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Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26




VALIDATED RP - HPLC METHOD FOR THE ESTIMATION OF LIRAGLUTIDE
                                        IN TABLET DOSAGE

                            P.V.V. Satyanarayana*, Alavala Siva Madhavi

  Department of Chemistry, Acharya Nagarjuna University, Nagarjuna Nagar, Guntur, Andhra Pradesh, India




                                                ABSTRACT

        A simple, selective, linear, precise and accurate RP-HPLC method was developed and validated for
rapid assay of Liraglutide in tablet dosage form. Isocratic elution at a flow rate of 1.0ml/min was employed on
a symmetry C18 (250x4.6mm, 5µm in particle size) at ambient temperature. The mobile phase consisted of
0.1% Ortho Phosphoric Acid: Acetonitrile: Methanol 5:60:35 (V/V). The UV detection wavelength was 245nm
and 20µl sample was injected. The retention time for Liraglutide was 4.447 min. The percentage RSD for
precision and accuracy of the method was found to be less than 2%. The method was validated as per the ICH
guidelines. The method was successfully applied for routine analysis of Liraglutide in tablet dosage form.

Key Words: Liraglutide, RP-HPLC, UV detection, recovery, precise.




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                   IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26


                                               INTRODUCTION

         Liraglutide is a long-acting glucagon-like peptide-1 (GLP-1) analog that has been developed by Novo
Nordisk for the treatment of type2 diabetes. The product was approved by the European Medicines
Agency (EMA) on July 3, 2009, and by the U.S. Food and Drug Administration (FDA) on January 25, 2010.




                                         Figure 1: Stricture of Liraglutide

         Liraglutide intended to help lower blood sugar levels along with diet, exercise, and selected other
diabetes medicines. It is not recommended as initial therapy in patients who have not achieved adequate
diabetes control on diet and exercise alone.

         Liraglutide is an incretin mimetic. This means that it mimics the actions of incretin hormones in the
body. As an incretin mimetic, liraglutide increases insulin production in response to meals and decreases the
amount of glucose (sugar) that the liver produces. The medicine also slows the emptying of food from the
stomach and decreases the amount of food that people eat.

                                               EXPERIMENTAL

Chemicals and Reagents:

         HPLC grade Actonitrile, Methanol and Ortho Phosphoric Acid (OPA)were purchased from Merck
Specalities Pvt. Ltd.

Instrumentation and Analytical Conditions:

         The analysis of drug was carried out on a PEAK HPLC system equipped with a reverse phase C18
column (250x4.6mm, 5µm in particle size), a LC-P7000 isocratic pump, a 20µl injection loop and a LC-UV7000
absorbance detector and running on PEAK Chromatographic Software version 1.06. Isocratic elution with
0.1% OPA: Acetonitrile: Methanol 30:40:30 (V/V) (PH-5.5) was used at a flow rate of 1.0ml/min. The mobile




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                        IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26


phase was prepared freshly and degassed by sonicating for 5 min before use.

Stock and Working Standard Solutions:

        10mg of Liraglutide working standard was accurately weighed and transferred into a 10ml
volumetric flask containing diluent. It was sonicated, dissolved completely and made volume up to the mark
with the same solvent. 1ml of the above stock solution was pipetted into a 10ml volumetric flask and diluted
up to the mark with diluent. The contents were mixed well and filtered through 0.45µm nylon filter paper and
60ppm was prepared finally. The calibration curve was plotted with the six concentrations of the 30 ppm-90
ppm working standard solutions. Calibration solutions were prepared daily and analyzed immediately after
preparation.

Assay of Liraglutide Tablets:

        20 Liraglutide tablets were weighed and the average weight was calculated. The sample equivalent to
10mg of Liraglutide was accurately weighed and transferred in to a 10ml volumetric flask. The diluent was
added, sonicated for complete dissolution. The mixture wasmade volume up to the mark with diluents. They
were mixed well and filterd through 0.45um filter. Further, 1ml of the above stock solution pipetted into a
10ml volumetric flask and diluted up to mark with diluents and finally 60 ppm were prepared. They were
mixed well and filterd through 0.45um filter. An aliquot of this solution was injected into HPLC system. Peak
area of Liraglutide was measured for the determination.

