Liraglutide
Victoza, Saxenda (brand names), NN2211; generic liraglutide (available since 2024)
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It has since been superseded in efficacy by semaglutide and tirzepatide, but it remains important: it has the longest safety record of the modern GLP-1 drugs, it is approved for children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
3What the research shows
Weight loss in people with obesity
Type 2 diabetes glucose control
Cardiovascular outcomes
Kidney
Other indications
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.
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Self-reported side effects Phase 2
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