How to Use Victoza Pen: Complete Step-by-Step Guide

How do you use Victoza pen correctly for type 2 diabetes management? The Victoza pen is a pre-filled injection device containing liraglutide, a GLP-1 receptor agonist that helps control blood sugar levels. Proper technique is essential for effective treatment and minimising side effects. This guide explains step-by-step how to prepare, inject, and store your Victoza pen safely, including dose selection, injection site rotation, and troubleshooting common issues. Whether you're starting treatment or need a refresher, understanding correct pen use ensures optimal diabetes control and reduces the risk of complications.

What Is the Victoza Pen 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 belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. The Victoza pen is a pre-filled, multi-dose injection device designed for subcutaneous (under the skin) administration, making it convenient for daily use at home.

Liraglutide works by mimicking the action of GLP-1, a naturally occurring hormone in the body. When blood sugar levels rise after eating, Victoza stimulates the pancreas to release insulin in a glucose-dependent manner (meaning the effect decreases as blood glucose normalises), whilst simultaneously reducing the release of glucagon, a hormone that raises blood sugar. Additionally, it slows gastric emptying, which helps reduce post-meal glucose spikes and may contribute to modest weight loss in some patients.

The Victoza pen delivers doses ranging from 0.6 mg to 1.8 mg once daily. Treatment typically begins with a lower dose (0.6 mg) for at least one week to minimise gastrointestinal side effects, then increases gradually to 1.2 mg or 1.8 mg as directed by your healthcare professional. According to NICE guidance (NG28), GLP-1 receptor agonists like Victoza are recommended for certain patients with type 2 diabetes who have not achieved adequate glycaemic control with other medications and typically have a BMI ≥35 kg/m² (or ≥30 kg/m² where insulin would have significant occupational implications).

In the UK, Victoza is licensed for adults and children aged 10 years and above with type 2 diabetes. It is not indicated for type 1 diabetes or diabetic ketoacidosis and is not a substitute for insulin. The risk of hypoglycaemia (low blood sugar) is low unless Victoza is used alongside insulin or sulfonylureas. Combining Victoza with DPP-4 inhibitors is not recommended.

The pen is designed for ease of use, with a dose selector and an injection button. Each pen contains multiple doses and can be used for several days before requiring replacement. Understanding how to use the pen correctly is essential for achieving optimal blood sugar control and reducing the risk of injection-site reactions or dosing errors.

Preparing Your Victoza Pen for First Use

Before using a new Victoza pen for the first time, several important preparation steps must be completed to ensure safe and effective administration. These steps are crucial for verifying the medication's integrity and priming the pen mechanism.

Initial checks:

• Remove the pen from the refrigerator and allow it to reach room temperature (this takes approximately 15–30 minutes)

• Check the expiry date printed on the pen label — never use an expired pen

• Inspect the liquid through the pen window; it should be clear and colourless. Do not use if the solution appears cloudy, discoloured, or contains particles

• If the pen has been dropped or damaged, inspect it carefully and replace if compromised

• Wash your hands thoroughly with soap and water

Attaching a new needle: Victoza pens do not come with needles attached. You must use a new, sterile needle for each injection. NovoFine or NovoTwist needles are compatible with Victoza pens. Remove the protective tab from a new needle, then screw or push the needle straight onto the pen until secure. Remove both the outer and inner needle caps, keeping the outer cap for later disposal.

Priming the pen (first use only): Before the first injection with a new pen, you must prime it to remove air bubbles and ensure proper flow. This priming step is only needed for the first use of each new pen, not for subsequent doses. Turn the dose selector to the flow check symbol (typically showing flowing drops). Hold the pen with the needle pointing upward, tap the cartridge gently to bring air bubbles to the top, then press and hold the injection button until a drop of medication appears at the needle tip. If no drop appears, repeat the process up to six times. If still unsuccessful, change the needle and try again. Once primed, the pen is ready for dose selection and injection.

Step-by-Step Guide to Injecting Victoza

Administering Victoza correctly ensures you receive the prescribed dose and minimises discomfort. Follow these steps carefully each time you inject:

1. Select your dose: Turn the dose selector until your prescribed dose (0.6 mg, 1.2 mg, or 1.8 mg) aligns with the dose pointer. The pen clicks as you turn it. If you accidentally select the wrong dose, you can turn the selector forwards or backwards to correct it. Check the dose counter window to confirm the correct amount.

2. Prepare the injection site: Choose an appropriate injection site (abdomen, thigh, or upper arm — see next section for details). Clean the area with an alcohol wipe if recommended by your healthcare professional, and allow the skin to dry completely. Pinch a fold of skin gently between your thumb and forefinger (this may not be necessary with very short needles; follow your diabetes nurse's advice on technique).

3. Insert the needle: Hold the pen at a 90-degree angle to your skin. Push the needle straight into the pinched skin fold using a quick, dart-like motion. The needle should go completely into the skin. Remember to inject subcutaneously only; never inject into a vein or muscle.

4. Inject the medication: Press and hold the injection button down fully. Keep the button pressed until the dose counter returns to 0, then count slowly to 6 before withdrawing the needle. This ensures the full dose is delivered. You may see a drop of medication at the needle tip after withdrawal — this is normal and does not mean you've lost a significant amount of your dose.

5. Dispose of the needle safely: Carefully replace the outer needle cap, unscrew the needle, and dispose of it immediately in a sharps container. Never recap using both hands, as this increases needlestick injury risk. Replace the pen cap and store the pen appropriately. Never share your Victoza pen with another person, even if the needle is changed, as this poses a serious infection risk.

