Once-daily GLP-1 agonist that acts mainly on glucose after meals. It was used in type 2 diabetes; the stand-alone forms have been withdrawn for commercial reasons and it has been studied in Parkinson's disease.
FDA (US): Approved (2016, Adlyxin) for type 2 diabetes; withdrawn from the US market by the manufacturer in January 2023 for commercial reasons. Remains available combined with insulin glargine (Soliqua)
EMA (EU): Approved (2013, Lyxumia) for type 2 diabetes; authorization withdrawn in December 2025 at the request of the holder for commercial reasons. The combination with insulin glargine (Suliqua, 2017) exists
Dose
Type 2 diabetes: 10 µg subcutaneously once a day for 14 days and then 20 µg once a day, within the hour before a meal (FDA/EMA label). In the Parkinson's trial, 20 µg a day was used.
Safety
Nausea (very frequent), vomiting, and diarrhea. Risk of pancreatitis and of hypoglycemia if combined with insulin or sulfonylureas. Rare allergic reactions. Use with a medical prescription.
Interactions
It slows gastric emptying: oral drugs that need rapid absorption or have a narrow margin (oral contraceptives, acetaminophen, some antibiotics) should be taken 1 hour before or 4 hours after the injection, according to the label.
Differences between women and men
The label recommends taking oral contraceptives at least 1 hour before or 11 hours after lixisenatide, because it alters their absorption. Not recommended in pregnancy.
Effect by goal · level of evidence
Cardiovascular safety after acute coronary syndrome
no clear effectHighRCT (AA)in people
HR 1.02 (neutral)
ELIXA trial with 6,068 people with type 2 diabetes and a recent heart attack or unstable angina, followed for about 25 months. Cardiovascular events: 13.4% with lixisenatide vs 13.2% with placebo (HR 1.02). Safe, but without cardiovascular benefit.
Phase 2 trial with 156 patients over 12 months. The motor scale (MDS-UPDRS III) remained stable with lixisenatide (−0.04) and worsened by 3.04 points with placebo. Nausea in 46% and vomiting in 13%.
It activates the GLP-1 receptor. Its most marked effect is slowing stomach emptying, which reduces glucose spikes after eating. It also increases glucose-dependent insulin and suppresses glucagon. In Parkinson's disease it is being investigated for possible protective effects on neurons.
What the evidence says
In people
Cardiovascular safety after acute coronary syndrome. ELIXA trial with 6,068 people with type 2 diabetes and a recent heart attack or unstable angina, followed for about 25 months. Cardiovascular events: 13.4% with lixisenatide versus 13.2% with placebo (HR 1.02). Safe, but with no cardiovascular benefit. PubMed 26630143
Motor progression in early Parkinson's disease. Phase 2 trial with 156 patients over 12 months. The motor scale (MDS-UPDRS III) remained stable with lixisenatide (−0.04) and worsened by 3.04 points with placebo. Nausea occurred in 46% and vomiting in 13%. PubMed 38598572