What to Know About Saxenda for Weight Loss: Safety, Cost and More

Saxenda at a Glance

Saxenda is a prescription medication for weight loss that is FDA-approved for:

• Adults with obesity who have a BMI of 30 or greater.
• Overweight adults with a BMI of 27 or greater with additional weight-related health problems.
• Adolescents between 12–17 years of age with a body weight above 60 kg (132 lbs) and a BMI of 30 or greater.

Saxenda works with your appetite hormones to control hunger and increase weight loss. It is intended to be part of a long-term weight management program that includes a calorie-reduced diet and exercise. There are no food restrictions when taking Saxenda.

Saxenda is manufactured by Novo Nordisk and contains liraglutide as its active ingredient. Liraglutide is the same ingredient as in Victoza, an FDA-approved diabetes treatment. However, the dosage of liraglutide in Saxenda is higher than in Victoza, and the two products should not be used together.

Saxenda comes in a multi-dose pen that allows you to inject the medication at home under your skin (subcutaneous).

You can buy Saxenda from the pharmacy once you receive a prescription. You can also order it through a mail-in prescription service.

You should see at least a 4% weight loss after using Saxenda for four months. If you have less weight loss by this time, it may not be effective for you, or you may need more time to see its full effect. Be sure to discuss your individual case and concerns with your doctor.

How Saxenda Works for Weight Loss

By promoting satiety, Saxenda reduces the urge to snack between meals or eat too often.

To accomplish this, Saxenda works in the following ways:

• Saxenda alters the body’s insulin and glucagon levels, two hormones that regulate blood sugar. Saxenda stimulates insulin and blocks glucagon. These actions drive blood sugar down to reduce hunger and food cravings. (1)
• In addition to lowering blood sugar, Saxenda slows gastric emptying. That means it keeps food in your stomach longer, so you feel full longer after eating. (1)

Clinical Trials

Novo Nordisk (the makers of Saxenda) conducted separate clinical trials for people with obesity — a few for adults and one for adolescents.

Researchers did a 56-week double-blind trial on 3,731 non-diabetic adults with a body mass index (BMI) over 30 or a BMI over 27 plus high blood pressure or high cholesterol. (2)

This study showed the participants experienced reduced BMIs and additional health improvements compared to the placebo group. People on Saxenda were also less likely to develop prediabetes and diabetes during the trial duration.

Initial studies following adults on Saxenda found that weight loss and associated health benefits were maintained during two years of treatment. (3)

A study on over 2,256 adults found that 26% of people on Saxenda maintained at least 5% body weight loss at the three-year mark compared to just 10% of people in the placebo group. (4)

In another 56-week randomized controlled trial of 201 adolescents with obesity (ages 12–18), Saxenda injections significantly lowered BMI scores compared to placebo. However, after treatment ended, the adolescents were followed for 26 more weeks. Those who had received Saxenda regained weight faster than those who had been on placebo during the follow-up period. (5)

Safety and Side Effects

The side effects of taking Saxenda (liraglutide) are similar to symptoms found with other GLP-1 receptor agonist medications.

Common side effects (6) from using Saxenda reported in over 5% of users include:

• Nausea
• Diarrhea
• Constipation
• Vomiting
• Reactions at the injection site
• Headache
• Hypoglycemia
• Dyspepsia (indigestion)
• Fatigue
• Dizziness
• Abdominal pain
• Increased lipase
• Upper abdominal pain
• Pyrexia (fever)
• Gastroenteritis (stomach flu)

Warnings and precautions for severe side effects include:

• Potential risk for thyroid C-cell tumors
• Acute pancreatitis risk
• Acute gallbladder disease risk (significant or rapid weight loss can increase the risk of gallstones)
• Hypoglycemia risk (low blood sugar)
• Increased heart rate risk
• Kidney failure
• Hypersensitivity allergic reactions (such as anaphylaxis, swelling, rash, or itchiness)
• Suicidal behavior and ideation

If you experience any of these more severe symptoms while taking Saxenda, discontinue this medication and seek medical assistance as soon as possible.

