Liraglutide

Dosing from the Literature

Published for fat loss: 3.0 mg a day (Saxenda), built up over 4 weeks, from the SCALE trials. Not published: nothing missing; the dose is on the label.

The FDA labels set the doses for weight management (Saxenda) and type 2 diabetes (Victoza). Both start at 0.6 mg a day and raise the dose at intervals of at least a week, to reduce the risk of gastrointestinal side effects (Saxenda and Victoza labels).

What It Is

Liraglutide is a once-daily, long-acting analog of the human glucagon-like peptide-1 (GLP-1) hormone. It was developed by Novo Nordisk under the code NN2211 and approved by the US FDA in January 2010 as Victoza for type 2 diabetes, then again in December 2014 as Saxenda at higher dose (3.0 mg/day) for chronic weight management in adults with obesity or overweight plus comorbidity (Saxenda label). In June 2019 it received pediatric approval for type 2 diabetes in patients aged 10+, and in December 2020 pediatric obesity approval for ages 12–17, as a Saxenda extension (Drugs@FDA).

Structurally, liraglutide is a 31-amino-acid GLP-1(7-37) analog with two key modifications: a single amino acid substitution (Lys34→Arg34) and a C16 palmitic acid chain attached at Lys26 via a glutamoyl spacer. The fatty acid serves two pharmacokinetic functions — it enables reversible binding to serum albumin (extending plasma half-life from native GLP-1's ~2 minutes to liraglutide's ~13 hours), and it slows absorption from the SubQ depot. The Arg34 substitution leaves Lys26 as the only lysine for the fatty acid, which allowed a semi-recombinant manufacturing process; liraglutide’s protection from DPP-4 breakdown, which is partial, may come from the albumin binding or from steric hindrance (Knudsen & Lau, 2019). Together these modifications make liraglutide the first commercially viable once-daily GLP-1 receptor agonist.

Liraglutide's clinical history matters because it is the bridge between the older twice-daily exenatide (Byetta, 2005) and the modern once-weekly GLP-1 era that began with weekly exenatide (Bydureon, 2012) and exploded with semaglutide (Ozempic 2017, Wegovy 2021). Liraglutide is the daily-dosing "second generation" — better tolerability and stronger glycemic effect than twice-daily exenatide, but requiring more injections than the weekly compounds that followed. LEADER (Marso et al., NEJM 2016) was the first trial to document a reduction in cardiovascular risk with a GLP-1 drug (Knudsen & Lau, 2019).

The SCALE program established liraglutide 3.0 mg as a foundational obesity intervention. SCALE Obesity and Prediabetes (Pi-Sunyer et al., NEJM 2015; PMID 26132939) showed 8.0% mean weight loss at 56 weeks vs 2.6% placebo in 3,731 patients without diabetes. SCALE Diabetes (Davies et al., JAMA 2015) showed 6.0% in T2D patients. SCALE Maintenance (Wadden 2013) extended these effects. Subsequent trials extended the indication to adolescents (Kelly et al., NEJM 2020; PMID 32233338) and most recently to children 6 to under 12 years of age with obesity (NEJM 2024–2025).

Mechanism of Action

Liraglutide is a GLP-1 receptor agonist that shares 97% of its amino acid sequence with the body’s own GLP-1(7-37). Like native GLP-1, it binds to and activates the GLP-1 receptor (GLP-1R); unlike native GLP-1, which lasts 1.5 to 2 minutes in the blood, it is stable against breakdown by DPP-4 and neutral endopeptidases and has a half-life of about 13 hours (Saxenda label). GLP-1 receptor agonists act through this receptor, which is found in the pancreas, gut, heart, lungs, kidneys and brain (Knudsen & Lau, 2019).

