Saxenda (liraglutide (daily injection)): the 2026 GLP-1 guide
Saxenda is Novo's daily liraglutide injection for weight management. ~5-8% loss in SCALE; older option, generally outperformed by Wegovy and Foundayo.
Overview
Saxenda is Novo Nordisk’s liraglutide subcutaneous injection, FDA-approved on December 23, 2014 for chronic weight management — the first GLP-1 receptor agonist to receive an on-label weight-management indication.
Liraglutide is a single-pathway GLP-1 receptor agonist (no GIP activity, unlike tirzepatide). It is the same molecule as Victoza (the older T2D liraglutide brand) but at a higher daily dose (3 mg vs 1.8 mg).
In 2026 Saxenda remains available but is generally outperformed by weekly semaglutide (Wegovy) and the dual-agonist tirzepatide (Zepbound). It retains a niche for patients with prior tolerability on liraglutide or coverage limitations on newer agents, and it is the only GLP-1 with an FDA-approved pediatric (≥12 years) weight-management indication.
Clinical Efficacy
In SCALE (3,731 adults with obesity or overweight + comorbidity, no T2D), Saxenda 3 mg daily produced 8.0% mean body-weight loss at 56 weeks vs 2.6% on placebo. 63% of Saxenda patients lost ≥5% of body weight vs 27% on placebo1.
This is a meaningful effect but lower than weekly semaglutide (Wegovy ~15%) and substantially lower than tirzepatide (Zepbound ~22%) on weekly dosing.
Dosing & Titration
Five doses across the 5-week titration to the 3 mg maintenance dose:
| Week | Daily dose |
|---|---|
| 1 | 0.6 mg |
| 2 | 1.2 mg |
| 3 | 1.8 mg |
| 4 | 2.4 mg |
| 5 onward | 3.0 mg (maintenance) |
Inject subcutaneously once daily in the abdomen, thigh, or upper arm — at any time of day, with or without meals. Pre-filled multi-dose pens deliver all five doses2.
If a dose is missed and the next scheduled dose is ≥12 hours away, take it as soon as remembered. Otherwise skip and resume the next day. Do not double up. If three or more daily doses are missed, restart titration from 0.6 mg.
Side Effects
Boxed warning — Risk of Thyroid C-Cell Tumors
Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. Whether Saxenda causes the same in humans (including MTC) is unknown. Saxenda is contraindicated in patients with a personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)2.
Most common adverse reactions (Saxenda 3 mg vs placebo)
| Adverse reaction | 3.0 mg | Placebo |
|---|---|---|
| Nausea | 39% | 14% |
| Diarrhea | 21% | 10% |
| Constipation | 19% | 9% |
| Vomiting | 16% | 4% |
| Injection-site reaction | 14% | 11% |
| Headache | 14% | 13% |
| Dyspepsia | 10% | 3% |
| Fatigue | 8% | 5% |
Saxenda’s nausea rate is the highest in the GLP-1 class — partly because daily dosing means daily peak-trough fluctuation rather than the smoother profile of weekly semaglutide or tirzepatide.
Contraindications
- Personal or family history of medullary thyroid carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Known serious hypersensitivity to liraglutide or excipients
- Pregnancy
2026 Availability
Saxenda is on Part D Tier 4 with a small subset of plans (22 indexed — narrower coverage than Wegovy or Mounjaro). Cash list price is approximately $1,349/month — the highest of the GLP-1 class for chronic weight management.
Saxenda is NOT on the Medicare GLP-1 Bridge program — the Bridge covers Foundayo, all Wegovy formulations, and Zepbound KwikPen only.
For most 2026 weight-loss patients, Foundayo (oral, $149/mo) or Wegovy Tablets ($149/mo via NovoCare) deliver more weight loss at lower cost. Saxenda’s remaining role is for: (a) adolescent patients (the only GLP-1 with that indication), (b) patients with prior good tolerability on liraglutide, and (c) patients whose specific insurance plan covers Saxenda but not the newer agents.
Footnotes
-
Pi-Sunyer X et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med 2015;373:11-22. (SCALE) ↩
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Saxenda Prescribing Information — DailyMed (NIH), revised February 2026. ↩ ↩2
Your monthly price for Saxenda
Saxenda: frequently asked questions
How does Saxenda compare to Wegovy?
Is Saxenda still worth considering in 2026?
Is Saxenda on the Medicare GLP-1 Bridge?
Can pediatric patients take Saxenda?
Sources & citations
Every clinical claim on this page traces to one of the 2 sources below — primarily FDA-approved labels via DailyMed (NIH) and peer-reviewed trial papers. Last reviewed ; next review due .
- 1 A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management (SCALE)Primary NEJM Accessed
- 2 SAXENDA (liraglutide) injection — Prescribing InformationPrimary National Library of Medicine (DailyMed) Published Accessed