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Saxenda Weight-Loss Shot
Saxenda Pre-Filled Pen
Liraglutide
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Prescription Required.
Product of Canada.
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What is Saxenda (liraglutide) ?

Saxenda, also known as liraglutide, is a daily injectable prescription medication. It is a glucagon-like peptide 1 (GLP-1) receptor agonist used for chronic weight management along with a lower-calorie diet and exercise in:

  • Adult patients with an initial body mass index (BMI) of
    • 30 kg/m2 (diagnosis of obesity), or
    • 27 kg/m2 (overweight) with at least one weight-related comorbid condition such as type 2 diabetes mellitus (T2DM), hypertension, or dyslipidemia)
  • Pediatric patients aged 12 years and older with:
    • A body weight greater than 60 kg (132 pounds) and
    • A BMI corresponding to 30 kg/m2 for adults (obese) by international cut-offs

Saxenda has a few limitations to its use. These include:

  • Co-administration with other GLP-1 receptor agonists or other products containing the active ingredient liraglutide like Victoza
  • Pediatric patients with a diagnosis of type 2 diabetes, as safety and efficacy has not been confirmed in this population
  • Combination with other weight loss medication, as safety and efficacy has not been confirmed when used with other products

How does Saxenda Work for Weight Loss?

Saxenda influences how much you eat and how hungry you feel by acting on a receptor called GLP-1 in different parts of the body that control appetite. Studies using animals have shown that Saxenda increases levels of a molecule called liraglutide in these brain regions. These combined effects make it effective for promoting weight loss in individuals with obesity or overweight who haven’t succeeded with diet and exercise alone.

Side Effects from Use of Saxenda

Common side effects of Saxenda include:

  • Nausea
  • Diarrhea
  • Constipation
  • Vomiting
  • Injection site reactions
  • Headache
  • Dyspepsia
  • Hypoglycemia
  • Fatigue
  • Stomach pain
  • Dizziness and loss of coordination
  • Alterations to serum lipase levels

* this is not a complete list – always consult with a healthcare professional for safety information

Saxenda: Warnings & Precautions

Thyroid C-Cell Tumors

Saxenda has been shown to cause thyroid C-cell tumors in rats. Liraglutide has demonstrated medullary thyroid carcinoma (MTC) in post-marketing data; though causality cannot be determined at this time.

Currently, it is not known if Saxenda can increase the risk of thyroid C-cell tumors, but those with a history of MTC should avoid use of Saxenda. Patients should look out for MTC symptoms, such as a neck mass, dysphagia, hoarseness, or dyspnea. If these signs are present, patients should be evaluated for thyroid disease by their health care provider. Signs include if a patient’s serum calcitonin is markedly elevated or if a neck mass is present.

Acute Pancreatitis

Both fatal and non-fatal hemorrhagic or necrotizing acute pancreatitis cases have been reported in post-marketing data. Patients should be monitored for pancreatitis signs, such as abdominal pain or vomiting. If these symptoms occur, Saxenda should be stopped immediately and the pancreatitis should be managed appropriately. Therapy with Saxenda should not be reinitiated in the presence of true pancreatitis.

Hypoglycemia

Saxenda can cause hypoglycemia when used in combination with other products that lower blood glucose, such as insulin for diabetes. Dose adjustments to insulin may be required to prevent development of hypoglycemia. Patients should be made aware of any other drug that can potentiate the glycemic effects of Saxenda and cause hypoglycemia. Patients should also get help for recognizing the typical signs of low blood sugar, and determine the best way to raise their blood sugar levels if feeling the effects of hypoglycemia.

Acute Gallbladder Disease

Saxenda has been shown to cause acute occurrences of gallbladder disease, such as cholelithiasis or cholecystitis. If gallbladder disease is suspected, providers should provide appropriate clinical interventions and monitoring of the patient’s health.