Where to Inject Victoza and Rotating Injection Sites

Proper injection site selection and rotation are essential for preventing lipodystrophy (changes in fat tissue under the skin), reducing discomfort, and ensuring consistent medication absorption. Victoza should be injected subcutaneously into areas with adequate fatty tissue.

Approved injection sites:

• Abdomen (stomach area): The most common site, offering a large surface area. Inject at least 5 cm (2 inches) away from the navel and avoid the area directly around it

• Thigh: Use the front and outer aspects of the thigh, in the middle section between hip and knee

• Upper arm: The outer, back area of the upper arm (this site may be more difficult to reach and often requires assistance from another person to ensure correct technique)

Avoid injecting into areas where the skin is tender, bruised, red, scaly, hard, or has scars or stretch marks. These areas may affect absorption and increase discomfort. Also avoid injecting into areas of lipohypertrophy (lumpy areas) or lipoatrophy (indented areas) until they have resolved.

Site rotation strategy: Systematic rotation of injection sites is crucial. If you inject in the same spot repeatedly, you may develop lipohypertrophy (lumpy areas of fat buildup) or lipoatrophy (loss of fat tissue), both of which can affect how your body absorbs the medication.

Best practice for rotation:

• Use a different injection site each day, following a consistent pattern

• If using the abdomen, imagine dividing it into quadrants and rotate through them

• Keep injections within the same general area (e.g., abdomen) at least 2–3 cm apart

• Some patients find it helpful to keep a simple diary or use the same site on the same day each week

You may inject Victoza at any time of day, with or without food, but try to use it at approximately the same time each day for consistency. If you notice any persistent lumps, hardness, or changes at injection sites, contact your GP or diabetes nurse for assessment.

Storing Your Victoza Pen Safely

Proper storage of your Victoza pen is essential for maintaining the medication's effectiveness and safety. Liraglutide is a protein-based medication that can degrade if exposed to inappropriate temperatures or conditions.

Before first use (unopened pens):

• Store in a refrigerator at 2°C to 8°C

• Keep in the original carton to protect from light

• Do not freeze; if a pen has been frozen, discard it even if it has thawed

• Keep away from the freezer compartment or cooling element

• Unopened pens can be stored until the expiry date printed on the label

After first use (in-use pens):

• Once you begin using a pen, you may store it at room temperature (below 30°C) or continue refrigerating it — whichever you prefer

• Keep the pen cap on when not in use to protect from light

• Discard the pen 30 days after first use, even if medication remains, regardless of storage method. Mark the date of first use on the pen label as a reminder

• Never store the pen with a needle attached, as this can cause air bubbles, medication leakage, or needle blockage

General safety precautions:

• Keep all pens out of sight and reach of children

• Do not store in direct sunlight, near heat sources, or in very hot environments (such as car glove compartments in summer)

• When travelling, you may carry your in-use pen at room temperature for up to 30 days. Use an insulated medication travel case if needed, but avoid ice packs that could freeze the medication

• If you're unsure whether your pen has been stored correctly, or if it has been exposed to extreme temperatures, contact your pharmacist for advice

Always transport unused pens in a cool bag when collecting from the pharmacy, particularly during warm weather.

Common Questions About Using the Victoza Pen

What if I miss a dose? If you forget a dose and it has been less than 12 hours since you normally inject, take it as soon as you remember. If more than 12 hours have passed, skip the missed dose and resume your normal schedule the next day. Never take a double dose to make up for a forgotten one. If you miss 3 or more consecutive days, restart at 0.6 mg and re-titrate as tolerated to reduce gastrointestinal side effects. If you miss doses frequently, speak with your healthcare professional about strategies to improve adherence.

What if I inject the wrong dose? If you accidentally inject less than prescribed, do not take an additional injection that day. If you inject more than prescribed, monitor your blood sugar levels closely and watch for signs of hypoglycaemia (low blood sugar), particularly if you take Victoza alongside insulin or sulfonylureas. Contact your GP or NHS 111 if you experience symptoms such as shakiness, sweating, confusion, or rapid heartbeat.

Can I reuse needles? No. Always use a new, sterile needle for each injection. Reusing needles increases infection risk, causes needle blunting (making injections more painful), and can lead to air bubbles or blocked needles affecting dose accuracy. Your GP, diabetes team or local pharmacy can arrange a sharps bin and disposal (local policies vary).

What are common side effects? The most frequent side effects are gastrointestinal: nausea, diarrhoea, vomiting, constipation, and abdominal discomfort. These typically improve over the first few weeks as your body adjusts. Taking the medication with food and staying well-hydrated may help. Injection-site reactions (redness, itching, or bruising) can occur but are usually mild. Gallbladder problems and kidney issues related to dehydration can also occur.

When should I seek medical advice? Contact your GP promptly if you experience:

• Severe, persistent abdominal pain (particularly if radiating to the back), which could indicate pancreatitis

• Neck swelling, persistent hoarseness, or difficulty swallowing (thyroid concerns)

• Symptoms of severe dehydration from vomiting or diarrhoea

• Unexplained weight loss or persistent nausea

Call 999 or go to A&E immediately for signs of severe allergic reaction (rash, swelling, difficulty breathing).

For routine questions about technique or minor concerns, your diabetes specialist nurse or practice nurse can provide valuable support and may offer refresher training on pen use.

You can report any suspected side effects to the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or via the Yellow Card app.

Frequently Asked Questions