Weight (Saxenda)
Label- Dose
- 0.6 mg rising to 3 mg
- How often
- Once daily
- How long
- Long-term
Rises 0.6 mg each week. 3 mg is the only adult maintenance dose; stop if it isn’t tolerated, or if weight hasn’t fallen at least 4% by week 16.
Approved drugGLP-1 receptor agonist
Liraglutide
Active ingredient in Victoza and Saxenda
- Common dose
- 0.6 → 1.8–3 mg daily
- Cycle
- Continuous
- Vial sizes
- 5, 10 mg
- Typical draw
- 12 units5 mg with 1 mL, 0.6 mg
A once-daily GLP-1 analog: human GLP-1 with one amino acid swapped and a fatty-acid chain attached, which makes it last about 13 hours. It lowers blood sugar, slows stomach emptying and reduces appetite.
Evidence. FDA-approved as Victoza (type 2 diabetes in adults and children 10 and older, and lowering heart attack and stroke risk) and Saxenda (weight management in adults and children 12 and older). Generic versions of both have been approved since 2024, and Novo Nordisk plans to discontinue the Saxenda brand in January 2027.
Status
- Approval
- Approved in the US as Victoza (type 2 diabetes in adults and children 10 and older, and heart-risk reduction) and Saxenda (weight management in adults and children 12 and older), plus generic versions of both. Novo Nordisk plans to discontinue the Saxenda brand in January 2027.
- Sport (WADA 2026)
- Not banned in sportNot named on the 2026 list, and S0 does not apply to an approved drug.
Sport status follows the WADA Prohibited List in force since January 1, 2026; athletes should confirm with their anti-doping organization. Checked October 5, 2026. Status of every compound.
How it works
Liraglutide is a copy of the gut hormone GLP-1, 97% identical, that binds and switches on the GLP-1 receptor. In the pancreas this raises insulin only when blood sugar is high and lowers glucagon, a hormone that raises blood sugar; it also slows stomach emptying. GLP-1 helps regulate appetite, and in animals liraglutide reached brain areas that control it, including the hypothalamus. Natural GLP-1 lasts about 2 minutes, but liraglutide resists breakdown and lasts about 13 hours.
LabelBased on the product label.
Not known
The label says the brain regions behind its appetite effect weren’t pinpointed in rats. Whether its rodent thyroid tumors matter for people is unknown; cases of medullary thyroid cancer in users have been reported, but the reports can’t show cause.
Protocol
Label
Saxenda
0.6 mg once daily, rising by 0.6 mg each week to 3 mg from week 5, the only adult maintenance dose. Adults who haven’t lost at least 4% of body weight by week 16 should stop. Also for ages 12–17 who weigh over 60 kg.
Label
Victoza
0.6 mg daily for 1 week (a starter dose only), then 1.2 mg. Increase to 1.8 mg (maximum) only if more blood-sugar control is needed, after at least 1 week. Also for children 10 and older.
- Frequency
- Once daily
- Route
- Subcutaneous injection
- Timing
- Once a day at any time, with or without meals.
- Cycle
- Continuous. The labels treat it as long-term therapy, not a cycle.
Continuous, shown over 26 weeks
Common protocols
The ways Liraglutide is most often run, each tagged with where it comes from.
Type 2 diabetes (Victoza)
Label- Dose
- 0.6 mg rising to 1.2–1.8 mg
- How often
- Once daily
- How long
- Long-term
0.6 mg for 1 week is only a starter dose. 1.8 mg if more blood-sugar control is needed. The same steps apply to children 10 and older.
Saxenda step-up schedule
| Period | Dose | Draw at 5 mg/mL |
|---|---|---|
| Days 1–7 | 0.6 mg | 12 units (0.12 mL) |
| Days 8–14 | 1.2 mg | 24 units (0.24 mL) |
| Days 15–21 | 1.8 mg | 36 units (0.36 mL) |
| Days 22–28 | 2.4 mg | 48 units (0.48 mL) |
| Day 29 on (maintenance) | 3 mg | 60 units (0.60 mL) |
Units assume a 5 mg vial mixed with 1 mL. Use the calculator for other vial sizes. One step per week, per the Saxenda label. A step can be delayed about a week if it isn’t tolerated. Victoza for diabetes stops at 1.2 mg, or 1.8 mg if needed.
Taking it
Where it goes
Under the skin of the belly, thigh or upper arm (label). Rotate sites.
If you miss a dose
Victoza and Saxenda labels: skip the missed dose and take the next one as scheduled; don’t take an extra dose. If more than 3 days have passed, restart at 0.6 mg (Saxenda then repeats the weekly step-up) to limit GI side effects.
What to expect
- Weeks 1–4
Saxenda rises 0.6 mg each week toward 3 mg. GI side effects are most common during these step-ups.
