Table 1.

Prescribing and Dose of Glucagon-Like Peptide-1 Receptor Agonist With Demonstrated Cardiovascular Benefit

Medication/administration	FDA approved for cardiovascular risk reduction?	Initial dose	Dose titration/target dosea	How medication is supplied	Need to prescribe pen needles separately?	Kidney adjustment
Once-daily administration
Liraglutide	Yes	0.6 mg Once daily (can be taken anytime)	Can increase weekly. After 1 wk, increase to 1.2 mg daily. Then increase to 1.8 mg daily if further glycemic control is needed.	1 Pen with 3 different programmable doses (0.6 mg, 1.2 mg, and 1.8 mg). Multiple-use pen is to be used with single-use needles.	Yes	None (limited data in ESKD)
Weekly administration
Semaglutide	Yes	0.25 mg Weekly (can be taken anytime)	Can increase dose every 4 wk. After 4 wk, increase to 0.5 mg weekly. Then increase to 1.0 mg weekly if further glycemic control is needed.	2 Different pens available, each with 2 programmable doses: 1 pen allows 0.25 mg and 0.5 mg doses, and 1 pen allows 1.0 mg doses. Multiple-use pen is to be used with single-use needles.	No (pen needles come in box with pens)	None (limited data in ESKD)
Dulaglutide	Yes	0.75 mg Weekly	Can increase dose to 1.5 mg weekly if further glycemic control is needed.	2 Different pens, each with a different dose (0.75 mg and 1.5 mg). Single-use pen.	No (needle is built into pen)	None (limited data in ESKD)

Abbreviations: ESKD, end-stage kidney disease; FDA, US Food and Drug Administration.

^aIf patients experience gastrointestinal adverse effects, wait until symptoms resolve before escalating the dose. If symptoms do not resolve with higher dose, reduce dose to highest tolerated dose. For liraglutide and semaglutide, the lowest doses (0.6mg and 0.25mg, respectively) are starting doses intended to reduce gastrointestinal symptoms during initial titration and are not intended for glycemic control.