Saxenda (Liraglutide) vs Newer GLP-1 Medications

Saxenda (liraglutide) was the first GLP-1 medicine licensed for weight management in the UK, but it has been largely overtaken by newer options. Liraglutide is injected daily, while Wegovy (semaglutide) and Mounjaro (tirzepatide) are injected weekly, and GLP-1 tablets are now also available. In the STEP 8 head-to-head trial, people on weekly semaglutide lost about 16% of their body weight on average, compared with about 6% on daily liraglutide. Branded Saxenda has reportedly been discontinued in the UK, but generic liraglutide remains available. This guide compares liraglutide with the newer medicines so you can discuss the options with a prescriber.

A short history of GLP-1 medicines for weight management

Liraglutide was first licensed for type 2 diabetes as Victoza, at doses up to 1.8mg daily. Novo Nordisk then studied a higher 3mg daily dose for weight management in the SCALE trial programme, leading to Saxenda. It was authorised in Europe and the UK in 2015, making it the first GLP-1 medicine for weight management. NICE recommended it in TA664 (2020) for a narrowly defined group.

Semaglutide followed. It lasts much longer in the body, allowing weekly dosing, and produced substantially greater weight loss in the STEP trials. Wegovy was authorised by the MHRA in 2021 and recommended by NICE in TA875 (2023). Tirzepatide (Mounjaro), which acts on both GIP and GLP-1 receptors, was authorised for weight management in 2023 and recommended by NICE in TA1026 (2024). In 2026, the MHRA authorised two GLP-1 tablets for weight management: Wegovy tablets (oral semaglutide) in June and Foundayo (orforglipron) in August.

Liraglutide's patent protection ended in 2024, and generic versions became available in the UK. Reports indicate that Novo Nordisk has since discontinued branded Saxenda in the UK to focus on newer medicines. Victoza, the diabetes brand, was also discontinued. Check with your pharmacist for the current position.

For an overview of all the options, see every UK weight loss injection compared and the weight loss injections hub.

At a glance

These are approximate figures from separate trials, except where marked as head-to-head. Check the current Summary of Product Characteristics (SmPC) for each medicine.

How they work

All of these medicines activate GLP-1 receptors, which reduce hunger, increase fullness and slow stomach emptying.

Liraglutide is about 97% similar to natural GLP-1 and is modified to last about a day in the body. That is why it needs a daily injection.

Semaglutide has further modifications that make it bind strongly to albumin, a protein in the blood, so it lasts about a week. It also appears to act more strongly on the brain's appetite centres at the doses used. See how Wegovy works.

Tirzepatide activates GIP receptors as well as GLP-1 receptors, which appears to enhance its effect on appetite and weight. See how Mounjaro works.

Orforglipron is a small-molecule tablet that activates GLP-1 receptors and can be taken without food restrictions. See our Foundayo guide.

What the trials show

SCALE: liraglutide against placebo

SCALE Obesity and Prediabetes (NEJM, 2015) included over 3,700 adults with obesity, or overweight with weight-related conditions, without diabetes. After 56 weeks:

• People on liraglutide 3mg lost about 8% of their body weight on average, compared with about 3% on placebo.
• Around 63% on liraglutide lost at least 5% of their body weight, compared with about 27% on placebo.

A three-year extension in people with prediabetes found that liraglutide reduced the proportion who developed type 2 diabetes compared with placebo.

STEP 8: semaglutide against liraglutide

STEP 8 (JAMA, 2022) is the key head-to-head trial. It randomly assigned 338 adults with obesity, or overweight with weight-related conditions, without diabetes, to weekly semaglutide 2.4mg, daily liraglutide 3mg, or placebo, alongside diet and activity support, for 68 weeks.

Gastrointestinal side effects were common with both medicines and reported at similar rates. Fewer people stopped semaglutide than liraglutide over the trial. STEP 8 was open-label for the comparison between the two active medicines, because their dosing schedules differ, and was funded by Novo Nordisk, which makes both.