Increased Heart Rate

In studies, Saxenda has been shown to increase resting heart rate up to 2 to 3 beats per minute (bpm). Other patients demonstrated increases between 10 to 20 bpm, with at least one person having a heart rate over 100 bpm. Consequently, Saxenda is thought to cause tachycardia. A patient’s heart rate should be monitored routinely while on Saxenda. In patients who experience a fast heart rate at rest for a long period of time, Saxenda should be stopped.

Renal Impairment

Saxenda has been shown to cause acute renal failure or worsening of existing renal failure. Some cases have needed treatment with hemodialysis. Some cases occurred in those with known renal disease. Most cases were accompanied by symptoms of nausea, diarrhea, or vomiting, causing volume depletion. Certain cases included patients who were on other medications that can influence renal function and volume status. Most cases of renal impairment were reversed after discontinuing causative agents, such as Saxenda, and initiating supportive treatment. If a patient has renal impairment, providers should use caution when starting Saxenda or increasing the dose.

Hypersensitivity Reactions

Saxenda has been shown to cause severe hypersensitivity reactions, including anaphylaxis and angioedema. Patients with a history of hypersensitivity reactions with other GLP-1 receptor agonists should be closely observed for allergic reactions. If anaphylaxis or angioedema occur, Saxenda should be stopped and the patient should seek medical attention.

Suicidal Ideation and Behavior

In clinical trials, 0.3% of patients on Saxenda experienced suicidal ideation compared to the 0.1% in the placebo group. One patient in the Saxenda arm attempted suicide. In pediatric studies, one patient (0.8%) died by suicide. It is currently unknown if there is a causal relationship between Saxenda and suicidal ideation. Patients should be monitored for difference in mood and worsening signs of depression and suicidal behavior. If patients exhibit these symptoms, Saxenda should be stopped. If patients have a history of depression or suicidal behavior, Saxenda should be avoided.

Saxenda: Drug Interactions

Orally Administered Drugs

Saxenda reduces the rate of gastric emptying, potentially causing Saxenda to slow the absorption rate of other oral drugs. Providers should take caution when patients are taking oral medications concomitantly with Saxenda, as a decreased oral absorption rate may reduce clinical effectiveness of important medications.

Consult a Healthcare Provider for all Safety and Dosage Information

Regarding drug interactions, side effects and dosage: the above content is just a summary and not a complete list of important information. Always consult with your healthcare provider – doctor, nurse or pharmacist – on all safety information when considering treatment with Saxenda.

Frequently Asked Questions for Saxenda

Your provider should demonstrate how you should use Saxenda before you administer it yourself. Use Saxenda exactly as prescribed by your healthcare provider. Saxenda should be injected under the skin into the stomach, upper arm, or thigh. Do not inject Saxenda into the muscle or vein. You should change the place you inject Saxenda every day. Do not inject into the same site.

Start Saxenda with 0.6 mg per day in your first week. In your second week, increase your daily dose to 1.2 mg. In the third week, increase your daily dose to 1.8 mg. In the fourth week, increase your daily dose to 2.4 mg and in the fifth week onwards, increase your daily dose to the full dose of 3 mg. After that, do not change your dose unless your healthcare provider tells you to. Children may reduce their dose to 2.4 mg daily if the maximum dose is not tolerated.

Your physician should also have you on a concomitant diet and exercise plan. This program should continue while you take Saxenda.

The cost of Saxenda from Canada varies based on the quantity purchased, with bulk pricing options available for greater savings. For the 6mg pens of Saxenda, the pricing structure is as follows:

  • 5 pens cost $515
  • 10 pens are priced at $1016
  • 15 pens can be purchased for $1500

These bulk pricing options provide an opportunity for Americans to save more, especially for those requiring a longer-term supply. Additionally, customers have the option to order up to a 90-day supply, further enhancing convenience and potentially reducing the overall cost of ongoing medication.

