP-4?

A fatty acid chain makes it bind albumin and leave the injection site slowly, shielding it from DPP-4 and lengthening its action.

A patient on liraglutide has severe upper abdominal pain spreading to the back. What is the concern?

Acute pancreatitis. The drug is stopped and the patient assessed (lipase, imaging).

Why can GLP-1 agonists injure the kidney?

Vomiting and diarrhea can cause dehydration, which leads to acute kidney injury.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: Liraglutide Injection: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); DailyMed - LIRAGLUTIDE injection, solution (DailyMed (U.S. National Library of Medicine), 2026); GLP-1 peptide hormone bound to Glucagon-Like peptide-1 (GLP-1) Receptor (RCSB Protein Data Bank, 2020); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.