Liraglutide

Liraglutide is Novo Nordisk’s injectable GLP-1 agonist, taken daily. FDA-approved products include Victoza for type 2 diabetes and Saxenda for obesity. In SCALE, body weight fell by 5–8%, with a substantial reduction in HbA1c. Weekly semaglutide and tirzepatide have largely displaced it for weight management, but it continues to play an important role in diabetes care. LEADER, a cardiovascular outcomes trial, demonstrated lower cardiovascular risk.

Research schedules also name a low starting amount and a titrated maintenance amount, both subcutaneous and once weekly, without numeric doses. Those weekly schedules conflict with liraglutide’s daily administration and must not be treated as a prescribing regimen.

• Weight Loss

  Most effective

  Clinical trials show substantial weight reduction with benefits that persist.

  Human, randomised · 1 reference

• Blood Sugar Control

  Most effective

  In type 2 diabetes, glycemic regulation and A1C measurements improve.

  Human, randomised · 1 reference

• Cardiovascular Health

  Effective

  High-risk patients experience fewer cardiovascular events in clinical investigations.

• Metabolic Syndrome

  Effective

  Several features of metabolic syndrome may improve at the same time.

• Other GLP-1 agonists (semaglutide, tirzepatide)

  Avoid

• Insulin

  Monitor

• Sulfonylureas

  Monitor

• Metformin

  Compatible

• SGLT2 Inhibitors

  Compatible

• Oral Contraceptives

  Caution

• Warfarin / Blood Thinners

  Monitor

• NAD+

  Compatible

Diluent: Use bacteriostatic water; avoid saline because precipitation may occur.

1. Let the refrigerated vial stand at room temperature for 15–20 minutes before preparation.
2. Disinfect the stopper using an alcohol swab, then wait until it has dried fully in the air.
3. Measure the calculated quantity of bacteriostatic water with a sterile syringe. Use only this diluent; avoid saline because precipitation may occur.
4. Add the water gradually against the inner vial wall. Keep the stream away from the powder itself.
5. Rotate the vial with a gentle swirling motion. Do not shake forcefully, because this can degrade the contents.
6. Wait 2–3 minutes for the powder to dissolve completely, and check that the liquid is transparent and has no color.
7. Use an insulin syringe to withdraw the calculated amount for injection beneath the skin.
8. Inject in the thigh, abdomen or upper arm. Change the injection location each time to help prevent lipodystrophy.
9. Refrigerate the mixed solution at 2–8°C. Use it within a maximum of 28 days after preparation.

Week 1–2

In weeks 1–2, appetite may begin to decrease. Mild nausea and fullness can accompany initial adaptation.

Week 2–4

By weeks 2–4, cravings and portion sizes may decline noticeably, with early changes in weight.

Week 4–8

Weeks 4–8 may bring stronger appetite control and continuing weight reduction, together with improved glycemia when relevant.

Week 8–16

During weeks 8–16, greater weight reduction and energy may accompany initial improvements in metabolic measurements.

Week 16–24

Weeks 16–24 may bring a major weight-loss milestone, cardiovascular benefits and a better lipid profile.

Week 24+

Beyond week 24, clinical effects may reach their maximum, with broad metabolic improvements and lasting benefits. Individual outcomes can differ.

• Nausea, usually temporary and related to dose · Most common
• Constipation or diarrhea while increasing the dose
• Vomiting, particularly at initiation or after a dose increase
• Less appetite and feeling full sooner
• Bruising or redness around the injection location
• Fatigue, especially during the initial weeks
• Pancreatitis; stop immediately if severe abdominal pain develops · Rare
• Effects on thyroid C cells · Rare

Contraindications

• MEN2
• History of thyroid cancer

Liraglutide: approved in the US.

• US

  Approved

  FDA approval covers prescription liraglutide products: Victoza for type 2 diabetes and Saxenda for obesity. Telehealth is available. No 503A ban is identified; that does not establish permission to compound.

  Rx required

  Yes

  Telehealth

  Available

1. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. (2016)

   PMID 27295427DOI 10.1056/NEJMoa1603827

2. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management (SCALE) (2015)

3. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. (2022)

   PMID 35015037DOI 10.1001/jama.2021.23619

4. Efficacy and Safety of Liraglutide 3.0 mg in Individuals With Overweight or Obesity and Type 2 Diabetes Treated With Basal Insulin: The SCALE Insulin Randomized Controlled Trial. (2020)

   PMID 32139381DOI 10.2337/dc19-1745

5. SAXENDA (liraglutide) injection — Prescribing Information (2014)

6. VICTOZA (liraglutide) injection — Prescribing Information (2010)