Saxenda alternatives: What can I take instead of Saxenda?

Compare Saxenda alternatives | Wegovy | Xenical | Qsymia | Contrave | Adipex-P | Natural alternatives | How to switch meds

Liraglutide has been a breakthrough drug for weight management, but it may not be working out for you. Produced under the brand name Saxenda, it has had Food and Drug Administration (FDA) approval for the long-term treatment of obesity since 2014. Liraglutide, the active ingredient in Saxenda, was the first glucagon-like peptide-1 (GLP-1) receptor agonist to receive this designation, and now other GLP-1 receptor agonists have followed. Despite the historical accolades, it does not always prove to be a good match and is not recommended if you’ve had pancreatitis (inflammation of the pancreas) Some people may also experience an allergic reaction to Saxenda. Whatever the reasoning might be, you may be looking for another option. Saxenda’s adverse effects or cost could be enough to make you consider an alternative, or perhaps, it has not produced the weight loss results you desire. We will cover the alternatives to know about and how to go about making a change if you decide to do so.

RELATED: Saxenda side effects and how to avoid them

What can I take in place of Saxenda?

The list of medications with FDA approval for weight management is not long. However, it has been slowly expanding in recent years. These new options cannot come soon enough.Defined as a body mass index (BMI) equal to or greater than 30 kg/m2, obesity has doubled in prevalence worldwide since 1980. If you find yourself searching for answers, you are certainly not alone.

Even if Saxenda is not working out, you may prefer to stick with a GLP-1 agonist drug. That is understandable since the class is also used for blood glucose (sugar) control and cardiovascular event (myocardial infarction or heart attack) risk reduction in Type 2 diabetes mellitus. In fact, liraglutide is produced under the brand name Victoza for these FDA indications. Outside of the GLP-1 agonist class, you should be aware of alternatives that include a lipase inhibitor, central nervous system stimulants, and combination agents.

Top 5 Saxenda alternatives

1. Wegovy (semaglutide)

Wegovy and Saxenda are both manufactured by the same company, Novo Nordisk. These two drugs have a lot in common. They are both injectable GLP-1 agonists that can slow gastric emptying, making your stomach feel full faster. Semaglutide is packaged as both Wegovy and Ozempic, which is used for treatment of Type 2 diabetes mellitus, comparable to liraglutide’s Saxenda and Victoza brand names. Their most common side effects are gastrointestinal, most commonly nausea. Animal studies have shown an increase in thyroid C-cell tumors with GLP-1 agonists, but the significance of this finding to humans is unknown. Nonetheless, this class is contraindicated in anyone with a personal or family history of medullary thyroid cancer or a history of multiple endocrine neoplasia syndrome Type 2. If these contraindications or side effects of Saxenda are driving your search for an alternative, you may want to look elsewhere.

There are a couple differences of note that could be appealing to you. If you are tired of a daily injection, then Wegovy may be of interest. It only needs to be injected once a week. Efficacy is another reason to consider Wegovy instead of Saxenda. A 2022 study comparing the two drugs found Wegovy produced significantly greater weight loss than Saxenda, about 15% of baseline weight lost with semaglutide compared to about 6% with liraglutide.

GLP-1 receptor activity is also a part of Mounjaro’s mechanism of action for lowering blood glucose in Type 2 diabetes mellitus. The drug stimulates the glucose-dependent insulinotropic polypeptide (GIP) receptor as well. A clinical trial published in June 2022 demonstrated body weight loss of about 21% with tirzepatide. Although this may be exciting information, you must know that Mounjaro does not have FDA approval for obesity treatment as of this writing.

2. Xenical (orlistat)

GLP-1 agonists like Saxenda typically carry a big price tag. If the expense does not make you sick, then their potential for nausea may be enough to turn you away. A different mechanism of action to produce weight loss is to impair the absorption of fat. Xenical accomplishes this by inhibiting lipase enzyme in the gut, blocking dietary fat breakdown and absorption. One study for example reported an 8% weight loss achieved with Xenical plus a behavioral intervention. The problem with impairing dietary fat digestion and causing more fat passage in the stool is that cramping, flatulence, and fecal incontinence are possible side effects that you should be aware of if you are considering changing from Saxenda to Xenical.

