Liraglutide pen prep: what the pharmacist gets right and wrong

What did @kelleyrosspharmac actually say?

A pharmacist at Kelley Ross walked through the steps for priming a new liraglutide pen for the first time. She described liraglutide as "a once daily, non-insulin, injectable medication commonly used in type 2 diabetes" and demonstrated a specific sequence: visual inspection, alcohol wipes on the rubber stopper and skin, needle attachment, a flow check using the "two dashes" symbol, and finally proper needle disposal into a sharps container.

She also used the word "lancet" throughout to describe the needle attachment for the pen. The video is clearly educational and procedural, aimed at patients who are new to this medication. No specific doses were mentioned, and no therapeutic claims beyond the general diabetes indication were made. That restraint is worth noting.

Does the science back this up?

Yes, in most respects. The procedural steps she described align with the FDA-approved prescribing information and Novo Nordisk's own patient instructions for Victoza. The flow check step, sometimes called a "priming" step, is standard for multi-dose injection pens and is designed to confirm the needle is patent and the device is working correctly.

The recommendation to inspect for clarity and absence of particulates before injection is supported by basic pharmacological safety practice. Injectable biologics and GLP-1 receptor agonists can degrade, and a cloudy or particulate-containing solution should not be used. The 2019 Victoza prescribing information from the FDA explicitly states the solution should be clear, colorless, and free of particles. Applying alcohol to both the rubber stopper and the injection site before use is consistent with standard aseptic technique guidelines, including those outlined by the CDC for home injectable medication use.

What did they get wrong (or right)?

The biggest factual error is a terminology one. She repeatedly called the needle a "lancet." That is incorrect. A lancet is a small, spring-loaded device used to prick a fingertip for blood glucose testing. The device used with the Victoza pen is a pen needle, not a lancet. These are different products with different designs and different purposes.

This is not a trivial distinction. Patients new to injectable therapy are already navigating unfamiliar equipment. Using the wrong term could genuinely confuse someone who goes to a pharmacy asking for lancets for their liraglutide pen. Credit where it is due: everything else in the procedural walkthrough was accurate and well-organized. She correctly described the two-dash flow check symbol, the proper direction for twisting the needle on, and the importance of recapping the needle using the outer cover before disposal, which reduces needlestick risk.

What should you actually know?

If you are starting liraglutide for the first time, the pen prep steps shown here are a reasonable guide, but your pharmacist or prescribing clinician should walk you through it in person or via a verified patient instruction sheet before your first injection. The Victoza pen uses NovoFine or compatible pen needles, which are sold separately and come in different lengths and gauges. Needle length matters for subcutaneous injection depth, and that choice should be made with your provider.

Storage also matters and was not covered in the video. Unopened Victoza pens must be refrigerated between 36 and 46 degrees Fahrenheit. Once in use, they can be stored at room temperature below 77 degrees Fahrenheit for up to 30 days. Injecting a pen that has been stored improperly, even one that looks visually clear, may result in reduced efficacy. Finally, liraglutide is also marketed as Saxenda at a higher dose for weight management. These are not interchangeable, and the dosing protocols differ significantly.