Liraglutide (Victoza / Saxenda)

Liraglutide (Victoza / Saxenda) at a Glance

Liraglutide is the once-daily GLP-1 receptor agonist that preceded semaglutide, and the compound that established the class for weight management rather than diabetes alone. It works the same way — amplifying the post-meal signal that drives insulin release, slows gastric emptying and reduces appetite — with a shorter duration requiring daily injection. It is an approved prescription medicine for type 2 diabetes and chronic weight management, and its cardiovascular outcome data were among the first to show this class does more than lower blood sugar.

History & Development

Liraglutide was the compound that made GLP-1 into a usable medicine - the first of Novo Nordisk’s analogues to solve the problem that native GLP-1 disappears from the bloodstream within minutes.

First described	Development programme described by its originators in 2019; originated as NN2211 25Reference 25Knudsen et al. · 2019The discovery and development of liraglutide and semaglutideView study →
Discovered / synthesised by	Novo Nordisk research programme; discovery account authored by Lotte Bjerre Knudsen and Jesper Lau 25Reference 25Knudsen et al. · 2019The discovery and development of liraglutide and semaglutideView study →
Institution	Novo Nordisk A/S, Maalov, Denmark 25Reference 25Knudsen et al. · 2019The discovery and development of liraglutide and semaglutideView study →
Origin	De-novo synthetic analogue of human GLP-1
Key patent	Not established in the sources consulted for this section
Assignee	Novo Nordisk A/S
Development status	Approved - EU 2009, FDA 2010 as Victoza (type 2 diabetes); later Saxenda (weight management)

Discovery

The therapeutic target was type 2 diabetes, not obesity. GLP-1 had been identified as an incretin

• a hormone released by the gut after eating that prompts the pancreas to release insulin - and its appeal was that this effect is glucose-dependent, so it lowers blood sugar without the hypoglycaemia risk that comes with insulin itself.

The obstacle was entirely pharmacokinetic. Native GLP-1 is cleaved by DPP-4 within a couple of minutes, so the natural hormone cannot be given as a drug. Novo Nordisk’s solution was to attach a C16 palmitic acid via a linker, allowing the molecule to bind reversibly to circulating albumin ^{25Reference 25Knudsen et al. · 2019The discovery and development of liraglutide and semaglutideView study →}. Bound peptide is protected from degradation and released gradually, which stretched the duration far enough for once-daily injection.

That albumin-binding strategy is the intellectual core of the entire class, and it is what semaglutide later extended - a C18 di-acid and a longer linker - to reach once-weekly dosing ^{25Reference 25Knudsen et al. · 2019The discovery and development of liraglutide and semaglutideView study →}.

Development & ownership

Liraglutide originated at Novo Nordisk as NN2211 and stayed with the company throughout. It was approved in the European Union in 2009 and by the FDA in 2010 as Victoza for type 2 diabetes, subsequently gaining a cardiovascular risk-reduction indication on the strength of the LEADER outcome trial - one of the first results to show this class does more than lower blood sugar.

A higher-dose formulation was later approved as Saxenda for chronic weight management, making liraglutide the compound that established the transition of this drug class from diabetes into obesity medicine. The specific composition-of-matter patent was not established in the sources consulted for this section.

How it reached the market

Liraglutide reached patients through the standard regulatory route as a prescription medicine, and its market position has since been reshaped by its own successor: once-weekly semaglutide has displaced once-daily liraglutide for most new prescriptions, and liraglutide has begun to face generic competition as its protection lapses.

What It's Used For

Liraglutide is a 31-amino-acid analogue of human GLP-1(7-37) — 97% sequence-identical to the native incretin — carrying a C16 palmitic-acid side chain attached at Lys26 through a glutamic-acid spacer. That acylation does two things: it drives self-association at the injection depot and reversible binding to serum albumin, which together slow absorption and shield the peptide from dipeptidyl peptidase-4. The result is a half-life of about 13 hours and once-daily subcutaneous dosing. This is the drug that established the GLP-1 class in clinical practice — approved as Victoza for type 2 diabetes in 2010 and as Saxenda for chronic weight management in 2014 — and it is the one incretin on this hub whose story has moved past exclusivity: liraglutide is now available as a regulated generic in the US, EU and UK, which changes the sourcing calculus more than any pharmacological fact here.