Label - Week 16
Saxenda label: adults who haven’t lost at least 4% of body weight should stop, because meaningful loss is unlikely.
Label - Week 56 (3 mg)
Mean loss 7.4% vs 3.0% on placebo in the main Saxenda trial; 62.3% vs 34.4% lost at least 5% of body weight.
Label - Over the trials
9.8% stopped Saxenda because of side effects vs 4.3% on placebo, most often for nausea.
Label
Side effects and what to do
Nausea (Saxenda label: 39.3% vs 13.8% placebo)
Most common during the step-up. The label allows delaying a step by about a week.
Diarrhea 20.9%, constipation 19.4%, vomiting 15.7% (Saxenda label; placebo 9.9%, 8.5%, 3.9%)
Drink enough fluids. Heavy vomiting or diarrhea can dehydrate you and strain the kidneys.
Faster heart rate (Saxenda label: a rise of more than 10 beats per minute in 34% vs 19%)
The label says to check it regularly and stop the drug if the resting rate stays up.
Gallstones (Saxenda label: 2.2% vs 0.8% placebo)
Pain in the upper right belly, fever or yellow eyes needs prompt medical care.
Low blood sugar in people with type 2 diabetes (Saxenda label: 12.6% vs 6.6%)
More likely with insulin or a sulfonylurea; the label suggests lowering those doses.
Stop and get medical help
Severe belly pain that won’t go away (may spread to the back), face or throat swelling or trouble breathing, a lump in the neck or trouble swallowing, or a resting heart rate that stays high.
Who should avoid it
What its label rules out or warns about, most important first.
- History of medullary thyroid cancer or MEN 2
- LabelRuled out, including a family history; MEN 2 is an inherited tumor syndrome. Liraglutide caused thyroid C-cell tumors, including cancers, in rats and mice; whether it does in people is unknown.
- Serious allergy to liraglutide
- LabelRuled out after a serious reaction to liraglutide or any ingredient; severe allergic reactions, including anaphylaxis and throat swelling, have been reported.
- Pregnancy
- LabelSaxenda’s label says it may harm a fetus and to stop once pregnancy is recognized; Victoza’s says to use it in pregnancy only if the benefit justifies the risk.
- Severe gastroparesis (very slow stomach emptying)
- LabelNot recommended by either label. Liraglutide slows stomach emptying, and severe stomach and gut side effects were more common than on placebo in the trials.
- Liver disease
- LabelBoth labels report limited experience in mild to severe liver impairment and advise using it with caution.
- Planned surgery or deep sedation
- LabelRare reports describe stomach contents entering the lungs under anesthesia, because the stomach empties slowly. The labels say to tell the care team beforehand; whether pausing the drug helps is unknown.
- Children and teens
- LabelSaxenda is approved for weight loss only from age 12 and over 60 kg, and not in children with type 2 diabetes; Victoza is approved for type 2 diabetes from age 10.
Interactions
Only interactions stated on a product label or measured in a human study are listed.
- Insulin or sulfonylureas (insulin-boosting diabetes pills such as glipizide)
- LabelLow blood sugar, including severe episodes, is more likely. The labels advise considering lower insulin or sulfonylurea doses when starting liraglutide.
- Oral medicines (such as digoxin or birth-control pills)
- LabelLiraglutide slows stomach emptying. In studies it cut digoxin’s peak level by 31% and total exposure by 16%, and barely changed birth-control hormones; the labels call these changes not clinically relevant but advise watching for delayed absorption.
- Other liraglutide products or GLP-1 drugs (such as semaglutide or tirzepatide)
- LabelBoth labels say not to combine it with other liraglutide products, and Saxenda’s says the same for any other GLP-1 drug.
Label: a product label rules it out, warns about it or lists the interaction. This isn’t a complete list: a pharmacist or doctor can check a specific medicine or condition.
Tracking and pairing
Worth tracking
- Resting heart rate
- Body weight at week 16 (Saxenda stop rule)
- Blood sugar if you use insulin or a sulfonylurea
- Kidney function if vomiting or diarrhea is heavy
Often paired with
Usually run on its own.
Human studies
5 key published human studies, with how many people took part. Animal studies aren’t listed here.
-
Heart attack, stroke or cardiovascular death in 13.0% vs 14.9% on placebo (HR 0.87) in type 2 diabetes with high heart risk; cardiovascular deaths 4.7% vs 6.0%.
- Design
- Randomized double-blind placebo-controlled trial
- Dose
- 1.8 mg daily (or the highest tolerated dose)
- Length
- Median 3.8 years
Marso et al., N Engl J Med 2016 (LEADER), PMID 27295427
-
Weight fell 8.4 kg vs 2.8 kg on placebo, and 63.2% vs 27.1% lost at least 5% of body weight, in adults with obesity or overweight without diabetes.
