GLP-1 weight management
Saxenda
liraglutide / pronounced [lir a gloo' tide]
FDA-approved daily injectable liraglutide for chronic weight management. Older-generation GLP-1, daily dosing.
- Manufacturer
- Novo Nordisk
- FDA approved
- 2014
- Pivotal efficacy
- 8.4% mean body-weight reduction at 56 weeks (3.0 mg dose) · SCALE Obesity & Prediabetes (NCT01272219)
FDA Boxed Warning
Risk of thyroid C-cell tumors. Liraglutide causes thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. Saxenda is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Why is Saxenda prescribed?
Saxenda is FDA-approved liraglutide 3.0 mg for chronic weight management. First-in-class anti-obesity GLP-1 (approved 2014). Pre-dates Wegovy. Daily injection, smaller average weight loss than semaglutide or tirzepatide. Generic liraglutide is expected as patents lapse.
How does Saxenda work?
Single GLP-1 receptor agonist. Same mechanism family as semaglutide/Wegovy but shorter half-life (~13 hours) requiring daily dosing instead of weekly.
Who qualifies for Saxenda?
FDA indication: adults BMI ≥30 or BMI ≥27 with at least one weight-related comorbidity. Adolescents 12+ with body weight >60 kg also approved. Insurance coverage often requires step therapy from older anti-obesity drugs.
How should Saxenda be used?
Titrated weekly: 0.6mg → 1.2mg → 1.8mg → 2.4mg → 3.0mg maintenance, all once daily.
What should I do if I forget a dose?
Saxenda is dosed daily. If missed: skip the dose if more than 12 hours late, take next day at usual time. Do NOT double up — increases nausea and hypoglycemia risk. After 3+ consecutive missed days, restart titration from 0.6mg per the FDA label.
How effective is Saxenda?
8.4% mean body-weight reduction at 56 weeks (3.0 mg dose)
- Trial:
- SCALE Obesity & Prediabetes (NCT01272219)
- Comparator:
- vs 2.8% with placebo
- Participants:
- n = 3,731
What side effects can Saxenda cause?
GI side effects (nausea, vomiting, diarrhea) common during titration and somewhat more frequent than weekly GLP-1s because daily dosing means constant exposure. Same boxed warning for thyroid C-cell tumors as semaglutide.
What interactions should clinicians watch for?
Insulin and sulfonylureas (hypoglycemia risk in T2D patients), oral contraceptives (delayed absorption — barrier method recommended during titration), warfarin (INR monitoring during dose changes). Same interaction class as semaglutide.
What special precautions should I follow?
Pregnancy & lactation
Not recommended during pregnancy or breastfeeding. Discontinue 2 months before planned conception. Liraglutide half-life is shorter than semaglutide's (~13 hours), so washout is faster — but still requires discontinuation period.
Alcohol
No formal contraindication. Same considerations as other GLP-1s: slowed gastric emptying changes alcohol absorption; severe GI side effects may amplify. Moderate amounts on non-titration weeks if you drink.
What does Saxenda cost?
List price ~$1,350/month. Cash-pay similar. Insurance coverage variable. Cheaper coupons through Novo Nordisk savings card programs.
In case of emergency or overdose
There is no specific antidote for liraglutide overdose. The half-life is shorter (~13 hours) than the weekly GLP-1s, so effects clear faster but supportive care is still required. Call US Poison Control at 1-800-222-1222 or go to the ER for severe hypoglycemia, persistent vomiting, dehydration, or significant abdominal pain. The dose is reset (re-titrated from 0.6 mg) after a 3-day or longer gap; an overdose followed by a missed period also requires restart-protocol guidance from your prescriber.
How should Saxenda be stored?
Refrigerate Saxenda pens between 36°F and 46°F (2°C to 8°C). Do not freeze. After first use, may be stored at room temperature up to 86°F (30°C) or refrigerated, for up to 30 days. Protect from heat and direct light. Replace cap when not in use.
Primary sources
Related clinical resources
What clinicians say
Quotes from published interviews, peer-reviewed commentary, and conference presentations. Each is attributed and linked to the original source.
“In this 56-week study involving overweight and obese adults without diabetes, 3.0 mg of liraglutide as an adjunct to diet and exercise was associated with reduced body weight and improved metabolic control.”
Source: New England Journal of Medicine — SCALE Obesity and Prediabetes trial publication (A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management) (July 2015 — DOI 10.1056/NEJMoa1411892)
“Liraglutide causes thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Saxenda causes thyroid C-cell tumors, including medullary thyroid carcinoma, in humans. Saxenda is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2.”
Source: FDA-approved Saxenda (liraglutide) prescribing information — current label (Approved December 2014; current label 2020)