Read alongside semaglutide and tirzepatide, liraglutide is the previous generation, and the honest framing is neither “lesser copy” nor “equal option”. On weight it is clearly beaten in head-to-head trials: weekly semaglutide 2.4 mg produced roughly twice the weight loss of daily liraglutide 3.0 mg in STEP 8 ^{8Reference 8Rubino DM et al. · 2022RCTEffect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight (STEP 8) — human (RCT, head-to-head)View study →}, and semaglutide 1.0 mg beat liraglutide 1.2 mg on both HbA1c and weight in SUSTAIN 10 ^{9Reference 9Capehorn MS et al. · 2020RCTEfficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in type 2 diabetes (SUSTAIN 10) — human (RCT, head-to-head)View study →}.

There is no direct randomized comparison of liraglutide against tirzepatide — that chain is indirect, running through the semaglutide comparator. What liraglutide has instead is the longest continuous safety record in the class, a genuine positive cardiovascular outcomes trial (LEADER) ^{10Reference 10Marso SP et al. · 2016RCTLiraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER) — human (RCT, cardiovascular outcomes)View study →}, the broadest pediatric licensing of any GLP-1 agonist, and an affordable, pharmacy-dispensed supply route that no other drug on this hub offers.

Route is load-bearing and absolute: a 31-residue peptide has negligible oral bioavailability, and unlike semaglutide there is no absorption-enhancer tablet. Liraglutide exists only as a subcutaneous injection.

Evidence by IndicationStrength of support · Beta

Support is an experimental score I’m building — a composite weighted by study type (human > animal > in vitro > review) and study volume. It’s a beta: a fast way to rank strength of evidence at a glance, not a validated metric. Each application links down to its write-up.

One row here is negative. The Alzheimer’s score is low because the trial was run and missed its primary endpoint — not because nobody has looked. A low number on this table can mean “untested” or “tested and failed”; here it means the latter, and the distinction matters.

01Type 2 diabetes glycemic controlProven90%Phase 3 LEAD program + active-comparator RCTs; approved indication (Victoza), generic available

02Cardiovascular event reduction in type 2 diabetesProven85%One large placebo-controlled CV-outcome RCT (LEADER, n=9,340); approved CV-risk indication

03Chronic weight management (obesity)Proven84%Phase 3 SCALE program (n≈3,700 pivotal) + 3-year extension; approved indication (Saxenda) — but beaten head-to-head by semaglutide

04Pediatric use (adolescent obesity and youth-onset type 2 diabetes)Promising74%Two dedicated phase 3 RCTs; approved from age 12 (obesity) and age 10 (T2D) — the broadest pediatric licensing in the class

05MASH (steatohepatitis)Promising48%One small phase 2 biopsy-endpoint RCT (LEAN, n=52); no phase 3, not approved

06Obstructive sleep apneaShaky42%One phase 3 RCT (SCALE Sleep Apnea); not an approved indication (tirzepatide holds the only OSA license)

07Alzheimer’s disease (negative primary endpoint)Shaky14%One phase 2b RCT (ELAD) that missed its primary endpoint — evidence against, with an exploratory signal

Mechanisms

Pharmacokinetics

Route is load-bearing, and here it is absolute. Liraglutide is given only by subcutaneous injection (abdomen, thigh or upper arm). A 31-residue peptide is digested rather than absorbed, and unlike semaglutide there is no SNAC-formulated oral tablet — no oral liraglutide exists in any approved form anywhere. Anything sold as “oral liraglutide”, sublingual drops or troches cannot deliver intact peptide.