- Design
- Randomized double-blind placebo-controlled trial
- Dose
- 3.0 mg daily
- Length
- 56 weeks
Pi-Sunyer et al., N Engl J Med 2015 (SCALE Obesity and Prediabetes), PMID 26132939
-
BMI fell at least 5% in 43.3% vs 18.7% on placebo in 12- to 17-year-olds with obesity; the BMI score rose again after treatment stopped.
- Design
- Randomized double-blind placebo-controlled trial
- Dose
- 3.0 mg daily
- Length
- 56 weeks, plus 26 weeks off treatment
Kelly et al., N Engl J Med 2020 (SCALE Teens), PMID 32233338
-
HbA1c fell 0.64 points vs a 0.42-point rise on placebo in 10- to 16-year-olds with type 2 diabetes (difference 1.06 points, widening to 1.30 at 52 weeks).
- Design
- Randomized double-blind placebo-controlled trial with open-label extension
- Dose
- Up to 1.8 mg daily, with metformin
- Length
- 26 weeks, plus 26-week extension
Tamborlane et al., N Engl J Med 2019 (Ellipse), PMID 31034184
-
BMI fell 5.8% vs a 1.6% rise on placebo in 6- to 11-year-olds with obesity; GI side effects 80% vs 54%. Not an approved US use under age 12.
- Design
- Randomized placebo-controlled Phase 3a trial
- Dose
- 3.0 mg daily (or the highest tolerated dose)
- Length
- 56 weeks, plus 26 weeks off treatment
Fox et al., N Engl J Med 2025 (SCALE Kids), PMID 39258838
Limits of the evidence
Liraglutide’s weight evidence comes from 56-week trials, the largest in 3,731 adults, and its heart benefit from LEADER, which followed 9,340 adults with type 2 diabetes for a median 3.8 years. In the teen trial, BMI rose again within 26 weeks of stopping. The labels report limited experience in end-stage kidney disease and liver impairment, and research or compounded vials fall outside the trials.
Mixing your vial
| Vial | Water | Common dose | Draw | Strength | Action |
|---|---|---|---|---|---|
| 5 mg | 1 mL | 0.6 mg | 12 units (0.12 mL) | 5 mg/mL | |
| 10 mg | 2 mL | 0.6 mg | 12 units (0.12 mL) | 5 mg/mL |
Victoza, Saxenda and generic pens are ready-made solutions (6 mg/mL). Lyophilized vials are mixed with bacteriostatic water: at 5 mg/mL each 0.6 mg step is 12 units, so the 3 mg dose is 60 units, more than a 0.5 mL syringe holds. Changing the water volume changes the units for every step.
Dose chart
Syringe units for common doses at different water volumes. Select a cell to open it in the calculator.
| Dose | Water added | ||
|---|---|---|---|
| 1 mL | 2 mL | 3 mL | |
| 0.6 mg | |||
| 1.2 mg | |||
| 1.8 mg | |||
| 2.4 mg | |||
| 3 mg | |||
U-100 insulin syringe: 100 units is 1 mL. Draws over 100 units show in mL. Faded values are under 2 units, which is hard to measure. Check that your vial holds the larger volumes.
Datasheet
- Half-life
- about 13 hours LabelAfter a subcutaneous dose; levels peak 8–12 hours after injection, and about 55% of the dose reaches the blood.
- Type
- Peptide, 31 amino acids
- Molecular weight
- 3,751.2 g/mol
- Formula
- C172H265N43O51
- Sequence
- HAEGTFTSDVSSYLEGQAAKEFIAWLVRGRGThe lysine at GLP-1 position 26 carries a C16 palmitic acid through a glutamic acid spacer; arginine replaces lysine at position 34
- Storage before use
- Not a powder: pens hold a ready-made solution. Before first use, refrigerate at 2–8 °C, away from the cooling element; never freeze.
- After mixing or opening
- After first use, a pen keeps 30 days at 15–30 °C or in the fridge. Keep the cap on and store it without a needle attached.
- Half-life: Victoza prescribing information rev. 10/2025 and Saxenda rev. 02/2026, section 12.3
- Molecule: Saxenda label rev. 02/2026, section 11 (formula; MW as free base); KEGG D06404 (sequence); PubChem CID 16134956
- Storage: Label Victoza prescribing information rev. 10/2025 and Saxenda rev. 02/2026, section 16
Every compound side by side: the half-life chart and the storage chart.
Cautions
- Boxed warning for thyroid C-cell tumors. Not for anyone with a personal or family history of medullary thyroid carcinoma or MEN 2.
- Nausea, diarrhea, constipation and vomiting are common, especially during the step-up. It slows stomach emptying, so tell the care team before surgery or sedation.
- Pancreatitis, gallbladder disease, and kidney injury from dehydration are listed risks.
- Saxenda raises resting heart rate by 2–3 beats per minute on average; the label says to stop if it stays up.