Validation Procedure:

        The objective of the method validation is to demonstrate that the method is suitable for its intended
purpose as it is stated in ICH guidelines. The method was validated for linearity, precision (repeatability and
intermediate precision), accuracy, specificity, stability and system suitability. Standard plots were
constructed with five concentrations in the range of 30 ppm to 90 ppm prepared in triplicates to test
linearity. The peak area of Liraglutide was plotted against the concentration to obtain the calibration graph.
The linearity was evaluated by linear regression analysis that was calculated by the least square regression
method. The precision of the assay was studied with respect to both repeatability and intermediate precision.
Repeatability was calculated from five replicate injections of freshly prepared Liraglutide test solution in the
same equipment at a concentration value of 100% (60 ppm) of the intended test concentration value on the
same day. The experiment was repeated by assaying freshly prepared solution at the same concentration
additionally on two consecutive days to determine intermediate precision. Peak area of the Liraglutide was
determined and precision was reported as %RSD.




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                   IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26


        Method accuracy was tested (% recovery and %RSD of individual measurements) by analyzing
sample of Liraglutide at three different levels in pure solutions using three preparations for each level. The
results were expressed as the percentage of Liraglutide recovered in the samples. Sample solution short term
stability was tested at ambient temperature (20±100C) for three days.

                                      RESULT AND DISCUSSION

Optimization of the Chromatographic Conditions:

        Proper selection of the stationary phase depends up on the nature of the sample, molecular weight
and solubility. Among C8 and C18, C18 column was selected. Non-polar compound is very attractive with
reverse phase columns. So the elution of the compound from the column was influenced by polar mobile
phase. Mixture of 0.1% OPA, Methanol and Acetonitrile was selected as mobile phase and the effect of
composition of mobile phase on the retention time of Liraglutide was thoroughly investigated. The
concentration of the 0.1% OPA, Methanol and Acetonitrile were optimized to give symmetric peak with short
run time (Fig.2).




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                    IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26




                             Fig 2: Typical chromatogram of Liraglutide standard

Validation of Method

Linearity:

        Five points graphs was constructed covering a concentration range 3-18ppm (Three independent
determinations were performed at each concentration). Linear relationships between the peak area signal of
Liraglutide the corresponding drug concentraton was observed. The standard deviation of the slope and
intercept were low. The statistical analysis of calibration is shown in Table 1.




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                    IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26




                S.NO                          Concentration in ppm                         Area
                  1                                      30                               125697
                  2                                      40                               167238
                  3                                      50                               213028
                  4                                      60                               250034
                  5                                      70                               298632
                  6                                      80                               342413
                  7                                      90                               377098
         Range 30 – 60 ppm                             Slope                               4226
                                                     Intercept                             -653
                                              Correlation coefficient                     0.999



                                              Table 1: Linearity of Liraglutide


                          400000
                          350000
                          300000
                          250000
                          200000
                   Area




                          150000
                          100000
                           50000
                               0
                                   0           20             40          60         80            100
                          -50000
                                                               Concentration



                                       Fig 3: Calibration curve of Liraglutide


Precision:

        The validated method was applied for the assay of commercial tablets containing Liraglutide. Sample
was analyzed for five times after extracting the drug as mentioned in assay sample preparation of the
experimental section. The results presented good agreement with the labeled content. Low values of standard


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                  IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26


deviation denoted very good repeatability of the measurement. Thus it was showing that the equipment used
for the study was correctly and hence the developed analytical method is highly repetitive. For the
intermediate precision a study carried out by the same analyst working on the same day on two consecutive
days indicated a RSD of 0.3135. This indicates good method precision.