Half-life is approximately 13 hours, which is why dosing is once daily rather than weekly. The duration comes from two engineered properties: the C16 palmitic-acid side chain attached at Lys26 via a glutamic-acid spacer drives reversible albumin binding and self-association into heptamers at the injection depot, slowing absorption and protecting the peptide from DPP-4 and neutral endopeptidase ^{16Reference 16Gallo M et al. · 2022In vitroOligomerization, albumin binding and catabolism of therapeutic peptides in the subcutaneous compartment: an investigation on lipidated GLP-1 analogs — in vitroView study →}. Peak concentration is reached roughly 8–12 hours after injection. Rat work comparing lipidated and non-lipidated GLP-1 agonists found lymphatic uptake was similar for liraglutide and exenatide, indicating the acylation prolongs exposure through albumin binding and depot retention rather than through a lymphatic-routing effect ^{17Reference 17Reddiar SB et al. · 2024AnimalLymphatic uptake of the lipidated and non-lipidated GLP-1 agonists liraglutide and exenatide is similar in rats — animal (rat)View study →} — animal data, cited for mechanism rather than for human dosing. Liraglutide is metabolized like a large protein, with no single organ dominating elimination, so no dose adjustment is specified for renal or hepatic impairment.

The shorter half-life has two practical consequences that cut in opposite directions. Against it: daily injection is a bigger adherence burden, and a missed dose produces a real gap in effect. For it: washout is days, not weeks — which matters when stopping ahead of a planned pregnancy, before surgery, or when an adverse effect needs to clear.

Licensed product is supplied as a sterile refrigerated solution in multi-dose prefilled pens, stored in the refrigerator before first use and at room temperature within a limited in-use window afterwards. Cold chain and in-use stability are part of the product specification.

Clinical & regulatory status

Liraglutide is an approved prescription medicine, not a dietary supplement and not a research chemical. Originated by Novo Nordisk as NN2211, it was approved by the FDA as Victoza (type 2 diabetes) in 2010 — later gaining a cardiovascular-risk-reduction indication in type 2 diabetes on the strength of LEADER, and a pediatric extension to age 10 on ELLIPSE — and as Saxenda (3.0 mg, chronic weight management) in 2014, extended to adolescents aged 12 and over in 2020. Corresponding approvals exist with the EMA, MHRA, TGA and elsewhere. It is prescription-only but not a scheduled/controlled substance.

The defining regulatory event is the loss of exclusivity. Liraglutide’s core patents have expired and it is now the first GLP-1 receptor agonist available as a generic — see Sourcing for the specific approvals and dates. Nothing else on this hub has crossed that line.

Registered trial activity remains substantial: about 513 interventional studies referencing liraglutide on ClinicalTrials.gov at the last check. Development of new indications has largely stopped, however — the sponsor’s program moved to semaglutide, and liraglutide’s remaining trial activity is mostly investigator-initiated. The headline readout of the last year was ELAD, which missed its primary endpoint ^{15Reference 15Edison P et al. · 2026RCTLiraglutide in mild to moderate Alzheimer’s disease: a phase 2b clinical trial (ELAD) — human (RCT, primary endpoint not met)View study →}; note that its registry record (NCT01843075) still shows an unknown status despite the 2026 publication, a reminder that registry status fields lag reality.

Last checked: July 2026.

Sourcing, Route & Legal Status

Regulatory status. Liraglutide is an approved prescription pharmaceutical — prescription-only, unscheduled, legal to possess and use with a valid prescription and dispensed through licensed pharmacies. That has been true since 2010. What is new, and what makes this section different from every other page on this hub, is who can now make it.

Generic liraglutide is real, approved, and on the market. This is the single most important practical fact about the compound:

• US, type 2 diabetes. The FDA approved the first generic of Victoza in December 2024 — the first generic of any once-daily GLP-1 injection — indicated to improve glycemic control in adults and pediatric patients aged 10 and over with type 2 diabetes. Hikma Pharmaceuticals launched it in the US that month.
• US, weight management. Teva announced FDA approval and US launch of generic Saxenda on 28 August 2025 — the first generic GLP-1 product carrying a weight-management indication, covering adults and pediatric patients aged 12 and over weighing more than 60 kg.
• Europe and the UK. Adalvo’s generic liraglutide prefilled pen received the first EU approval in June 2024; Biocon obtained the first UK approval in March 2024 and launched generic Victoza and Saxenda equivalents in the UK in February 2025, with Biocon/Zentiva securing EU decentralized-procedure approvals in December 2024. Further entrants have continued through 2026.

(These are regulatory and sponsor announcements, not journal articles, so they are attributed inline rather than numbered below.)