Saxenda may not be right for everyone. More testing is needed to determine its safety and effectiveness for certain groups. You should not take Saxenda if:

• You are taking other medications that contain liraglutide or other similar diabetes medications. Saxenda can interact with these drugs.
• You are pregnant, breastfeeding, or under 12 years old. Saxenda has not been adequately studied for safety and effectiveness in these groups.
• You have severe gastroesophageal reflux disease or delayed stomach emptying.
• You've had a serious allergic reaction to liraglutide or any Saxenda ingredients.

Since Saxenda can slow digestion, it may affect how well other oral medicines are absorbed. Discuss all your current medications with your healthcare providers. Dosing adjustments may be needed.

Consult your doctor on Saxenda's risks, side effects, and interactions based on your medical evaluation. Together, you can determine if Saxenda is appropriate for you.

Dosage and Usage

Saxenda’s active ingredient is 3 milligrams of liraglutide. It comes in a prefilled injection pen that allows you to inject the medication at home.

You’ll gradually work up to the 3-milligram dose over five weeks. This progression gives your body time to adjust. Most people starting Saxenda follow this schedule:

• Week 1: 0.6mg
• Week 2: 1.2 mg
• Week 3: 1.8 mg
• Week 4: 2.4 mg
• Week 5 and beyond: 3 mg

The injectable pen has a window with metered doses so that you can adjust the amount. You can inject Saxenda under the skin near the abdomen, thigh, or upper arm. It’s important to watch out for veins or muscles when injecting Saxenda since it’s meant to go just beneath the skin’s surface.

Many people are nervous about injecting themselves with medication, but your clinician should demonstrate and let you practice using the pen until you feel comfortable doing it yourself.

There’s also an instructional video on the Novo Nordisk website, and directions come with the medication. Additionally, you can call Saxenda Hotline at 1-844-845-6913 Monday through Friday, 8:30 AM to 6:00 PM ET.

Saxenda injections are meant to be taken every day. If you accidentally miss a dose, just continue with your usual dosage the next day — don’t double up. However, if it’s been more than three days since your last injection, you should ask your doctor for advice on restarting the medication.

Cost and Insurance Coverage

According to Novo Nordisk, the list price of Saxenda is $1,349 per 30-day supply (without any insurance coverage). Saxenda is only available through a prescription from your doctor.

The cost of your Saxenda prescription will be dependent on your insurance provider. Many private or commercial insurance companies may cover Saxenda but set forth contingencies and criteria for eligibility and require prior authorizations from your healthcare provider. Unfortunately, Medicare does not cover Saxenda, but contact them to verify.

Novo Nordisk offers a patient assistance program called NovoCare® to help you and your doctor check your insurance coverage and estimated out-of-pocket costs.

Your physician may also provide a free sample of Saxenda, which only lasts for 17 days. To stay on schedule, it’s important to plan to get your next pharmacy dose in time for day 18.

Comparison to Alternatives

There are several FDA-approved weight loss medications. All treatment options are meant to be used in addition to lifestyle changes, are expensive without insurance, and come with the risk of serious side effects. The benefits and drawbacks of each treatment should be carefully discussed with your physician.

The table below is intended to help you in your research and to prepare for a meeting with your doctor:

* All prices are accurate at the time of research and are subject to change without notice.

Alternative Next Steps

In studies on Saxenda, participants were placed on lifestyle programs for diet and exercise while taking the medication. (2) Although they still lost more weight than those not taking Saxenda, the placebo groups also experienced some weight loss, possibly due to the extra support during the study.

If you’re struggling to maintain a healthy weight, looking for outside help is a good idea. Meeting with a personal trainer, speaking with a health coach, or working with a registered dietitian nutritionist can provide guidance and accountability.

For people with diabetes, a group education class can help you meet people working on similar goals. Your doctor should be able to refer you to an in-person program or an online community.