Liraglutide (obesity)
SAXENDA
Pronunciation: lir-a-GLOO-tide
“Lir’s glue tide is a Sax ender”
Lir is a sea god in Irish mythology; they’re holding his statue victoriously
Tide Pod → GLP-1 agonist
What it isGLP-1 receptor agonist increasing satiety and slowing gastric emptying; chronic weight management.
Why this oneThis is the obesity-labeled formulation of liraglutide rather than its diabetes product.
What limits itNausea and vomiting can halt titration. Gallbladder disease and pancreatitis matter, and delayed gastric emptying complicates anesthesia.
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Chronic weight management (obesity, or overweight with >=1 weight-related comorbidity) with reduced-calorie diet and increased physical activity | Adults | 0.6 mg SC QD for one week | 3 mg QD (escalate weekly: 0.6, 1.2, 1.8, 2.4, 3 mg) | 3 mg QD |
| Chronic weight management (obesity, body weight >60 kg) | Pediatric 12 yr and older | 0.6 mg SC QD for one week | 3 mg QD (may reduce to 2.4 mg QD if 3 mg not tolerated) | 3 mg QD |
Titration Increase dose at weekly intervals per escalation schedule (pediatric escalation may take up to 8 weeks)
Renal Undefined (limited experience in mild, moderate, severe, and ESRD)
Hepatic Use with caution (limited experience in mild, moderate, or severe hepatic impairment)
Instructions
- Inject subcutaneously in the abdomen, thigh, or upper arm once daily, any time of day, without regard to meals
- Rotate injection sites
- If more than 3 days since last dose, reinitiate at 0.6 mg daily and re-escalate
- Not recommended in patients with severe gastroparesis
Available strengths
- inj 6 mg/mL
Contraindications
- Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
Cautions
- Acute pancreatitis
- Acute gallbladder disease
- Hypoglycemia (with insulin secretagogue or insulin)
- Heart rate increase
- Acute kidney injury due to volume depletion
- Severe gastrointestinal reactions
- Hypersensitivity reactions (anaphylaxis, angioedema)
- Pulmonary aspiration during general anesthesia or deep sedation
Adverse reactions
- Nausea
- Diarrhea
- Constipation
- Vomiting
- Injection site reactions
- Headache
- Hypoglycemia
- Dyspepsia
- Fatigue
- Dizziness
- Abdominal pain
Pregnancy May cause fetal harm (animal data); weight loss offers no benefit in pregnancy. Discontinue when pregnancy is recognized.
Lactation No human data; liraglutide present in milk of lactating rats. Weigh benefits vs mother's clinical need.
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 6 mg/mL | inj | per unit | $31.41/mL | offered |
Other forms: Liraglutide (VICTOZA, SAXENDA)
⚠ BOXED WARNING
- Thyroid C-cell tumors in rodents
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityGI intolerance, gallbladder disease and rare pancreatitis; hypoglycemia is uncommon without insulin or sulfonylureas.
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