                                     %             % Recovery            Mean
                              Concentration                            Recovery
                                    50%                99.67


                                   100%                99.29            99.31 %

                                   150%                98.97



                                   Table 2: Recovery studies of Liraglutide


System Suitability:

        The system suitability parameter like capacity factor, asymmetry factor, tailing factor and number of
theoretical plates were also calculated. It was observed that all the values are within the limits (Table.3). The
statistical evaluation of the proposed method was revealed its good linearity, reproducibility and its
validation for different parameters and let us to the conclusion that it could be used for the rapid and reliable
determination of Liraglutide in tablet formulation. The results are furnished in Table 3.




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                   IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26


             Parameters                              Values

              λ max (nm)                             245nm

      Beer’s law limit (ppm)                       30 – 90 ppm

      Correlation coefficient                         0.999

            Retention time                             6.11

         Theoretical plates                           11453
             Tailing factor                            1.26

         Limit of detection                          0.06ppm

      Limit of quantification                        0.2 ppm

                 Slope                                4226

               Intercept                               -653

               Accuracy                               99.31

                 R.S.D.                                1.13

   % Estimation of Liraglutide in                    98.97%
             formulation


                    Table 3: System stability parameters


Formulation                Label claim (mg)        % Amount found


  Victoza                       1.8 mg                  98.97%



                                Table 4: Assay




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  IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26


                           Mobile phase             Methanol:Acetonitrile:0.1% OPA
                                                                (35:60:5)
                                PH                                 5.1


                           UV detection                          245nm


                         Analytical column                        C18


                             Flow rate                         1.0ml/min


                           Temperature                          ambient


                         Injection volume                         20µl


                             Runtime                             10 min


                          Retention time                        6.11 min




                                     Table 5: Chromatographic condition


                                               CONCLUSION

        A validated RP-HPLC method has been developed for the determination of Liraglutide in tablet
dosage form. The proposed method is simple, rapid, accurate, precise and specific. Its chromatographic run
time of 10 min allows the analysis of a large number of samples in short period of time. Therefore, it is
suitable for the routine analysis of Liraglutide in pharmaceutical dosage form. The limit of detection for
Liraglutide was found to be 0.06 ppm and the limit of quantification was found to be 0.2 ppm. It proves the
sensitivity of method.




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                   IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26


                                           REFERENCES

 1.   http://www.novonordisk.com/science/about_rd/quarterly_rd_update.asp Oct 2008 Inc results of
      LEAD 6 extension
 2.   http://money.cnn.com/news/newsfeeds/articles/marketwire/0580389.htm January 2009
 3.   Hirschler, Ben (January 13, 2010). "UPDATE 1-Novo starts tests on pill version of Victoza drug".
      Reuters.
 4.   "Sector Snap: New Diabetes Drugs under FDA Review". Forbes. Retrieved March 27, 2009.
 5.   http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/Endocr
      inologicandMetabolicDrugsAdvisoryCommittee/UCM148659.pdf
 6.   Victoza Package Insert Date of Issue: January 2010 Version: 1
 7.   N Engl J Med, 362:774
 8.   http://www.drugs.com/fda/victoza-liraglutide-rdna-origin-rems-risk-thyroid-c-cell-tumors-acute-
      pancreatitis-12979.html
 9.   http://diabetes.webmd.com/news/20080924/new-diabetes-drug-liraglutide-works Sept 2008
10.   http://care.diabetesjournals.org/cgi/content/abstract/32/1/84 "Efficacy and Safety Comparison of
      Liraglutide, Glimepiride, and Placebo, All in Combination with Metformin, in Type 2 Diabetes"
      Diabetes Care. Oct 2008
11.   "Novo Nordisk Limited, Eli Lilly and Company Limited, Grünenthal Ltd and Napp Pharmaceuticals
      Limited named in advertisements". Prescription Medicines Code of Practice Authority (PMCPA).
      Retrieved 2011-02-07.
12.   http://www.mmm-online.com/novo-reps-to-spotlight-weight-loss-for-victoza-
      launch/article/163167/ | Medical Media & Marketing; Novo reps to spotlight weight loss for Victoza
      launch; 2/4/2010; Ben Comer.