Why that reframes everything. Every other peptide on this hub presents the same dilemma: the only affordable supply is unregulated, so people buy lyophilized powder from vendors labeling it not for human consumption and perform the reconstitution, sterile handling, concentration arithmetic and dose measurement themselves. Liraglutide no longer sits in that dilemma. There is a licensed, pharmacy-dispensed, generically priced product carrying the same indications as the brand, made under manufacturing oversight, supplied in a prefilled pen, with a cold chain and a real adverse-event reporting pathway behind it. Anyone weighing gray-market GLP-1 powder against a prescription should know that for this molecule the regulated route is now the cheap route too. Given the effect-size gap to semaglutide, “cheaper and legal” is exactly the trade-off liraglutide now represents.

Gray-market liraglutide still exists, and it is now a worse deal than it used to be. Research-chemical vendors continue to sell liraglutide and generic “GLP-1” powders outside the prescription channel. The documented failure modes are unchanged and concrete: mislabeling (wrong peptide, wrong quantity, or a salt form never shown to be equivalent), sub- or super-potency, endotoxin and sterility failures, degradation from absent cold chain, and dosing errors during self-reconstitution — a licensed pen is engineered specifically to eliminate that last category. A third-party certificate of analysis is the minimum any buyer would want, and a COA from an unaccountable vendor is itself unverifiable. What has changed is the calculus: with a regulated generic available, the price argument that sustained the gray market for this molecule has largely evaporated, and buying unregulated liraglutide now means accepting identity and sterility risk to avoid a prescription rather than to avoid a cost.

How it’s supplied & administered. Licensed product — brand or generic — is a sterile refrigerated solution in a multi-dose prefilled pen, injected subcutaneously once daily and titrated upward by a clinician over weeks specifically to limit gastrointestinal effects.

This page does not recommend or link vendors. The efficacy and safety record above belongs to pharmaceutical-grade liraglutide used under medical supervision, and it does not transfer to material of unknown provenance.

Safety

Liraglutide is a prescription medicine with an approval-grade safety file, and the everyday experience of it is gastrointestinal — but the label-defining risks are the boxed thyroid C-cell warning and the pancreatic, biliary and gastric complications of a drug whose therapeutic action is to slow the gut.

Safety at a Glance

⚠️ Moderate toxicityDrug interactions

• Boxed warning for thyroid C-cell tumors. Contraindicated with a personal or family history of medullary thyroid carcinoma or MEN 2.
• Pancreatitis, gallbladder disease and gastroparesis are label-carried risks. The signal concentrates at higher doses and in weight-loss rather than diabetes use.
• Not recommended in pregnancy. Discontinue when pregnancy is planned or recognized — see the box below.
• Tell the anesthetist or endoscopist before any sedation or surgery. Delayed gastric emptying is a documented aspiration concern.
• Gastrointestinal effects are dose-limiting. Nausea, vomiting, diarrhea and constipation, worst during titration and the leading reason for stopping.
• Additive hypoglycemia with insulin and sulfonylureas. The companion drug commonly needs its dose reduced.

Full Safety & Interactions Detail

Adverse effects (from trials). The dominant, dose-limiting effects are gastrointestinal — nausea, vomiting, diarrhea, constipation — dose-dependent, worst during titration, improving over time, and the leading reason for discontinuation across the LEAD and SCALE programs ^{1,4Reference 1Garber A et al. · 2009RCTLiraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono) — human (RCT)View study →Reference 4Pi-Sunyer X et al. · 2015RCTA Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management (SCALE Obesity and Prediabetes) — human (RCT)View study →}. Injection-site reactions occur. Acute pancreatitis and gallbladder disease (cholelithiasis, cholecystitis) are label-carried risks; a systematic review and meta-analysis of randomized trials found GLP-1 receptor agonists increased the risk of gallbladder and biliary disease, with the signal concentrated at higher doses, longer durations, and in weight-loss rather than diabetes indications ^{20Reference 20He L et al. · 2022Meta-analysisAssociation of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases: A Systematic Review and Meta-analysis of Randomized Clinical Trials — human (meta-analysis)View study →} — which places the 3.0 mg Saxenda dose at the more exposed end. Acute kidney injury has been reported, typically secondary to dehydration from gastrointestinal losses. Hypoglycemia is uncommon on liraglutide alone (its insulin effect is glucose-dependent) but rises sharply in combination — see Interactions. Resting heart rate rises by a few beats per minute as a class effect ^{24Reference 24Zhang Y et al. · 2026Meta-analysisEffect of glucagon-like peptide-1 receptor agonists on heart rate in non-diabetic individuals with overweight or obesity: a systematic review and pairwise and network meta-analysis of randomised controlled trials — human (meta-analysis)View study →}.

