Liraglutide
Also called Saxenda, Victoza.
Dr Chad OkayFounder, Suna Health3 min read. Updated .
Liraglutide is a GLP-1 receptor agonist taken as a daily injection. It is the active drug in Victoza (for type 2 diabetes) and Saxenda (for weight management). It was the first GLP-1 medication approved for weight loss, but weekly newer drugs (semaglutide, tirzepatide) have largely replaced it in new prescriptions because they produce more weight loss with less injecting.
What it does
Liraglutide mimics GLP-1, a hormone the gut releases after meals. It prompts the pancreas to release insulin, slows the rate at which food leaves the stomach, and signals fullness to the brain. Same mechanism as semaglutide, just a much shorter-acting molecule.
Brands
- Victoza: 1.2 mg or 1.8 mg daily, licensed for type 2 diabetes.
- Saxenda: up to 3 mg daily, licensed for weight management.
- Generic liraglutide: now available in some markets after the patent expired.
Liraglutide vs semaglutide
- Schedule: liraglutide daily, semaglutide weekly.
- Half-life: liraglutide ~13 hours, semaglutide ~7 days.
- Average weight loss in trials: 8% for liraglutide 3 mg vs 15% for semaglutide 2.4 mg.
- Diabetes blood sugar control: in head-to-head trials semaglutide lowered HbA1c (a three-month average of blood sugar) more than liraglutide (SUSTAIN 10), though oral semaglutide was non-inferior to the maximum 1.8 mg liraglutide dose (PIONEER 4).
- Cost: liraglutide is now the cheaper option in some markets, especially in generic form.
Side effects
- Nausea, especially in the first month and after each dose increase.
- Constipation. Slowed gut transit is part of the mechanism.
- Diarrhoea in a smaller subset, often early.
- Reflux, burping.
- Injection-site reactions are more common with daily injecting.
- Rare but serious: pancreatitis, gallstones, severe gastroparesis. Severe, persistent abdominal pain needs a doctor the same day, not a wait-and-see approach (see below).
Why it's still used
Liraglutide has one of the longest post-launch safety records of any GLP-1 drug, behind only exenatide. It is sometimes preferred when supply of weekly options is unstable, when generic pricing brings the cost down, or when a clinician wants the shorter half-life for taper flexibility. Some people also tolerate the smaller daily peak better than the weekly peak and trough of semaglutide.
If something feels wrong
This entry is reference information, not medical guidance. Your doctor and pharmacist know you and your medicine; if anything about how you feel worries you, speak to them promptly, and if you ever feel seriously unwell, treat it as an emergency. The medicine's own patient information leaflet carries the important safety information and is worth reading in full.
Common questions
- Is liraglutide the same as semaglutide?
- Same drug class (GLP-1 agonists), different molecules. Liraglutide is shorter-acting and dosed daily. Semaglutide is longer-acting and dosed weekly. Semaglutide produces more weight loss in trials.
- Is generic liraglutide as good as branded?
- In principle yes, regulatory approval requires bioequivalence. The active drug is identical. Real-world data on generics is still accumulating because they only became available recently.
- Why does liraglutide cause nausea more than semaglutide for some people?
- The daily peak hits the gut hormone receptors more sharply than the slow weekly rise of semaglutide. Some people find this tolerable, others don't. It's genuinely individual.
- Can children take liraglutide?
- Yes, in specific cases. Saxenda is approved for adolescents (12 to 17) with obesity and over 60 kg, accessed through specialist paediatric services. Use is rare and supervised.
Sources
- Saxenda (liraglutide) 6 mg/mL SmPC - dosing (up to 3 mg), adolescent 12-17 >60 kg indication, adverse reactions (electronic Medicines Compendium (emc, UK))
- Victoza-equivalent liraglutide 6 mg/mL SmPC - type 2 diabetes maintenance dosing 1.2 mg / 1.8 mg daily (electronic Medicines Compendium (emc, UK))
- SCALE Obesity & Prediabetes: liraglutide 3.0 mg in weight management, Pi-Sunyer 2015 (mean weight loss 8.4 kg) (NEJM (PMID 26132939))
- STEP 1: once-weekly semaglutide 2.4 mg, mean weight change -14.9% at 68 weeks, Wilding 2021 (PMC (exploratory analysis of STEP 1 reporting -15.0% body weight change))
- LEADER trial: liraglutide cardiovascular outcomes in type 2 diabetes, Marso 2016 (NEJM (PMID 27295427))
- SUSTAIN 10: once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg, HbA1c superiority of semaglutide (Diabetes & Metabolism (PMID 31539622))
- PK review: liraglutide half-life ~13h (11-15h), semaglutide ~7 days (PMC (Comprehensive Review on Pharmacokinetics of GLP-1 Receptor Agonists))
- FDA approves first generic liraglutide (Saxenda) injection indicated for weight loss - Aug 2025 (Healio Endocrinology)
- GLP-1 RA delayed gastric emptying mechanism and GI side effects (nausea, constipation, gastroparesis) (Journal of Clinical Endocrinology & Metabolism)
- Drugs@FDA: Saxenda (liraglutide) NDA 206321 - original approval for chronic weight management December 2014; adolescent 12-17 indication added December 2020 (US Food and Drug Administration)
- Drugs@FDA: Victoza (liraglutide) NDA 022341 - original approval for type 2 diabetes January 2010 (US Food and Drug Administration)
- Multisociety clinical practice guidance for the safe use of GLP-1 receptor agonists in the perioperative period (2024) (Clinical Gastroenterology and Hepatology)