Liraglutide

Liraglutide is best known as the first daily GLP-1 medicine for diabetes and weight loss — sold as Victoza and Saxenda, it's a lab-made peptide that copies a natural gut hormone involved in fullness and blood-sugar control. It's an FDA-approved prescription medicine given as a once-daily injection under the skin; Victoza treats type 2 diabetes and Saxenda treats chronic weight management. A first generic was approved in December 2024.

Liraglutide is a daily GLP-1 injection FDA-approved for type 2 diabetes and weight management. In a cardiovascular outcomes trial (LEADER) it was associated with a 13% reduction in major adverse cardiovascular events versus placebo in adults with type 2 diabetes at high risk, and in a weight-management trial (SCALE Obesity) it produced about 8% average weight loss versus about 2.6% on placebo over 56 weeks. It produces less weight loss than semaglutide or tirzepatide. The research attributes these weight and blood-sugar changes largely to reduced appetite and food intake (greater satiety via the gut-hormone pathway these agents act on), an appetite and energy-intake mechanism measured across the trials.

FDA-approved under multiple NDAs across two branded products with overlapping active ingredient at different therapeutic doses: Victoza (NDA 022341, approved January 25, 2010 for T2D in adults; expanded to pediatric T2D ages ≥10 years in June 17, 2019) and Saxenda (NDA 206321, approved December 23, 2014 for chronic weight management in adults with BMI ≥30 or ≥27 with weight-related comorbidity; expanded to pediatric obesity ages 12–17 in December 4, 2020). First generic liraglutide approved December 23, 2024 — Hikma (ANDA 215503), the first liraglutide generic to reach the US market. Ten further liraglutide generics have since been approved (Nanjing King Friend, Lupin, Teva, Orbicular ×2, Biocon ×2, Fresenius Kabi, Mylan, Sandoz — approvals running Apr 2025 to Jul 2026), so this is now a multi-supplier generic market rather than a single-source one. Not DEA-scheduled. Not listed in the WADA 2026 Prohibited List — confirmed by direct text-search of the canonical PDF on 2026-05-04 (zero matches for liraglutide, semaglutide, tirzepatide, GLP-1, glucagon-like, incretin, or exenatide). Currently sold under multiple brand names (Victoza, Saxenda) and as authorized and unauthorized generics.

Liraglutide is a prescription-only medication and carries a class boxed warning related to thyroid C-cell tumors. It is not on the WADA Prohibited List. VialWise is a research and educational reference, not medical advice — consult a licensed professional.

⚠️ For research and educational purposes only. Liraglutide is FDA-approved as a prescription drug under two branded products (Victoza for type 2 diabetes; Saxenda for chronic weight management) plus the first FDA-approved generic liraglutide (December 2024). Information in this entry is informational, not medical advice. Always confirm dose calculations with the in-app calculator and consult appropriate professional guidance before any protocol decisions.

⚠️ Liraglutide and semaglutide are not the same drug. They are both GLP-1 receptor agonists from the same Novo Nordisk research pipeline, share substantial structural homology (~94% sequence identity), and are mechanistically similar — but they have meaningfully different dosing schedules (liraglutide daily vs semaglutide weekly), pharmacokinetic profiles (liraglutide ~13h half-life vs semaglutide ~7-day half-life), efficacy magnitudes (liraglutide produces ~5-8% weight loss; semaglutide produces ~15% weight loss), and FDA-approved indications. Researchers comparing or switching between liraglutide and semaglutide should be explicit with themselves about the differences. See [semaglutide.md](./semaglutide.md) for the broader GLP-1 family discussion.

⚠️ Same active ingredient, two distinct products with different therapeutic dose ranges. Victoza and Saxenda are the same molecule (liraglutide) at the same concentration ( pre-filled multi-dose pen) but at substantially different therapeutic doses: - Victoza (T2D): → → daily SC titration (max for T2D) - Saxenda (obesity): → → → → daily SC titration (max for chronic weight management) The pen devices look similar but have different dose-titration mechanics. Researchers should follow the specific product's labeled dose-titration schedule and not interchange them.