Gastroparesis and other serious GI events. A large population-based cohort study of GLP-1 receptor agonists prescribed for weight loss — including liraglutide specifically — found increased risks of pancreatitis, gastroparesis and bowel obstruction compared with bupropion-naltrexone ^{19Reference 19Sodhi M et al. · 2023ObservationalRisk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss — human (cohort)View study →}. These are uncommon in absolute terms, but they are the mechanistically predictable consequence of a drug whose therapeutic action is to slow the gut, and they are more than a titration nuisance.

Delayed gastric emptying and anesthesia. Because liraglutide slows gastric emptying by design, retained stomach contents at induction of anesthesia or during upper endoscopy are a documented aspiration concern, and peri-procedural guidance in several jurisdictions now addresses GLP-1 receptor agonists as a class ^{22Reference 22Jalleh RJ et al. · 2024ReviewClinical Consequences of Delayed Gastric Emptying With GLP-1 Receptor Agonists and Tirzepatide — reviewView study →}. The ~13-hour half-life means the washout window is shorter than for the weekly agents, but the precaution is the same: anyone taking liraglutide should tell the anesthetist, endoscopist or proceduralist before any sedation or surgery.

Boxed warning. Liraglutide carries a boxed warning for thyroid C-cell tumors (medullary thyroid carcinoma) observed in rodents, and is contraindicated in anyone with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). The rodent finding has not been established in humans. The human picture is not entirely quiet, however: a French nationwide case-control study reported an association between 1–3 years of GLP-1 receptor agonist use and increased thyroid cancer risk, including medullary thyroid cancer ^{21Reference 21Bezin J et al. · 2023ObservationalGLP-1 Receptor Agonists and the Risk of Thyroid Cancer — human (nationwide case-control)View study →}. That is observational, subject to detection bias, and contested — but it is why the contraindication is treated as absolute in practice rather than dismissed as a rodent artifact.

NAION — and this is where liraglutide differs from semaglutide. Non-arteritic anterior ischemic optic neuropathy is a sudden, usually irreversible loss of vision in one eye. The EMA’s pharmacovigilance committee concluded in June 2025 that NAION is a very rare side effect of semaglutide medicines, and semaglutide product information was updated accordingly. That labeling change is semaglutide-specific — it was not extended to liraglutide, and it is not imported here. The dedicated evidence supports that separation: a pooled analysis of placebo-controlled randomized trials of liraglutide and semaglutide (96,829 participants) found three confirmed NAION cases on GLP-1 receptor agonist versus five on placebo — roughly 3 versus 6 cases per 100,000 patient-years — and concluded the randomized data do not show an increased incidence versus placebo ^{23Reference 23Vilsbøll T et al. · 2026RCTNon-arteritic anterior ischaemic optic neuropathy incidence in placebo-controlled clinical trials of liraglutide or semaglutide — human (pooled trial analysis)View study →}. The observational signal that triggered the semaglutide review has not been reproduced in randomized data for liraglutide. Sudden vision loss on any treatment remains an urgent medical problem, but it is not a liraglutide-labeled risk.

Interactions. The clinically important, mechanism-based interactions are additive hypoglycemia with insulin and insulin secretagogues (sulfonylureas) — these commonly require dose reduction of the companion drug — and altered absorption and timing of orally co-administered medicines through delayed gastric emptying ^{22Reference 22Jalleh RJ et al. · 2024ReviewClinical Consequences of Delayed Gastric Emptying With GLP-1 Receptor Agonists and Tirzepatide — reviewView study →}. A complete interaction census belongs to the current label, not from here.

