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Liraglutide31 residuesHAEGTFTSDVSSYLEGQAAKEFIAWLVKGRGEach bubble = one amino acid. Size = residue mass. Color = chemical class.Also known as: Victoza, Saxenda, NN2211
Over 9,300 patients in the LEADER trial. A 13% drop in major cardiovascular events. Liraglutide (Victoza, Saxenda) is a GLP-1 receptor agonist with two FDA approvals and more than 15 years of real-world safety data. The SCALE trial landed on 8% mean weight loss at 56 weeks with the 3 mg dose. That's less than semaglutide, and honesty about that matters. Liraglutide's 13-hour half-life means side effects wash out in about a day if you stop. That short clearance time is why many clinicians still reach for it first, especially for patients new to GLP-1 therapy or those with a history of GI sensitivity.
A 13% reduction in heart attacks, strokes, and cardiovascular death across 9,340 patients over 3.8 years. That LEADER trial finding [1] made liraglutide the first GLP-1 drug proven to protect the heart. Liraglutide (also sold as Victoza for diabetes and Saxenda for weight management) is a modified version of human GLP-1 with 97% amino acid homology to the native hormone. A palmitic acid chain at position 26 lets it bind albumin in the blood. That binding shields it from DPP-IV breakdown and extends the half-life from about 2 minutes to roughly 13 hours, long enough for once-daily dosing. On the weight side, the SCALE Obesity and Prediabetes trial (n=3,731)[2] showed 8.0% mean body weight loss at 56 weeks on the 3 mg dose versus 2.6% on placebo. A head-to-head comparison in STEP 8 (PMC8753508) put those numbers in context: semaglutide 2.4 mg weekly produced 15.8% loss versus 6.4% for liraglutide 3 mg daily over 68 weeks. The practical picture for most users looks like this: a pre-filled pen (no mixing needed), weekly dose increases from 0.6 mg up to 3.0 mg, and GI side effects that peak during titration but usually settle within a few weeks. Appetite suppression kicks in within days of the first injection. Teva's generic launched in August 2025, bringing costs down from brand Saxenda pricing (~$1,300 to $1,800 per month) to roughly $1,165 per month, with compounded options running $150 to $249.
A C-16 fatty acid (palmitic acid) attached via a glutamic acid spacer at position 26. That single modification gives liraglutide its clinical utility. The palmitic acid promotes non-covalent binding to serum albumin, which does two things: it shields the molecule from DPP-IV and neutral endopeptidase degradation, and it slows absorption from the subcutaneous injection site. Native GLP-1 has a plasma half-life of about 2 minutes. Liraglutide's is roughly 13 hours. Once circulating, liraglutide activates GLP-1 receptors across multiple tissues. In the pancreas, it boosts glucose-dependent insulin secretion and suppresses inappropriate glucagon release. The glucose-dependent part is important; hypoglycemia risk stays low when liraglutide is used alone because insulin release only ramps up when blood sugar is raised. In the GI tract, gastric emptying slows by 10 to 15%. In the brain, liraglutide acts on hypothalamic and brainstem GLP-1 receptors to reduce appetite and food reward signaling. The cardiovascular protection spotted in LEADER [1] likely involves direct effects on vascular endothelial function and anti-inflammatory pathways, though the exact mechanisms are still being mapped out.
FDA-approved for chronic weight management (Saxenda, 3 mg/day) and type 2 diabetes (Victoza, up to 1.8 mg/day). Strong RCT evidence for ~8% weight loss at 56 weeks and 13% MACE reduction in high-CV-risk T2D. Well-characterized safety profile after 15+ years on market. Less effective than semaglutide or tirzepatide for weight loss.
SCALE Obesity and Prediabetes (PMID 25673007): n=3,731, 3 mg/day vs placebo, 56 wk: 8.0% vs 2.6% mean weight loss. LEADER (PMID 27295427): n=9,340 T2D high-CV-risk, 3.8-yr median follow-up: 13% MACE reduction (HR 0.87, 95% CI 0.78-0.97). STEP 8 head-to-head (PMC8753508): semaglutide 2.4 mg/wk vs liraglutide 3 mg/day, 68 wk: −15.8% vs −6.4% weight loss.
Substantially less effective than semaglutide (-6.4% vs -15.8% in STEP 8) and tirzepatide. Daily injection vs once-weekly alternatives. Weight regain expected on discontinuation. Black box warning for medullary thyroid carcinoma (rodent data only; LEADER found 0 MTC in liraglutide arm vs 1 placebo). Slight numerical imbalance in total malignancies in LEADER (10.1% liraglutide vs 9.0% placebo, HR ~1.06, not statistically significant: clinical relevance unclear). Pancreatitis rate similar to placebo in LEADER.
