Saxenda Cannot Be Taken Orally for Weight Loss
Saxenda (liraglutide) is administered exclusively as a once-daily subcutaneous injection and is not available in oral form for weight loss. 1, 2, 3
Route of Administration
- Liraglutide for weight management (Saxenda) must be injected subcutaneously once daily—there is no oral formulation approved for weight loss. 1, 2
- The dosing protocol starts at 0.6 mg daily for 1 week and increases by 0.6 mg weekly until reaching the target maintenance dose of 3.0 mg. 2, 3
- Patients should be counseled that this medication requires daily self-injection, which may affect adherence and acceptability. 4
Important Distinction: Oral Semaglutide vs. Liraglutide
- While oral semaglutide (Rybelsus) exists, it is FDA-approved only for type 2 diabetes, not for weight loss, and insurance coverage is typically restricted to its diabetes indication. 1
- Oral semaglutide should not be confused with injectable semaglutide (Wegovy) or liraglutide (Saxenda), which are the GLP-1 receptor agonists approved for weight management. 1
- Injectable semaglutide demonstrates superior weight loss efficacy (14.9-16.0% at 68 weeks) compared to liraglutide (5.8-8.0% weight loss). 2, 3
Clinical Efficacy of Injectable Liraglutide
- Liraglutide 3.0 mg subcutaneously produces mean weight loss of 8.4 kg (versus 2.8 kg with placebo) at 56 weeks, with 63.2% of patients achieving ≥5% weight loss. 4
- The medication works by suppressing appetite, delaying gastric emptying, and increasing satiety through GLP-1 receptor activation. 3, 5
- Weight loss correlates with slowed gastric emptying time, and patients should be monitored for <4% weight loss after 16 weeks (discontinue if inadequate response). 2, 5
Safety Profile and Monitoring
- The most common adverse effects are gastrointestinal: nausea, vomiting, and diarrhea, which are most pronounced initially and decline with time. 1, 2, 6
- Serious safety concerns include pancreatitis, thyroid C-cell tumors in rodents (contraindicated in patients with personal/family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2), and acute renal failure. 1, 2
- Liraglutide was associated with increased risk of miscarriage in trials and should not be used in women who are or may become pregnant. 1, 7
- Gallstones occur more frequently with liraglutide treatment, and weight regain is common after discontinuation. 7
Practical Considerations
- Liraglutide is indicated for patients with BMI ≥30 kg/m² or BMI ≥27 kg/m² with at least one weight-related comorbidity (hypertension, dyslipidemia, or type 2 diabetes). 2, 3
- The average wholesale price is approximately $1,385 per month for the maintenance dose, which may limit accessibility. 2
- Patients must be counseled that this is a long-term treatment requiring continued use to maintain weight loss benefits, as weight regain occurs after discontinuation. 3, 7