Who should avoid it. Anyone with a personal or family history of medullary thyroid carcinoma or MEN 2 (contraindicated); anyone with a history of pancreatitis; anyone with severe gastrointestinal disease or established gastroparesis; and — outside a supervised prescription — anyone who cannot guarantee product identity, sterility and correct dosing.

Scope disclosure (honesty, not a claim):

• Human data? Yes — extensive, approval-grade phase 3 RCTs across diabetes, weight, and cardiovascular outcomes, plus two pediatric pivotal trials and a phase 2b Alzheimer’s trial that missed its primary endpoint. This is the opposite of most peptides on this hub.
• Interactions assessed? Partially. The mechanism-based ones (insulin/sulfonylurea hypoglycemia, delayed gastric emptying affecting oral absorption, peri-procedural aspiration) are established; a complete census belongs to the current FDA/EMA label.
• Pregnancy/lactation assessed? At label level — not recommended in pregnancy; lactation data limited. No human outcome dataset.
• Long-term safety established? More so than anything else on this hub. Multi-year randomized data exist (LEADER over a median 3.8 years, the prediabetes extension over 3 years) and the molecule has been marketed since 2010 with a correspondingly long pharmacovigilance record. That still does not establish decade-scale safety, the safety of indefinite use for weight maintenance, the human relevance of the rodent thyroid C-cell signal, or long-term pediatric outcomes — and it says nothing at all about gray-market product.

Never imply safety from silence — and never transfer this trial record to unlicensed product. Everything above describes pharmaceutical-grade liraglutide used as prescribed.

Pregnancy & Lactation

⚠ Avoid in pregnancy? Not established in lactation

Not recommended in pregnancy. The label advises against use, on the basis of animal reproductive-toxicity findings and the fact that intentional weight loss confers no benefit during pregnancy; liraglutide should be discontinued when pregnancy is planned or recognized. Human pregnancy safety is not established and lactation data are limited. The ~13-hour half-life means washout is a matter of days rather than the weeks required for semaglutide or tirzepatide — a genuine practical advantage in this specific situation. Two points still compound: delayed gastric emptying can affect oral contraceptive absorption, and weight loss itself can restore fertility in people who did not expect it. Contraception planning belongs at the start of treatment, not after.

Dosage

Liraglutide is a prescription medicine that is dosed and titrated by a clinician. Nothing here is a recommendation, and it must not be self-sourced or self-dosed. The figures below are reported as trial and label data for context.

For type 2 diabetes (Victoza and its generics), dosing starts at 0.6 mg once daily by subcutaneous injection — a starting dose intended for tolerability, not effect — and escalates after at least a week to 1.2 mg, and if needed to a maximum of 1.8 mg daily; this is the range used throughout the LEAD program and in LEADER ^{1,2,10Reference 1Garber A et al. · 2009RCTLiraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono) — human (RCT)View study →Reference 2Nauck M et al. · 2009RCTEfficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2 diabetes (LEAD-2) — human (RCT)View study →Reference 10Marso SP et al. · 2016RCTLiraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER) — human (RCT, cardiovascular outcomes)View study →}. For chronic weight management (Saxenda and its generics), dosing starts at 0.6 mg daily and escalates in 0.6 mg steps at weekly intervals to 3.0 mg once daily, the dose used in the SCALE trials ^{4,5,6Reference 4Pi-Sunyer X et al. · 2015RCTA Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management (SCALE Obesity and Prediabetes) — human (RCT)View study →Reference 5Davies MJ et al. · 2015RCTEfficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes (SCALE Diabetes) — human (RCT)View study →Reference 6Wadden TA et al. · 2013RCTWeight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss (SCALE Maintenance) — human (RCT)View study →}. Pediatric trials used up to 1.8 mg in youth-onset type 2 diabetes ^{12Reference 12Tamborlane WV et al. · 2019RCTLiraglutide in Children and Adolescents with Type 2 Diabetes (ELLIPSE) — human (RCT, paediatric)View study →} and 3.0 mg in adolescent obesity ^{11Reference 11Kelly AS et al. · 2020RCTA Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity — human (RCT, paediatric)View study →}. There is no oral form, so no oral figure exists to report.

