What are the brand names of GLP-1 (Glucagon-like peptide-1) receptor agonists, such as liraglutide (Saxenda), semaglutide (Wegovy), and dulaglutide (Trulicity), used for weight loss?

GLP-1 Receptor Agonists for Weight Loss: Brand Names

The FDA-approved GLP-1 receptor agonists for weight loss are liraglutide (brand name: Saxenda) at 3.0 mg daily and semaglutide (brand name: Wegovy) at 2.4 mg weekly, with tirzepatide (brand name: Zepbound) representing the newest dual GIP/GLP-1 receptor agonist approved in November 2023. 1

FDA-Approved Medications for Weight Loss

Semaglutide (Wegovy)

• Wegovy (semaglutide 2.4 mg weekly) was FDA-approved in 2021 specifically for chronic weight management in adults with BMI ≥30 or BMI ≥27 with weight-related comorbidities 2, 1
• Achieves mean weight loss of 14.9% at 68 weeks, significantly superior to placebo (2.4%) 1, 3
• Administered as once-weekly subcutaneous injection 1
• Dosing starts at 0.25 mg weekly and titrates up to maintenance dose of 2.4 mg weekly over 16 weeks 1

Liraglutide (Saxenda)

• Saxenda (liraglutide 3.0 mg daily) was FDA-approved in 2014 for weight management 2, 4
• Achieves mean weight loss of 5.24-6.1% 3, 2
• Administered as once-daily subcutaneous injection 4
• Less effective than semaglutide but still clinically meaningful for weight reduction 3

Tirzepatide (Zepbound)

• Zepbound (tirzepatide) was FDA-approved in November 2023 as the first dual GIP/GLP-1 receptor agonist for obesity treatment 1
• Demonstrates superior weight loss of 20.9% at 72 weeks, exceeding semaglutide's 14.9% 1
• Administered as once-weekly subcutaneous injection with starting dose of 5 mg weekly, titrating up to maximum 15 mg weekly 1
• Represents the most effective pharmacotherapy currently available, approaching weight loss comparable to bariatric surgery 2, 1

Medications NOT Approved for Weight Loss (But Used Off-Label)

Dulaglutide (Trulicity)

• Trulicity (dulaglutide) is FDA-approved only for type 2 diabetes management, not for weight loss 5
• Available in doses of 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg weekly 5
• Used off-label for obesity in some countries like Australia 2
• Administered as once-weekly subcutaneous injection 5

Semaglutide (Ozempic)

• Ozempic (semaglutide 1.0 mg weekly) is FDA-approved only for type 2 diabetes, not weight loss 1
• Lower dose than Wegovy and less effective for weight management 1
• Achieves mean weight loss of only 3.74 kg compared to Wegovy's 12.47 kg 3

Oral Semaglutide (Rybelsus)

• Rybelsus (oral semaglutide) is FDA-approved only for type 2 diabetes treatment, not for obesity management 1, 6
• Uses SNAC technology to enable oral absorption 6
• Not recommended for weight loss as injectable formulations are superior 1

Clinical Decision Algorithm

For obesity management, prioritize tirzepatide (Zepbound) 15 mg weekly as first-line therapy due to greatest weight loss (20.9%) and superior cardiometabolic benefits. 1

If tirzepatide is unavailable or not tolerated, use semaglutide (Wegovy) 2.4 mg weekly as second-line, which offers proven cardiovascular benefits in patients with obesity and established cardiovascular disease. 1

Reserve liraglutide (Saxenda) 3.0 mg daily for patients who cannot tolerate weekly injections or when other options are contraindicated, accepting lower efficacy (5-6% weight loss). 2, 3

Critical Safety Considerations

Absolute Contraindications (All Agents)

• Personal or family history of medullary thyroid carcinoma 1, 5
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) 1, 5
• Serious hypersensitivity to the medication or its components 5

Common Adverse Effects

• Gastrointestinal symptoms (nausea, vomiting, diarrhea, constipation) are dose-dependent and most common during titration 1
• Gradual dose escalation minimizes these effects 1
• Symptoms typically decrease over time with continued use 7

Serious but Rare Risks

• Pancreatitis and gallbladder disease (cholelithiasis, cholecystitis) require monitoring 1
• Delayed gastric emptying may increase aspiration risk during anesthesia 2, 1
• Acute kidney injury possible with severe gastrointestinal reactions 5

Essential Monitoring Requirements

• Blood pressure monitoring as weight loss may necessitate antihypertensive medication adjustment 1
• Signs and symptoms of pancreatitis (persistent severe abdominal pain) 1
• Gallbladder disease symptoms 1
• Thyroid function monitoring 1
• Nutritional status assessment 1

Common Pitfalls to Avoid

Do not use lower doses than FDA-approved for weight loss. Real-world data shows patients using suboptimal doses achieve significantly less weight loss than in clinical trials 7

Do not prescribe Ozempic (semaglutide 1.0 mg) or Trulicity (dulaglutide) for weight loss when Wegovy or Zepbound are available. These are diabetes medications with lower efficacy for weight management 1, 3

Do not stop GLP-1 receptor agonists abruptly without a maintenance plan. Weight regain of 11.6% occurs within 52 weeks after cessation, requiring lifelong use for sustained benefit 1

Counsel patients that these medications must be combined with lifestyle modifications (reduced-calorie diet and increased physical activity) and may require lifelong use. 1