• Pancreatic β-cell GLP-1R activation — Glucose-dependent insulin secretion: in beta cells, liraglutide raises cyclic AMP, so insulin is released when glucose is high and the release subsides as glucose falls toward normal (Victoza label). Unlike most glucose-lowering drugs, GLP-1 receptor agonists act in this glucose-dependent way (Buse et al., 2009).
• Glucagon suppression — GLP-1 receptor agonists lower glucagon secretion in a glucose-dependent way, which in turn lowers the liver’s glucose output; whether they act on α-cells directly or through other islet cells is still debated (Knudsen & Lau, 2019). A single dose of liraglutide did not blunt the glucagon response to low blood sugar (Victoza label).
• CNS appetite suppression (arcuate nucleus, area postrema) — In mice, liraglutide injected under the skin reached the area postrema and other circumventricular organs and a few hypothalamic sites, including the arcuate nucleus, where it entered GLP-1R-expressing POMC/CART neurons; it did not broadly cross the blood–brain barrier. In rats, 28 days of liraglutide raised CART, but not POMC, gene expression there; the authors propose this as how it increases satiety (Knudsen & Lau, 2019).
• Gastric emptying delay — Liraglutide delays gastric emptying, slowing the rate at which glucose from a meal reaches the blood (Victoza label). Long-acting GLP-1 drugs such as liraglutide have less effect on gastric emptying than short-acting ones, little of it remains at steady state, and the authors judge slower emptying unlikely to be how these drugs cut food intake (Knudsen & Lau, 2019).
• Weight loss via lower calorie intake — Liraglutide lowers body weight by reducing calorie intake, not by raising 24-hour energy expenditure (Saxenda label); in a 5-week study, energy intake fell 16% vs placebo (Knudsen & Lau, 2019). In SCALE, weight fell 8.0% on liraglutide vs 2.6% on placebo at 56 weeks (Pi-Sunyer et al., 2015); both groups were counseled on a diet about 500 kcal a day below their needs and on exercise (Saxenda label).
• Cardiovascular protection — LEADER demonstrated 13% reduction in MACE (CV death, nonfatal MI, nonfatal stroke) over a median 3.8 years in T2D patients at high cardiovascular risk (Marso et al., 2016). The mechanism has not been established: the differences in HbA1c, weight and systolic blood pressure in LEADER seem too small to explain it, and the consistent effect on all three event types led to the hypothesis that liraglutide acts on underlying atherosclerosis; in atherosclerosis-prone mice, it slowed plaque development (Knudsen & Lau, 2019).
• Renal protection — In LEADER’s prespecified kidney analysis, the composite kidney outcome occurred in fewer people on liraglutide than on placebo (268 of 4,668 vs 337 of 4,672; HR 0.78), driven mainly by fewer new cases of persistent macroalbuminuria (Mann et al., 2017).
• Albumin binding (PK feature, not mechanism) — The C16 fatty acid lets liraglutide bind albumin reversibly (Knudsen & Lau, 2019). More than 98% is bound to plasma protein; with slow absorption from self-association under the skin and stability against DPP-4 and NEP, this gives a half-life of about 13 hours (Saxenda label).
• Brain access — In animal studies, liraglutide given under the skin reached brain regions that regulate appetite, including the hypothalamus (Saxenda label). GLP-1 receptors in the brain and in the pancreas have been shown to account for liraglutide’s effects on body weight and on glucose control, respectively; in one animal study, knocking down brain GLP-1 receptors almost abolished its weight effect (Knudsen & Lau, 2019).

What the Research Shows

Liraglutide has one of the deepest clinical trial datasets of any chronic-use peptide drug. Major published trials:

• LEAD program (T2D approval, 2007–2010) — Six pivotal Phase 3 trials (LEAD-1 through LEAD-6) establishing T2D efficacy and safety. Basis for 2010 Victoza approval.
• SCALE Obesity and Prediabetes (Pi-Sunyer et al., NEJM 2015; PMID 26132939) — 56-week double-blind RCT in 3,731 non-diabetic adults with BMI ≥30 or ≥27 with comorbidity. Liraglutide 3.0 mg: −8.0% body weight; placebo −2.6%. ≥5% loss in 63%, >10% in 33%. Basis for Saxenda approval.
• SCALE Diabetes (Davies et al., JAMA 2015) — 56-week RCT in T2D patients. 6.0% weight loss at 3.0 mg vs 2.0% placebo, plus HbA1c improvement.
• SCALE Maintenance (Wadden et al., 2013) — Liraglutide for weight maintenance after prior weight loss. Reduced regain vs placebo.
• LEADER (Marso et al., NEJM 2016; PMID 27295427) — Cardiovascular outcomes trial in 9,340 T2D patients with established or high CV risk. Median 3.8 years follow-up. Primary MACE: 13.0% liraglutide vs 14.9% placebo, HR 0.87 (P<0.001 noninferiority, P=0.01 superiority). All-cause mortality 8.2% vs 9.6%, HR 0.85 (P=0.02). Defining CV outcome trial for the GLP-1 class.
• LEADER renal (Mann et al., NEJM 2017) — Reduced incidence of new or worsening nephropathy with liraglutide.
• Pediatric T2D (Tamborlane et al., NEJM 2019) — Liraglutide in 134 patients aged 10–17. HbA1c improvement vs placebo. Basis for pediatric T2D approval.
• Pediatric obesity 12–17 (Kelly et al., NEJM 2020; PMID 32233338) — 56-week RCT in 251 adolescents with obesity. Liraglutide 3.0 mg produced significant BMI standard deviation score reduction vs placebo. Basis for adolescent obesity approval.
• Children 6 to <12 years (NEJM 2024–2025) — Most recent pediatric expansion. Liraglutide in younger children with obesity; favorable BMI reduction; basis for further label expansion.
• Healthy weight maintenance with exercise (Lundgren et al., NEJM 2021) — After diet-induced weight loss, liraglutide alone or combined with exercise was superior to placebo for maintaining weight loss at 1 year. Combined arm best.
• Real-world effectiveness — Multiple registry studies and meta-analyses confirm trial-level effects translate to clinical practice, with attrition and adherence as the main real-world limitations.
• Long-term safety (LEADER) — Over a median 3.8 years, pancreatitis was nonsignificantly less common on liraglutide than on placebo (Marso et al., 2016). In the adult Saxenda trials, acute pancreatitis was confirmed in 0.3% on liraglutide vs 0.1% on placebo (Saxenda label).

Human Data

Liraglutide has been administered to hundreds of thousands of patients across 15+ years of approved use. Key human datasets:

• LEAD-1 through LEAD-6 (T2D Phase 3) — Six pivotal trials supporting 2010 Victoza approval.
• SCALE Obesity and Prediabetes — 3,731 patients, 56 weeks. Pi-Sunyer 2015.
• SCALE Diabetes — Davies 2015. 56 weeks in T2D obesity.
• SCALE Maintenance — Wadden 2013. Post-weight-loss maintenance.
• SCALE Sleep Apnea — Liraglutide in obstructive sleep apnea.
• LEADER — 9,340 high-CV-risk T2D patients. 3.8-year median follow-up. Marso 2016.
• LEADER subanalyses — Renal (Mann 2017), prior MI/stroke subgroups, heart failure subgroups.
• Pediatric T2D approval trial (Tamborlane 2019) — 134 patients aged 10–17.
• Adolescent obesity (Kelly 2020) — 251 patients aged 12–17.
• Children 6–<12 obesity (2024–2025) — Most recent label expansion trial.
• Maintenance with exercise (Lundgren 2021) — Combined liraglutide + exercise after diet-induced weight loss.
• Real-world registry data — Multiple post-approval studies confirm effectiveness in routine clinical use.

Reconstitution & Storage

Saxenda and Victoza come as prefilled, single-patient-use pens with nothing to mix. Each pen holds 18 mg of liraglutide in 3 mL of solution (6 mg/mL) (Saxenda and Victoza labels).

• Injection sites — The labels list the abdomen, thigh or upper arm, rotating sites within the same region to reduce the risk of cutaneous amyloidosis (Saxenda and Victoza labels). Practitioner reports also describe rotating sites to prevent lipohypertrophy.
• Daily timing — The labels list one injection a day at any time of day, with or without meals; changing the time needs no dose change (Saxenda and Victoza labels). User reports describe injecting in the evening or at bedtime to sleep through any nausea.
• Missed dose — The labels describe going on with the next scheduled dose, with no extra dose to make up; after more than 3 days without a dose, they restart at 0.6 mg (Saxenda and Victoza labels).
• Needle — Pen needles are sold separately; the Saxenda pen takes disposable needles up to 8 mm long, and both labels describe a new needle for each injection (Saxenda and Victoza labels).
• Inspection — The solution is clear and colorless; the labels say to use it only if it is clear, colorless and free of particles (Saxenda and Victoza labels).

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Side Effects & Risks

The Saxenda label’s safety data come from five placebo-controlled trials in which 3,384 adults took liraglutide 3 mg for up to 56 weeks, and one 56-week trial in 125 adolescents (Saxenda label).

• Nausea — The most common side effect: 39% of adults on Saxenda 3 mg vs 14% on placebo, and 42% of adolescents vs 14%; the share reporting nausea declined as treatment continued (Saxenda label). On Victoza, 18–20% vs 5% on placebo (Victoza label).
• Vomiting — 16% of adults on Saxenda 3 mg vs 4% on placebo, and 34% of adolescents vs 4% (Saxenda label); 6–9% on Victoza vs 2% (Victoza label).
• Diarrhea / constipation — Diarrhea in 21% of adults on Saxenda 3 mg vs 10% on placebo, and constipation in 19% vs 9% (Saxenda label).
• Injection site reactions — 14% of adults on Saxenda vs 11% on placebo, most often redness, itching or rash at the site (Saxenda label); fewer than 0.2% of people on Victoza stopped because of them (Victoza label).
• Heart rate elevation — In adults, resting heart rate rose 2–3 beats per minute on average more than on placebo, and 34% on Saxenda vs 19% on placebo had a rise of more than 10 beats per minute at two visits in a row; in adolescents it rose 3–7 beats per minute from baseline. The label calls for checking heart rate at regular intervals and stopping Saxenda if resting heart rate stays raised (Saxenda label).
• Hypoglycemia — More likely when liraglutide is used with insulin or a sulfonylurea; the labels note the risk may be lowered by reducing the dose of those drugs. In the Saxenda trial in adults with type 2 diabetes, glucose fell below 54 mg/dL in 28% of those on a sulfonylurea vs 13% on placebo. In adolescents without diabetes, symptomatic glucose below 70 mg/dL occurred in 15% on Saxenda vs 4% on placebo (Saxenda label).
• Pancreatitis — A warning on the labels, not a boxed warning: acute pancreatitis, including fatal hemorrhagic or necrotizing cases, has been seen with GLP-1 receptor agonists, and the labels direct stopping liraglutide if it is suspected (Saxenda and Victoza labels). In the adult Saxenda trials, acute pancreatitis was confirmed in 0.3% on liraglutide vs 0.1% on placebo (Saxenda label); in LEADER it was nonsignificantly less common on liraglutide than on placebo (Marso et al., 2016).
• Gallbladder disease — In the adult Saxenda trials, gallstones were reported in 2.2% on liraglutide vs 0.8% on placebo and cholecystitis in 0.8% vs 0.4%; most of those affected needed their gallbladder removed. Rapid weight loss raises gallstone risk, but the excess held even after accounting for weight lost (Saxenda label). In LEADER, 3.1% on Victoza vs 1.9% on placebo had an acute gallbladder event (Victoza label).
• MTC / thyroid C-cell warning — Boxed warning: liraglutide causes thyroid C-cell tumors in rats and mice, and whether it does so in people is unknown; the data from cases of medullary thyroid carcinoma (MTC) reported since approval are insufficient to establish or exclude a link. A personal or family history of MTC, or MEN 2, is a contraindication (Saxenda and Victoza labels).
• Pregnancy — In animal studies, liraglutide was teratogenic in rats at 0.8 times or more of the human exposure at 3 mg a day, and caused major fetal abnormalities in rabbits at exposures below it. The Saxenda label says it may cause fetal harm and directs stopping it once pregnancy is recognized, since weight loss offers no benefit in pregnancy (Saxenda label).
• Renal events — Acute kidney injury, sometimes needing dialysis, has been reported since approval, mostly in people dehydrated by nausea, vomiting or diarrhea; the labels call for monitoring kidney function in people with such side effects, especially while the dose is being raised (Saxenda and Victoza labels). In LEADER, kidney adverse events occurred at similar rates on liraglutide and placebo (Mann et al., 2017).
• Drug interactions — Liraglutide delays gastric emptying, which may affect the absorption of other oral drugs; in clinical pharmacology studies it did not change the absorption of the drugs tested to any clinically relevant degree. With an oral contraceptive, peak levels fell 12–13% while total exposure was unchanged or up to 18% higher (Saxenda label).

What to Expect — Timeline

• Non-responders — In the two largest Saxenda trials, 25% of people on liraglutide had lost less than 4% of their weight by week 16, and 35% less than 5% (EMA assessment report, 2015). The US label calls for stopping in adults who have not lost at least 4% by week 16, since lasting, meaningful loss is then unlikely, and in adolescents whose BMI has not fallen at least 1% after 12 weeks on the maintenance dose (Saxenda label).

Quick Compare — Liraglutide vs Semaglutide vs Tirzepatide vs Retatrutide

How they compare:

• Liraglutide vs semaglutide — In STEP 8, weight fell 15.8% on weekly semaglutide 2.4 mg vs 6.4% on daily liraglutide 3.0 mg over 68 weeks (Rubino et al., 2022).
• Pediatric use — In the US, Saxenda is approved for weight management from age 12, in children who weigh more than 60 kg, and Victoza for type 2 diabetes from age 10 (Saxenda and Victoza labels). In the EU, Saxenda’s label also covers children 6 to under 12 with obesity who weigh at least 45 kg (EU product information).
• Cost / access — Liraglutide can be modestly cheaper than newer competitors in some insurance contexts and is often the first GLP-1 covered for obesity in tighter formularies.

→ See semaglutide profile  •  → See tirzepatide profile  •  → See retatrutide profile

Practical User Notes

• Bedtime dosing — User reports describe evening or bedtime dosing as easier to tolerate, sleeping through the nausea after the injection.
• Protein first — User reports describe eating 30–40 g of protein at the first meal of the day, before appetite suppression makes more eating difficult.
• Fluids — The Medication Guide says drinking fluids helps reduce the chance of dehydration from nausea, vomiting or diarrhea, which can lead to kidney problems (Saxenda label).
• With insulin or a sulfonylurea — The labels note a higher risk of low blood sugar, which may be lowered by reducing the dose of those drugs, and describe giving Victoza and insulin as separate injections, never mixed (Saxenda and Victoza labels).
• Pen technique — The labels describe a new needle for each injection, rotating injection sites, a flow check before the first injection with each new pen (not before every dose), and never sharing a pen, even with a new needle (Saxenda and Victoza labels).
• Regain after stopping — In the adolescent trial, BMI standard-deviation score rose more in the 26 weeks after liraglutide was stopped than after placebo was stopped (Kelly et al., 2020).
• Warning signs on the label — Severe stomach pain that will not go away, sometimes reaching the back (pancreatitis); upper-stomach pain, fever, yellow skin or eyes, or clay-colored stools (gallbladder); a racing or pounding heartbeat at rest that lasts several minutes; nausea, vomiting or diarrhea that will not stop (dehydration and kidney problems); a lump or swelling in the neck, hoarseness, trouble swallowing or shortness of breath (thyroid tumors) (Saxenda label).

Bloodwork & Monitoring

What the FDA labels list, what the trials measured, and what practitioner protocols describe; the labels set no routine schedule of blood tests:

• Metabolic panel and kidney function — Practitioner protocols describe a baseline metabolic panel (liver, kidney, glucose), repeated at 3, 6 and 12 months. The labels call for monitoring kidney function in people with nausea, vomiting or diarrhea that could dehydrate them, especially while the dose is being raised (Saxenda and Victoza labels).
• Blood glucose and HbA1c — In adults with type 2 diabetes, the Saxenda label calls for monitoring blood glucose before starting and during treatment (Saxenda label). Change in HbA1c was the primary end point of LEAD-3, LEAD-6 and the pediatric Victoza trial (Garber et al., 2009; Buse et al., 2009; Tamborlane et al., 2019).
• Amylase / lipase — Measured routinely in the Saxenda trials: lipase reached 3 times the upper limit of normal at some point in 2.1% on liraglutide vs 1.0% on placebo; the label calls the significance of such rises unknown without other signs of pancreatitis (Saxenda label).
• Calcitonin or thyroid ultrasound — The labels call routine calcitonin or thyroid ultrasound monitoring of uncertain value for finding medullary thyroid cancer early, since it may lead to unnecessary procedures (Saxenda and Victoza labels).
• Heart rate — The Saxenda label calls for checking heart rate at regular intervals; resting heart rate rose 2–3 beats per minute on average vs placebo in adults (Saxenda label).