Liraglutide compared with tirzepatide and tablets

There is no head-to-head trial of liraglutide against tirzepatide or the GLP-1 tablets for weight management. Separate trials suggest substantially greater average weight loss with tirzepatide (about 21% at the highest dose in SURMOUNT-1) and with the 25mg Wegovy tablet (about 14% in OASIS 4). Orforglipron produced around 11–12% at the highest dose in ATTAIN-1. Comparisons across separate trials are approximate. For tirzepatide versus semaglutide, see Mounjaro vs Wegovy.

Side effects compared

All GLP-1 medicines share a similar side-effect profile.

Frequencies are approximate; check the current SmPC for each medicine.

Daily versus weekly: what difference does it make?

• Daily injections mean 365 injections a year rather than 52. Some people find the daily routine easy; for others it becomes a burden.
• Shorter action. Liraglutide leaves the body within a day or two of stopping, while weekly medicines last for several weeks. If side effects become a problem, liraglutide's effects wear off faster. Some people also find it reassuring to start with a shorter-acting medicine, although this is a personal preference rather than a clinical rule.
• Missed doses. Missing a daily liraglutide dose is less significant than missing a weekly dose, but frequent missed doses may reduce effectiveness. The SmPC explains what to do; if more than three days are missed, restarting at the lowest dose may be advised.

See our guides to Wegovy side effects and Mounjaro side effects.

Dosing compared

Liraglutide is increased weekly, reaching the full dose after four weeks. Semaglutide and tirzepatide are increased every four weeks or more, reaching maintenance over several months.

The Saxenda SmPC includes a stopping rule: treatment should be stopped if a person has not lost at least 5% of their starting weight after 12 weeks on the 3mg dose. Wegovy and Mounjaro do not have an identical rule in their SmPCs, but NICE sets review criteria for NHS use.

Liraglutide pens do not include needles, which are supplied separately. Ask your pharmacist about the right needles and how to use your specific pen, particularly with generic versions, whose pens may differ from Saxenda's.

Who might each suit?

These are general considerations, not recommendations.

Situations where liraglutide may be discussed

• Adolescents aged 12 to 17, where liraglutide has a licence (as does Wegovy), subject to criteria
• Cost, where generic liraglutide may be priced differently from newer medicines
• Previous good response to liraglutide with acceptable side effects
• Preference for a shorter-acting medicine whose effects wear off quickly
• Availability, if newer medicines are in short supply

Situations where newer medicines may be discussed

• Wanting greater average weight loss, based on STEP 8, STEP 1 and SURMOUNT-1
• Preferring weekly injections over daily
• Established cardiovascular disease, where semaglutide has outcome evidence from the SELECT trial (see Wegovy and heart health)
• Not reaching the 5% threshold on liraglutide
• Preferring a tablet, where a GLP-1 tablet is suitable (see oral vs injectable GLP-1s)

Who should not take any of them

GLP-1 medicines are generally unsuitable in pregnancy and breastfeeding, and caution or avoidance applies with a history of pancreatitis, severe gastrointestinal disease, a personal or family history of medullary thyroid cancer, or some eating disorders. See who should not take GLP-1 medications.

Liraglutide and young people

Liraglutide was the first GLP-1 medicine licensed for weight management in adolescents. The SCALE Teens trial (NEJM, 2020) studied liraglutide 3mg in young people aged 12 to 17 with obesity, alongside lifestyle therapy, and found a greater reduction in BMI than with placebo over 56 weeks. Wegovy has since also been licensed for adolescents aged 12 and over, based on the STEP TEENS trial, which reported larger average reductions in BMI.

Treatment of obesity in young people is usually led by specialist paediatric services, and decisions take account of growth, development, mental health and family circumstances. The SmPC for each medicine sets out the specific criteria for adolescents, including the stopping rules. Weight-loss medicines for under-18s should only be considered with appropriate specialist involvement.

