Liraglutide
Liraglutide (Victoza/Saxenda) was one of the first GLP-1 receptor agonists with extensive long-term safety data. While producing less weight loss than newer agents, it has the longest cardiovascular outcomes data and pediatric approval.
Evidence Summary
LEADER trial (n=9,340) showed 13% reduction in major cardiovascular events over 3.8 years. SCALE trials demonstrated 5-8% weight loss. SCALE Teens established pediatric efficacy.
Evidence Scale
Mechanism of Action
GLP-1 receptor agonist with 97% amino acid homology to native GLP-1. Binds to albumin for extended half-life (~13 hours). Activates pancreatic GLP-1 receptors to enhance glucose-dependent insulin secretion and suppress glucagon. Delays gastric emptying and reduces appetite via hypothalamic signaling.
Who Is This For?
Type 2 diabetes. Weight management (BMI criteria). Adolescent obesity (age 12+). Patients preferring established safety data over maximum efficacy.
Protocol & Dosing
Dose
Victoza (T2D): Start 0.6mg daily for 1 week, then 1.2mg, max 1.8mg. Saxenda (weight): Start 0.6mg daily, increase by 0.6mg weekly to target 3.0mg daily.
Frequency
Daily injection
Duration
Ongoing / Long-term
Protocol Summary
Daily subcutaneous injection. Requires daily dosing unlike newer weekly options. Well-established safety profile with 10+ years of real-world data.
Interactions & Precautions
Contraindications
- Medullary thyroid carcinoma history
- MEN2
- Pancreatitis history
- Pregnancy
Potential Risks
- •Thyroid tumor risk (preclinical)
- •Pancreatitis
- •Gallbladder disease
Potential Side Effects
Practitioner Notes
Clinical annotations from Dr. Goel
Best option when long-term safety data is priority. Daily injection may reduce adherence vs weekly options. Good stepping stone before newer, more potent agents. Consider switching to semaglutide if weight loss plateau.
Dr. Sanjeev Goel
Chief Medical Officer, Peak Human
Cost & Access
Cost Range
$$$
Accessibility
Availability varies by location
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