Lixisenatide
Approved short-acting, once-daily exendin-based GLP-1 receptor agonist for type 2 diabetes. Strong postprandial glucose effect; more modest weight loss than long-acting agents.
01 Overview
Lixisenatide (Adlyxin/Lyxumia) is a once-daily GLP-1 receptor agonist derived from exendin-4. As a short-acting agonist it produces a pronounced slowing of gastric emptying and marked lowering of post-meal glucose spikes.
It is approved for type 2 diabetes and was studied for cardiovascular safety in the ELIXA trial, which showed neutral cardiovascular outcomes. Its weight-loss effect is smaller than long-acting agents like semaglutide, and it has been partly superseded commercially.
02 Mechanism
Short-acting exendin-4-based GLP-1 receptor agonist that strongly slows gastric emptying and blunts postprandial glucose, with glucose-dependent insulin secretion.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Starting | 10 mcg/day | SubQ | First 14 days |
| Maintenance | 20 mcg/day | SubQ | Once daily before a meal |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Postprandial glucose loweringStrong blunting of after-meal glucose spikes. | Marked reduction | Clinical | |
| Modest weight lossSmaller weight effect than long-acting GLP-1 agonists. | ~1-3 kg | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Nausea and vomitingCommon, particularly early in treatment. | Moderate | Very common | Clinical | |
| Hypoglycaemia (with sulfonylurea/insulin)Increased hypoglycaemia risk when combined with insulin or sulfonylureas. | Moderate | Common | Clinical |