Regarded as the "old reliable" GLP-1: effective, well-understood, and now accessible via generic and compounding. Most users follow the FDA titration closely. The daily injection and lower weight loss vs semaglutide drive switching; many transition to semaglutide or tirzepatide after experiencing or researching the options.
Community closely follows FDA titration protocol. Real-world outcomes (~5–8% weight loss at maintenance) are consistent with trial data. The primary divergence is that many community users elect to stay at sub-maximal doses (1.2–1.8 mg) rather than pushing to 3.0 mg: driven by tolerability, not ignorance of dosing. No significant off-label dose escalation patterns observed.
| Level | Dose / Injection | Frequency |
|---|---|---|
| Beginner | 600mcg | Daily |
| Moderate | 1,800mcg | Daily |
| Aggressive | 3mg | Daily |
Liraglutide comes as a pre-filled pen, so there's no reconstitution math to worry about. Saxenda pens hold 18 mg total and deliver doses from 0.6 mg to 3.0 mg via a dial selector. At the 3 mg maintenance dose, one pen lasts 6 days. For compounded liraglutide from 503A pharmacies, the common concentration is 6 mg/mL. With that concentration in a standard insulin syringe: 10 units equals 0.6 mg, 20 units equals 1.2 mg, 30 units equals 1.8 mg, 40 units equals 2.4 mg, and 50 units equals 3.0 mg. The thing most beginners miss: if you skip more than 3 consecutive days, you need to restart at 0.6 mg and re-titrate. Jumping back to your prior dose after a gap causes disproportionate GI distress. Keep your pens on schedule or plan for the ramp back up. Store unused pens in the fridge (2 to 8 degrees Celsius). Once you start using a pen, it can stay at room temperature (up to 30 degrees Celsius) for 30 days.
Designed for continuous long-term use. Weight regain expected after discontinuation. If you miss more than 3 consecutive days, restart at 0.6mg and re-titrate.
Liraglutide is an FDA-approved chronic weight management medication designed for continuous long-term use. Cycling is not recommended: discontinuation results in weight regain. The cyclingProtocol in peptides.ts (onWeeks: 52, offWeeks: 0) correctly reflects this. Users who stop liraglutide and wish to restart after a gap of >3 days should re-titrate from 0.6 mg to minimize GI side effects.
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Expected: ~8% mean body weight loss at 56 weeks (SCALE trial); real-world 5–8% typical
Monitor: Check fasting glucose, HbA1c, lipid panel, and gallbladder symptoms at baseline and 3–6 months. Monitor body weight at each visit. Screen for pancreatitis symptoms (severe abdominal pain radiating to back: stop immediately).
Remove the pen from the refrigerator 15 to 30 minutes before injecting. Room-temperature solution reduces injection discomfort.
It should be clear and colorless. Do not use if cloudy or if you see particles.
Remove both the outer and inner needle caps.
If using the pen for the first time or if it's been stored without a needle, prime by dialing to 0.6 mg and pressing the dose button until solution appears at the needle tip.
Titration schedule for Saxenda: 0.6 mg daily for week 1, 1.2 mg for week 2, 1.8 mg for week 3, 2.4 mg for week 4, then 3.0 mg ongoing.
Choose your injection site: abdomen or upper arm for best absorption. The thigh works but absorption drops by about 22%. Rotate sites; avoid the same spot for at least a week.
Pinch the skin, insert the needle at 90 degrees, press the dose button, and hold for 6 seconds before withdrawing.
Replace the pen cap. Never store the pen with a needle attached.
For compounded liraglutide (6 mg/mL concentration): draw 10 units on a standard insulin syringe for 0.6 mg, 20 units for 1.2 mg, 30 units for 1.8 mg, 40 units for 2.4 mg, or 50 units for 3.0 mg. Inject subcutaneously at the same sites. 29 to 31 gauge, half-inch needle.
Timing is flexible. Inject at the same time each day, with or without meals.
Community-reported fat-loss synergy: AOD-9604 targets adipose lipolysis via a different mechanism (GH fragment). No clinical interaction data; anecdotal stacking for additional fat mobilization.
Used by community to manage GLP-1-induced GI side effects. BPC-157 is a gut mucosal healing peptide; anecdotally reported to reduce liraglutide-related nausea and GI discomfort. No clinical trial data for this combination.
Amylin analog clinically studied in combination with semaglutide (CagriSema) for additive weight loss. Theoretical synergy with any GLP-1 including liraglutide: complementary mechanism via amylin receptor. No liraglutide-specific combo trial.
Research-stage only; no established human dosing for liraglutide + cagrilintide combination
Additive hypoglycemia risk. Liraglutide enhances glucose-dependent insulin secretion: combining with exogenous insulin substantially increases hypoglycemia risk. Dose reduction of insulin required if used together.
