Saxenda (Liraglutide) is a medication that is approved by FDA for chronic weight management. It works best when used in combination with a reduced-calorie diet and physical activity(exercise).
It belongs to a class of drugs called glucagon-like peptide-1(GLP-1) agonists. Saxenda is similar to a hormone that occurs naturally in the body and helps control blood sugar, insulin levels and digestion.
It is an injectable prescription medicine that may help some obese adults or overweight adults who also have weight-related health conditions (like Type 2 diabetes, high blood pressure or high cholesterol) and children aged 12 to 17 years with a body weight above 132 pounds(60kg) and obesity, to lose weight and keep the weight off.
Saxenda is approved for use in adults with a body mass index (BMI) of 30kg/m² o higher. It can also be used in adults with a BMI of 27kg/m² that have at least one weight-related health condition.
In 2010, the FDA approved liraglutide (Victoza®) to help people with Type 2 diabetes control their blood sugar. Researchers found that some people also lost weight while taking it. So, they explored whether it could have the same benefit in people without diabetes, too.
Four years later, Saxenda – a higher-strength version of liraglutide – was approved for weight loss. It also opened the door for similar Type 2 diabetes medications to be approved for weight loss as well.
How Saxenda® Works
Saxenda addresses one of your body’s natural responses to weight loss.
- Your body naturally produces an appetite hormone known as glucagon-like peptide-1(GLP-1) that helps to regulate your hunger.
- Saxenda works like GLP-1 by regulating your appetite, which can lead to eating fewer calories and losing weight.
- It slows down gastric emptying after meals. This means the food stays longer in your stomach, causing you to feel full. This effect is primarily the cause of stomach upset when you use Saxenda.
Presentation of Saxenda
Saxenda is a prescription medication. Manufactured by Novo Nordisk. It comes as a once-daily, self-injectable medicine that comes in a prefilled pen.
There are three doses in a Saxenda pen. The pens deliver doses of 0.6 mg, 1.2 mg, 1.8mg, 2.4mg and 3.0mg each and contain 3ml solutions.
Saxenda is available in packs of 1, 3, or 5 pens. Saxenda does not come with a needle in the pack.
How to Use Saxenda
Saxenda is usually given subcutaneously (under the skin) once daily. It can be under the skin in your stomach area (abdomen), upper leg(thigh), or upper arm, as instructed by your healthcare provider.
Make sure not to inject into a vein or muscle. Change or rotate your injection site within the area you choose with each injection to reduce your risk of getting lumps under the skin (cutaneous amyloidosis).
Saxenda is injected under the skin at any time of the day, with or without a meal. Your doctor will show you how. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Do not use Saxenda if it has changed colours or if it has particles in it. Request for a change from your pharmacist. Do not freeze Saxenda. Discard if it has become frozen.
Adult Dosing Information
Dose escalation should be followed to avoid the likelihood of gastrointestinal symptoms. The dose escalation may be delayed by 1 week if necessary. Below is a 5 weeks dosing plan:
WEEK 1: Inject 0.6 mg subcutaneously once daily.
WEEK 2: Inject 1.2 mg subcutaneously once daily.
WEEK 3: Inject 1.8 mg subcutaneously once daily.
WEEK 4: Inject 2.4mg subcutaneously once daily.
WEEK 5: Inject 3 mg subcutaneously once daily.
MAINTENANCE DOSE: 3mg subcutaneously once a day.
If a maintenance dose is not tolerated, discontinuation is recommended. Efficacy for chronic weight management has not been established at lower doses.
Pediatric Dosing
This is for 12 years and older:
Dose escalation should be followed to reduce the likelihood of gastrointestinal symptoms: dose escalation may be delayed, if necessary, based on tolerability; dose escalation may take up to 8 weeks:
WEEK 1: Inject 0.6 mg subcutaneously once a day
WEEK 2: Inject 1.2 mg subcutaneously once a day
WEEK 3: Inject 1.8 mg subcutaneously once a day
WEEK 4: Inject 2.4 mg subcutaneously once a day.
WEEK 5: Inject 3 mg subcutaneously once a day.
MAINTENANCE DOSE: 2.4 mg or 3 mg subcutaneously once a day.
-If maintenance dose is not tolerated then discontinuation is recommended.
-Efficacy for chronic weight management has not been established at lower doses.
