Liraglutide
Victoza · Saxenda
Once-daily GLP-1 RA. Victoza 1.8 mg is T2D; Saxenda 3 mg is obesity. LEADER/SCALE describe branded pens. Not Wegovy and not a reconstitution hobby.
Use-case scores
0–10 against the evidence we have, not a gym ranking. Hidden domains do not apply here.
- Metabolic / weight8/10
Approved T2D and obesity (LEADER, SCALE). Ceiling 9 for approval; haircut because weekly sema/tirz beat it on weight and because a daily pen is not a research cake.
Compound card
- Sequence
- GLP-1 analog (Arg34, C16 fatty acid on Lys26)
- Class
- Once-daily GLP-1 RA (Victoza 1.8 mg / Saxenda 3 mg)
- Formula
- C172H265N43O51
- Status
- FDA-approved
How it works
Liraglutide is a GLP-1 receptor agonist with 97% sequence homology to native human GLP-1. A C18 fatty acid chain attached to Lys26 enables reversible albumin binding, extending the half-life from ~2 minutes (native GLP-1) to approximately 13 hours - enabling once-daily dosing.
Liraglutide activates GLP-1R on pancreatic beta cells (glucose-dependent insulin secretion), hypothalamic satiety neurons (reduced appetite), gastric pacemaker cells (delayed gastric emptying), and cardiac tissue (cardioprotective). It is FDA-approved at 1.8 mg for T2DM (Victoza) and at 3 mg for obesity (Saxenda). As the first-generation daily GLP-1 RA, liraglutide established the clinical framework later succeeded by weekly semaglutide.
Source: FDA Label (Saxenda), PMID: 24665709 (SCALE trial)
Background & History
Liraglutide is a once-daily GLP-1 RA. Victoza 1.8 mg is T2D; Saxenda 3 mg is obesity. LEADER/SCALE describe branded pens. Not Wegovy and not a reconstitution hobby.
Research Use Cases
- ✓Victoza vs Saxenda vs a compounded daily GLP-1 cake
- ✓Why daily titration is not weekly semaglutide math
- ✓Not a NASH DIY protocol
Dosing
| Phase | Dose | Frequency | Notes |
|---|---|---|---|
| Titration (Weeks 1-4) | 0.6 mg | Daily SC (first week), then 1.2 mg (week 2), 1.8 mg (week 3+) | Dose escalation minimizes GI side effects. Titrate slowly. |
| T2DM Maintenance (Victoza) | 1.2 - 1.8 mg | Daily SC injection | FDA-approved dose for type 2 diabetes. Demonstrated cardiovascular mortality benefit (LEADER trial). |
| Obesity (Saxenda) | 3 mg | Daily SC injection | FDA-approved for obesity. Average 5-8% body weight reduction at 56 weeks. |
Administration
Timeline
Who it is for
Type 2 Diabetes
HighFDA-approved. LEADER trial showed 22% reduction in cardiovascular mortality. HbA1c reduction of ~1-1.5%.
Obesity / Weight Loss
HighFDA-approved (Saxenda). 5-8% body weight reduction at 56 weeks. Now largely superseded by semaglutide.
Reconstitution
| Vial | Water | Concentration | Example dose |
|---|---|---|---|
| Pen (Victoza / Saxenda) | n/a (prefilled) | Device-labeled | Follow the pen. Saxenda titrates to 3 mg daily. Do not recon a pen. |
Change vial size or water volume? Open the reconstitution calculator.
Safety & Considerations
FDA-approved (Victoza, Saxenda). Common: nausea, vomiting, diarrhea (improve with slow titration). Black box warning: thyroid C-cell tumors in rodents (human relevance unclear). Contraindicated in personal/family history of MTC or MEN2. Monitor for pancreatitis.
Regulatory & Legal Status
FDA-approved as Victoza® (T2D) and Saxenda® (obesity)
Not currently on the WADA 2026 Prohibited List. Policies may change - verify before competition.
Prescription Drug
US Compounding: Available via licensed pharmacy Rx
⚠️ This information is for educational purposes only and may not reflect the most current regulatory updates. Always verify with official FDA, WADA, and jurisdiction-specific sources before use.
Limits of current evidence
- SCALE/LEADER describe branded liraglutide, not a compounded daily vial.
- Once-daily is the PK, not a “weaker semaglutide you inject more often” meme without the trials.
- Same MTC/MEN2 class warning.
Verdict
Liraglutide is the daily GLP-1 that taught the class. Saxenda 3 mg is the obesity label. It is not Wegovy and not a reconstitution hobby. Use a pen under a clinician.
Interactions & Contraindications
MTC/MEN2 class warning. Slowed gastric emptying vs oral drugs. Pancreatitis symptoms stop the drug. A cake is not the LEADER pen.
Synergies & Common Stacks
Do not stack GLP-1 RAs. Switch, do not add.
Liraglutide vs. Semaglutide
Canonical comparison: Liraglutide vs Semaglutide
| Attribute | Liraglutide | Semaglutide |
|---|---|---|
| Dosing | Daily injection (1.2–1.8 mg/day) | Once weekly injection (0.5–2.4 mg/wk) |
| Peak Weight Loss | ~8% (SCALE trials) | 14.9–17% (STEP trials) |
| Mechanism | GLP-1 agonist | GLP-1 agonist (same class, newer generation) |
| Cardiovascular | Proven (LEADER trial) | Proven (SUSTAIN-6) |
| Convenience | Daily - less convenient | Weekly - more convenient |
Verdict: Semaglutide is the modern upgrade to liraglutide: dramatically better weight loss efficacy (~2× improvement) and once-weekly dosing vs. daily. Most clinicians prefer semaglutide unless specific insurance or tolerance considerations apply.
Frequently Asked Questions
Is liraglutide better than semaglutide for weight loss?▼
How is liraglutide injected?▼
References
- Marso SP et al. “"Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER)".” NEJM (2016). PMID: 27295427
- Armstrong MJ, et al. “Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN).” Lancet (2016). PMID: 26318520
- Pi-Sunyer X, et al. “A randomized, controlled trial of 3.0 mg of liraglutide in weight management.” N Engl J Med (2015). PMID: 26132939
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