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                 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012

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VALIDATED RP - HPLC METHOD FOR THE ESTIMATION OF LIRAGLUTIDE IN TABLET DOSAGE

  • 1. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 VALIDATED RP - HPLC METHOD FOR THE ESTIMATION OF LIRAGLUTIDE IN TABLET DOSAGE P.V.V. Satyanarayana*, Alavala Siva Madhavi Department of Chemistry, Acharya Nagarjuna University, Nagarjuna Nagar, Guntur, Andhra Pradesh, India ABSTRACT A simple, selective, linear, precise and accurate RP-HPLC method was developed and validated for rapid assay of Liraglutide in tablet dosage form. Isocratic elution at a flow rate of 1.0ml/min was employed on a symmetry C18 (250x4.6mm, 5µm in particle size) at ambient temperature. The mobile phase consisted of 0.1% Ortho Phosphoric Acid: Acetonitrile: Methanol 5:60:35 (V/V). The UV detection wavelength was 245nm and 20µl sample was injected. The retention time for Liraglutide was 4.447 min. The percentage RSD for precision and accuracy of the method was found to be less than 2%. The method was validated as per the ICH guidelines. The method was successfully applied for routine analysis of Liraglutide in tablet dosage form. Key Words: Liraglutide, RP-HPLC, UV detection, recovery, precise. 17 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 2. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 INTRODUCTION Liraglutide is a long-acting glucagon-like peptide-1 (GLP-1) analog that has been developed by Novo Nordisk for the treatment of type2 diabetes. The product was approved by the European Medicines Agency (EMA) on July 3, 2009, and by the U.S. Food and Drug Administration (FDA) on January 25, 2010. Figure 1: Stricture of Liraglutide Liraglutide intended to help lower blood sugar levels along with diet, exercise, and selected other diabetes medicines. It is not recommended as initial therapy in patients who have not achieved adequate diabetes control on diet and exercise alone. Liraglutide is an incretin mimetic. This means that it mimics the actions of incretin hormones in the body. As an incretin mimetic, liraglutide increases insulin production in response to meals and decreases the amount of glucose (sugar) that the liver produces. The medicine also slows the emptying of food from the stomach and decreases the amount of food that people eat. EXPERIMENTAL Chemicals and Reagents: HPLC grade Actonitrile, Methanol and Ortho Phosphoric Acid (OPA)were purchased from Merck Specalities Pvt. Ltd. Instrumentation and Analytical Conditions: The analysis of drug was carried out on a PEAK HPLC system equipped with a reverse phase C18 column (250x4.6mm, 5µm in particle size), a LC-P7000 isocratic pump, a 20µl injection loop and a LC-UV7000 absorbance detector and running on PEAK Chromatographic Software version 1.06. Isocratic elution with 0.1% OPA: Acetonitrile: Methanol 30:40:30 (V/V) (PH-5.5) was used at a flow rate of 1.0ml/min. The mobile 18 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 3. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 phase was prepared freshly and degassed by sonicating for 5 min before use. Stock and Working Standard Solutions: 10mg of Liraglutide working standard was accurately weighed and transferred into a 10ml volumetric flask containing diluent. It was sonicated, dissolved completely and made volume up to the mark with the same solvent. 1ml of the above stock solution was pipetted into a 10ml volumetric flask and diluted up to the mark with diluent. The contents were mixed well and filtered through 0.45µm nylon filter paper and 60ppm was prepared finally. The calibration curve was plotted with the six concentrations of the 30 ppm-90 ppm working standard solutions. Calibration solutions were prepared daily and analyzed immediately after preparation. Assay of Liraglutide Tablets: 20 Liraglutide tablets were weighed and the average weight was calculated. The sample equivalent to 10mg of Liraglutide was accurately weighed and transferred in to a 10ml volumetric flask. The diluent was added, sonicated for complete dissolution. The mixture wasmade volume up to the mark with diluents. They