3. Qsymia (phentermine–topiramate)

Qsymia reduces appetite in order to produce weight loss. The product combines a relatively low-dose stimulant, phentermine, along with a drug historically used for seizures, topiramate, that has long been known to reduce appetite. Together, they produced a degree of weight loss between 8 and 10% in a clinical trial. You could find Qsymia’s mechanism of action more effective and the oral capsule more acceptable than an GLP-1 agonist injection. However, the list of possible adverse effects deserves careful review. Dry mouth, constipation, paresthesia (abnormal skin sensation), depression, and tachycardia (fast heart beat) are among the common side effects. The effects of phentermine on the heart are enough of a concern that if you have a history of cardiovascular disease, your healthcare provider will likely advise against Qsymia. In fact, this issue is important enough that any healthcare professional who prescribes Qsymia is encouraged to complete training on Qsymia safety and any pharmacy that dispenses it must be certified to do so.

4. Contrave (naltrexone–bupropion)

Another combination product for obesity treatment is Contrave. Naltrexone is a drug used to treat opioid dependence and alcohol dependence. Bupropion is used for depression and smoking cessation. Bringing both together in the form of Contrave provides a once-daily tablet that was found to result in approximately 5-6% weight loss from baseline. Those modest results may not seem enticing, or you might be rightfully concerned about Contrave’s risk of increasing heart rate and blood pressure or its black box warning from the FDA about suicidality risk with antidepressants like bupropion. Efficacy limitations, serious side effects, and safety concerns likely contribute to less use of Contrave than other options.

RELATED: Compare Contrave vs. phentermine

5. Adipex-P (phentermine)

Phentermine is the most commonly prescribed option for obesity. It is a central nervous system stimulant that makes people feel full quicker, similar to other stimulants like diethylpropion, benzphetamine, and phendimetrazine. Phentermine was associated with a 8 to 11% weight reduction in a study. Adipex-P has a convenience advantage over Saxenda by being a once-daily pill and an economic advantage by costing much less than Saxenda. Before you get too excited about Adipex-P, there are some hazards that could stop you from moving forward with it. For starters, phentermine is listed as a controlled substance by the Drug Enforcement Administration, meaning it has the potential to be abused. In addition, all stimulants can increase blood pressure or heart rate. Based on this risk, Adipex-P is contraindicated in the setting of cardiovascular disease and uncontrolled hypertension (high blood pressure). 

Natural alternatives to Saxenda

Experiencing Saxenda side effects or hearing about possible adverse effects of other obesity medications could raise your interest in natural alternatives. Dieting can absolutely be an effective natural method for achieving weight loss. More important than the type of diet is the degree of adherence to the restrictions. Rather than debating which fad diet to try, you may be better off discussing a daily calorie goal with your healthcare provider, setting the goal, and sticking to it. Goals will range widely between individuals and could be as low as 800 calories per day. While a reduced-calorie diet may be effective, calorie restriction is not easy, so seeing a psychologist for behavioral modification therapy may be helpful. Add in 30 minutes or more of daily exercise and muscle strength training at least twice a week, based on physical activity guidelines published in 2018, if your provider approves.

Dietary supplements generate a lot of interest from those desiring weight loss. Preliminary findings from small studies sometimes draw attention to a supplement, such as chromium, but larger clinical trials are often lacking. In general, reviews of supplements conclude that there is not enough proof of safety and effectiveness to be recommended.

How to switch to a Saxenda alternative

If expense is the primary problem, a SingleCare discount card, which can be used at over 35,000 pharmacies nationwide, may be of assistance. Otherwise, you now have a few alternatives to think about. Saxenda may still be your best bet, or another treatment for obesity could be in order. Set up a time to talk to your prescribing healthcare provider about this. The potential benefits and risks are too much to make this decision on your own. A healthcare professional can look over your list of medical conditions, over-the-counter medicines, and prescription drugs to help determine if an alternative to Saxenda is right for you. Aside from a conversation about pharmacologic treatment, you can use the appointment to set goals for your diet, exercise, and weight gain concerns. This is truly an opportunity for you to better your health in many ways.