Lixisenatide (Adlyxin)

What Is Lixisenatide?

Lixisenatide is a short-acting GLP-1 receptor agonist developed for improving glycemic control in people with type 2 diabetes. Marketed under the brand name Adlyxin (formerly Lyxumia in Europe), it mimics the GLP-1 hormone to help regulate blood sugar levels post-meal.

Mechanism of Action

Lixisenatide works by:

  • Stimulating insulin release in a glucose-dependent manner
  • Suppressing inappropriate glucagon secretion
  • Slowing gastric emptying to reduce postprandial glucose spikes
  • Promoting satiety and reducing food intake

Indications

  • Adults with type 2 diabetes inadequately controlled with diet, exercise, or oral antidiabetic agents
  • Can be used in combination with basal insulin or oral medications (e.g., metformin)
  • Not indicated for type 1 diabetes or diabetic ketoacidosis
  • Not approved for pediatric use

Dosage & Administration

  • Subcutaneous injection once daily, ideally within one hour before the first meal of the day
  • Initial dose: 10 mcg daily for 14 days, then increase to 20 mcg daily
  • Administer in the abdomen, thigh, or upper arm

Benefits

  • Reduces postprandial glucose excursions effectively
  • Modest HbA1c reduction (~0.5–1.0%)
  • Can support mild weight loss (~1–3 kg)
  • Useful for patients who struggle with high after-meal glucose levels

Side Effects

  • Nausea, especially at initiation
  • Vomiting, diarrhea, and headache
  • Injection site reactions
  • Rare: pancreatitis, acute kidney injury in dehydrated individuals

Contraindications & Warnings

  • History of serious hypersensitivity to lixisenatide
  • Not recommended in patients with severe gastrointestinal disease (e.g., gastroparesis)
  • Use caution in those with renal impairment

Clinical Evidence

  • GetGoal Clinical Program: Series of trials demonstrated effectiveness in combination with metformin, sulfonylureas, and basal insulin
  • Particularly strong impact on postprandial glucose, less on fasting glucose
  • Lower risk of hypoglycemia unless used with sulfonylureas or insulin

Comparison to Other GLP-1 Agonists

  • Shorter-acting than semaglutide, liraglutide, or dulaglutide
  • Less effective for weight loss and fasting glucose reduction
  • Better for patients with primarily post-meal glucose issues

Cost & Access

  • May be covered by insurance for diabetes care
  • Manufacturer support programs may be available

Summary

Lixisenatide (Adlyxin) remains a useful short-acting GLP-1 option for individuals focused on postprandial glucose control. Though less potent than newer agents, it is simple to use and can be effective in tailored treatment plans.

References

  1. Rosenstock J, et al. “Efficacy and safety of lixisenatide once daily in type 2 diabetes inadequately controlled on oral therapies: The GetGoal-Duo 1 trial.” Diabetes Care. 2013.
  2. Adlyxin Prescribing Information. U.S. FDA. Updated 2023.
  3. American Diabetes Association. Standards of Care in Diabetes—2024. Diabetes Care.