Can Victoza (liraglutide) be used for weight loss?

Using Victoza (Liraglutide) for Weight Loss

Victoza (liraglutide) is FDA-approved for diabetes management at doses up to 1.8 mg daily, but is commonly used off-label for weight loss, though the higher 3.0 mg dose (marketed as Saxenda) is the FDA-approved formulation specifically for weight management. 1

Efficacy for Weight Loss

• Liraglutide promotes weight loss through multiple mechanisms including appetite suppression, increased satiety, and delayed gastric emptying 2
• At the 3.0 mg dose (Saxenda), liraglutide produces significant weight loss of approximately 8.4 kg (compared to 2.8 kg with placebo) over 56 weeks 3
• Lower doses used for diabetes (Victoza) also produce modest weight loss, with mean weight loss of approximately 3.6% from baseline 1
• GLP-1 receptor agonists like liraglutide are among the most effective medications for weight management, though the weight loss effect is more robust at the higher 3.0 mg dose 1

Dosing Considerations

• For weight management, proper titration is essential to minimize side effects 1:
  • Start with 0.6 mg subcutaneously once daily for 1 week
  • Increase to 1.2 mg once daily
  • May increase to 1.8 mg once daily if needed (maximum Victoza dose)
  • For optimal weight loss, the 3.0 mg dose (Saxenda) is recommended 4
• Slower dose titration may help manage gastrointestinal side effects 1

Safety Considerations

• Most common adverse effects are gastrointestinal, including nausea (17-44%), diarrhea (16-32%), vomiting (7-25%), and constipation (10-23%) 1
• Serious but rare adverse events include:
  • Acute pancreatitis (case reports exist) 5
  • Risk of thyroid C-cell tumors (black box warning) 1
• Contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 1
• Caution is advised when initiating or increasing dose due to potential risk of acute kidney injury 1

Clinical Recommendations

• For optimal weight management, the 3.0 mg dose (Saxenda) is preferred over the lower Victoza doses 3
• Treatment should be discontinued if 4% weight loss is not achieved after 16 weeks at the 3.0 mg dose 1
• Real-world data shows that Victoza is primarily prescribed according to its approved indication for diabetes, while Saxenda is prescribed for weight management 6
• Insurance coverage may be restricted to the FDA-approved indication (diabetes for Victoza, weight management for Saxenda) 1

Practical Considerations

• Victoza requires daily subcutaneous injection, unlike some newer GLP-1 RAs that offer weekly dosing 4
• Cost may be a significant barrier, with monthly costs ranging from approximately $835-$1,077 for the maximum approved daily dose of liraglutide (1.8mg) 4
• Medicare excludes coverage of antiobesity medications for a diagnosis of obesity alone 1
• Global shortages of GLP-1 receptor agonists currently exist, which may affect availability 1

For patients seeking weight loss medication, the 3.0 mg dose (Saxenda) has stronger evidence for efficacy, though Victoza at lower doses can still contribute to modest weight reduction while providing glycemic control for patients with diabetes.