Saxenda (liraglutide): doses, uses, and side effects

For people trying—and struggling—to achieve a healthy weight, the old advice to “just eat less and exercise more” isn’t very helpful (and can encourage a pretty unhealthy relationship with your body). 

Instead, a comprehensive plan that includes a balanced diet, regular exercise, and medical interventions (if appropriate) can help many people achieve their goals. Medications like Saxenda may be an option on your weight loss journey. Here’s what you need to know.

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Saxenda (liraglutide) is an injectable prescription drug used to help with weight management. It belongs to a drug class called glucagon-like peptide-1 (GLP-1) receptor agonists. These medications are used to promote weight loss and treat type 2 diabetes mellitus. 

Examples of other GLP-1 receptor agonists are exenatide and semaglutide. Victoza, a lower-dose version of liraglutide (the same active ingredient in Saxenda), is FDA-approved to treat type 2 diabetes. 

In a clinical trial of more than 3,000 people with obesity or who had a weight-related medical condition, the majority of participants lost 5–10% of their body weight while on Saxenda. The average weight loss was 12–23 pounds over a 56-week timeframe.

Saxenda is meant to help you consume fewer calories. When paired with healthy food choices and regular exercise, Saxenda can assist you in reaching and maintaining your long-term weight goals. 

Saxenda works for weight loss by mimicking a hormone called glucagon-like peptide-1 (thus the name). GLP-1 reduces appetite and slows down the movement of food through your stomach. These effects make you feel fuller after eating. While perhaps not as pleasant, some of the drug’s side effects (like nausea or stomach pain) also contribute to reduced appetite. 

In addition, Saxenda lowers blood sugar by regulating certain hormones. Saxenda stimulates the release of insulin, a hormone that tells sugar to move from the bloodstream into cells. The drug also blocks the release of glucagon, a hormone that tells your liver to break down sugar storage units called glycogen. Even if you don't have diabetes, Saxenda can lower your blood sugar.

Healthcare providers may prescribe Saxenda for weight management in certain demographics, specifically:

• Adults with obesity (a body mass index or BMI of 30 or greater).

• Adults who are overweight (have a BMI of 27 or greater) and have at least one. weight-related health conditions, such as high cholesterol, high blood pressure, or type 2 diabetes.

• Children 12 years of age and older who weigh at least 132 pounds or live with obesity (which is equivalent to an adult BMI of 30)

Liraglutide is one of the preferred treatment options for managing obesity, according to guidelines from the American Association of Clinical Endocrinologists. It’s important to pair it with a reduced-calorie diet and regular physical activity. Losing weight can drastically improve or even reverse medical problems like hypertension, high cholesterol, and type 2 diabetes.

If you want to know how much weight you can lose on Saxenda, the answer depends on several factors:

• Initial body weight 

• Exercise routine

• Diet and calorie consumption

• Existing medical conditions (type 2 diabetes, hypertension, mobility issues, etc.)

• Lifestyle (stress levels, a social support system, etc.)

The majority of participants in one clinical trial with obesity or a weight-related medical condition lost 5–10% of their body weight while on Saxenda. Non-diabetic patients who completed the 56-week clinical trial lost an average of 9% of their body weight when Saxenda was paired with a reduced-calorie diet and increased physical activity. However, these results don’t mean that every person will experience the same amount of weight loss on Saxenda. 

While the average weight loss in clinical trials falls between 5-10% of participants’ initial body weight, there’s no exact answer for how much weight you can lose on Saxenda. Speak to your healthcare provider about strategies to help you achieve the best possible results for you on Saxenda.

Saxenda doesn’t work overnight. However, tell your healthcare provider if you haven’t lost at least 4% of your body weight after four months of Saxenda treatment. They’ll likely recommend a different plan if Saxenda isn’t working by then or if you can’t tolerate the goal dose of 3 mg per day.

Saxenda is just one part of a comprehensive plan for losing weight. You’ll still need to follow a healthy eating and exercise program. But you don’t have to figure it all out on your own. There are lots of experts who can help optimize your chances of success, like dietitians and personal trainers. 

You can take full advantage of convenient calorie-tracking apps and wearable devices like fitness watches. Online communities and supportive friends or family members are invaluable for walking this journey with you.

Common side effects of Saxenda include:

• Nausea

• Diarrhea

• Constipation

• Injection site reactions like pain or skin irritation

• Skin irritation or pain at the injection site 

• Headaches

• Low blood sugar (hypoglycemia)

• Indigestion

• Fatigue

• Dizziness

• Abdominal pain

• Fever

These aren’t seen as often, but serious side effects can result in some people taking Saxenda. The drug has been linked to:

• Increased risk of thyroid tumors

• Pancreatitis (inflammation of the pancreas)

• Severe hypoglycemia (very low blood sugar)

• Kidney and gallbladder problems

• Fast heartbeat

• Insomnia

• Anxiety

• Serious allergic reactions

• Suicidal thoughts or behaviors (very rare)

Tell your healthcare provider if you have side effects that don’t go away while taking Saxenda. If your symptoms feel life-threatening, call 911 or seek emergency medical help right away.

The usual dosage when you first use Saxenda is 0.6 mg once daily. Typically, your dose will increase each week (depending on how well you tolerate the medication) until you reach the maximum amount of 3 mg per day.

Saxenda comes in boxes with 3–5 injection pens. Each pen contains multiple doses of a clear liquid solution. The number of doses per pen depends on your individual dosage. You’ll learn how to give yourself a daily injection subcutaneously (under the skin). Attach a new pen needle before each dose and never share your pen with anyone else. Pen needles are typically dispensed or sold separately.

Saxenda isn’t right for everyone. Your healthcare provider will want to know if you have any of the following before prescribing it:

• A personal or family history of medullary thyroid carcinoma (MTC), a type of thyroid cancer 

• You have a condition called multiple endocrine neoplasia syndrome type 2

• You’re pregnant, trying to conceive, or breastfeeding

• Have had an allergic reaction to liraglutide before

• You have kidney (renal) impairment, gallbladder disease, liver or pancreas problems, or a stomach-emptying disorder called gastroparesis

• Live with mental health issues like depression or suicidal thoughts

A healthcare professional can provide more medical advice regarding the risks and benefits of Saxenda.

Certain medications interact with liraglutide, which can change how each drug impacts the body. 

Hypoglycemia risk

Your blood sugar could drop too low if you take certain diabetes medications at the same time as Saxenda. These include: 

• Meglitinides like nateglinide and repaglinide

• Sulfonylureas like glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (Diabeta)

• Insulins like Lantus or Humalog

Delayed stomach emptying 

Liraglutide can slow down the rate at which your stomach empties, which could affect how well oral drugs are absorbed. 

To help avoid potentially harmful interactions, be sure to tell your healthcare provider and pharmacist about everything you take. Don’t forget about prescription and over-the-counter medications, vitamins, supplements, and herbs. 

No, there are no specific foods you must avoid while taking Saxenda. And it doesn’t matter what time of day you take your dose or when you eat your meals.

However, Saxenda works best when you use it along with a low-calorie diet, so you’ll want to limit your intake of high-calorie foods like candy, sugary drinks, and fried foods.

On average, the undiscounted retail price for a one-month supply of Saxenda is around $1,350. You’ll pay less if you have insurance that covers this medication. You can also try a coupon or savings program from the drug’s manufacturer, Novo Nordisk. 

Currently, there is no generic version of Saxenda. A generic version will likely not become available for several years.

If you’re struggling to meet your weight loss goals through diet and exercise alone, a medication like Saxenda may be right for you. Speak to your healthcare provider about medical interventions to help you reach a healthy weight, to learn more about how much weight you can lose on Saxenda, and to develop healthy lifestyle habits to feel your best. 

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Current version

August 18, 2023

Written by

Patricia Weiser, PharmD

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.