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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
If you have Type 2 diabetes, your endocrinologist or primary healthcare provider may have mentioned using an injectable medication to help control your blood sugar, or blood glucose. Ozempic (semaglutide) and Victoza (liraglutide) are two brand-name prescription medications used along with diet and exercise to control blood sugar in people with Type 2 diabetes. Both Ozempic and Victoza are made by Novo Nordisk and are approved by the U.S. Food and Drug Administration (FDA).
Ozempic and Victoza are injectable diabetes drugs but are not insulin. They are classified in a group of medications called glucagon-like peptide-1 agonists (GLP-1 agonists). Ozempic and Victoza work by helping prevent the liver from making and releasing too much sugar, and helping the pancreas release more insulin in response to high blood sugar. They also slightly delay gastric emptying, which helps control both appetite and postprandial (after a meal) blood sugar levels. They may aid weight loss, and may help to reduce body weight. Ozempic and Victoza also help with hemoglobin A1c (HbA1c) reduction, which is a measure of glucose control over time. Although both medications are GLP-1 agonists, they have some differences, which we will discuss below.
What are the main differences between Ozempic vs. Victoza
Ozempic and Victoza are both brand-name GLP-1 agonists that are available in prefilled pens. Ozempic contains the ingredient semaglutide, and Victoza contains liraglutide. Generic versions are not available at this time. Both are injected subcutaneously, under the skin of the abdomen (stomach), upper arm, or thigh. They are never injected into a muscle or vein. Ozempic is injected once weekly, and Victoza is injected every day.
Main differences between Ozempic and Victoza |
||
|---|---|---|
| Ozempic | Victoza | |
| Drug class | GLP-1 agonist | GLP-1 agonist |
| Brand/generic status | Brand | Brand |
| What is the generic name? | Semaglutide | Liraglutide |
| What form does the drug come in? | Prefilled injection pen | Prefilled injection pen |
| What is the standard dosage? | Starting dose: 0.25 mg SC* weekly. After 4 weeks, increase the dose to 0.5 mg SC weekly. If after 4 weeks, more control is needed, increase to 1 mg SC weekly. Maximum dosage is 1 mg weekly |
Adults Starting dose: 0.6 mg SC daily for 1 week, then increase to 1.2 mg SC daily. If after 4 weeks more control is needed, increase to 1.8 mg daily. Pediatric Starting dose: 0.6 mg SC daily for at least 1 week. If more control is needed, increase to 1.2 mg SC daily. If after 1 week of treatment with 1.2 mg daily, more control is needed, increase to 1.8 mg SC daily. Maximum dosage is 1.8 mg daily |
| How long is the typical treatment? | Varies | Varies |
| Who typically uses the medication? | Adults 18 years and older | Adults and children 10 years and older |
*SC means subcutaneous injection, which is an injection under the skin of the upper arm, abdomen, or thigh.
Conditions treated by Ozempic and Victoza
Ozempic or Victoza can be used along with diet and exercise to improve blood sugar control, also known as glycemic control, in people with Type 2 diabetes. Ozempic can be used in adults 18 years and older, and Victoza can be used in adults and children 10 years and older.
Ozempic or Victoza can also be used to lower the risk of major cardiovascular events, such as death, heart attack, or stroke, in adults with Type 2 diabetes who also have cardiovascular disease (heart disease).
Ozempic and Victoza are not indicated for the treatment of Type 1 diabetes.
| Condition | Ozempic | Victoza |
| Improve blood sugar control in people with Type 2 diabetes (along with diet and exercise) | Yes (in adults 18 years and older) | Yes (in adults and children 10 years and older) |
| Lower the risk of heart attack, stroke, and cardiovascular death in adults who have Type 2 diabetes and heart disease | Yes | Yes |
| Weight loss (in combination with diet and exercise) | Off-label | Off-label |
Is Ozempic or Victoza more effective?
A study comparing Ozempic and Victoza concluded that Ozempic was better than Victoza in terms of lowering HbA1C and weight; however, people who took Ozempic had more stomach-related side effects than people who took Victoza.
A 2019 review of studies was published in The Lancet. This study looked at Ozempic, Victoza, and other drugs in the GLP-1 agonist class. The study found that all of the drugs lowered the risk of heart problems, kidney problems, and death.
A consensus report by the American Diabetes Association and the European Association for the Study of Diabetes recommends a GLP-1 agonist as an option for people with Type 2 diabetes who have heart disease. This recommendation is based on evidence that GLP-1 agonists (or another drug class called SGLT2 inhibitors) improve cardiovascular outcomes as well as other outcomes such as kidney disease, in patients who have established heart or kidney disease.
