Saxenda vs Victoza: What's the difference between these similar GLP-1 medications?

Talking about both Saxenda® and Victoza® can be confusing. They share the same active ingredient, liraglutide; they’re both from the same glucagon-like peptide 1 receptor agonist (GLP-1) drug class, they’re both prescription drugs, and they’re both manufactured by the company Novo Nordisk. So, i's understandable if you’re left scratching your head wondering how they’re so different if they’re practically the same.

Fair question. Saxenda and Victozado have all of those similarities. Still, they’re indicated for different treatments: Victoza for the treatment of type 2 diabetes and Saxenda for weight loss. 

Well, then, are they interchangeable? Nope. Still feeling a little bamboozled? We’ve got you covered. Here’s everything you need to know about Saxenda vs Victoza for weight management.

What is Saxenda?

Saxenda is a GLP-1weight-loss medication that was approved by the U.S. Food and Drug Administration in 2014 as a long-term weight-loss treatment for adults with a body mass index (BMI) of 30 or greater, or 27 or greater with at least one weight-related condition, like hypertension (high blood pressure) or high cholesterol. Then, in December 2020, Saxenda was FDA-approved for children 12 years and older who weigh more than 132 pounds and have obesity based on their age, sex, and height (the equivalent of a BMI of 30 or greater in an adult).

Saxenda mimics the GLP-1incretin hormone our bodies naturally produce that helps regulate and control hunger. By regulating your appetite, you’ll eat less and lose weight. It’s meant to be prescribed in addition to lifestyle changes like healthier eating habits and increased physical activity. 

What is Victoza?

Victoza was FDA-approved for treating type 2 diabetes in adults and children 10 years and older. Victoza works like the GLP-1 hormone to help control blood sugar by telling the pancreas to produce more insulin when you eat and stop your liver from making too much sugar. This GLP-1 also works to slow digestion, also known as stomach emptying, to help manage blood sugar levels after meals. Keep in mind that Victoza works the same way Saxenda does, which can also affect your appetite. 

Victoza is also proven to help reduce the risk of negative cardiovascular events like heart attack and stroke in patients with type 2 diabetes or an established history of heart disease. One thing to note, it’s not meant for patients with type 1 diabetes.

So if they’re both liraglutide, why are Saxenda and Victoza used for different purposes? 

We get it. This is probably a little bit confusing. Two drugs, one ingredient that works the same way. What gives? Truthfully, it comes down to FDA approval, risks, and medication licensing.

Novo Nordisk originally developed liraglutide for type 2 diabetes treatment but later found that patients taking it were losing weight because of the effect the GLP-1 receptor agonist had on controlling hunger. A clinical trial between June 2011 and January 2013 funded by Novo Nordisk and published in the journal JAMA compared two doses—1.8 mg and 3 mg— of liraglutide (Victoza).  At the conclusion of the trial, participants had decreased blood glucose levels (HbA1C) and showed weight loss, with those on the higher dose losing more weight.

So, armed with information like this, Novo Nordisk set out to do additional research and testing to see if increased doses of liraglutide were more effective at supporting weight loss. Saxenda was FDA-approved after three clinical trials and long-term testing.

The two meds have different indications, so doctors can determine which maximum dosage of the drug is right for you. And Victoza and Saxenda are effective for their indicated uses. An example is that Saxenda can only be taken if you have a BMI of at least 27. At the same time, Victoza can be prescribed to patients with type 2 diabetes mellitus who are 10 years old,  regardless of BMI. Keep in mind that Victoza can also be prescribed off-label for the treatment of overweight and obesity.

Do Saxenda and Victoza come in the same dosages?

No, this is a major difference between Saxenda and Victoza. Here’s how.

With both treatments, the prescribing information recommends you start at a once-daily dose of 0.6 mg for seven days before increasing to 1.2 mg the next week and then again a week after that increasing to 1.8 mg.

But, this is where the Victoza dosing increases stop, as its maximum dose is 1.8 mg once daily, though your prescription may be at a lower dose, depending on your provider’s recommendation. Saxenda doses continue to increase to 2.4 mg the following week and to 3-mg dose of liraglutide daily on week five if indicated.

Victoza and Saxenda doses are upped weekly like this to give your body a chance to adjust to the medication and reduce their side effects.

Victoza and Saxenda come in prefilled subcutaneous (under-the-skin) injectable pens. You’ll inject the amount prescribed to you by your healthcare provider in your upper arm, upper thigh, or stomach once a day during treatment.

Does Saxenda or Victoza work better for weight loss?

According to some clinical trials, Saxenda does work better for weight loss. 

In a 2015 study, The New England Journal of Medicine reported on a 56-week double-blind trial of about 3,750 patients who received a 3-mg daily dose of liraglutide or placebo in addition to lifestyle counseling. At the end of the trial, about 63 percent of the patients in the liraglutide group lost at least five percent of their body weight compared with only about 27 percent of the placebo group. Also, about 33 percent of those taking liraglutide lost more than 10 percent of their body weight compared to only 11 percent    of those on the placebo . 

Along the same lines, a review of studies published in 2016 in Clinical Pharmacokinetics found that when assessing a number of studies, when Victoza was added to metformin, adults showed meaningful weight loss—in one study it was an average of about six pounds.

Saxenda vs Victoza: side effects

Like with GLP-1s, there are common side effects, but they typically subside after the first couple of weeks. When prescribed Saxenda or Victoza, chat with your doctor about possible side effects, and ask for tips on how to best manage them. 

You’d also think the side effects would be the same because Saxenda and Victoza share the same active ingredient. Still they do slightly differ because of dosing. Also, be aware of more serious side effects that, although rare, can still happen. Here’s what we know.

Saxenda’s common side effects

• Nausea
• Diarrhea 
• Constipation 
• Vomiting 
• Injection site reaction 
• Headache 
• Tiredness (fatigue) 
• Dizziness 
• Stomach pain 
• Change in enzyme (lipase) levels in your blood

More serious Saxendaside effects

• Inflammation of the pancreas (pancreatitis)
• Gallbladder problems
• Increased risk of low blood sugar (hypoglycemia) in adults who also take medicines to treat type 2 diabetes, such as sulfonylureas or insulin
• Increased heart rate 
• Kidney problems (kidney failure)
• Serious allergic reactions 
• Depression or suicidal thoughts

As a special note, Saxenda isn’t recommended for people who plan to become pregnant or who are pregnant or breastfeeding. 

Victoza's common side effects

• Nausea
• Diarrhea 
• Vomiting
• Decreased appetite
• Indigestion
• Constipation

More serious Victoza side effects

• Inflammation of your pancreas (pancreatitis)
• Low blood sugar (hypoglycemia)
• Kidney problems (kidney failure)
• Serious allergic reactions.
• Gallbladder problems
• Possible thyroid tumors, including thyroid cancer

There are warnings from the manufacturer on both Victoza and Saxenda prescribing information about not taking either if you have a  family history of MTC or if you’ve had it, or if you have an endocrine system condition called multiple endocrine neoplasia syndrome type 2 (MEN 2). Before being prescribed any new medications, talk with your doctor about what’s best for you and discuss any drug interactions you might have with current meds or supplements you’re on.

Which is best, Saxenda or Victoza?

We know there’s other GLP-1 meds on the market that have similar confusing “backgrounds” (hello, Ozempic® and Wegovy®—two brand namesemaglutide drugs—we’re looking at you!). But at the end of the day, deciding on a med comes down to one person, and that’s you. Ask your doctor for medical advice on which one they think may be a fit. You may find that you get the results with Victoza and it’s more sustainable than Saxenda. 

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GLP-1*

GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.

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