Liraglutide

Victoza, Saxenda (brand names), NN2211; generic liraglutide (available since 2024)

Metabolic & weight

Awaiting medical reviewEN ES DE FR PT ZH+ Follow for updates

Note on this profile. Liraglutide is an approved prescription medicine in most countries, with generic versions now available in some markets. This page explains the published science. Use outside a prescription — including grey-market or compounded versions — carries real risks discussed below.

Summary

Class: GLP-1 receptor agonist; analogue of human GLP-1 (97% sequence match) with a C16 fatty-acid side chain that binds albumin and slows absorption and breakdown
Mechanism: Mimics the gut hormone GLP-1: glucose-dependent insulin release, lower glucagon, slower gastric emptying and reduced appetite via the brain
Routes studied: Subcutaneous once-daily
Dose range reported: Approved: type 2 diabetes (Victoza) 0.6 mg daily for 1 week, then 1.2 mg, optionally 1.8 mg; weight management (Saxenda) 0.6 mg daily, increasing weekly by 0.6 mg to 3.0 mg. Approved in adolescents (12+) for both indications and in children 10+ for diabetes
Half-life: ~13 hours, hence once-daily dosing
Storage: Pens: refrigerate before first use; after first use, room temperature (up to 30 °C) or fridge for up to 30 days. Do not freeze
Regulatory status: Approved medicine (US, EU, UK, AU, ZA and many others); generics approved in the EU (2024) and US (2024–2025)

Doses are as reported in studies or by the community — never recommendations.

1What it is

Liraglutide was the first GLP-1 analogue suitable for once-daily injection and the first approved for weight management. Novo Nordisk attached a fatty-acid chain to a GLP-1 molecule so that it forms slow-release clusters under the skin and binds albumin in the blood, extending the two-minute life of natural GLP-1 to around 13 hours. It was approved for type 2 diabetes in 2009–2010 (Victoza) and at a higher dose for obesity in 2014–2015 (Saxenda).

It has since been superseded in efficacy by semaglutide and tirzepatide, but it remains important: it has the longest safety record of the modern GLP-1 drugs, it is approved for children and adolescents, and with patent expiry generic versions have begun to make GLP-1 therapy cheaper and more widely available. Daily dosing also gives faster if side effects occur.

2How it's thought to work

Pancreas. increases insulin and decreases glucagon only when glucose is high, so it rarely causes hypoglycaemia on its own.

Stomach. slows gastric emptying, increasing fullness after meals; this effect diminishes with continued use.

Brain. acts on appetite centres in the hypothalamus and brainstem to reduce hunger and increase satiety.

Heart. reduces cardiovascular events in people with type 2 diabetes through mechanisms not fully explained by glucose or weight.

GLP-1 receptor activation: more insulin from the pancreas, slower stomach emptying, stronger fullness signals in the brain. A fatty-acid tail lets the peptide ride on albumin, so it lasts a day.Schematic — not to scale

3What the research shows

Weight loss in people with obesity

SCALE Obesity and Prediabetes (n≈3,731): mean weight loss of 8.0% vs 2.6% with placebo at 56 weeks on 3.0 mg daily (Pi-Sunyer 2015, NEJM); about 63% lost at least 5% of body weight. The 3-year extension showed a 79% lower risk of developing type 2 diabetes among those with prediabetes (le Roux 2017, Lancet). SCALE Maintenance showed continued loss after an initial diet-induced loss (Wadden 2013, Int J Obes). [1][2]

Adolescents with obesity

A 56-week in 12–17-year-olds showed a BMI standard-deviation reduction and weight loss vs placebo (Kelly 2020, NEJM), leading to adolescent approval. A 2024 trial in children aged 6–11 (SCALE Kids) also reported BMI reduction (Fox 2024, NEJM). [5][6]

Type 2 diabetes glucose control

LEAD 1–6: HbA1c reductions of roughly 1.0–1.5 percentage points, with modest weight loss (Garber 2009, Lancet; Buse 2009 LEAD-6, Lancet). Inferior to semaglutide in head-to-head comparison (SUSTAIN 10) and to tirzepatide indirectly. [7]

Cardiovascular outcomes

LEADER (n≈9,340 with type 2 diabetes at high cardiovascular risk): 13% relative reduction in major adverse cardiovascular events and 22% reduction in cardiovascular death over 3.8 years (Marso 2016, NEJM). This was the first GLP-1 cardiovascular-outcomes trial to show benefit. [3]

Graded A (secondary)

Kidney

LEADER secondary analysis showed fewer new or worsening kidney outcomes, driven by reduced macroalbuminuria (Mann 2017, NEJM). [4]

Graded B/A (mixed)

Other indications

Trials in type 1 diabetes (ADJUNCT) showed small HbA1c and weight benefits but more hypoglycaemia and ketosis; not approved. Small trials in MASH (LEAN) showed histological improvement (Armstrong 2016, Lancet). A 2024 Phase 2b trial in Alzheimer's disease (ELAD) reported slower brain-volume loss without meeting its primary endpoint †. [8]

4Reported side effects and interactions

Literature-reported

Common (literature). nausea (around 40% at 3.0 mg in SCALE), diarrhoea, constipation, vomiting, dyspepsia, abdominal pain, headache, fatigue, dizziness, injection-site reactions. Mostly during escalation; nausea usually subsides over weeks.

