Victoza vs. Saxenda: Differences, similarities & side effects

In this article:

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost
• Side effects
• Drug interactions and warnings

In this article

• Main differences
• Conditions treated
• Efficacy
• Coverage and cost
• Side effects
• Drug interactions and warnings

GLP-1 agonists are some of the most popular diabetes and weight loss medications on the market, and Victoza and Saxenda are two common options. They’re two different brand names containing the same drug, liraglutide. Both are manufactured by Novo Nordisk, and both work by regulating blood sugar levels and appetite. However, they have different FDA-approved purposes: Type 2 diabetes for Victoza and obesity management for Saxenda. The two are available in different dosages and may have different insurance coverage or prices as well. 

What are the main differences between Victoza vs. Saxenda?

What conditions are treated by Victoza vs. Saxenda?

As we mentioned, these drugs are FDA-approved for different purposes. However, healthcare providers can prescribe them “off-label” for other conditions. This means insurance companies often do not pay for this prescription, but otherwise, it’s perfectly safe and legal. 

Victoza is “approved purely for the management of Type 2 diabetes, not for weight loss,” says Dr. Austin Shuxiao, MD, founder and medical director of Peach IV. “It is also approved for use in adults with Type 2 diabetes and established cardiovascular disease because it has shown to reduce the risk of future major cardiovascular events.” Conversely, Saxenda is “approved for weight loss in adults with a body mass index (BMI) greater than 30 or in patients with a BMI greater than 27 with a weight-related comorbidity,” like high blood pressure (hypertension), Type 2 diabetes, or high cholesterol. 

Is Saxenda better than Victoza?

Neither drug is inherently better than the other. But one or the other might be better for your specific condition. A healthcare provider will determine which is best for you depending on your medical condition, history, other medications, and more. 

That said, Saxenda and Victoza have shown safety and effectiveness in managing blood glucose levels and weight. A study from the American Diabetes Association found that patients who took 3 mg of liraglutide lost an average of 5.8% body weight over 56 weeks. During that period, they also observed significantly larger reductions in blood sugar compared to a placebo. A separate study studied cardiovascular events in over 9,000 Type 2 diabetes patients over 3.8 years. Researchers discovered that those taking liraglutide had significantly lower rates of heart attack, stroke, and death from cardiovascular events than those taking a placebo. 

However, a study on different doses showed that patients taking 3 mg of liraglutide (the highest Saxenda dose) lost an average of 6.0% body fat. In comparison, those taking 1.8 mg (the highest Victoza dose) lost an average of 4.7%. So while Victoza’s dosage is specifically designed for controlling blood sugar, with mild weight loss as a bonus, Saxenda’s 3 mg dosage is more effective for weight loss in particular than Victoza’s 1.8 mg dose. 

Victoza vs. Saxenda: Insurance coverage and cost comparison

“Victoza is the least expensive GLP1 for the treatment of diabetes. Most insurances cover it without requiring prior authorization. Victoza is now available as generic liraglutide, further lowering the cost,” says Dr. Jennifer Brown, MD, medical and health writer at MyObesityTeam. She prescribes Victoza as the go-to diabetes drug in her rural practice, since many patients can’t afford the copay and out-of-pocket costs associated with Ozempic or Mounjaro. 

Insurance coverage for Saxenda can be trickier, since some insurance plans won’t cover weight loss drugs. “Those plans that do cover Saxenda usually have particular guidelines for coverage and require prior authorization,” Dr. Brown says. “Many insurance plans require documentation of 3 months of a physician-supervised weight loss program before they agree to pay for Saxenda.”

On average, Victoza is typically less expensive than Saxenda, although both drugs can still cost over $1,000/month for patients who are paying completely out of pocket. Fortunately, there are some reliable ways to save, like free coupons from SingleCare, which can cut those costs by hundreds of dollars per month. 

Saxenda vs. Victoza side effects

Since they have the same active ingredient, the side effects for Victoza and Saxenda are fairly similar. “The most common side effect of nausea is common, and similar to other GLP-1 Agonists like semaglutide and tirzepatide,” Dr. Shuxiao says. He notes that he sees this kind of gastrointestinal side effects in a significant percentage of patients who take liraglutide.

A glance at the clinical trials on Victoza’s label confirms that the most common side effects for a 1.8 mg dose are nausea (20%), diarrhea (12%), headache (10%), nasopharyngitis (10%), vomiting (9%), and reduced appetite (9%). 

Saxenda can cause many of the same side effects, but they can be more common than those of Victoza’s. Also, per Dr. Brown, “the higher doses of Saxenda can sometimes cause worse GI side effects or an elevated heart rate compared to Victoza.” According to Saxenda’s label, the most common adverse effects are nausea (39.3%), diarrhea (20.9%), constipation (19.4%), vomiting (15.7%), injection site reaction (13.9%), and headache (13.6%). 

These aren’t all the possible side effects for either drug—just the most common. For a more complete list of adverse reactions, see our articles on Saxenda side effects and Victoza side effects. 

Victoza and Saxenda drug interactions and warnings

Liraglutide can interact with a long list of drugs. However, some of the most significant interactions are with other GLP-1 drugs like Wegovy, the antiviral drug cidofovir, other diabetes medications like sulfonylureas or metformin, loop diuretics, quinolone antibiotics, and aminoglycoside antibiotics. This isn’t a comprehensive list, so it’s important to inform your healthcare provider and pharmacist about all your medications and supplements before starting either Victoza or Saxenda. 

Additionally, there are some warnings to know about these drugs. For example, “There is also a black box warning for an increased risk in thyroid C-cell tumors (medullary thyroid cancer), thus Victoza and Saxenda are both contraindicated in patients with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN2),” Dr. Shuxiao says. MEN2 is a rare genetic condition that increases the risk of cancerous thyroid tumors. Research has also connected GLP-1 drugs, specifically liraglutide, to certain gallbladder issues.

Dr. Brown adds, “There has been some concern about the possibility of GLP-1s, including Victoza and Saxenda, causing pancreatitis.” This is rare, but healthcare professionals may be cautious in prescribing it for people with pancreas issues. Additionally, “they should be used with caution for diabetes on other types of diabetic medications, since the combination can cause low blood sugar.”