Lixisenatide Disease Interactions

The use of lixisenatide may result in cross-sensitivity in patients with a history of anaphylaxis reaction or angioedema to another GLP-1 receptor agonist. These patients should be informed of the risk of anaphylaxis when using lixisenatide. Close monitoring is recommended when prescribing lixisenatide to these patients.

Lixisenatide slows gastric emptying and patients with preexisting gastroparesis were excluded from clinical trials. Lixisenatide should not be used in patients with severe gastroparesis.

Acute pancreatitis, including fatal and non- fatal hemorrhagic or necrotizing pancreatitis, has been reported postmarketing in patients treated with lixisenatide. Some patients had risk factors such as cholelithiasis and alcohol abuse. Patients should be observed carefully for any symptoms of pancreatitis including persistent abdominal pain, sometimes radiating to the back, that may or may not be accompanied by vomiting. If pancreatitis is suspected, lixisenatide should be discontinued and appropriate management should be established. If pancreatitis is confirmed, lixisenatide should not be restarted. Lixisenatide is not recommended for patients with history of pancreatitis.

Acute kidney injury and worsening of chronic renal failure which sometimes required hemodialysis has been reported postmarketing in patients treated with lixisenatide. Renal function should be closely monitored when initiating or escalating doses. Lixisenatide is not recommended for patients with end stage renal disease. Patients with mild and moderate renal impairment need close monitoring but no dose adjustment. There is limited experience in patients with severe renal impairment but drug exposure showed to be higher, so close monitoring is recommended for changes in renal function or gastrointestinal adverse reactions.