Serious / warnings. gallbladder disease (gallstones, cholecystitis — more frequent with greater weight loss); pancreatitis (rare); boxed warning for thyroid C-cell tumours in rodents — contraindicated with personal/family history of medullary thyroid carcinoma or MEN2; increased heart rate (2–3 beats per minute on average); hypoglycaemia with insulin or sulfonylureas; acute kidney injury from dehydration; delayed gastric emptying with aspiration risk under anaesthesia; suicidal-ideation signals reviewed by regulators with no causal link established (Saxenda label advises monitoring for mood changes).

Muscle mass. lean mass is lost alongside fat, though less in absolute terms than with more potent agents; protein intake and resistance training are standard advice.

Grey-market and compounded product risks. liraglutide is a daily injection in milligram doses, so unit confusion is possible; unverified vials may contain the wrong salt form, impurities or wrong strength. With generics now approved, legitimate lower-cost product exists through prescription channels in some countries.

Interactions. increased hypoglycaemia with insulin or sulfonylureas (doses are usually reduced); slowed absorption of oral medicines; not for use in pregnancy — discontinue when pregnancy is recognised; should not be combined with other GLP-1 .

Markers researchers commonly monitor

Marker	Why it's watched
HbA1c and fasting glucose	primary glycaemic markers; hypoglycaemia risk if combined with insulin or sulfonylureas.
Body weight, waist circumference and body composition	to track fat versus lean loss.
Heart rate	a small sustained rise is typical; relevant with pre-existing tachyarrhythmia.
Creatinine/eGFR and electrolytes	dehydration from GI effects.
Lipase/amylase	only with symptoms suggestive of pancreatitis.
Lipids and blood pressure	generally improve.
Liver enzymes	generally improve; useful if liver fat is a concern.
Mood	the Saxenda label advises monitoring for depression or suicidal thoughts.

Free for everyone. Safety information is never behind a paywall.

5Reconstitution and handling

Approved and generic pens need no ; they are multi-dose pens dialled to 0.6–3.0 mg. vials, if encountered, require milligram-level care; use the calculator and double-check units.

Open in calculator, pre-loaded →

6Commonly studied alongside

Metformin, basal insulin and sulfonylureas (LEAD programme); lifestyle interventions; compared head-to-head against semaglutide (SUSTAIN 10, STEP 8) and against exenatide, dulaglutide and sitagliptin. Community combinations with other peptides have no trial basis.

Informational cross-links. Not stack recommendations.

7Regulatory status by region

Region	Status (checked —)
United States	FDA-approved (Victoza 2010; Saxenda 2014). First generic liraglutide (Victoza-equivalent) approved 2024; generic Saxenda-equivalent approved 2025 †
European Union	EMA-authorised; generic liraglutide authorised 2024
United Kingdom	MHRA-licensed; prescription-only; generics available
Australia	TGA-approved; prescription-only; Saxenda not PBS-subsidised
South Africa	SAHPRA-registered; prescription-only
Sport (WADA)	Not prohibited (as of review date) †

8Open questions

Whether liraglutide's cardiovascular benefit extends to people with obesity but without diabetes (not tested in an outcomes trial).
Long-term outcomes of adolescent and paediatric use into adulthood.
Whether generic availability changes real-world adherence and outcomes compared with weekly agents.

9References

1Pi-Sunyer X et al. (2015). A randomized, controlled trial of 3.0 mg of liraglutide in weight management (SCALE Obesity and Prediabetes). N Engl J Med. PubMed · DOI
2le Roux CW et al. (2017). 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes. Lancet. PubMed
3Marso SP et al. (2016). Liraglutide and cardiovascular outcomes in type 2 diabetes (LEADER). N Engl J Med. PubMed · DOI
4Mann JFE et al. (2017). Liraglutide and renal outcomes in type 2 diabetes. N Engl J Med. PubMed · DOI
5Kelly AS et al. (2020). A randomized, controlled trial of liraglutide for adolescents with obesity. N Engl J Med. PubMed · DOI
6Fox CK et al. (2024). Liraglutide for children 6 to <12 years of age with obesity — a randomized trial (SCALE Kids). N Engl J Med. PubMed · DOI
7Garber A et al. (2009). Liraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono). Lancet. PubMed
8Armstrong MJ et al. (2016). Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN). Lancet. PubMed
9Novo Nordisk. Victoza / Saxenda prescribing information (current label). PubMed

References are being resolved to PubMed/DOI identifiers; links search PubMed for the citation until then.

† Being confirmed by our reviewers against current sources.

10Community

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Self-reported side effects Phase 2

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11Page history

25 Oct 2026Profile published — awaiting medical review

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