- Low blood sugar is more likely when combined with insulin or a sulfonylurea.
Questions
What is liraglutide?
A once-daily GLP-1 analog: human GLP-1 with one amino acid swapped and a fatty-acid chain attached, which makes it last about 13 hours. It lowers blood sugar, slows stomach emptying and reduces appetite.
How does liraglutide work?
Liraglutide is a copy of the gut hormone GLP-1, 97% identical, that binds and switches on the GLP-1 receptor. In the pancreas this raises insulin only when blood sugar is high and lowers glucagon, a hormone that raises blood sugar; it also slows stomach emptying. GLP-1 helps regulate appetite, and in animals liraglutide reached brain areas that control it, including the hypothalamus. Natural GLP-1 lasts about 2 minutes, but liraglutide resists breakdown and lasts about 13 hours. The label says the brain regions behind its appetite effect weren’t pinpointed in rats. Whether its rodent thyroid tumors matter for people is unknown; cases of medullary thyroid cancer in users have been reported, but the reports can’t show cause.
Is liraglutide FDA-approved?
Approved in the US as Victoza (type 2 diabetes in adults and children 10 and older, and heart-risk reduction) and Saxenda (weight management in adults and children 12 and older), plus generic versions of both. Novo Nordisk plans to discontinue the Saxenda brand in January 2027.
What is the usual liraglutide dose?
From the label (Saxenda): 0.6 mg once daily, rising by 0.6 mg each week to 3 mg from week 5, the only adult maintenance dose. Adults who haven’t lost at least 4% of body weight by week 16 should stop. Also for ages 12–17 who weigh over 60 kg. Victoza: 0.6 mg daily for 1 week (a starter dose only), then 1.2 mg. Increase to 1.8 mg (maximum) only if more blood-sugar control is needed, after at least 1 week. Also for children 10 and older. These are the amounts sources reference, not recommendations.
How much water do I mix liraglutide with?
There’s no single right amount, because the water only sets the strength. With 1 mL of bacteriostatic water in a 5 mg vial, the strength is 5 mg/mL, so 0.6 mg is 12 units on a U-100 insulin syringe. More water makes small doses easier to measure. The dose chart above shows other volumes.
Who should avoid liraglutide?
History of medullary thyroid cancer or MEN 2: Ruled out, including a family history; MEN 2 is an inherited tumor syndrome. Liraglutide caused thyroid C-cell tumors, including cancers, in rats and mice; whether it does in people is unknown. Serious allergy to liraglutide: Ruled out after a serious reaction to liraglutide or any ingredient; severe allergic reactions, including anaphylaxis and throat swelling, have been reported. Pregnancy: Saxenda’s label says it may harm a fetus and to stop once pregnancy is recognized; Victoza’s says to use it in pregnancy only if the benefit justifies the risk. The “Who should avoid it” section lists 4 more groups and 3 interactions.
What is the half-life of liraglutide?
About 13 hours, according to the prescribing information. After a subcutaneous dose; levels peak 8–12 hours after injection, and about 55% of the dose reaches the blood.
How should liraglutide be stored?
Not a powder: pens hold a ready-made solution. Before first use, refrigerate at 2–8 °C, away from the cooling element; never freeze. After first use, a pen keeps 30 days at 15–30 °C or in the fridge. Keep the cap on and store it without a needle attached.
Is liraglutide banned in sport?
No. Not named on the 2026 list, and S0 does not apply to an approved drug.
Has liraglutide been studied in people?
Yes. The human studies section lists 5 published studies. The largest, from 2016, included 9,340 people. Heart attack, stroke or cardiovascular death in 13.0% vs 14.9% on placebo (HR 0.87) in type 2 diabetes with high heart risk; cardiovascular deaths 4.7% vs 6.0%.
Sources
- Saxenda prescribing information, rev. 02/2026 (Novo Nordisk)
- Victoza prescribing information, rev. 10/2025 (Novo Nordisk)
- FDA drug shortage and discontinuation lists: liraglutide injection (Novo Nordisk entries, August–September 2026)
- Marso et al., LEADER trial (NEJM 2016) PMID 27295427
- Pi-Sunyer et al., SCALE Obesity and Prediabetes trial (NEJM 2015) PMID 26132939
For the protocol details
- Saxenda prescribing information, rev. 02/2026, sections 2, 5, 6 and 14
- Victoza prescribing information, rev. 10/2025, section 2
- Kelly et al., liraglutide for adolescents with obesity (NEJM 2020) PMID 32233338
For how it works, who should avoid it and the limits of the evidence
- Saxenda prescribing information, sections 1, 4, 5, 7, 8 and 12 (Novo Nordisk, DailyMed, rev. 02/2026)
- Victoza prescribing information, sections 1, 4, 5, 7, 8 and 12 (Novo Nordisk, DailyMed, rev. 10/2025)