6.3.1.4 Glucagon-like peptide-1 receptor agonists

Please see information under each individual drug monograph below for further preparation specific information.

Please prescribe GLP-1 RAs by brand, for licensed indications only (prescribing for off-label indications remains as not recommended or supported by Kent and Medway ICB), and ensure that quantities prescribed are appropriate - please follow standard guidelines on prescribing quantities.

Saxenda (liraglutide), see NICE TA664, is for specialist prescribing only when used for weight management in line with the NICE TA.

Wegovy (semaglutide), see NICE TA875, is for specialist prescribing only when used for weight management in line with the NICE TA. It is only available via Tier 3 services within Kent and Medway. Only commissioned obesity services are able to undertake the appropriate level of service.

GLP1 mimetics should be initiated by clinicians who have received appropriate training (eg PITSTOP training). Adequate training on the use of the injectables and follow up reviews should be provided to patients initiated on GLP-1 mimetics. GLP-1 mimetics across Kent and Medway have a green status so can be initiated in primary, community or secondary care. Where MDT support is also possible (not for all of Kent and Medway) this can be utilised. In primary care Arden’s templates are available in EMIS to support the initiation of GLP-1 mimetics and are encouraged to be used.

Oral Semaglutide has been approved as an option for insufficiently controlled type 2 diabetes, especially where an injectable GLP-1 mimetic may not be preferrable. GLP-1 mimetic would be considered as part of this pathway. Oral semaglutide is not a replacement for injectable GLP-1 mimetics and should still be initiated by a clinician with PITSTOP or equivalent training. It can be prescribed alongside other diabetes medications (apart from DPP-4 inhibitors and other GLP-1 mimetics).

K&M type 2 diabetes guidelines in Adults