Liraglutide

What is liraglutide and how does it work?

Liraglutide is a modified copy of the glucagon-like peptide-1 (GLP-1) hormone secreted in the intestine. According to the Türkiye SmPC (Turkish KÜB), its amino acid sequence is 97% similar to human GLP-1; it binds to the GLP-1 receptor and activates it. ^[1]

The same document describes the two main effects separately:

• Appetite and weight: Liraglutide increases the feeling of fullness and satiety and reduces the feeling of hunger; it thereby lowers food intake. It does not increase energy expenditure compared with placebo. Weight loss is predominantly from fat mass, especially intra-abdominal (visceral) fat. ^[1]
• Blood sugar: It stimulates insulin secretion in a blood-sugar-dependent manner and reduces glucagon secretion; this effect is more pronounced in prediabetes and diabetes than in people with normal blood sugar. ^[1]

After subcutaneous administration, the peak blood level is reached in about 11 hours and the elimination half-life is about 13 hours. ^[1] Liraglutide is administered once daily; the semaglutide in the direct comparison trial is used once weekly. ^[7] The general logic of the GLP-1 drug class is explained in a separate guide: What are GLP-1 agonists?

What is the difference between Saxenda and Victoza?

The active substance of the two drugs is the same; the difference is in indication and dose.

• Victoza is for type 2 diabetes. According to the EMA, it is used in adults and in children from age 10, in addition to diet and exercise, alone (if metformin is not suitable) or added to other diabetes medicines. The EMA summary reports that Victoza achieved blood sugar control in six main studies in which 4,289 adults and children took part; when used alone, it lowered HbA1c more than glimepiride (0.8 with 1.2 mg, 1.1 points with 1.8 mg; 0.5 points with glimepiride). In 134 children and adolescents aged 10 and over, HbA1c fell by 0.64 points with liraglutide and rose by 0.42 points with placebo. ^[3]
• Saxenda is for weight management and the dose is increased up to a daily maintenance dose of 3.0 mg. According to the Türkiye SmPC, a dose higher than 3.0 mg/day is not recommended and Saxenda should not be used together with another GLP-1 receptor agonist. ^[1]

In Türkiye, a combination product that combines liraglutide with the long-acting insulin degludec is also licensed. ^[2] The US Saxenda label states that use together with other products containing liraglutide or with another GLP-1 receptor agonist is not recommended. ^[12]

Is liraglutide licensed in Türkiye?

Yes. In the TİTCK (Turkish Medicines and Medical Devices Agency) Licensed Human Medicinal Products List dated October 16, 2026, the products containing liraglutide (ATC A10BJ02) are as follows: ^[2]

• Victoza 6 mg/mL ready-to-use pen — first license date October 18, 2012
• Saxenda 6 mg/mL ready-to-use pen — first license date June 21, 2017
• Liraglutide and insulin degludec combination — first license date February 19, 2018

No licensed generic or hybrid product containing liraglutide, other than these three products, appears in the same list. ^[2] The prescription type of the products is not stated in the list or in the SmPC reviewed; this guide does not make that distinction. In the EK-4/A Medicines to Be Reimbursed List published in the Official Gazette (Resmî Gazete) of April 8, 2026 by SGK (Social Security Institution), no product containing liraglutide appears; among products containing GLP-1 receptor agonists, only exenatide (Byetta) and the fixed combination of insulin glargine and lixisenatide (Soliqua) appear on the list. ^[13]

Who is Saxenda used for?

According to the Türkiye SmPC, Saxenda is indicated, as an addition to a reduced-calorie diet and increased physical activity, for weight management in the following groups: ^[1]

• Adults: BMI of 30 kg/m² and above (obesity), or BMI 27–30 kg/m² (overweight) together with at least one weight-related condition such as prediabetes/type 2 diabetes, hypertension, dyslipidemia, or obstructive sleep apnea.
• Adolescents (aged 12 and over): Those with obesity according to international age and sex thresholds and a body weight of 60 kg and above.

The same SmPC writes that the safety and efficacy of Saxenda have not been established in children under 12. ^[1] In the European Union, the EMA summary of the hybrid product that references Saxenda and was licensed in 2026 defines the indication to also cover children aged 6 to under 12 who weigh at least 45 kg and whose BMI is at or above the 95th percentile for age and sex. ^[9] The US label (02/2026) limits the indication to adults and children aged 12 and over with obesity who weigh more than 60 kg. ^[12] The product information of the three regulators was updated at different dates and with different scope; what applies to the product in Türkiye is the Türkiye SmPC.