Do not combineAdditive hypoglycemia risk from dual insulin secretagogue effect. Reduce sulfonylurea dose when adding liraglutide.
Do not combineLiraglutide reduces OCP Cmax by ~12% due to slowed gastric emptying. Clinical significance is low but OCP should be taken at least 1 hour before liraglutide injection per FDA label.
Liraglutide reduces digoxin AUC by ~16% and Cmax by ~31% via delayed gastric emptying. Monitor digoxin levels if co-administering.
Pricing updated 2026-04-09
Liraglutide carries a black box warning for medullary thyroid carcinoma. In rodent studies, liraglutide caused dose-dependent thyroid C-cell tumors at exposures 8 times the human dose. No confirmed human cases appeared in the LEADER trial (0 MTC in the liraglutide arm versus 1 in placebo, n=9,340). Still, the warning makes liraglutide off-limits for anyone with a personal or family history of MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN2). GI side effects are the most common reason people quit. Nausea hits roughly 40% of users at the 3 mg dose. Vomiting, diarrhea, and constipation affect 15 to 20%. The pattern is predictable: symptoms peak during each dose increase and fade over 2 to 3 weeks at a stable dose. Slow titration (advancing by 0.6 mg per week as labeled) reduces the severity. Some community users extend to 2 weeks per step if nausea is severe. Pancreatitis occurs in under 0.4% of patients. The LEADER trial found rates similar to placebo, but the risk is real. Severe abdominal pain radiating to the back, with or without vomiting, means stop the drug and get evaluated immediately. Gallbladder disease showed up in about 2.2% of SCALE trial participants. GLP-1 receptor agonists slow gallbladder emptying, and rapid weight loss adds to gallstone risk. Right upper quadrant pain warrants an ultrasound. LEADER turned up a slight numerical imbalance in total malignancies (10.1% liraglutide versus 9.0% placebo, HR approximately 1.06). This was not statistically significant. The clinical meaning is unclear, but it was observed and should be noted. Hypoglycemia is rare when liraglutide is used alone. It becomes a genuine risk when combined with insulin or sulfonylureas; dose reductions of those medications are often needed. Injection site reactions are mild and infrequent. Hair thinning (telogen effluvium) shows up in community reports. This is driven by rapid weight loss rather than a direct drug effect. It's typically self-limiting. When to seek medical attention: severe abdominal pain, persistent vomiting, signs of allergic reaction, or any visual changes. Stop liraglutide at least 2 months before planned conception; the drug was detected in milk of lactating rats, and human data on infant risk are insufficient.
Verify Liraglutide dosing and safety with a second opinion
Brand-name Saxenda and Victoza are FDA-approved pre-filled pens with Novo Nordisk manufacturing quality controls: quality risk is minimal. Teva generic (launched August 2025) is FDA-approved and bioequivalent. Compounded liraglutide from 503A pharmacies (PCAB-accredited, COA-verified) represents low-to-medium risk: liraglutide remains on FDA shortage list permitting legitimate compounding, but quality depends entirely on the specific pharmacy.
| Test | When | Target |
|---|---|---|
| Body weight | Baseline, then monthly | — |
| Fasting glucose and HbA1c | Baseline, then every 3 months | HbA1c <7.0% (T2D), fasting glucose 70–100 mg/dL |
| Lipid panel | Baseline, then every 6 months | — |
| Liver function tests (AST, ALT) | Baseline, then every 6 months | — |
| Amylase / Lipase | If symptoms of pancreatitis develop (severe abdominal pain radiating to back, nausea/vomiting) | — |
| Gallbladder ultrasound | If right upper quadrant pain or cholecystitis symptoms develop | — |
| Heart rate | Each clinical visit | — |
| Serum calcitonin | Baseline and annually if monitoring thyroid cancer risk (family history of MTC or MEN2: though liraglutide is contraindicated in these patients) | — |
Primary efficacy measure; if <4% weight loss at 16 weeks on 3 mg, reassess therapy
For T2D patients or those with prediabetes. Liraglutide improves glycemic control even in non-diabetics
Weight loss and GLP-1 action improve triglycerides and LDL; monitor for gallbladder-related lipid changes
Not required by FDA label but prudent for long-term users given metabolic changes and fatty liver context
Pancreatitis risk exists with GLP-1 class; rate similar to placebo in LEADER but monitor for symptoms
Gallbladder disease incidence 2.2% in SCALE trial; GLP-1s slow gallbladder emptying
GLP-1 RAs modestly increase resting heart rate; relevant for patients with pre-existing arrhythmia or cardiac history
Black box warning for medullary thyroid carcinoma based on rodent data; no confirmed human cases in LEADER
Titration phase: dose increases weekly from 0.6mg to 2.4mg. Appetite suppression begins within days. Nausea most common but typically improves.