Patients can save an additional 10% when they purchase Saxenda with coupon code: SAXENDA10OFF

  • Minimum order amount $100
  • Maximum discount $50
  • 1 use per customer

Saxenda can be taken with or without regard to food.

Your physician should also have you on a concomitant diet and exercise plan. This program should continue while you take Saxenda.
If you miss your daily dose of Saxenda, just take your next daily dose as usual on the following day. Do not take an extra dose of Saxenda or increase your dose on the following day to make up for your missed dose. If you miss your dose of Saxenda for 3 days or more, call your healthcare provider to talk about how to restart your treatment.

Common side effects of Saxenda include:

  • Nausea
  • Diarrhea
  • Constipation
  • Vomiting
  • Injection site reactions
  • Headache
  • Upset stomach
  • Low blood sugar
  • Tiredness
  • Stomach pain
  • Dizziness
  • Changes to enzyme levels in your blood

More rare, serious side effects of Saxenda include:

  • Pancreas inflammation (pancreatitis)
  • Gallbladder issues
  • Severe low blood sugar
  • Kidney problems
  • Increased heart rate
  • Depression and suicidal thoughts
It is important that you tell your doctor all of the medications, vitamins, and supplements that you take. Additionally, do not take Saxenda if you:

  • Have a medical history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia Syndrome (MEN 2) type 2
  • Are pregnant or plan to become pregnant
  • Are allergic to liraglutide or any of the ingredients in Saxenda

It is also important to let your doctor know if you:

  • Are taking other medications classified as GLP-1 agonists especially weight loss medications
  • Have mental health problems or suicidal thoughts
  • Have problems with your kidneys, pancreas, or liver
  • Have stomach problems, such as indigestion or slowed stomach emptying (gastroparesis)
  • Are breastfeeding or plan to breastfeed
  • Are taking diabetes medicines, specifically insulin and sulfonylurea products
Prior to first use, Saxenda should be stored in a refrigerator between 36ºF to 46ºF (2ºC to 8ºC). Do not store in the freezer or directly adjacent to the refrigerator cooling element. Do not freeze Saxenda and do not use Saxenda if it has been frozen.

After initial use of the Saxenda pen, the pen can be stored for 30 days at controlled room temperature (59°F to 86°F; 15°C to 30°C) or in a refrigerator (36°F to 46°F; 2°C to 8°C). Keep the pen cap on when not in use.

Before disposing of Saxenda, safely remove and discard the needle. This is an important step as needle contamination can cause infection and leakage. Throw away a used Saxenda pen after it has been opened for 30 days.

Saxenda is a glucagon-like peptide-1 (GLP-1) receptor agonist. Saxenda helps you lose weight by acting like a natural hormone in your body called glucagon-like peptide-1 or GLP-1. GLP-1 helps you feel full, and Saxenda mimics this effect by targeting receptors in your gut. This slows down digestion and keeps you feeling fuller for longer, reducing your hunger.
While Saxenda isn’t a direct treatment for high cholesterol or high blood pressure (often called hypertension), weight loss can help improve both. If you have these conditions, talk to your doctor about whether Saxenda could be part of your weight management plan to potentially lower your cholesterol and blood pressure.

The duration of treatment when using Saxenda will typically depend on the patient’s weight loss goals. When chronic obesity is an ongoing concern for certain individuals, long-term treatment with Saxenda may be required. However, individuals using this medication will be monitored by their physician during treatment, and any necessary changes to the medication dosage or treatment plan may be made as needed.

It is not required for a healthcare professional to administer Saxenda injections. This medication is available in a prefilled pen that is intended for self-use by the patient. However, if a patient is struggling with performing the injections properly, they may consult with their physician or pharmacist for additional info.

As a subcutaneous injection, Saxenda should typically be injected into the upper arm, the thigh, or the abdominal area. Saxenda should never be injected into a muscle or a vein.

