Saxenda® (liraglutide 3mg once daily)

Saxenda® (liraglutide 3mg once daily)

Saxenda® is a medication used in the management of obesity. It contains the active ingredient liraglutide, which is a glucagon-like peptide-1 (GLP-1) receptor agonist. It has 97% amino acid homology to human endogenous GLP-1 (see also the GLP-1 topic).

 

Saxenda® is indicated as an adjunct to a reduced-calorie diet and increased physical activity for weight management in adult patients with an initial body mass index (BMI) of:

  • ≥30 kg/m² (obesity), or
  • ≥27 kg/m² to <30 kg/m² (overweight) in the presence of at least one weight-related comorbidity such as dysglycaemia (pre-diabetes or type 2 diabetes mellitus), hypertension, dyslipidaemia or obstructive sleep apnoea

Titration

  • The starting dose is 0.6mg once daily. The dose should be titrated to 3mg once daily in increments of 0.6 weekly.
  • The dose should be increased to 3.0 mg daily in increments of 0.6 mg with a minimum of a 1-week interval between incremental increases to improve gastrointestinal tolerability (see below)
  • If escalation to the next dose step is not tolerated for 2 weeks consecutively, consider discontinuing treatment
  • Treatment with Saxenda® should be discontinued after 12 weeks on the 3.0 mg/day dose if patients have not lost at least 5% of their initial body weight.

Missed doses:

If a dose is missed within 12 hours from when it is usually taken, the patient should take the dose as soon as possible. If there is less than 12 hours to the next dose, the patient should not take the missed dose and resume the once-daily regimen with the next scheduled dose.

How are Saxenda®and Wegovy®different?

Saxenda® (liraglutide 3mg) and Wegovy® (semaglutide 2.4mg) are different molecules, which are both GLP-1 RAs. Saxenda® is taken as a once-daily injection, whilst Wegovy® is a once-weekly  injection.

Treatment with semaglutide 2.4mg (in the STEP clinical trials) resulted in weight loss of 15% sustained over 68 weeks for people with obesity. Across all the SCALE® clinical trials – assessing the safety and efficacy of Saxenda® for weight management in conjunction with reduced calorie intake and increased physical activity – people with overweight or obesity treated with Saxenda® achieved superior weight loss compared with placebo, and a greater proportion of people achieved ≥5% and >10% weight loss. Saxenda® was the first obesity medication to have been approved by NICE for use on the NHS in 10 years.

References:

  1. EMA. Wegovy Summary of Product Characteristics. Available at: https://www.ema.europa.eu/en/documents/product-information/wegovy-epar-product-information_en.pdf
  2. EMA. Saxenda Summary of Product Characteristics. Available at: https://www.ema.europa.eu/en/medicines/human/EPAR/saxenda
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