Saxenda dosage: forms, strengths, and how to take

Overweight and obesity are medical conditions that don’t always improve with the traditional “eat right and exercise more” approach. Some people need more assistance, which may come from prescription weight management drugs like Saxenda. However, the different Saxenda dosing schedules and strengths can be confusing. Read on to learn more about how to take Saxenda to get the most out of it, while minimizing potential side effects.

Saxenda (active ingredient liraglutide) belongs to a class of drugs known as glucagon-like peptide-1 receptor agonists, or GLP-1 agonists for short. These prescription medications were initially developed to help people with type 2 diabetes control their blood sugar levels. But it soon became apparent that it can also help people achieve their weight loss goals. GLP-1 agonists slow the movement of food through your stomach, decreasing appetite and allowing you to feel fuller for longer.

Saxenda is FDA-approved to help with weight management, alongside a healthy diet and regular exercise, in the following groups:

• Adults with body mass index (BMI) greater than 30 kg/m2, or greater than 27 kg/m2 with a weight-related health problem (e.g., high blood pressure, type 2 diabetes, or high cholesterol)

• Children 12 years of age and older who weigh over 132 lbs and have a high BMI

Saxenda is injected once a day under the skin (subcutaneously) of your belly, thigh, or upper arm. Most people start with the lowest Saxenda dose of 0.6 mg once daily. Your dose typically increases weekly depending on how well you tolerate the medication. The maximum dose you can take is 3 mg per day.

Saxenda strengths 

Saxenda comes in a box with three prefilled pens containing 18mg of liraglutide in 3 mL of solution. But you won’t be taking all of that medicine at once. You can adjust the pen each time you take the medication to deliver a dose of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, and 3 mg. 

What are the usual dosages of Saxenda?  

To reduce the risk of side effects and maximize the benefits, healthcare providers recommend starting at the lowest dose (0.6 mg) and working your way up to the maximum dose (3 mg) by increasing your dose each week. How quickly your dose escalates may depend on if you experience any side effects (e.g., nausea, diarrhea, etc.) and their severity. Your healthcare professional can guide you in adjusting your dosing schedule. 

A typical dosing schedule would look like this:

• Week 1: Inject 0.6 mg under the skin once daily.

• Week 2: Inject 1.2 mg under the skin once daily.

• Week 3: Inject 1.8 mg under the skin once daily.

• Week 4: Inject 2.4 mg under the skin once daily.

• Week 5 and after: Inject 3 mg under the skin once daily.

What’s the dosage of Saxenda for children? 

The Saxenda dosages for children over 12 are the same as those for adults. The starting dose is 0.6 mg, increasing weekly depending on how well the medication is tolerated and the severity of the side effect. If a particular dose causes too many side effects, you can drop down to the previous week's dose and try the higher dose again later. Children may take up to 8 weeks for children to reach the maximum dose. 

And some children do not tolerate the highest dose of 3 mg. In these cases, they can stay at 2.4 mg for as long as it is deemed appropriate by their healthcare provider. 

Each pen holds 3 mL of 6 mg/mL liraglutide solution. This means that each pen holds 18 mg of the medication. The number of doses per pen will vary depending on how much you are injecting with each dose. At the highest dose of 3 mg daily, each pen will hold 6 doses (so almost a week). That means a box containing three pens will last 18 days if you are at the maximum maintenance dose. However, especially at the beginning of your Saxenda treatment, you may take less than 3 mg daily. In that case, one pen will last you longer than 6 days. 

If you miss a dose of Saxenda, not to worry. Just resume your once-a-day dosing with the next scheduled dose. Do not try to take an extra dose or increase your dose the following day to “make up” for the missed dose. 

However, if you don’t take Saxenda for more than 3 days, you should drop back to the starting dose of 0.6 mg and restart the escalation schedule. By decreasing your dose and slowly working your way back up again each week, you are less likely to experience Saxenda side effects than if you skip 3 days and jump right back to a higher dose. 

This is why it is so important to remember to take Saxenda every day. One tip is to try to take it at the same time every day, simply to develop the habit. However, it doesn’t matter what time you take Saxenda, as long as you remember to take it each day. Setting an alarm or using a medication reminder app may help. 

That depends on how you are trying to split your dose.

Even though the Saxenda pens can deliver doses in different increments (0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, and 3 mg) you should not split your dose throughout the day. For example, if you are supposed to take 1.2 mg daily, you should not take 0.6 mg in the morning and 0.6 mg in the evening. The medication was studied and approved for the entire dose to be taken all at once —so 1.2 mg in a single dose. 

However, if instructed to by your healthcare provider, you may need to split your dose between your current Saxenda pen and a new one. So if you are at the 3 mg dose but only have 2.4 mg left in your pen, your healthcare provider may advise you to use that 2.4 mg and then use 0.6 mg from a new pen. But this “split” dose is still taken at the same time and not spread out over the course of the day. If you have any questions, check with your healthcare provider to ensure you get the correct amount of medication.

Everyone responds to Saxenda differently, and this response often guides the dosing schedule. One of the main factors affecting the Saxenda dosage your healthcare provider recommends for you is how well you tolerate the medication. Many people experience mild to moderate side effects from Saxenda, especially after increasing the dose. The most common side effects include nausea, vomiting, diarrhea, constipation, and skin reactions at the injection site. Fortunately, these side effects typically get better on their own over time. But if you find the side effects too uncomfortable, you can always drop back down to the lower dose and try the higher dose again later. 

Other factors that may affect the Saxenda dosage include medical conditions like:

• severe stomach problems, such as slowed stomach emptying (gastroparesis) 

• Recent or past problems with your pancreas, kidneys, or liver

• Recent or past problems with depression or suicidal thoughts, or other mental health issues

• Medications, including other diabetes medications like insulin or metformin

While none of these factors means you can’t use Saxenda, your healthcare provider should know about them. Also, if you are breastfeeding or plan to breastfeed, tell your provider. Scientists don’t know if Saxenda can get into breastmilk, so you and your provider should decide whether Saxenda is right for you. It is unknown if Saxenda passes into your breast milk. You and your healthcare provider should decide whether to use Saxenda or breastfeed.

You should not take any dose of Saxenda if you are pregnant or plan to become pregnant as it may cause harm to the unborn baby. Also, if you or anyone in your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) you should not take Saxenda. 

Lastly, your weight loss response may also affect your dosage. Adults taking Saxenda should have their healthcare provider evaluate their change in body weight 16 weeks after starting Saxenda therapy. If you have not lost at least 4% of your baseline body weight, it may be that continued Saxenda treatment is unlikely to help you achieve and sustain clinically meaningful weight loss, especially if you have been taking the maximum dose. This is an important discussion to have with your healthcare provider. 

As with many other medications, you should not take more Saxenda than your provider prescribes. Symptoms of Saxenda overdose include severe nausea, vomiting, and low blood sugar (hypoglycemia). If you think you have taken too much Saxenda, call your healthcare provider immediately, and they will instruct you regarding the appropriate supportive treatment based on your signs and symptoms.

Remember that Saxenda is not a miracle cure, nor does it work overnight. It is meant to be used as a part of your overall plan for losing weight, which also includes healthy eating and exercise. As you start your weight loss journey, know you are not alone. Online support groups and weight loss programs, like Ro’s Body Program, can help you navigate food and activity options, allowing you to optimize your chances of success and achieve your weight goals. 

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Current version

June 07, 2023

Written by

Chimene Richa, MD

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.