Full dose (3mg) reached. Noticeable reduction in hunger. Most see 2-4% body weight loss by week 8.
Steady weight loss of 0.5-1 lb per week. Blood sugar improvements measurable on labs.
Weight loss approaches 8% average from SCALE trial. Cardiovascular markers improve. Rate slows near equilibrium.
Weeks 1 through 4, Titration. The dose advances weekly from 0.6 mg to 2.4 mg. Appetite suppression is measurable by week 2 in most users. GI side effects peak during each dose step; nausea is the most common complaint and hits roughly 40% at therapeutic doses. Community reports consistently describe noticeably reduced appetite within 3 to 5 days of the first injection. Most people see 1 to 3 pounds of loss in the first month, driven by reduced caloric intake rather than any direct metabolic effect. Weeks 5 through 8, Full Dose. At 3.0 mg daily, GLP-1 receptor engagement reaches its maximum. SCALE trial data predicts 2 to 4% body weight loss by week 8. Users describe the reduction in "food noise" as the most noticeable change. Smaller portions feel satisfying. GI side effects typically start improving from their peak. Community reports land on 2 to 5 pounds of additional loss in this window. Constipation and fatigue are common but usually resolve. Mild nausea continues to diminish. Weeks 9 through 26, Active Loss Phase. Steady progressive weight loss averages 0.5 to 1 pound per week. Blood glucose improvements become measurable on lab work. SCALE data shows approximately 6% weight loss by week 26. Some users hit plateaus at the 1 to 2 month mark; these typically resolve with caloric adjustment or dose confirmation. Hair thinning (telogen effluvium from the weight loss itself, not a direct drug effect) may appear during this window. It is typically self-limiting. Weeks 27 through 56, Deceleration. The SCALE trial's primary endpoint sits here: 8.0% mean weight loss at 56 weeks. The rate of loss slows as the body adjusts to a new equilibrium. Cardiovascular markers, blood pressure, and lipid profiles continue to improve. Many community users transition to semaglutide or tirzepatide during this window if they want additional loss. Those who stay on liraglutide report satisfaction with maintained weight and improved metabolic markers. Cost becomes the primary concern at this stage. Gallstone risk increases with prolonged weight loss; cholecystitis occurred in roughly 2.2% of SCALE participants.
Dose advances weekly: 0.6 → 1.2 → 1.8 → 2.4 mg. Appetite suppression measurable by week 2. GI side effects peak during dose steps.
Nausea most common complaint. Appetite noticeably reduced within 3–5 days of first injection. Most see 1–3 lb loss in first month from reduced caloric intake.
At 3.0 mg, maximal GLP-1 receptor engagement. ~2–4% body weight loss expected by week 8 in SCALE trial data.
"Food noise" reduced. Smaller portions feel satisfying. GI side effects typically improving from peak. 2–5 lb loss reported in this window by most users.
Steady progressive weight loss at 0.5–1 lb/week average. Blood glucose improvements measurable. SCALE data shows ~6% weight loss by week 26.
Most users report consistent loss. Some plateau at 1–2 month marks: often resolve with caloric adjustment or dose confirmation. Hair thinning may appear (telogen effluvium from weight loss, typically self-limiting).
SCALE trial: 8.0% mean weight loss at 56 weeks. Rate slows as body adjusts. Cardiovascular markers, blood pressure, and lipid improvements continue.
Many users switch to semaglutide or tirzepatide in this window for additional loss. Those who stay report satisfaction with maintained weight and improved metabolic markers. Cost becomes the main issue at this stage.
Source: FDA Prescribing Information (Victoza), Section 12.3
Loading the interactive decay curve.
Liraglutide holds two active FDA approvals: Victoza (approved 2010) for type 2 diabetes at doses up to 1.8 mg daily, and Saxenda (approved 2014) for chronic weight management at 3.0 mg daily. Both are prescription-only medications. Teva Pharmaceuticals launched the first generic liraglutide injection in August 2025. It is FDA-approved and bioequivalent to the branded products. Additional generics are expected after February 2026 exclusivity expiry. Compounded liraglutide is available from 503A pharmacies while liraglutide remains on the FDA drug shortage list (active as of April 2026). PCAB-accredited compounding pharmacies offer prescription access, typically at $150 to $249 per month. Always request a Certificate of Analysis (COA) from compounded suppliers. Liraglutide is banned by the World Anti-Doping Agency (WADA) under the S2 category (peptide hormones, growth factors, and related substances) in competition. Athletes subject to anti-doping testing should verify current prohibited substance lists. This content is for educational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any peptide therapy.
Peptide Schedule Research TeamReviewed Apr 20267 Citations
