Short answer: Saxenda (liraglutide) is a once-daily injection approved for weight loss. Wegovy (semaglutide) is a once-weekly injection, or a daily tablet, approved for weight loss and also to lower heart attack and stroke risk in adults with heart disease.12 In STEP 8, a head-to-head trial, average weight change was −15.8% on Wegovy's drug vs −6.4% on Saxenda's at 68 weeks.3
| Saxenda (liraglutide) | Wegovy (semaglutide) | |
|---|---|---|
| Form | Pen injected once a day; one 3 mL pen gives 0.6, 1.2, 1.8, 2.4 or 3 mg doses1 | Single-dose pen or syringe once a week; a 4-dose FlexTouch pen; or a daily tablet2 |
| Approved for | Weight loss in adults, and in children 12 and older with obesity who weigh more than 60 kg1 | Weight loss in adults and children 12 and older (injection); lowering heart attack, stroke and cardiovascular death in adults with heart disease; MASH liver disease with fibrosis in adults (injection)2 |
| Label dosing | 0.6 mg a day for a week, then up 0.6 mg each week to 3 mg a day from week 51 | 0.25 mg a week for 4 weeks, then up every 4 weeks; usual dose 2.4 mg a week, up to 7.2 mg for adult weight loss2 |
| When to stop (label) | Adults: if under 4% weight loss after 16 weeks. Children: if BMI has not dropped 1% after 12 weeks on the full dose1 | No weight-loss cutoff in the dosing section2 |
| Missed dose | Skip it and take the next one. After more than 3 days off, restart at 0.6 mg1 | Take it if the next dose is more than 2 days away; otherwise skip. After 2 or more missed weeks, restart at a lower dose2 |
| Half-life | about 13 hours1 | about 7 days2 |
| Main adult weight trial | 56 weeks: −7.4% vs −3.0% on placebo1 | 68 weeks: −14.9% vs −2.4% on placebo2 |
| STEP 8 (head to head, 68 weeks) | −6.4%3 | −15.8%3 |
| Nausea in label trials | 39.3% vs 13.8% on placebo1 | 44% vs 16% on placebo2 |
| Pen after first use | 30 days at 59°F to 86°F or in the fridge1 | Single-dose pen: up to 28 days at 46°F to 86°F before the cap comes off. FlexTouch: 56 days2 |
Yes. STEP 8 randomized 338 adults with overweight or obesity and no diabetes to weekly semaglutide 2.4 mg (the Wegovy dose) or daily liraglutide 3 mg (the Saxenda dose) for 68 weeks, with diet and activity counseling. The drug comparison was open label. Average weight change was −15.8% vs −6.4%. At least 10% weight loss was reached by 70.9% vs 25.6%, and at least 15% by 55.6% vs 12.0%.3
Treatment was stopped for any reason by 13.5% on semaglutide vs 27.6% on liraglutide. Stomach and gut side effects were reported by 84.1% vs 82.7%.3
In Saxenda's Study 1, 3,731 adults without diabetes lost 7.4% of body weight on Saxenda vs 3.0% on placebo over 56 weeks.1 In Wegovy's Study 2, 1,961 similar adults lost 14.9% vs 2.4% over 68 weeks.2 These numbers come from separate placebo-controlled trials with different people, lengths and methods, so they are not a head-to-head comparison. STEP 8 is the trial that compared them directly.
In teens 12 to 17, body weight changed −2.65% on Saxenda vs +2.37% on placebo at 56 weeks, and −14.7% on Wegovy vs +2.7% on placebo at 68 weeks, again in separate trials.12
Wegovy has an outcome trial that Saxenda does not. In it, 17,604 adults 45 or older with heart disease and overweight or obesity, but no diabetes, were followed for a median of 41.8 months. Heart attack, stroke or cardiovascular death occurred in 6.5% on Wegovy vs 8% on placebo (hazard ratio 0.80).2 The Saxenda label has no cardiovascular outcome approval.1
More detail: Saxenda side effects, Wegovy side effects, the Saxenda and Wegovy dosing schedules, what to do if you miss a Saxenda dose or miss a Wegovy dose, how to store Saxenda and Wegovy, how long semaglutide takes to work, and the Liraglutide and Semaglutide guides.