were mixed well and filterd through 0.45um filter. Further, 1ml of the above stock solution pipetted into a 10ml volumetric flask and diluted up to mark with diluents and finally 60 ppm were prepared. They were mixed well and filterd through 0.45um filter. An aliquot of this solution was injected into HPLC system. Peak area of Liraglutide was measured for the determination. Validation Procedure: The objective of the method validation is to demonstrate that the method is suitable for its intended purpose as it is stated in ICH guidelines. The method was validated for linearity, precision (repeatability and intermediate precision), accuracy, specificity, stability and system suitability. Standard plots were constructed with five concentrations in the range of 30 ppm to 90 ppm prepared in triplicates to test linearity. The peak area of Liraglutide was plotted against the concentration to obtain the calibration graph. The linearity was evaluated by linear regression analysis that was calculated by the least square regression method. The precision of the assay was studied with respect to both repeatability and intermediate precision. Repeatability was calculated from five replicate injections of freshly prepared Liraglutide test solution in the same equipment at a concentration value of 100% (60 ppm) of the intended test concentration value on the same day. The experiment was repeated by assaying freshly prepared solution at the same concentration additionally on two consecutive days to determine intermediate precision. Peak area of the Liraglutide was determined and precision was reported as %RSD. 19 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 4. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 Method accuracy was tested (% recovery and %RSD of individual measurements) by analyzing sample of Liraglutide at three different levels in pure solutions using three preparations for each level. The results were expressed as the percentage of Liraglutide recovered in the samples. Sample solution short term stability was tested at ambient temperature (20±100C) for three days. RESULT AND DISCUSSION Optimization of the Chromatographic Conditions: Proper selection of the stationary phase depends up on the nature of the sample, molecular weight and solubility. Among C8 and C18, C18 column was selected. Non-polar compound is very attractive with reverse phase columns. So the elution of the compound from the column was influenced by polar mobile phase. Mixture of 0.1% OPA, Methanol and Acetonitrile was selected as mobile phase and the effect of composition of mobile phase on the retention time of Liraglutide was thoroughly investigated. The concentration of the 0.1% OPA, Methanol and Acetonitrile were optimized to give symmetric peak with short run time (Fig.2). 20 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 5. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 Fig 2: Typical chromatogram of Liraglutide standard Validation of Method Linearity: Five points graphs was constructed covering a concentration range 3-18ppm (Three independent determinations were performed at each concentration). Linear relationships between the peak area signal of Liraglutide the corresponding drug concentraton was observed. The standard deviation of the slope and intercept were low. The statistical analysis of calibration is shown in Table 1. 21 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 6. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 S.NO Concentration in ppm Area 1 30 125697 2 40 167238 3 50 213028 4 60 250034 5 70 298632 6 80 342413 7 90 377098 Range 30 – 60 ppm Slope 4226 Intercept -653 Correlation coefficient 0.999 Table 1: Linearity of Liraglutide 400000 350000 300000 250000 200000 Area 150000 100000 50000 0 0 20 40 60 80 100 -50000 Concentration Fig 3: Calibration curve of Liraglutide Precision: The validated method was applied for the assay of commercial tablets containing Liraglutide. Sample was analyzed for five times after extracting the drug as mentioned in assay sample preparation of the experimental section. The results presented good agreement with the labeled content. Low values of standard 22 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 7. