Lixisenatide

ADLYXIN

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Pronunciation: lix-i-SEN-a-tide (ad-LIX-in)

Lixisenatide ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Lixisenatide ballicule

Lixisenatide ADLYXIN mascot mnemonic cartoon — Visual mnemonic: Lixisenatide mascot
**“Add licks in”**
Tide Pod → GLP-1 agonist

What it isShort-acting GLP-1 receptor agonist; type 2 diabetes.

Why this oneIts short action targets postprandial glucose more than fasting, which complements basal insulin.

What limits itDaily injection with GI intolerance, and no cardiovascular benefit demonstrated, unlike the long-acting agents.

Lixisenatide molecular structure (skeletal formula) — Molecular structure: Lixisenatide

FDA-approved for

type 2 diabetes (2016)

FDA label

Read the full label on DailyMed ↗

FDA dosing	Population	Start	Target	Max
Type 2 diabetes mellitus (adjunct to diet/exercise)	Naive to basal insulin/GLP-1, on a GLP-1 RA, or <30 units basal insulin/day	15 units SC QD	titrate to fasting plasma glucose goal	60 units/day (20 mcg lixisenatide)
Type 2 diabetes mellitus	On 30–60 units basal insulin/day	30 units SC QD	titrate to fasting plasma glucose goal	60 units/day (20 mcg lixisenatide)

Titration Adjust by 2–4 units weekly based on fasting plasma glucose

Renal Mild–moderate: no dose adjustment, monitor; not recommended in end-stage renal disease (eGFR <15)

Hepatic Undefined

Fixed-ratio combination pen with insulin glargine; max 60 units/day

Instructions

Inject SC once daily within 1 hr before the first meal
Rotate injection sites (abdomen, thigh, upper arm)
Do not give IV or via pump; do not dilute or mix
Discontinue basal insulin or GLP-1 RA before initiating
Never exceed 60 units/day

Available strengths

inj 100/33 units/mL

Contraindications

During episodes of hypoglycemia

Cautions

Anaphylaxis / serious hypersensitivity
Acute pancreatitis
Never share pen between patients
Hypo-/hyperglycemia with insulin regimen changes
Overdose from medication errors (two drugs in one pen)
Hypoglycemia
Acute kidney injury from volume depletion
Severe GI reactions (avoid in severe gastroparesis)
Immunogenicity
Hypokalemia
Fluid retention/heart failure with PPAR-gamma agonists
Acute gallbladder disease
Pulmonary aspiration under anesthesia/deep sedation

Adverse reactions

Hypoglycemia
Nausea
Nasopharyngitis
Diarrhea
Upper respiratory tract infection
Headache

Pregnancy Possible fetal risk (animal visceral/skeletal defects with lixisenatide); use only if benefit justifies risk

Lactation No human data on either component; weigh benefits against potential risk

Cost

Lixisenatide (ADLYXIN)

Strength		#/mo	generic $/unit	CostPlus
100/33 units/mL	inj	per unit		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Lixisenatide is administered under clinical supervision and dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

⚠ BOXED WARNING

Thyroid C-cell tumors in rodents

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4

Overdose danger1 / 4

Weight-gain liability0 / 4

Sedation liability0 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryN/A (post-2015 labeling)

Defining liabilityGastrointestinal intolerance and dehydration-related kidney injury

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