Evidence in adolescents

The adolescent indication in the SmPC rests on a double-blind RCT in which 251 adolescents aged 12–18 with obesity took part. In 56 weeks of treatment, liraglutide produced a difference of −0.22 (95% CI −0.37 to −0.08) in BMI standard deviation score compared with placebo; a decrease of at least 5% in BMI was an estimated 43.3% in the liraglutide group and 18.7% in the placebo group. In the 26-week follow-up after treatment was stopped, the BMI standard deviation score rose more in the liraglutide group than in the placebo group (difference 0.15). Gastrointestinal adverse events were 64.8% versus 36.5%, and adverse events leading to discontinuation were 10.4% versus 0%. The study was funded by the manufacturer of the drug. ^[6]

Dose escalation and the treatment stopping rule according to the product information

The information below is a relay of prescribing information intended for physicians, not a personal recommendation. According to the Türkiye SmPC, the starting dose in adults is 0.6 mg daily; to improve gastrointestinal tolerance, the dose is increased by 0.6 mg at intervals of at least one week up to a maintenance dose of 3.0 mg daily. According to the SmPC, if an adult patient has not lost at least 5% of starting weight at the end of 12 weeks of treatment at 3.0 mg/day, treatment should be stopped; in adolescents, if there is no decrease of at least 4% in BMI or BMI z score after 12 weeks at 3.0 mg or the highest tolerated dose, treatment should be stopped and reassessed. ^[1] The rule in the US label is different: at least 4% weight loss after 16 weeks from the start in adults, and at least a 1% decrease in BMI after 12 weeks at the maintenance dose in children. ^[12]

How much weight does liraglutide cause to be lost?

The Türkiye SmPC summarizes four phase 3, randomized, double-blind, placebo-controlled trials (the SCALE program) in which a total of 5,358 adults took part. ^[1] In all studies, participants also received diet and exercise counseling; the differences below are the effect of the drug on top of this counseling.

The NEJM publication of the SCALE trial gives the same result in kilograms: over 56 weeks the liraglutide group lost an average of 8.4 kg and the placebo group 2.8 kg (difference 5.6 kg). 78.5% of participants were women and 61.2% had prediabetes. Serious adverse events occurred in 6.2% of the liraglutide group and 5.0% of the placebo group. The study was funded by the manufacturer. ^[4]

The average does not mean everyone gets the same result. According to the SmPC, in the first 56-week part, 67.5% of patients had lost at least 5% weight after 12 weeks at the 3.0 mg dose; of those who did not respond early, 93.4% did not reach a loss of 10% or more at one year. ^[1] The “stop if no response at 12 weeks” rule in the product information rests on this observation.

Does weight come back when treatment is stopped?

The available evidence shows that the effect lasts as long as the drug is used. In the adolescent study, in the 26 weeks after the drug was stopped, the BMI score rose more in the liraglutide group than in placebo. ^[6] In adults, the SCALE Maintenance trial shows that liraglutide is superior to placebo in maintaining weight lost with diet; however, this does not measure the course after the drug is stopped. ^[1] Weight regain after stopping has been examined in more detail for weekly GLP-1 drugs: Semaglutide guide.

Does liraglutide reduce cardiovascular risk?

This question has been answered in people with type 2 diabetes and high cardiovascular risk. In the LEADER trial, 9,340 patients with type 2 diabetes were randomized to liraglutide or placebo in addition to standard treatment and were followed for a median of 3.8 years. The primary outcome, consisting of cardiovascular death, nonfatal heart attack, or nonfatal stroke, occurred in 13.0% of the liraglutide group and 14.9% of the placebo group (HR 0.87; 95% CI 0.78–0.97). Cardiovascular death (HR 0.78) and all-cause death (HR 0.85) were also lower; differences in nonfatal heart attack, nonfatal stroke, and hospitalization for heart failure were not significant. The study was funded by the manufacturer and the US National Institutes of Health. ^[5]

The limits must be stated clearly: LEADER was conducted at the diabetes dose (up to 1.8 mg daily) and in people with type 2 diabetes; people with obesity without diabetes were not included in the study and the result cannot be carried directly over to this group. The US Saxenda label also writes that liraglutide 1.8 mg is used in the treatment of adult type 2 diabetes and that efficacy for weight reduction has not been established for doses below 3 mg. ^[12] The Türkiye SmPC reports 6 major cardiovascular events with liraglutide and 10 with placebo in the weight management trials (odds ratio 0.33; 95% CI 0.12–0.90); so few events do not substitute for a study designed for cardiovascular outcomes. ^[1]

Liraglutide or semaglutide?

STEP 8 is the only phase 3 trial that compares the two drugs directly. At 19 centers in the US, 338 adults without diabetes, with BMI ≥30 or ≥27 with a comorbidity, received weekly semaglutide 2.4 mg, daily liraglutide 3.0 mg, or matched placebo for 68 weeks. The comparison between the two active drugs was open-label. ^[7]

• Mean weight change was −15.8% with semaglutide and −6.4% with liraglutide (difference −9.4 points; 95% CI −12.0 to −6.8); −1.9% in the pooled placebo group.
• The proportion reaching at least 10% weight loss was 70.9% with semaglutide and 25.6% with liraglutide.
• The rate of discontinuing treatment for any reason was 13.5% with semaglutide and 27.6% with liraglutide.
• Gastrointestinal adverse events were similar in the two groups (84.1% and 82.7%). ^[7]

STEP 8 compares weight loss and adverse events; it does not answer questions such as use in adolescents, cost, or access to the product. For weekly drugs: Semaglutide (Ozempic, Wegovy) and Tirzepatide (Mounjaro).