The best drug for the patient, however, can only be determined by the healthcare provider, who can take into account the patient’s complete medical history.
Coverage and cost comparison of Ozempic vs. Victoza
Ozempic and Victoza are usually covered by insurance or Medicare prescription plans, but the copay will vary based on the plan. Contact your insurance provider for up-to-date coverage information.
A typical prescription of an Ozempic pen can cost around $1008, but you can use a free SingleCare card to lower the price to less than $750.
A typical prescription of a Victoza pen can cost about $1270, but a free SingleCare coupon can lower the price to approximately $910.
| Ozempic | Victoza | |
| Typically covered by insurance? | Usually—contact insurance provider for coverage information | Usually—contact insurance provider for coverage information |
| Typically covered by Medicare Part D? | Usually—contact insurance provider for coverage information | Usually—contact insurance provider for coverage information |
| Quantity | 1 prefilled injection pen | 1 prefilled injection pen |
| Typical Medicare copay | $25-$979 | $16-$1169 |
| SingleCare cost | $739+ | $910+ |
Common side effects of Ozempic vs. Victoza
The most common side effects of Ozempic are gastrointestinal (stomach) problems such as pain, nausea, vomiting, and diarrhea, or constipation.
Similarly, the most common side effects of Victoza are also stomach-related and include nausea, vomiting, indigestion, and diarrhea or constipation.
With either drug, injection site reactions can occur. Hypoglycemia (low blood sugar) can also occur. Hypoglycemia is more likely to occur when Ozempic or Victoza is used along with insulin or another medication (such as metformin) for Type 2 diabetes. Allergic reactions are rare. Symptoms of hives, difficulty breathing, or swelling around the face, lips, tongue, or throat, require emergency medical attention.
A summary of common side effects is listed in the table below. This is not a full list of side effects. Contact your doctor for a full list of side effects.
| Ozempic | Victoza | |||
| Side Effect | Applicable? | Frequency | Applicable? | Frequency |
| Nausea | Yes | 15.8-20.3%* | Yes | 18-20* |
| Vomiting | Yes | 5-9.2%* | Yes | 6-9%* |
| Diarrhea | Yes | 8.5-8.8%* | Yes | 10-12%* |
| Stomach pain | Yes | 5.7-7.3%* | No |
|
| Constipation | Yes | 3.1-5%* | Yes | 5% |
| Indigestion | Yes | 2.7-3.5%* | Yes | 4-7%* |
| Hypoglycemia | Yes | Varies | Yes | Varies |
| Headache | No |
|
Yes | 10-11%* |
| Common cold | No |
|
Yes | 9-10%* |
| Back pain | No |
|
Yes | 4-5%* |
* depending on dosage
Source: Ozempic (DailyMed), Victoza (DailyMed)
Drug interactions of Ozempic vs. Victoza
Using Ozempic or Victoza with insulin or certain oral diabetes medications can increase the risk of low blood sugar. If you take this combination of medications, your prescriber may adjust the dosing of your insulin or oral medication. Also, because Ozempic and Victoza delays stomach emptying, the absorption of oral medications may be affected if taken at the same time. When the drugs were studied, these drug interactions did not occur to a clinically relevant degree. However, it is a good idea to consult your healthcare provider about the timing of your medications. Narrow therapeutic index drugs should especially be monitored. These include drugs with a small window between therapeutic effect and toxicity such as Coumadin (warfarin), Lanoxin (digoxin), and seizure medications.
Before taking Ozempic or Victoza, review your medication list with a healthcare provider. Be sure to tell your provider about all the medications you take, including prescription and OTC drugs, vitamins, and supplements.
This is not a full list of drug interactions. Consult your healthcare provider for a full list of drug interactions.
| Drug | Drug Class | Ozempic | Victoza |
| Meglitinides (nateglinide, repaglinide) Sulfonylureas (glimepiride, glipizide, glyburide) |
Insulin secretagogues | Yes | Yes |
| Basaglar Humalog Lantus Levemir Novolog Toujeo Tresiba |
Insulin | Yes | Yes |
| Oral medications | Oral medications | Yes | Yes |
Warnings of Ozempic and Victoza
Because both medications are in the same drug class, warnings and precautions are mostly the same. You will receive a medication guide any time you fill a prescription for Ozempic or Victoza, which goes over side effects and warnings.
There is a boxed warning for Ozempic and Victoza, which is a serious warning required by the FDA. In rodents, Ozempic or Victoza can cause thyroid cancer (thyroid C-cell tumors, including medullary thyroid carcinoma (MTC)). It is unknown whether this can occur in humans. Patients with a history or family history of MTC or with multiple endocrine neoplasia syndrome Type 2 (MEN 2) should not take Ozempic or Victoza.
