Saxenda vs Wegovy vs Ozempic: comparing GLP-1 drugs

Saxenda, Wegovy, and Ozempic are injectable prescription medications that can help with weight loss. The three medications belong to the same drug class — GLP-1 agonists — and while they share much in common, they also have some key differences. 

If you’re exploring treatment options or have been prescribed one as an alternative due to a shortage, you may be interested in learning about those differences. 

Both Saxenda and Wegovy are GLP-1 medications manufactured by Novo Nordisk. They are prescribed for chronic weight management, along with diet and exercise, to people with obesity (BMI of 30 or above) as well as those who are overweight (BMI of 27 or above) and have a weight-related health condition like type 2 diabetes, high blood pressure, or high cholesterol. 

As GLP-1 agonists, both drugs mimic a gut hormone named GLP-1 which is involved in insulin production. After you eat, these medications promote insulin release, inhibit glucagon (sugar) production, and delay gastric emptying (slowing down how quickly food leaves your stomach). Together, these effects lead to weight loss. 

Saxenda and Wegovy work similarly to produce weight loss, but they have different active ingredients and are effective to different extents. The main active ingredient in Saxenda is liraglutide, while in Wegovy, the active ingredient is semaglutide. In a trial comparing liraglutide and semaglutide, people on Wegovy lost almost 16% of their body weight, on average, while those taking Saxenda lost over 6%. Saxenda and Wegovy also differ in that Saxenda is injected daily, while Wegovy is injected weekly. Also, side effects are reported more often in those taking Wegovy. 

Ozempic (semaglutide)is a GLP-1 receptor agonist like Saxenda and Wegovy, and it has the same active ingredient as Wegovy. Ozempic received FDA approval for type 2 diabetes in 2017. As researchers discovered that it produced significant weight loss, its manufacturer Novo Nordisk sought FDA approval for the same active ingredient to treat weight loss specifically. This newer drug, called Wegovy, received FDA approval in 2021 and is available in higher dosage strengths than Ozempic. In other words: Ozempic and Wegovy are the same medication but available in different strengths. 

The main difference between Ozempic and Wegovy and Saxenda is that Ozempic is FDA-approved to treat type 2 diabetes, not weight management. However, the weight loss results of Ozempic are so significant that healthcare providers can prescribe it off-label. In one trial, people with diabetes taking 1.0 mg of semaglutide (a common Ozempic dosage), along with diet and exercise, saw an average weight loss of 7% of their body weight over 68 weeks. 

Ozempic is injected weekly. Health providers will prescribe a starting dosage of 0.25 mg and they will increase the dosage every four weeks until the person’s blood sugar levels are adequately controlled. The highest maintenance dosage of Ozempic is 2 mg weekly.

The most common side effects of Ozempic include:

• Nausea

• Vomiting

• Diarrhea

• Abdominal pain

• Constipation

While rare, Ozempic (semaglutide) can cause serious side effects such as an allergic reaction, pancreatitis, kidney injury, hypoglycemia (low blood sugar), gallstones, or diabetic retinopathy. If you notice these side effects, contact your health provider immediately. They may tell you to stop using Ozempic, and recommend an alternative medication to control your blood sugar. Or, in the case of hypoglycemia, they make changes to your insulin dosage to keep your blood sugar steady. Ozempic should not be used by people with a personal or family history of thyroid cancer, including medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2).

Wegovy shares the same active ingredient as Ozempic, semaglutide, but it is FDA-approved for weight loss. Adults taking Wegovy may lose nearly 15% of their body weight, on average, within a year and a half of starting treatment. 

Wegovy may be prescribed to adults with obesity (BMI of 30 or higher), as well as those who are overweight (BMI of 27 or higher) and have a weight-related health condition. Children ages 12 and up may also be prescribed Wegovy if they meet certain BMI conditions for their age and sex.

Wegovy is injected weekly and is available in five dosages. The starting dosage is 0.25 mg weekly. Your health provider will increase the dosage every four weeks until you reach the maintenance dosage of 2.4 mg weekly.

The most common side effects of Wegovy include:

• Nausea

• Diarrhea

• Vomiting

• Constipation

• Abdominal pain

• Headache

• Fatigue

• Upset stomach

• Dizziness

• Belching

• Flatulence

• Stomach flu

• Runny nose or sore throat

While rare, Wegovy can cause serious side effects such as an allergic reaction, acute pancreatitis, acute gallbladder disease, acute kidney injury, suicidal behavior and ideation, an increase in heart rate, and hypoglycemia or diabetic retinopathy in people who have type 2 diabetes. If you notice these side effects, contact your health provider immediately. They may tell you to stop using Wegovy, and recommend an alternative weight-loss medication. Or, in the case of hypoglycemia, they make changes to your insulin dosage to keep your blood sugar steady. 

Wegovy should not be used by people with a personal or family history of thyroid cancer, including medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2). 

Like Wegovy, Saxenda is FDA-approved for chronic weight management in adults and adolescents. However, it has a different active ingredient: liraglutide. After completing a clinical trial, adults taking Saxenda had lost an average of 9.2% of their body weight in about a year, when Saxenda was paired with a reduced-calorie diet and increased physical activity.

Saxenda also improves blood sugar control, although it is not FDA-approved to treat type 2 diabetes.

Saxenda may be prescribed to adults with obesity (BMI of 30 or higher), as well as those who are overweight (BMI of 27 or higher) and have a weight-related health condition. 

Unlike Wegovy and Ozempic, Saxenda is a daily injection for weight loss. It is available in five dosages. The starting dosage of 0.6 mg daily. Your health provider will increase the dosage every week until the highest maintenance dosage of 3 mg daily is reached. 

The most common side effects of Saxenda include:

• Nausea

• Diarrhea

• Constipation

• Vomiting

• Injection site reactions

• Headache

• Hypoglycemia (low blood sugar)

• Upset stomach

• Fatigue

• Dizziness

• Abdominal pain

• Increased lipase levels (a potential warning sign of acute pancreatitis)

• Fever

• Stomach flu

While rare, Saxenda can cause serious side effects such as an allergic reaction, acute pancreatitis, acute gallbladder disease, hypoglycemia, an increase in heart rate, kidney problems, and suicidal behavior and ideation. If you notice any of these side effects, contact your health provider immediately. They may tell you to stop using Saxenda, and recommend an alternative medication for weight loss. Or, if you experience hypoglycemia and are taking insulin, they make changes to your insulin dosage to keep your blood sugar steady. 

Saxenda should not be used by pregnant people or anyone with a personal or family history of thyroid cancer, including medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN 2). 

While Saxenda, Wegovy, and Ozempic have their similarities, they also have differences in dosage schedules, effectiveness, and side effects you may want to be aware of. 

If you’re being impacted by the Wegovy shortage, your health provider may have recommended Saxenda or Ozempic as an alternative. The Wegovy shortage is expected to last through the end of summer 2023, and will affect the lower dosage strengths of Wegovy (0.25 mg, 0.5 mg, and 1mg). If you have just started Wegovy or were planning to, you may have a tougher time getting your prescription filled. If you’re considering switching to Saxenda or Ozempic, here’s a quick look at the key differences between the three medications.

Dosage 

You can inject your dose of Wegovy, Saxenda, and Ozempic at any time of day, with or without meals. However, Wegovy and Ozempic are weekly injections that should be administered on the same day each week, while Saxenda is a daily injection that should be administered every day of the week. 

Wegovy is a single-use pen, meaning that each pen of the medication contains a single dose of Wegovy. Ozempic and Saxenda, on the other hand, come prefilled with multiple doses of the medication. 

All three medications should be injected subcutaneously, or under the skin, of your abdomen, thigh or upper arm. Also, all three medications follow a ramp-up dosage schedule in the beginning, where your health provider gradually increases your dosage over a period of weeks in order to minimize side effects. 

Wegovy and Saxenda both have a recommended maintenance dose you reach after a period of weeks. Ozempic, however, can have different maintenance doses depending on how well your blood sugar is controlled. If your blood sugar is adequately controlled at the weekly 0.5 mg dosage, your health provider may have you stick with that dosage. If not, they may recommend increasing to 1 mg or 2 mg weekly.

Effectiveness 

All three medications produce significant results. When it comes to weight loss, however, there is a clear winner, and it is Wegovy. Study after study shows that  Wegovy produces more weight loss than Saxenda, which in turn produces more weight loss than Ozempic. Specifically, in about a year’s time, people taking Wegovy lose 27.5 pounds, on average, while people taking Saxenda lose 11.5 pounds and those taking Ozempic lose 8.2 pounds. 

In one clinical trial comparing Wegovy and Saxenda directly, participants on Wegovy lost nearly 16% of their body weight, while those on Saxenda lost 6.4%.

Remember: Even if one drug is generally considered more effective, another one may be a better option for you. Different people may experience different side effects, and your body may respond better to another medication, based on various factors such as your age, underlying health conditions, and other medications you may be taking. 

Side effects 

The three drugs belong to the same family of medications, GLP-1 agonists, so there’s a lot of overlap when talking about side effects. Gastrointestinal side effects are common to all three medications, including nausea, vomiting, diarrhea, constipation, and abdominal pain. In general, one large meta-analysis found that people were most likely to report side effects with Wegovy, followed by Saxenda, and then Ozempic. Side effects tend to range from mild to moderate. 

Side effects like nausea can be dose-dependent, meaning that they are worse at the beginning when you are increasing your dose, and decrease with time as your body gets used to the medication. 

Here is a list of the most common side effects of Saxenda, Wegovy, and Ozempic, from the drug labels of the medications. “Common” usually means that more than 5% of the people in the studies experienced these side effects in clinical trials. Keep in mind that Ozempic was studied and is approved for blood sugar control, whereas Saxenda and Wegovy are weight loss medications, with comparably higher maintenance doses.

Depending on the medication, potentially serious side effects of Ozempic, Wegovy, or Saxenda may include:

• Acute pancreatitis

• Hypoglycemia 

• Gallbladder problems

• Kidney problems 

• Allergic reaction to the medication

• Diabetic retinopathy in people with type 2 diabetes (Wegovy and Ozempic only)

• Increased heart rate (Wegovy and Saxenda only)

• Suicidal behavior and ideation (Wegovy and Saxenda only)

Also, all three medications delay gastric emptying, which may affect the absorption of other oral medications you are taking. GLP-1 medications like Saxenda, Wegovy, and Ozempic have been shown to cause thyroid C-cell tumors in studies of rats and mice. While it is unknown if these drugs have the same effect in humans, the U.S. Food and Drug Administration has issued a black box warning for all three medications that states that people with a personal or family history of medullary thyroid carcinoma, or with multiple endocrine neoplasia syndrome type 2 (MEN 2), should not take the medication.

Saxenda vs Wegovy vs Ozempic Cost

Currently, all three medications are available only as brand-name drugs, which makes them expensive. Both Saxenda and Wegovy have a list price of $1,349.02 for a 30-day supply, while Ozempic has a list price of $935.77. The list price is the price set by the manufacturer. The final price you’ll pay will depend on the condition you are treating, your insurance coverage, the pharmacy you use, and any coupons you are eligible for. For example, all three medications offer savings coupons for people with private or commercial insurance, which can bring the cost of a 30-day supply down to as little as $0–$25. For the best price, shop around at local and online pharmacies (which tend to offer more competitive pricing). Also see if you can order a 90-day supply, which may be more cost-effective. 

It depends. Saxenda, Wegovy, and Ozempic are all effective, safe, and well-tolerated, making them great weight loss options. The right GLP-1 medication for you can depend on numerous factors, including your age, health situation, treatment goals, personal preferences, as well as medication shortages and insurance coverage. As for personal preferences, Wegovy and Ozempic offer the convenience of weekly injections, while Saxenda is daily. Wegovy can be easier to manage as each pen contains a single dose, so you don’t need to worry about properly storing the pen between each use, as you do with Saxenda or Ozempic. Regarding cost, Ozempic has the lowest price of the three medications. Moreover, some studies suggest that Ozempic can be more cost-effective. For example, it costs around $1,400 less to lose 1% of your body weight with Ozempic than with Saxenda. But, your insurance plan may cover one medication, and not the other. And, some of these medications experience shortages from time to time, like the current shortage affecting Wegovy through the end of summer 2023. While Wegovy costs more, it also leads to the most weight loss. It also has the most frequent side effects. Plus, side effects tend to worsen when you increase your dose.As you can see, all three medications have their pros and cons, some of which may be more or less important to you. Talk to your healthcare provider about the best option for you. 

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Current version

June 26, 2023

Written by

Amelia Willson

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.