⚠️ Generic liraglutide now available — first GLP-1-class generic in the US. The first generic liraglutide (applicant: Hikma, ANDA 215503) was FDA-approved on December 23, 2024. Eleven liraglutide generics are now listed as marketed (RX) in the FDA Orange Book, approved between December 2024 and July 2026. Generic liraglutide is therapeutically equivalent to Victoza and is dispensed under the same labeling for T2D treatment. The availability of generic liraglutide has practical pricing implications for the broader GLP-1 / weight-management therapeutic landscape, particularly given that generic semaglutide and generic tirzepatide are still years from market.

Liraglutide is the first-generation daily-injection GLP-1 receptor agonist that established the modern incretin therapeutic class for both type 2 diabetes and weight management. Developed by Novo Nordisk under the development code NN2211 and launched as Victoza in 2010, liraglutide preceded semaglutide (the same Novo Nordisk pipeline; Ozempic 2017, Wegovy 2021) and the broader expansion of the GLP-1 / GIP / glucagon agonist landscape (tirzepatide 2022, retatrutide currently in phase 3). As of 2026, liraglutide is the GLP-1 with a broad multi-supplier generic market in the US — eleven liraglutide generics are listed as marketed in the FDA Orange Book. It is not the only GLP-1 with a generic: a generic exenatide (Amneal, ANDA 206697) is also listed as marketed, though the branded exenatide products (Byetta, Bydureon, Bydureon BCise) are all listed as discontinued. Generic semaglutide and tirzepatide do not exist — the Orange Book lists no ANDA for either.

Mechanism. Liraglutide is a 31-amino-acid acylated peptide with 97% sequence homology to native GLP-1(7-37). Two structural modifications differentiate it from native GLP-1: (1) substitution of arginine for lysine at position 34, and (2) addition of a C-16 palmitoyl fatty-acid chain at Lys26, with a glutamic acid spacer. The palmitoyl modification enables non-covalent binding to serum albumin, dramatically extending half-life (native GLP-1 has <2 minute half-life due to rapid DPP-4 cleavage; albumin-bound liraglutide has ~13 hour half-life). Mechanistically liraglutide is a GLP-1 receptor agonist — it stimulates glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, and reduces appetite via central pathways (the same downstream effects as semaglutide and the broader GLP-1 class).

Clinical development history. Victoza was approved by the FDA on January 25, 2010 for treatment of T2D in adults — the first daily GLP-1 agonist (preceded by twice-daily exenatide/Byetta in 2005, which liraglutide eventually displaced as the standard daily GLP-1). The pivotal LEAD program (six phase 3 trials in T2D adults) demonstrated A1c reduction and weight loss across various populations. Saxenda was approved on December 23, 2014 for chronic weight management in adults with BMI ≥30 (or ≥27 with weight-related comorbidity), based on the SCALE program of phase 3 trials in non-diabetic and diabetic obesity populations.[²] The LEADER trial (2016) — a 9,340-patient, 3.8-year cardiovascular outcomes RCT — demonstrated that liraglutide at the Victoza dose range ( max) reduced major adverse cardiovascular events (MACE) by 13% vs placebo in T2D patients with high cardiovascular risk, establishing the cardiovascular safety and benefit of the GLP-1 class.[¹] Pediatric T2D approval came in June 17, 2019 based on the ELLIPSE trial in adolescents 10–17 years[³]; pediatric obesity approval came in December 4, 2020 based on subsequent SCALE-pediatric trials. The first FDA-approved generic liraglutide was approved on December 23, 2024 — the first GLP-1-class generic to reach the US market.

Regulatory status (US). Liraglutide is FDA-approved under multiple NDAs and as a recently-approved generic. Indications: - Victoza (NDA 022341): T2D in adults; T2D in pediatric patients ≥10 years[⁴] - Saxenda (NDA 206321): chronic weight management in adults with BMI ≥30 (or ≥27 with weight-related comorbidity); chronic weight management in pediatric patients aged 12–17 years with BMI corresponding to obesity for adults[⁵] - Generic liraglutide (first approved December 2024 — applicant of record Hikma, ANDA 215503; ten further liraglutide ANDAs approved through July 2026): therapeutically equivalent to Victoza for T2D treatment

Liraglutide is not a DEA-scheduled controlled substance.

