Does Victoza Cause Fatigue, Burping or Joint Pain?

Does Victoza cause fatigue, burping, or joint pain? Victoza (liraglutide) is a GLP-1 receptor agonist used to manage type 2 diabetes in adults and children aged 10 years and above. Whilst gastrointestinal symptoms such as nausea and diarrhoea are very common, fatigue and joint pain are classified as uncommon side effects, affecting between 1 in 100 and 1 in 1,000 people. Burping (eructation) may occur as part of the digestive effects related to Victoza's mechanism of slowing gastric emptying. Understanding which side effects are expected, how to manage them, and when to seek medical advice is essential for safe and effective treatment.

What Is Victoza and How Does It Work?

Victoza (liraglutide) is a prescription medicine used to improve blood sugar control in people with type 2 diabetes mellitus. It is licensed for adults and children/adolescents aged 10 years and above. It belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists, which work by mimicking the action of a naturally occurring hormone in the body.

The mechanism of action of Victoza involves several complementary processes. Firstly, it stimulates insulin secretion from the pancreas in a glucose-dependent manner, meaning it only promotes insulin release when blood sugar levels are elevated. This reduces the risk of hypoglycaemia compared to some other diabetes medications. Secondly, Victoza suppresses the release of glucagon, a hormone that raises blood glucose levels, particularly after meals. Thirdly, it slows gastric emptying, which helps to moderate the rise in blood sugar following food intake.

Victoza is administered as a once-daily subcutaneous injection into the abdomen, thigh, or upper arm. It can be taken at any time of day, independent of meals. The dose is usually started at 0.6 mg daily for at least one week, then increased to 1.2 mg. After at least another week, the dose may be increased to 1.8 mg if needed, depending on individual response and tolerability. This gradual titration helps minimise gastrointestinal side effects, which are common when initiating GLP-1 receptor agonists.

In the UK, Victoza is licensed for use alongside diet and exercise modifications. According to NICE guidance (NG28), GLP-1 receptor agonists like Victoza may be considered for patients with type 2 diabetes when triple therapy with oral medications has failed, is not tolerated or is contraindicated. They are particularly suitable for those with a body mass index (BMI) of 35 kg/m² or higher (adjusted for ethnicity), or when insulin therapy would have significant occupational implications, or when weight loss would benefit other obesity-related comorbidities. Treatment should only be continued if there is a reduction of at least 11 mmol/mol (1%) in HbA1c and a weight loss of at least 3% of initial body weight after 6 months.

Common and Serious Side Effects of Victoza

Like all medications, Victoza can cause side effects, though not everyone experiences them. Understanding which adverse effects are common and which require urgent attention is essential for safe medication use.

Very common side effects (affecting more than 1 in 10 people) include:

• Gastrointestinal symptoms: Nausea, vomiting, diarrhoea, and constipation are the most frequently reported side effects, particularly during the initial weeks of treatment. These symptoms often improve as the body adjusts to the medication.

• Decreased appetite: Many patients experience reduced hunger, which contributes to the weight loss often seen with Victoza.

Common side effects (affecting between 1 in 10 and 1 in 100 people) include headache, dizziness, and dyspepsia.

Regarding the specific symptoms mentioned in the query:

• Fatigue is listed as an uncommon side effect (affecting between 1 in 100 and 1 in 1,000 people) in the Victoza Summary of Product Characteristics (SmPC).

• Burping/belching (eructation) may occur as part of the digestive system effects.

• Joint pain (arthralgia) is listed as an uncommon side effect in the SmPC.

While these symptoms are not among the most common effects, they have been reported in some patients taking Victoza.

Serious side effects requiring medical attention include:

• Pancreatitis: Severe, persistent abdominal pain (often radiating to the back) may indicate inflammation of the pancreas. If pancreatitis is suspected, Victoza should be discontinued immediately and urgent medical care sought. Treatment should not be restarted if pancreatitis is confirmed.

• Gallbladder disease: Cholelithiasis (gallstones) or cholecystitis (gallbladder inflammation) can occur, particularly with weight loss. Symptoms include right upper quadrant pain, fever, or jaundice.

• Severe hypoglycaemia: Particularly when Victoza is used in combination with insulin or sulphonylureas.

• Acute kidney injury: Dehydration from gastrointestinal side effects can impair kidney function.

• Allergic reactions: Rash, itching, difficulty breathing, or swelling of the face, lips, or throat require emergency care.

As a precaution, patients should be aware that animal studies have shown an increased risk of thyroid C-cell tumours with liraglutide, though the relevance to humans remains uncertain. Patients should report any persistent neck lumps, hoarseness, or difficulty swallowing to their healthcare provider.

Patients should be counselled about these potential adverse effects before starting treatment and encouraged to report any unusual or persistent symptoms, including through the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).