Daily injection and staying on treatment

The difference between daily and weekly use is seen most concretely in discontinuation rates. In STEP 8, discontinuation in the liraglutide group was about twice as common as with weekly semaglutide. ^[7] In the placebo-controlled SCALE trials, on the other hand, according to the US Saxenda label, in the 56-week trials discontinuation was 27% with liraglutide and 35% with placebo; discontinuation due to adverse effects was about 10% and 4%, respectively. ^[12] These two findings belong to different comparisons and cannot be converted into each other.

Is there generic liraglutide?

• US: On 23 December 2024, the FDA approved the first generic liraglutide injection referencing Victoza; the approval covers the indication of blood sugar control in people with type 2 diabetes aged 10 and over. In the same announcement, the FDA states that liraglutide injection and some other GLP-1 drugs were on the drug shortage list at that date and that generic applications for drugs in shortage were given priority. ^[8]
• European Union: A hybrid liraglutide product referencing Saxenda, whose active substance is produced by a chemical method instead of in living cells, received an EU-wide license on 15 July 2026. According to the EMA, its benefits and risks rest on studies conducted with the reference product; the company submitted quality studies and a bioequivalence study. ^[9]
• Türkiye: No generic or hybrid product containing liraglutide appears in the TİTCK list of October 16, 2026. ^[2]

What is known about counterfeit Saxenda pens?

The UK medicines regulator MHRA reported in its safety bulletin of 23 November 2023 that counterfeit Ozempic and Saxenda products were present in the country. According to the bulletin, among the counterfeit pens were some containing insulin; this can cause hypoglycemia (low blood sugar). MHRA states that counterfeit Saxenda pens reached the public through illegal routes that do not require a prescription and that products in the legal supply chain were not affected. ^[10]

In Türkiye, a letter sent by the Erzurum Provincial Health Directorate to the pharmacists’ chamber (chamber record date May 20, 2026), citing the TİTCK letter dated May 14, 2026, reports a serious increase in reports of suspected counterfeits among medicines containing GLP-1 receptor agonists from health professionals, citizens, and companies. The letter counts Saxenda pens among the products carrying a high counterfeit risk in pharmacy and warehouse inspections; for these cold-chain products, it asks that refrigerator checks be attended to, that medicines not be bought over the internet, and that medicines that cannot be registered in the Medicine Tracking System (İlaç Takip Sistemi, İTS) not be kept or used. ^[11] This document is an official letter relaying the TİTCK letter at the provincial level.

Who should not use liraglutide or needs caution?

According to the Türkiye SmPC, the main points are as follows; frequencies and details are on the side effects page. ^[1]

• Contraindication: Hypersensitivity to liraglutide; people with a personal or family history of medullary thyroid carcinoma and people with multiple endocrine neoplasia type 2 (MEN 2) syndrome. Thyroid C-cell tumors have been seen in two-year studies in rodents; the SmPC writes that the relevance of this finding to humans is probably low but cannot be completely ruled out.
• Pancreatitis and gallbladder: Acute pancreatitis has been observed with GLP-1 drugs; if suspected, treatment is stopped, and if confirmed, it is not restarted. In weight management trials, gallstones and gallbladder inflammation were seen more often than with placebo.
• Heart rate and fluid loss: An increase in heart rate is seen; fluid loss from nausea, vomiting, and diarrhea can impair kidney function.
• Anesthesia: Cases of aspiration into the lungs have been reported in people using a GLP-1 drug during general anesthesia or deep sedation.
• Groups not recommended: Age 75 and over, severe kidney or liver failure, NYHA class IV heart failure, inflammatory bowel disease, and diabetic gastroparesis.
• Pregnancy and breastfeeding: Liraglutide should not be used in pregnancy; if pregnancy is desired or occurs during treatment, treatment should be stopped. Because it is not known whether it passes into breast milk, it should not be used during breastfeeding either.
• Together with diabetes medicines: When used together with insulin or a sulfonylurea, the risk of hypoglycemia increases; the SmPC writes that a dose reduction of these medicines should be considered. In people using warfarin, more frequent monitoring of INR is recommended.

Detailed guideSaxenda (liraglutide) side effects: frequencies, serious risks, and discontinuation→

Limits of this guide

This page summarizes what liraglutide is, its license status in Türkiye and in other countries, and the main studies it rests on. Dose and stopping rules are relayed from the product information; an individual treatment decision, suitability assessment, and monitoring are the physician’s task. This guide does not address the drug’s price or where and how to obtain it. For an investigational-stage molecule in the same drug class: Retatrutide.