Regulatory status (sport — WADA). Liraglutide is not listed in the 2026 WADA Prohibited List.[⁶] Direct text-search of the canonical 2026 WADA pdf (downloaded and archived at `docs/legal/wada-2026-prohibited-list.pdf` on 2026-05-04) returned zero matches for liraglutide, semaglutide, tirzepatide, GLP-1, glucagon-like, incretin, or exenatide. The entire GLP-1 / GIP / glucagon agonist class is currently absent from the WADA Prohibited List — a notable absence given the class's prominence in metabolic medicine, but consistent with the WADA list's focus on athletic-performance-relevant compounds rather than weight-management drugs broadly. Researchers competing in WADA-tested sport should still confirm against the most recent annual Prohibited List edition before any competitive event.

Common research interests / use cases. Liraglutide is used in three meaningfully distinct contexts: 1. T2D treatment (Victoza FDA-approved indication) — adult and pediatric. The original FDA-approved use case; supported by the LEAD phase 3 program and the LEADER cardiovascular outcomes trial.[¹][⁴] 2. Chronic weight management (Saxenda FDA-approved indication) — adult and pediatric. Supported by the SCALE phase 3 program, particularly the SCALE Obesity & Prediabetes trial.[²][⁵] 3. Off-label and combination use — sometimes combined with other compounds (testosterone, GH-secretagogue stacks) during body-composition-focused protocols. Mechanistic rationale parallels the semaglutide/tirzepatide off-label combination patterns.

Liraglutide vs Semaglutide vs Tirzepatide — the practical comparison. This comparison is the most useful framing for researchers selecting between modern incretin agents: - Liraglutide (daily SC): ~5-8% weight loss at max dose ( Saxenda); A1c reduction ~1.0-1.5%; cheapest now (generic available); strongest CV outcomes evidence base (LEADER 2016 + multiple subsequent meta-analyses) - Semaglutide (weekly SC at Wegovy, or daily oral at Rybelsus): ~15% weight loss at max dose; A1c reduction ~1.5-1.8%; more expensive (no generic); strong CV outcomes (SUSTAIN-6, SELECT) — see [semaglutide.md](./semaglutide.md) - Tirzepatide (weekly SC, Mounjaro/Zepbound): ~20% weight loss at max dose; A1c reduction ~2.0-2.4%; most expensive; emerging CV outcomes (SURPASS-CVOT pending) — see [tirzepatide.md](./tirzepatide.md) - Retatrutide (in development, not FDA-approved): ~24% weight loss in phase 2b — see [retatrutide.md](./retatrutide.md)

The functional consequence: liraglutide is the cost-conscious, daily-injection, well-established GLP-1 option for researchers prioritizing regulatory clarity, generic-pricing access, and the largest body of long-term safety data. Researchers prioritizing magnitude of weight loss will more often select semaglutide or tirzepatide.

Commonly reported

• Nausea — most common, especially during titration; typically mild-to-moderate and transient (resolves within 4–8 weeks of dose stabilization)
• Vomiting — less common than nausea; primarily during titration
• Diarrhea, constipation — both reported; constipation more common at higher doses
• Decreased appetite — often a desired effect for weight management; can be excessive in some patients
• Dyspepsia / abdominal discomfort
• Headache — particularly during initial titration
• Injection site reactions — typically mild, local
• Hypoglycemia — uncommon as monotherapy; more common when combined with insulin or sulfonylureas

Serious

• Severe persistent vomiting or signs of dehydration
• Acute pancreatitis symptoms (severe abdominal pain radiating to back) — class-wide concern
• Gallbladder symptoms (right upper quadrant pain, jaundice) — gallstones and cholecystitis reported at elevated rates
• Acute kidney injury (typically secondary to dehydration from GI side effects)
• Severe hypersensitivity reactions
• Signs of medullary thyroid cancer (neck mass, dysphagia, dyspnea, persistent hoarseness)
• Suicidal ideation or new-onset mood changes (under regulatory review across the GLP-1 class as of 2024–2026)
• Sustained palpitations or tachycardia (mild heart rate increase is class-typical but persistent symptoms warrant evaluation)

Personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN2) — FDA-mandated boxed warning across the GLP-1 class, based on rodent thyroid C-cell tumor findings

History of pancreatitis — caution; weigh against benefit

Severe gastrointestinal disease (gastroparesis especially — liraglutide further slows gastric emptying)

Severe renal impairment — caution; dehydration risk amplifies

Hypersensitivity to liraglutide or any product component

Pregnancy — discontinue at least 2 months before a planned pregnancy due to long half-life

Pregnancy and lactation: discontinue. Animal studies showed reproductive toxicity.

Concurrent use of other GLP-1, GIP, or glucagon receptor agonists: contraindicated due to compounded incretin effect.

Diabetic retinopathy: observed worsening in some GLP-1 trials; caution in patients with proliferative retinopathy.

Regulatory note (US): Victoza and Saxenda are prescription-only but not DEA-scheduled. The first FDA-approved generic liraglutide (Hikma, ANDA 215503, December 2024) is also prescription-only, as are the ten further liraglutide generics approved since.

Regulatory note (sport): Liraglutide is not listed in the WADA 2026 Prohibited List.[⁶] The entire GLP-1 / GIP / glucagon agonist class is currently absent from the Prohibited List. May change in future annual editions.

GLP-1 receptor agonist

A compound that switches on the GLP-1 receptor, the same target a natural gut hormone uses to signal fullness and help regulate blood sugar.

Subcutaneous

An injection into the fatty layer just under the skin, rather than into a muscle or vein.

Half-life

Roughly how long the body takes to clear half of a dose. A long half-life is why some compounds can be taken only once a week.

Titration

Starting at a low dose and increasing it gradually.

1. 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; LEADER Trial Investigators. (2016). Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. The New England Journal of Medicine, 375(4):311–322.(PMID 27295427 · NCT01179048)
2. 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. (2015). A Randomized, Controlled Trial of Liraglutide in Weight Management. The New England Journal of Medicine, 373(1):11–22.(PMID 26132939 · NCT01272219)
3. Tamborlane WV, Barrientos-Pérez M, Fainberg U, Frimer-Larsen H, Hafez M, Hale PM, Jalaludin MY, Kovarenko M, Libman I, Lynch JL, Rao P, Shehadeh N, Turan S, Weghuber D, Barrett T; Ellipse Trial Investigators. (2019). Liraglutide in Children and Adolescents with Type 2 Diabetes. The New England Journal of Medicine, 381(7):637–646.(PMID 31034184)
4. Novo Nordisk. Victoza (liraglutide) injection prescribing information. US Food and Drug Administration. NDA 022341, originally approved January 25, 2010; pediatric T2D supplement approved June 17, 2019; current label SUPPL-042 (2025).
5. Novo Nordisk. Saxenda (liraglutide) injection prescribing information. US Food and Drug Administration. NDA 206321, originally approved December 23, 2014; pediatric obesity supplement approved December 4, 2020; current label SUPPL-025 (February 2026).
6. World Anti-Doping Agency. The 2026 Prohibited List, International Standard (effective 1 January 2026). Canonical PDF: wada-ama.org/sites/default/files/2025-09/2026list_en_final_clean_september_2025.pdf (linked from the WADA landing page; local archival copy in `docs/legal/wada-2026-prohibited-list.pdf`). Liraglutide and the entire GLP-1 / GIP / glucagon agonist class is not listed in the 2026 WADA Prohibited List.
7. US Food and Drug Administration. Approval of First Generic Liraglutide. FDA News Release, December 23, 2024.

• Testosterone — discussed together in this entry's stacks section
• AOD-9604 — discussed together in this entry's stacks section
• BPC-157 / TB-500 Blend — discussed together in this entry's stacks section
• Amycretin — same mechanism class
• CagriSema — same mechanism class
• Dulaglutide — same mechanism class