GLP1-RA

Contraindication

Renal impairment

Majority of the available GLP1-RAs except OW semaglutide, Liraglutide and dulaglutide [6] - [12] [63]

End-stage renal disease (estimated glomerular filtration rate [eGFR] < 15 mL/min/1.73 m²)

Exenatide ER and exenatide twice daily [6] [8]

Severe renal impairment (creatinine clearance < 30 mL/min): do not use

Moderate renal impairment (creatinine clearance 30 - 50 mL/min):

use with caution

Lixisenatide [7]

Severe renal impairment

Liraglutide [12]

Renal impairment (eGFR < 60): caution in dose escalation

Dulaglutide [11]

Severe renal impairment

Diabetic retinopathy

OW semaglutide and dulaglutide [9] [63] [64]

OW semaglutide and dulaglutide are up-titrated more slowly (every 2 - 3 months). Patients should have regular assessments for retinopathy