Other warnings include:
- Acute pancreatitis may occur. Patients should be carefully monitored for signs and symptoms of pancreatitis, which may include severe, persistent abdominal pain (which may radiate to the back), and may be accompanied by vomiting. If pancreatitis is suspected, Ozempic or Victoza should be stopped and the patient should seek medical care. If pancreatitis is confirmed, the drug should not be started again.
- Complications of diabetic retinopathy may occur, and the risk is higher in patients with a history of diabetic retinopathy. Rapid blood sugar control improvement may be associated with temporary worsening of diabetic retinopathy. Patients should be monitored.
- Ozempic or Victoza pens should never be shared between patients, even if the needle is changed. This is due to an increased risk for transmission of blood-borne pathogens.
- Low blood sugar (hypoglycemia) may occur, and is more likely when Ozempic or Victoza is taken with insulin or other diabetes medication. A dose adjustment may be required. Patients should talk to their physician about low blood sugar treatment, blood sugar monitoring, and a prescription for glucagon. Glucagon can be used in an emergency low blood sugar situation.
- Acute kidney injury or worsening of kidney failure may occur, which may require dialysis. Symptoms of kidney problems can include nausea, vomiting, diarrhea, and/or dehydration. Monitor kidney function while taking Ozempic or Victoza.
- Serious hypersensitivity reactions have been reported. Symptoms may include hives, difficulty breathing, and swelling of the face, lips, tongue, or throat. If this occurs, Ozempic or Victoza should be discontinued and the patient should get emergency medical help right away. Patients with a previous hypersensitivity reaction should not use Ozempic or Victoza.
- Because of the potential risk to the unborn baby, Ozempic or Victoza generally should not be used in pregnancy, unless your doctor determines that the benefits outweigh risks. Your healthcare provider will likely find an alternative medication to use.
Additionally, in one clinical trial, some patients who took Victoza had gallbladder problems. Most of the cases required hospitalization and/or surgical gallbladder removal.
Frequently asked questions about Ozempic vs. Victoza
What is Ozempic?
Ozempic is a once-weekly injectable medication used along with diet and exercise to control blood sugar in adults with Type 2 diabetes mellitus. It is known as a GLP-1 receptor agonist.
What is Victoza?
Victoza is a daily injectable medication used along with diet and exercise to control blood sugar in adults and children 10 years and older with Type 2 diabetes. Victoza is also a GLP-1 receptor agonist.
Are Ozempic and Victoza the same?
Ozempic and Victoza work the same way, but they have some differences. For example, Ozempic is injected weekly, while Victoza is injected daily. The information above outlines the similarities and differences between Ozempic and Victoza.
Is Ozempic or Victoza better?
The consensus of the American Diabetes Association is that treatment with a GLP-1 agonist, such as Ozempic or Victoza, can be beneficial in improving cardiovascular outcomes as well as kidney disease, especially in patients with heart or kidney disease. Your doctor can determine if a GLP-1 agonist is appropriate for you, and if so, which one would be a better choice.
Can I use Ozempic or Victoza while pregnant?
There is limited data on Ozempic and Victoza in pregnancy. They may cause fetal harm. If you are already taking Ozempic or Victoza and find out that you are pregnant, contact your OB/GYN immediately for guidance. Consult your healthcare provider for medical advice if you are pregnant, planning to become pregnant, or breastfeeding.
Can I use Ozempic or Victoza with alcohol?
It is best to avoid alcohol while using Ozempic or Victoza. Alcohol can cause low blood sugar, and Ozempic or Victoza can cause low blood sugar as well. The combination, therefore, can cause severe or prolonged low blood sugar.
How much weight can you lose in a month with Ozempic?
In clinical trials, patients with Type 2 diabetes who took Ozempic as the only treatment lost an average of 8 to 10 pounds in 30 weeks of Ozempic treatment. However, weight loss can vary greatly depending on the individual. Talk to your doctor about what kind of weight loss to expect from Ozempic.
What drug is comparable to Ozempic?
Drugs in the GLP-1 agonist class that, like Ozempic, contain semaglutide include:
- Wegovy, which is a weekly semaglutide injectable medication indicated for weight management. Wegovy costs $1,778 for 4, 0.75 mL of 2.4 mg/0.75 mL auto-injectors without insurance and $1,198 with a SingleCare card.
- Rybelsus, which is an oral medication indicated to improve blood sugar control, along with diet and exercise, in adults with Type 2 diabetes. Rybelsus costs $1,270 per 30, 7 mg tablets without insurance and $815 with a SingleCare coupon.
Other GLP-1 agonist drugs besides Ozempic and Victoza include:
