1.2. Pediatrics
The use of GLP-1 agonists dulaglutide (Trulicity), liraglutide (Victoza) and exenatide (Bydureon BCise) have been proven to be safe and effective as an adjunct to diet and exercise to improve glycemic control in pediatric patients that are 10 years of age and older with established Type 2 diabetes [1,2,4,5]. Saxenda (liraglutide) is approved as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in patients 12 years of age and older weighing over 60 kg and an initial BMI of 30 kg/m2 or greater, and semaglutide (Wegovy) is approved as an adjunct to a reduced-calorie diet and increased physical activity to reduce excess body weight and maintain weight reduction long term in patients 12 years and older with obesity [1,11,12].
| Drug Name | Dosage Form/Strength | Treatment Indications | Maximum Recommended Dosage |
|---|---|---|---|
| dulaglutide (Trulicity) | extended-release SC solution; 0.75 mg/0.5 mL, 1.5 mg/0.5mL as single-dose pens | type 2 diabetes mellitus | 10 years to 17 years: 0.75 mg SC once weekly; if glycemic control is not achieved, may titrate to a maximum of 1.5 mg SC weekly after at least 4 weeks on the current dosage |
| exenatide (Bydureon BCise) | extended-release SC injectable suspension; 2 mg/0.85 mL single dose autoinjector+ | type 2 diabetes mellitus | 10 years to 17 years: 2 mg SC once weekly at any time of day, with or without meals |
| liraglutide (Victoza, generic) | SC solution; multi-dose pen (18 mg/3 mL) that delivers 0.6 mg, 1.2 mg, or 1.8 mg | type 2 diabetes mellitus | 10 years to 17 years: 0.6 mg SC daily for at least one week; if glycemic control is not achieved, may titrate up to 1.2 mg SC daily, after one week may increase to maximum of 1.8 mg daily |
| liraglutide (Saxenda) | SC solution; multi-dose pen (18 mg/3 mL) that delivers doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg | chronic weight management | 12 years to 17 years: 0.6 mg SC daily for at least one week, followed by an increase in increments of 0.6 mg every week up to maximum of 3 mg daily |
| semaglutide (Wegovy) | SC solution; single-dose pen that delivers doses of 0.25 mg, 0.5 mg, 1 mg, 1.7 mg, or 2.4 mg | chronic weight management# | 0.25 mg SC weekly for at least 4 weeks, followed by a dose escalation every 4 weeks up to maximum of 2.4 mg weekly |
Legend:
- + each exenatide extended-release autoinjector is single-dose; supplied in carton of 4 pens
- # TAC Rule section 354.1923 excludes coverage of these products for obesity control indications