Why newer medicines produce more weight loss

The gap between liraglutide and the newer medicines comes down to several factors:

• Strength of effect on appetite. Semaglutide and tirzepatide appear to have a stronger and more sustained effect on the brain areas that regulate appetite at their licensed doses.
• Steady drug levels. Weekly medicines maintain steady levels across the week, while a daily medicine depends on consistent daily dosing.
• Additional receptor activity. Tirzepatide's action on GIP receptors appears to add to the effect of GLP-1 activation.
• Adherence. In STEP 8, more people stopped liraglutide than semaglutide over the trial, which also affects average results.

Liraglutide's role in the history of obesity treatment is still significant. Its trials established that GLP-1 medicines could produce meaningful weight loss and improve markers such as blood glucose and blood pressure, paving the way for the medicines that followed.

Switching from liraglutide to a newer medicine

Many people who started on Saxenda have since moved to Wegovy or Mounjaro. There is no official dose conversion between liraglutide and semaglutide or tirzepatide. Prescribers usually:

• Stop liraglutide and start the weekly medicine the following day, or after a short gap
• Start the new medicine at a low dose and increase it gradually, even if the person tolerated liraglutide well
• Review side effects and progress at each step

Never take liraglutide alongside another GLP-1 medicine. Our guides to switching from Wegovy to Mounjaro and switching providers mid-treatment cover related situations.

NHS and private access

NHS

• Liraglutide (TA664): NICE recommends it only for adults with a BMI of at least 35 (or 32.5 for some ethnic groups), with non-diabetic hyperglycaemia and a high risk of cardiovascular disease, within specialist weight-management services.
• Semaglutide (TA875): mainly for adults with a BMI of at least 35 and at least one weight-related condition, within specialist services, for up to two years.
• Tirzepatide (TA1026): for adults with a BMI of at least 35 and at least one weight-related condition, with a phased rollout in primary care that began in June 2025.

NHS access varies by area. See Wegovy on the NHS and Mounjaro on the NHS.

Private

Private providers can prescribe any of these medicines within their licences after an assessment by a registered prescriber. Check that a provider is registered with the General Pharmaceutical Council (GPhC) or the Care Quality Commission (CQC). See getting weight loss injections online safely.

Cost: what affects it

We do not quote prices. Factors affecting private costs include:

• Generic competition. Generic liraglutide may be priced differently from branded medicines, and prices can change as more versions enter the market.
• Daily versus weekly supply. A month of daily liraglutide typically requires several pens plus needles; weekly medicines come in pens holding several doses.
• List prices of newer medicines. The UK list price of Mounjaro rose in September 2025, for example.
• Dose and what is included, such as consultations, support, needles, sharps bins and delivery.

Lower cost per month does not necessarily mean lower cost per kilogram lost, given the differences in average effect. See our prices page and the long-term cost of GLP-1 treatment.

Questions to ask your prescriber

• Given my health and goals, is liraglutide still a reasonable option for me, or would a newer medicine be more suitable?
• If I am on liraglutide now and doing well, is there a reason to change?
• If I switch, what starting dose would I use, and how long until I reach a maintenance dose?
• Are generic liraglutide pens used differently from Saxenda pens?
• How will we decide whether treatment is working?

When to speak to a professional

Speak to your GP, pharmacist or prescriber before starting, switching or stopping liraglutide or any other GLP-1 medicine. Tell them about all your medicines, including diabetes medicines and contraception, and any history of pancreatitis, gallbladder disease, kidney problems, thyroid cancer or eating disorders. Let them know if you are pregnant, planning pregnancy or breastfeeding.

Seek urgent medical help through NHS 111, or call 999 in an emergency, if you experience:

• Severe, persistent abdominal pain, especially spreading to the back, with or without vomiting (possible pancreatitis)
• Pain in the upper right abdomen, fever, or yellowing of the skin or eyes (possible gallbladder problems)
• Vomiting or diarrhoea that stops you keeping fluids down, or signs of dehydration
• A fast or pounding heartbeat that does not settle
• Signs of a severe allergic reaction, such as swelling of the face or throat, or difficulty breathing

Report suspected side effects through the MHRA Yellow Card scheme. To compare regulated services, see our provider comparison.