There are no strict requirements regarding the time of day that Saxenda should be injected. Patients are recommended to find an appropriate time on their own schedule to perform the injections to ensure that they will be able to administer the medication at the same time each day. Saxenda also does not have any requirements regarding using the medication with food or a meal, so patients have the freedom to inject the medication whenever it is most convenient for them.

After a Saxenda pen has been used and is ready for disposal, the patient should remove the needle from the pen carefully and avoid placing the needle cap back on. Ideally, the patient should dispose of the needle in a container specifically for sharps. Patients may consult with their pharmacist or physician regarding how to acquire one of these containers or simply make a suitable alternative for at-home use themselves. Needles should not be tossed into recycling containers or in household trash. After the needle has been safely disposed of, the cap should be placed back onto the pen, and the pen should be properly stored away from light until the next use.

The lifespan of a Saxenda pen depends on whether you’re in the initial dose-escalation phase or on the maintenance dose. Therefore, the number of times you can use each pen depends on the particular dose you are taking. Ask your healthcare provider if you have questions about your dose and how often you’ll need to refill your Saxenda prescription.
The only needles approved for use in Saxenda injection pens are NovoFine® or NovoTwist® disposable needles up to a length of 8 mm. These needles are not included with Saxenda pens and will need to be purchased separately. In some areas, a prescription may be required. It has not been determined whether other needles are suitable for use with Saxenda injection pens.

Nausea is a very common side effect when first using Saxenda that eventually fades away as the patient adjusts to the medication. If nausea is a serious problem for you when beginning the medication, stay hydrated, eat bland foods, sit upright, and try to get some fresh air outdoors to help the feelings pass. If you have any serious concerns related to ongoing nausea or other adverse gastrointestinal side effects while using Saxenda, please consult with your physician.

Saxenda has not been studied in patients who are also using additional dietary and weight-loss products, whether these are supplements or additional medications. As Saxenda is capable of impacting a medication’s absorption, it’s essential to get advice from your doctor to ensure the safe and effective use of such products when undergoing treatment with Saxenda.

Certain individuals should not use Saxenda. You should not use this medication if you are pregnant, planning to become pregnant, have previously experienced an allergic reaction to the medication or any of the other ingredients included in Saxenda. Additionally, you should not use Saxenda if you or any of your family have ever had a type of thyroid cancer called medullary thyroid carcinoma (MTC) or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Do not share your Saxenda pen with others.

The most common side effects associated with Saxenda tend to be adverse gastrointestinal symptoms. These may include stomach pain, vomiting, constipation, diarrhea, and nausea. Additionally, many patients also experience hypoglycemia (low blood sugar), changes in lipase levels in the blood, dizziness, headache, fatigue, and reactions at the site of injection.

Medications that are taken orally may be impacted by those who are also using Saxenda. It can cause a reduced rate of gastric emptying, and this can result in slower absorption of certain medications that are processed in the digestive tract. Please discuss all current medications with your physician or pharmacist before beginning treatment.

Saxenda is associated with quite a few serious side effects that should be reported to the patient’s prescribing physician immediately. Serious side effects can include an increased heart rate, serious allergic reactions, kidney failure and other kidney-related problems, hypoglycemia, pancreatitis, gallbladder issues, depression, and suicidal ideation.

When you start Saxenda, your doctor will likely recommend changes to help you lose weight and get the most out of the medication. This might include things like reducing your calorie intake and getting more exercise each day.
Sean Moshrefi, PharmD, MS

Sean Moshrefi, PharmD, MS, is a licensed pharmacist based in California. He holds a Doctor of Pharmacy degree from the University of California, San Francisco (UCSF) and a Master of Science in Regulatory Sciences from the University of Southern California (USC). With expertise in medical writing and medical communications, Sean adeptly provides written and verbal drug information to healthcare professionals and patients, contributing significantly to the healthcare landscape and empowering healthcare professionals and patients alike with actionable insights.