Table 6.

Renal and hepatic adjustments of GLP-1 agonists.

	Dose adjustment for renal impairment	Dose adjustment for hepatic impairment
Exenatide twice daily [17]	Not appropriate for patients with severe renal impairment (CrCL <30 mL/min) or end-stage renal disease. Caution should be applied when initiating or escalating doses from 5 to 10 µg in patients with moderate renal impairment (CrCL 30–50 mL/min).	Exenatide undergoes renal elimination, thus hepatic impairment is not expected to affect blood concentrations. Dose adjustment is not indicated.
Liraglutide [22]	Few post-marketing reports of acute renal failure with liraglutide exist in patients with pre-existing kidney disease. Utilize with caution in patients with chronic kidney disease. Dose adjustment is not recommended.	Dose adjustment is not necessary.
Exenatide once weekly [26]	Not recommended for use in patients with end-stage renal disease or severe renal impairment (CrCL <30 mL/min). Exercise caution in patients with moderate renal impairment (CrCL 30–50 mL/min). Dose adjustment is not necessary.	Exenatide undergoes renal elimination, thus hepatic impairment is not expected to affect blood concentrations. Dose adjustment is not indicated.
Dulaglutide [35]	Dose adjustment is not necessary. Exercise caution when initiating or escalating doses in patients with renal impairment.	Dose adjustment is not necessary.
Abliglutide [30]	Dose adjustment is not necessary. Exercise caution when initiating or escalating doses in patients with renal impairment.	Dose adjustment is not necessary.

CrCL, creatinine clearance.