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 deviation denoted very good repeatability of the measurement. Thus it was showing that the equipment used for the study was correctly and hence the developed analytical method is highly repetitive. For the intermediate precision a study carried out by the same analyst working on the same day on two consecutive days indicated a RSD of 0.3135. This indicates good method precision. % % Recovery Mean Concentration Recovery 50% 99.67 100% 99.29 99.31 % 150% 98.97 Table 2: Recovery studies of Liraglutide System Suitability: The system suitability parameter like capacity factor, asymmetry factor, tailing factor and number of theoretical plates were also calculated. It was observed that all the values are within the limits (Table.3). The statistical evaluation of the proposed method was revealed its good linearity, reproducibility and its validation for different parameters and let us to the conclusion that it could be used for the rapid and reliable determination of Liraglutide in tablet formulation. The results are furnished in Table 3. 23 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 8. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 Parameters Values λ max (nm) 245nm Beer’s law limit (ppm) 30 – 90 ppm Correlation coefficient 0.999 Retention time 6.11 Theoretical plates 11453 Tailing factor 1.26 Limit of detection 0.06ppm Limit of quantification 0.2 ppm Slope 4226 Intercept -653 Accuracy 99.31 R.S.D. 1.13 % Estimation of Liraglutide in 98.97% formulation Table 3: System stability parameters Formulation Label claim (mg) % Amount found Victoza 1.8 mg 98.97% Table 4: Assay 24 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 9. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 Mobile phase Methanol:Acetonitrile:0.1% OPA (35:60:5) PH 5.1 UV detection 245nm Analytical column C18 Flow rate 1.0ml/min Temperature ambient Injection volume 20µl Runtime 10 min Retention time 6.11 min Table 5: Chromatographic condition CONCLUSION A validated RP-HPLC method has been developed for the determination of Liraglutide in tablet dosage form. The proposed method is simple, rapid, accurate, precise and specific. Its chromatographic run time of 10 min allows the analysis of a large number of samples in short period of time. Therefore, it is suitable for the routine analysis of Liraglutide in pharmaceutical dosage form. The limit of detection for Liraglutide was found to be 0.06 ppm and the limit of quantification was found to be 0.2 ppm. It proves the sensitivity of method. 25 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012
  • 10. Alavala Siva Madhavi et al., IJSIT, 2012, 1(1), 17-26 REFERENCES 1. http://www.novonordisk.com/science/about_rd/quarterly_rd_update.asp Oct 2008 Inc results of LEAD 6 extension 2. http://money.cnn.com/news/newsfeeds/articles/marketwire/0580389.htm January 2009 3. Hirschler, Ben (January 13, 2010). "UPDATE 1-Novo starts tests on pill version of Victoza drug". Reuters. 4. "Sector Snap: New Diabetes Drugs under FDA Review". Forbes. Retrieved March 27, 2009. 5. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/Endocr inologicandMetabolicDrugsAdvisoryCommittee/UCM148659.pdf 6. Victoza Package Insert Date of Issue: January 2010 Version: 1 7. N Engl J Med, 362:774 8. http://www.drugs.com/fda/victoza-liraglutide-rdna-origin-rems-risk-thyroid-c-cell-tumors-acute- pancreatitis-12979.html 9. http://diabetes.webmd.com/news/20080924/new-diabetes-drug-liraglutide-works Sept 2008 10. http://care.diabetesjournals.org/cgi/content/abstract/32/1/84 "Efficacy and Safety Comparison of Liraglutide, Glimepiride, and Placebo, All in Combination with Metformin, in Type 2 Diabetes" Diabetes Care. Oct 2008 11. "Novo Nordisk Limited, Eli Lilly and Company Limited, Grünenthal Ltd and Napp Pharmaceuticals Limited named in advertisements". Prescription Medicines Code of Practice Authority (PMCPA). Retrieved 2011-02-07. 12. http://www.mmm-online.com/novo-reps-to-spotlight-weight-loss-for-victoza- launch/article/163167/ | Medical Media & Marketing; Novo reps to spotlight weight loss for Victoza launch; 2/4/2010; Ben Comer. 26 IJSIT (www.ijsit.com), Volume 1, Issue 1, September-October 2012