FDA (US): Approved (2010, Victoza) for type 2 diabetes and, since 2017, to reduce cardiovascular events in people with diabetes and cardiovascular disease; Saxenda (2014) for weight management in adults and, since 2020, adolescents aged 12 years and older.
EMA (EU): Approved (2009, Victoza) for type 2 diabetes; Saxenda (2015) for weight management in adults and adolescents aged 12 years and older.
Dose
Diabetes (Victoza): start with 0.6 mg/day subcutaneously and increase to 1.2–1.8 mg/day. Obesity (Saxenda): increase by 0.6 mg each week up to 3.0 mg/day (FDA/EMA labels).
Safety
Nausea, vomiting, diarrhea or constipation, especially at the start. Risk of pancreatitis and gallstones. Contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2 (boxed warning in the US because of tumors in rodents). Requires a prescription and medical follow-up.
Interactions
Greater risk of hypoglycemia with insulin or sulfonylureas (adjust doses). By slowing gastric emptying, it may change the absorption of oral drugs.
Differences between women and men
Should not be used in pregnancy: Saxenda is contraindicated during pregnancy and should be stopped if the woman becomes pregnant. In the main obesity trial (SCALE), 78.5% of participants were women, so the data in men are more limited. View the study →
Effect by goal · level of evidence
Weight loss in obesity (SCALE)
improvesVery highRCT (AA)in people
−8.4 kg vs −2.8 kg
3,731 adults without diabetes with obesity or overweight and comorbidity, 56 weeks, alongside diet and exercise. They lost 8.4 kg with liraglutide 3.0 mg vs 2.8 kg with placebo; 63% lost at least 5% of their weight (27% with placebo).
9,340 patients with type 2 diabetes and high cardiovascular risk, median follow-up of 3.8 years. Liraglutide reduced the composite of cardiovascular death, nonfatal heart attack, or stroke (13.0% vs 14.9%; HR 0.87) and cardiovascular death (4.7% vs 6.0%).
It mimics GLP-1: it stimulates insulin only when glucose is high, suppresses glucagon, slows stomach emptying, and acts in the brain to reduce appetite. It lasts about 13 hours, which is why it is injected once a day.
What the evidence says
In people
Weight loss in obesity (SCALE). 3,731 adults without diabetes who had obesity or overweight with a comorbidity, 56 weeks, alongside diet and exercise. They lost 8.4 kg with liraglutide 3.0 mg versus 2.8 kg with placebo; 63% lost at least 5% of their weight (27% with placebo). PubMed 26132939
Cardiovascular events in type 2 diabetes (LEADER). 9,340 patients with type 2 diabetes and high cardiovascular risk, median follow-up of 3.8 years. Liraglutide reduced the composite of cardiovascular death, nonfatal heart attack, or nonfatal stroke (13.0% versus 14.9%; HR 0.87) and cardiovascular death (4.7% versus 6.0%). PubMed 27295427