Liraglutide: The Complete Guide

What is Liraglutide?

Liraglutide is a GLP-1 receptor agonist developed by Novo Nordisk — the same company behind semaglutide. In fact, liraglutide was semaglutide's predecessor and paved the way for the GLP-1 revolution. It was first approved by the FDA in 2010 for type 2 diabetes (as Victoza) and later in 2014 for weight management at a higher dose (as Saxenda).

While newer agents like semaglutide and tirzepatide have surpassed liraglutide in terms of weight loss efficacy, liraglutide remains an important option — particularly for patients who need a medication with extensive long-term safety data, or who may not tolerate weekly injections well.

Two Brand Names

How Liraglutide Works

Liraglutide shares the same fundamental mechanism as semaglutide — it's a GLP-1 receptor agonist that mimics the incretin hormone. The key differences are pharmacokinetic:

• Shorter half-life — Liraglutide has a half-life of approximately 13 hours (vs. ~7 days for semaglutide), necessitating daily dosing.
• 97% homology — It shares 97% structural similarity with human GLP-1 (vs. 94% for semaglutide).
• Same targets — Appetite suppression, slowed gastric emptying, improved insulin secretion, and reduced glucagon.

The shorter duration of action means side effects may be milder for some patients, and if a serious adverse reaction occurs, the drug clears the system faster than weekly injectables.

Clinical Trial Results

SCALE Trials (Weight Management — Saxenda)

• SCALE Obesity: Participants lost an average of 8% of body weight over 56 weeks (vs. 2.6% placebo).
• SCALE Diabetes: Patients with type 2 diabetes lost 6% over 56 weeks.
• About 33% of participants achieved ≥10% body weight loss.

LEADER Trial (Cardiovascular — Victoza)

The landmark LEADER trial demonstrated that liraglutide reduced the risk of major adverse cardiovascular events by 13% in patients with type 2 diabetes and high cardiovascular risk. This made Victoza one of the first diabetes drugs with proven heart benefits and was a pivotal moment for the GLP-1 class.

Dosing Schedule

Saxenda (Weight Management)

Victoza (Diabetes)

Liraglutide can be injected at any time of day, with or without meals. Many patients find a consistent time (like bedtime) works best for compliance.

Side Effects

The side effect profile is similar to other GLP-1s, though the daily dosing and faster titration may cause more frequent but shorter-duration GI symptoms.

Very Common (>10%)

• Nausea (~39%)
• Diarrhea (~21%)
• Constipation (~19%)
• Vomiting (~16%)
• Headache (~14%)

Serious (Rare)

• Pancreatitis
• Gallbladder disease
• Thyroid C-cell tumors (boxed warning — same class effect)
• Acute kidney injury

Cost & Insurance

• Victoza: ~$900–$1,000/month (list price)
• Saxenda: ~$1,300–$1,400/month (list price)

Despite being an older medication, liraglutide hasn't dropped significantly in price. However, insurance coverage for Victoza is generally better than for newer agents, particularly for diabetes. Saxenda coverage for weight management varies but has become more common.

Some patients and providers consider liraglutide a good "starter" GLP-1 before moving to more potent options, particularly if insurance covers it more readily.

Who is Liraglutide Best For?

While semaglutide and tirzepatide get more attention, liraglutide may be the right choice for certain patients:

• Patients wanting a shorter-acting option — The daily dosing means faster washout if side effects are problematic.
• Adolescents — Saxenda is FDA-approved for ages 12+ for weight management, making it one of the few GLP-1 options for teens.
• Patients prioritizing safety data — With 15+ years of real-world use, liraglutide has the most extensive post-marketing safety record of any GLP-1.
• Insurance-driven choices — Some plans cover Victoza/Saxenda but not newer, more expensive alternatives.
• Cardiovascular risk patients — The LEADER trial data supports its use for cardiovascular risk reduction in diabetic patients.