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References

1. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, Lau DC, le Roux CW, Violante Ortiz R, Jensen CB, Wilding JP; SCALE Obesity and Prediabetes NN8022-1839 Study Group. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015;373(1):11-22. PMID: 26132939. DOI: 10.1056/NEJMoa1411892.
2. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB; LEADER Steering Committee. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016;375(4):311-322. PMID: 27295427. DOI: 10.1056/NEJMoa1603827.
3. Mann JFE, Ørsted DD, Brown-Frandsen K, Marso SP, Poulter NR, Rasmussen S, Tornøe K, Zinman B, Buse JB; LEADER Steering Committee and Investigators. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med. 2017;377(9):839-848. PMID: 28854085.
4. Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, Andreasen AH, Jensen CB, DeFronzo RA; NN8022-1922 Study Group. Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes: The SCALE Diabetes Randomized Clinical Trial. JAMA. 2015;314(7):687-699. PMID: 26284720.
5. Wadden TA, Hollander P, Klein S, et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study. Int J Obes (Lond). 2013;37(11):1443-1451. PMID: 23812094.
6. Kelly AS, Auerbach P, Barrientos-Perez M, Gies I, Hale PM, Marcus C, Mastrandrea LD, Prabhu N, Arslanian S; NN8022-4180 Trial Investigators. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity. N Engl J Med. 2020;382(22):2117-2128. PMID: 32233338.
7. Tamborlane WV, Barrientos-Pérez M, Fainberg U, et al. Liraglutide in Children and Adolescents with Type 2 Diabetes. N Engl J Med. 2019;381(7):637-646. PMID: 31034184.
8. Lundgren JR, Janus C, Jensen SBK, et al. Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined. N Engl J Med. 2021;384(18):1719-1730. PMID: 33951361.
9. Garber A, Henry R, Ratner R, et al. Liraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono). Lancet. 2009;373(9662):473-481. PMID: 18819705.
10. Buse JB, Rosenstock J, Sesti G, et al. Liraglutide once a day versus exenatide twice a day for type 2 diabetes (LEAD-6). Lancet. 2009;374(9683):39-47. PMID: 19515413.
11. Astrup A, Rössner S, Van Gaal L, et al. Effects of liraglutide in the treatment of obesity: a randomised, double-blind, placebo-controlled study. Lancet. 2009;374(9701):1606-1616. PMID: 19853906.
12. Marso SP, Baeres FMM, Bain SC, et al. Effects of Liraglutide on Cardiovascular Outcomes in Patients With Diabetes With or Without Heart Failure (LEADER substudy). J Am Coll Cardiol. 2020;75(13):1505-1517. PMID: 32164886.
13. Rubino DM, Greenway FL, Khalid U, et al. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes (STEP 8). JAMA. 2022;327(2):138-150. PMID: 35015037. (Head-to-head sema vs lira.)
14. Iepsen EW, Lundgren J, Holst JJ, Madsbad S, Torekov SS. Successful weight loss maintenance includes long-term increased meal responses of GLP-1 and PYY3-36. Eur J Endocrinol. 2016;174(6):775-784. PMID: 26976129.
15. Knudsen LB, Lau J. The Discovery and Development of Liraglutide and Semaglutide. Front Endocrinol (Lausanne). 2019;10:155. PMID: 31031702. (Comprehensive Novo Nordisk discovery review.)
16. FDA. Saxenda (liraglutide) prescribing information. December 2014, updated periodically.
17. FDA. Victoza (liraglutide) prescribing information. January 2010, updated periodically.
18. NICE. Liraglutide for the treatment of type 2 diabetes mellitus and weight management. UK National Institute for Health and Care Excellence guidance documents.
19. EMA. Saxenda and Victoza European Public Assessment Reports.
20. Fox CK, Barrientos-Pérez M, Bomberg EM, et al. Liraglutide for Children 6 to <12 Years of Age with Obesity — A Randomized Trial. N Engl J Med. 2025;392(6):555-565. doi:10.1056/NEJMoa2407379. PMID: 39258838. (Pediatric obesity expansion data.)
21. FDA. Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the FD&C Act (503A categories list), versions updated April 15, April 22 and May 14, 2026. fda.gov/media/94155/download. Read October 3, 2026. (Notice that 12 peptides would leave Category 2 because their nominations were withdrawn; their removal; GHK-Cu, except injectable, back in Category 1.)
22. FDA. List of Bulk Drug Substances for Which There Is a Clinical Need Under Section 503B of the Federal Food, Drug, and Cosmetic Act (notice). Federal Register, 91 FR 23431–23444, May 1, 2026; FR Doc. 2026-08552; Docket No. FDA-2018-N-3240. federalregister.gov/documents/2026/05/01/2026-08552/list-of-bulk-drug-substances-for-which-there-is-a-clinical-need-under-section-503b-of-the-federal. Comment period extended to July 30, 2026: 91 FR 38719, June 26, 2026; FR Doc. 2026-12937. Read October 3, 2026. (Proposes not to include semaglutide, tirzepatide and liraglutide on the 503B bulks list; lists the approved liraglutide products: Victoza and Saxenda (NDAs) and generic liraglutide (ANDAs); notes that section 503B separately allows compounding from bulk while a drug is on FDA’s shortage list.)
23. FDA. Drug Shortages database: Liraglutide Injection (Currently in Shortage; date first posted July 18, 2023; presentations updated August 27 to September 22, 2026). accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Liraglutide%20Injection&st=c. Read October 3, 2026.
24. Blonde L, Belousova L, Fainberg U, et al. Liraglutide as add-on to sodium-glucose co-transporter-2 inhibitors in patients with inadequately controlled type 2 diabetes: LIRA-ADD2SGLT2i, a 26-week, randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2020;22(6):929-937. PMID: 31984646. DOI: 10.1111/dom.13978.
25. Jastreboff AM, Kaplan LM, Davies MJ, et al. Retatrutide, a Triple Hormone Receptor Agonist, for Treatment of Obesity (TRIUMPH-1). N Engl J Med. 2026 (published online September 29, 2026). PMID: 42814954. DOI: 10.1056/NEJMoa2604169.
26. Eli Lilly and Company. Lilly’s triple agonist, retatrutide, successful in two additional Phase 3 obesity trials, delivering significant improvements in weight and A1C. Press release, July 23, 2026 (PR Newswire). prnewswire.com/news-releases/lillys-triple-agonist-retatrutide-successful-in-two-additional-phase-3-obesity-trials-delivering-significant-improvements-in-weight-and-a1c-302832674.html. Read October 4, 2026.
27. Nicholls SJ, Pavo I, Bhatt DL, Buse JB, Del Prato S, Kahn SE, Lincoff AM, McGuire DK, Miller D, Nauck MA, Nishiyama H, Nissen SE, Sattar N, Weerakkody G, Wiese RJ, Zinman B, Zoungas S, Basile J, Davies MJ, Giorgino F, Kellerer M, Ji L, Varkonyi T, Menon V, Broder JC, Herschtal A, D'Alessio D; SURPASS-CVOT Investigators. Cardiovascular Outcomes with Tirzepatide versus Dulaglutide in Type 2 Diabetes. N Engl J Med. 2025;393(24):2409-2420. PMID: 41406444.

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