– Evaluate weight loss at 12 weeks on the maintenance dose; if 1% or more of the body weight has not been lost, it is unlikely the patient will achieve and sustain clinically meaningful weight loss with continued treatment and this medication should be discontinued.
Caution
- Saxenda® should not be used with any other Glucagon-like Peptide-1 (GLP-1) receptor agonist (for example Victoza®, Ozempic®, Rybelsus® etc.)
- The safety and effectiveness of Saxenda in combination with other products intended for weight loss, including prescription drugs, over-the-counter (OTC) drugs and herbal preparations have not been established.
- Evaluate weight loss at 16 weeks; if 4% or more of body weight has not been lost, it is unlikely the patient will achieve and sustain clinically meaningful weight loss with continued treatment.
Side Effects of Saxenda
It is good to know some of the side effects of Saxenda. Some of these side effects are experienced due to the way the medication works. Saxenda as mentioned earlier slows down the movement of food through your stomach. This can upset your stomach, resulting in some of the side effects listed below termed as common side effects, which are most common when you first start taking Saxenda, and with dose changes. That is why your dose is usually adjusted slowly over several weeks to minimize these side effects:
- Nausea and vomiting
- Diarrhoea
- Constipation
- Indigestion
- Abdominal pain
Other common side effects include:
- Pain at the injection site
- Headache
- Fatigue
- Dizziness
- Fever
Serious Side Effects
- GLP-1 agonists have a boxed warning (the FDA’s strictest warning) for the risk of thyroid C-cell tumours. This risk was seen in animal studies. So, you should not use Saxenda if you or your family has a history of medullary thyroid cancer.
Rare But Serious Side Effects
- Pancreatitis (inflamed pancreas)
- Gallbladder disease
- Low blood sugar(hypoglycemia)
- Fast heartbeat or chest palpitations
- Kidney problems
- Severe allergic reactions
- Suicidal thoughts and behaviours
Who Should Not Use Saxenda?
Do not use Saxenda® if:
- Have you or any of your family ever had MTC (Medullary Thyroid Carcinoma) or if you have MEN 2(Multiple Endocrine Neoplasia Syndrome type 2)?
- You have had a serious allergic reaction to liraglutide or any of the ingredients in Saxenda®.
- You are pregnant or plan to become pregnant. Saxenda may harm the unborn baby.
- You have insulin-dependent diabetes.
- You have diabetic ketoacidosis.
What Do You Do Before You Commence Treatment With Saxenda?
When you go to see your healthcare provider so he can start you off on the Saxenda® endeavor let him know the following:
- If you have any medical condition.
- If you are taking certain medicines called GLP-1 receptor agonists.
- If you have severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems digesting food.
- If you have had problems with your pancreas, kidneys or liver.
- If you have had depression or suicidal thoughts, or mental health issues.
- If you are breastfeeding or plan to breastfeed. It is not known if Saxenda passes into your breast milk.
- If you are on any medications including prescription medicines, over-the-counter medicines, vitamins, and herbal supplements. Note that Saxenda slows down stomach emptying and can affect medications that need to pass through the stomach quickly. Saxenda may affect the way some medicines work or some other medicines may affect the way Saxenda works.
How Effective is Saxenda in Weight Loss?
Let us look at the average weight loss with Saxenda®. In clinical studies, a greater number of people who took Saxenda for 56 weeks lost 5% to 10% of their body weight, compared with people who took a placebo (a substance that has no effect and is used as a control when testing medication).
This means participants lost 12 to 23 pounds. People in the studies were overweight (BMI 27-29.9 kg/m²) or obese (BMI greater than or equal to 30kg/m²) before taking Saxenda.
Conclusion
Saxenda® (liraglutide) is an FDA-approved, daily injection for weight loss. It must be used in combination with lifestyle changes, including a healthy diet and exercise. It was the first GLP-1 agonist approved for weight
Stomach upset is a common side effect of Saxenda and this is usually minimized by raising the dose slowly over several weeks. You must involve your healthcare provider to guide you all through the process of using Saxenda, from making a decision to use it at first and actual usage for weight loss to help compliance.
There are many ways you can save on Saxenda. If you are eligible, a manufacturer saving card can help you access Saxenda for as little as $25/month. You can always find out how through your healthcare provider. Thank you!