Liraglutide
VICTOZA, SAXENDA
Pronunciation: lir-a-GLOO-tide
“Lir’s glue tide is a Sax ender”
Lir is a sea god in Irish mythology; they’re holding his statue victoriously
Tide Pod → GLP-1 agonist
What it isGLP-1 receptor agonist; type 2 diabetes and obesity.
Why this oneDaily dosing allows finer titration than the weekly agents, and it has cardiovascular outcome data.
What limits itLess effective than weekly semaglutide or tirzepatide; GI intolerance common; slowed gastric emptying matters before anesthesia.
Pearls
- Obesity: stop if under 4% weight loss at week 16
- MACE reduction shown in diabetes; not established without diabetes
- Generic available; Saxenda approved from age 12
Liraglutide prescription history
Animated chart of estimated U.S. prescriptions per year, Obesity meds (1959–2026). Liraglutide enters in 2010 (estimated).
FDA-approved for
- type 2 diabetes (2010)
- obesity (2014)
Off-label
- antipsychotic weight gain
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityGI intolerance, gallbladder disease and rare pancreatitis; hypoglycemia is uncommon without insulin or sulfonylureas.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Type 2 diabetes mellitus (glycemic control) | Adults | 0.6 mg SC QD x1 week | 1.2 mg SC QD; increase to 1.8 mg QD if needed | 1.8 mg QD |
| Type 2 diabetes mellitus (glycemic control) | Pediatric >=10 yr | 0.6 mg SC QD | Increase in 0.6 mg increments after >=1 week per response | 1.8 mg QD |
Titration Increase only after at least 1 week at the current dose (0.6 -> 1.2 -> 1.8 mg; pediatric in 0.6 mg increments).
Renal No adjustment needed
Hepatic No adjustment needed (use with caution; limited experience)
Instructions
- Inject subcutaneously once daily at any time of day, independent of meals, in the abdomen, thigh, or upper arm.
- Rotate injection sites within the same region to reduce cutaneous amyloidosis.
- When used with insulin, administer as separate injections — never mix.
- The 0.6 mg dose is for titration only and is not effective for glycemic control.
- If more than 3 days have elapsed since the last dose, reinitiate at 0.6 mg QD and retitrate.
Available strengths
- inj 6 mg/mL
Contraindications
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Cautions
- Acute pancreatitis — discontinue if suspected
- Hypoglycemia when combined with insulin secretagogues or insulin (reduce their dose)
- Acute kidney injury from volume depletion (nausea/vomiting/diarrhea/dehydration)
- Severe gastrointestinal reactions; not recommended in severe gastroparesis
- Serious hypersensitivity reactions incl. anaphylaxis and angioedema
- Acute gallbladder disease (cholelithiasis/cholecystitis)
- Pulmonary aspiration under general anesthesia/deep sedation (delayed gastric emptying)
- Never share a pen between patients
Adverse reactions
- Nausea
- Diarrhea
- Vomiting
- Decreased appetite
- Dyspepsia
- Constipation
- Headache
- Small mean heart-rate increase
Pregnancy Animal studies show fetal harm (early embryonic deaths, major malformations); use in pregnancy only if the potential benefit justifies the risk.
Lactation No data on presence in human milk; present in milk of lactating rats.
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 6 mg/mL | inj | per unit | $31.41/mL | offered |
Other forms: Liraglutide (obesity) (SAXENDA)
Generic entry2024
Open Liraglutide in the interactive console ↗
Memory aids: interaction avatars
Open Liraglutide in the interactive console ↗
Self-check
- What titration advantage does daily liraglutide offer over weekly agents?
Finer titration. - Why does liraglutide matter before anesthesia?
It delays gastric emptying.