The titration schedule is not a formality. Escalating faster than the label sequence is the main cause of severe gastrointestinal effects and of discontinuation. “Microdosing” — indefinite use of sub-therapeutic amounts, common in the gray market — has no trial evidence at all; it extrapolates from a dose-response curve that was never studied at those doses, usually using product whose actual concentration is unverified. This entry is informational only.

References

1. Garber A, et al. (2009). Liraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono) — human (RCT). Lancet. https://pubmed.ncbi.nlm.nih.gov/18819705/
2. Nauck M, et al. (2009). Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2 diabetes (LEAD-2) — human (RCT). Diabetes Care. https://pubmed.ncbi.nlm.nih.gov/18931095/
3. Buse JB, et al. (2009). Liraglutide once a day versus exenatide twice a day for type 2 diabetes (LEAD-6) — human (RCT, head-to-head). Lancet. https://pubmed.ncbi.nlm.nih.gov/19515413/
4. Pi-Sunyer X, et al. (2015). A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management (SCALE Obesity and Prediabetes) — human (RCT). N Engl J Med. https://pubmed.ncbi.nlm.nih.gov/26132939/
5. Davies MJ, et al. (2015). Efficacy of Liraglutide for Weight Loss Among Patients With Type 2 Diabetes (SCALE Diabetes) — human (RCT). JAMA. https://pubmed.ncbi.nlm.nih.gov/26284720/
6. Wadden TA, et al. (2013). Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss (SCALE Maintenance) — human (RCT). Int J Obes (Lond). https://pubmed.ncbi.nlm.nih.gov/23812094/
7. le Roux CW, et al. (2017). 3 years of liraglutide versus placebo for type 2 diabetes risk reduction and weight management in individuals with prediabetes — human (RCT). Lancet. https://pubmed.ncbi.nlm.nih.gov/28237263/
8. Rubino DM, et al. (2022). Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight (STEP 8) — human (RCT, head-to-head). JAMA. https://pubmed.ncbi.nlm.nih.gov/35015037/
9. Capehorn MS, et al. (2020). Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in type 2 diabetes (SUSTAIN 10) — human (RCT, head-to-head). Diabetes Metab. https://pubmed.ncbi.nlm.nih.gov/31539622/
10. Marso SP, et al. (2016). Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER) — human (RCT, cardiovascular outcomes). N Engl J Med. https://pubmed.ncbi.nlm.nih.gov/27295427/
11. Kelly AS, et al. (2020). A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity — human (RCT, paediatric). N Engl J Med. https://pubmed.ncbi.nlm.nih.gov/32233338/
12. Tamborlane WV, et al. (2019). Liraglutide in Children and Adolescents with Type 2 Diabetes (ELLIPSE) — human (RCT, paediatric). N Engl J Med. https://pubmed.ncbi.nlm.nih.gov/31034184/
13. Armstrong MJ, et al. (2016). Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN) — human (RCT, phase 2). Lancet. https://pubmed.ncbi.nlm.nih.gov/26608256/
14. Blackman A, et al. (2016). Effect of liraglutide 3.0 mg in individuals with obesity and moderate or severe obstructive sleep apnea (SCALE Sleep Apnea) — human (RCT). Int J Obes (Lond). https://pubmed.ncbi.nlm.nih.gov/27005405/
15. Edison P, et al. (2026). Liraglutide in mild to moderate Alzheimer’s disease: a phase 2b clinical trial (ELAD) — human (RCT, primary endpoint not met). Nat Med. https://pubmed.ncbi.nlm.nih.gov/41326666/
16. Gallo M, et al. (2022). Oligomerization, albumin binding and catabolism of therapeutic peptides in the subcutaneous compartment: an investigation on lipidated GLP-1 analogs — in vitro. J Pharm Biomed Anal. https://pubmed.ncbi.nlm.nih.gov/35042144/
17. Reddiar SB, et al. (2024). Lymphatic uptake of the lipidated and non-lipidated GLP-1 agonists liraglutide and exenatide is similar in rats — animal (rat). Eur J Pharm Biopharm. https://pubmed.ncbi.nlm.nih.gov/38789061/
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