Managing Side Effects While Taking Victoza

Effective management of side effects can significantly improve treatment adherence and quality of life for patients taking Victoza. Most adverse effects are manageable with appropriate strategies and often diminish over time.

For gastrointestinal symptoms (nausea, vomiting, diarrhoea):

• Gradual dose escalation: Following the recommended titration schedule allows the digestive system to adapt gradually. If troublesome gastrointestinal effects occur, discuss with your prescriber about pausing dose escalation or temporarily stepping back to the previous tolerated dose.

• Dietary modifications: Eating smaller, more frequent meals rather than large portions can reduce nausea. Avoiding fatty, spicy, or heavily processed foods may also help.

• Timing of injection: Some patients find that injecting Victoza at a consistent time each day helps minimise gastrointestinal discomfort. Remember that Victoza can be taken at any time of day, independent of meals.

• Adequate hydration: Maintaining fluid intake is crucial, especially if experiencing vomiting or diarrhoea, to prevent dehydration.

If fatigue is experienced whilst taking Victoza, consider the following:

• Blood glucose monitoring: Fatigue may indicate either hypoglycaemia or persistent hyperglycaemia. Regular monitoring helps identify patterns.

• Review concurrent medications: Fatigue could be related to other medications or underlying health conditions rather than Victoza itself.

• Lifestyle factors: Ensure adequate sleep, balanced nutrition, and appropriate physical activity levels.

For burping or belching (eructation):

• Eat slowly and chew food thoroughly

• Avoid carbonated beverages and foods that produce gas

• Remain upright for at least 30 minutes after eating

• If symptoms persist, discuss with your healthcare provider as this may be related to the slowed gastric emptying effect of Victoza

Regarding joint pain (arthralgia):

• Keep a symptom diary to identify any patterns or triggers

• Discuss with your GP whether the pain might be related to other factors such as increased physical activity, weight changes, or concurrent conditions

• For pain relief, paracetamol is generally the safest first-line option. Avoid non-steroidal anti-inflammatory drugs (NSAIDs) if you're experiencing gastrointestinal side effects or dehydration, as these may worsen these conditions or affect kidney function. Always consult a pharmacist or doctor before taking any pain relief.

Patients should never discontinue Victoza without consulting their healthcare team, as abrupt cessation may lead to deterioration in glycaemic control.

When to Seek Medical Advice About Victoza Side Effects

Knowing when to contact a healthcare professional is crucial for patient safety. Whilst many side effects are mild and self-limiting, certain symptoms require prompt medical evaluation.

Contact your GP or diabetes specialist nurse within 24–48 hours if you experience:

• Persistent nausea or vomiting lasting more than a few days, particularly if it prevents adequate food or fluid intake

• Unexplained fatigue that significantly impacts daily activities or doesn't improve with rest

• Persistent or worsening gastrointestinal symptoms despite following management strategies

• Signs of dehydration: decreased urination, dark urine, dry mouth, dizziness upon standing

• Unusual or persistent joint pain, especially if accompanied by swelling, redness, or limitation of movement

• Recurrent hypoglycaemia (blood glucose below 4 mmol/L), particularly if you're also taking insulin or sulphonylureas

• Right upper abdominal pain, fever or yellowing of the skin or eyes, which could indicate gallbladder problems

• A lump in the neck, persistent hoarseness, or difficulty swallowing

• Persistent palpitations (awareness of your heartbeat)

Seek immediate medical attention (call 999 or go to A&E) if you develop:

• Severe, persistent abdominal pain that may radiate to the back, potentially indicating pancreatitis. If pancreatitis is suspected, stop taking Victoza immediately and do not restart if pancreatitis is confirmed.

• Signs of a severe allergic reaction: difficulty breathing, swelling of the face or throat, rapid heartbeat, severe rash

• Symptoms of severe hypoglycaemia: confusion, loss of consciousness, seizures

• Severe chest pain, especially if spreading to arms, neck, jaw, back or stomach

• Severe dehydration with inability to keep fluids down

If you're unsure about the urgency of your symptoms, contact NHS 111 for advice.

Regular monitoring and follow-up are essential components of safe Victoza therapy. Your healthcare team should:

• Review your HbA1c levels every 3–6 months to assess glycaemic control

• Assess treatment continuation at 6 months (treatment should continue only if HbA1c has reduced by at least 11 mmol/mol [1%] and weight by at least 3%)

• Monitor kidney function, particularly if you've experienced gastrointestinal side effects

• Assess weight and BMI regularly

• Review your overall diabetes management plan, including diet, exercise, and other medications

Patients should maintain open communication with their healthcare providers about any concerns or side effects, no matter how minor they may seem. Early intervention can prevent complications and ensure optimal therapeutic outcomes whilst maintaining quality of life.

Suspected side effects can also be reported through the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).

Frequently Asked Questions