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Liraglutide

GLP-1 receptor agonist · Saxenda, Victoza

UK status

MHRA licensed

Availability

Prescription only

Evidence base

Human RCT, phase 3

Controlled drug

No

Liraglutide is the older generation. It works on the same receptor as semaglutide, but it is cleared faster, so it needs injecting daily rather than weekly. That difference alone explains most of why it has fallen out of favour.

01What it is

Liraglutide is a GLP-1 analogue that stays closer to the natural hormone than semaglutide does. One amino acid is substituted and a fatty acid chain is attached, which extends its life in the body from minutes to around a day.

It matters historically because it established that the GLP-1 approach worked, both for blood glucose and for weight. Everything since has essentially been an attempt to improve on it.

02UK legal and licensing status

Two brands, two indications. Victoza is licensed for type 2 diabetes. Saxenda is licensed for weight management. As with semaglutide, the same active drug under different brands with different licences is a common source of confusion.

NICE has issued guidance covering liraglutide for weight management within specialist services. In practice, availability has shifted towards the weekly drugs.

03How it works

Identical mechanism to semaglutide at the GLP-1 receptor: glucose-dependent insulin release, slower gastric emptying, reduced appetite signalling. The practical differences come from how long it lasts, not from what it does.

• Daily injection. A shorter half-life means daily administration, which most people find less convenient.
• Smaller average effect. Trial results for weight change are generally lower than those reported for semaglutide and tirzepatide, though the trials differ in design and population.

04What the evidence shows

The main programmes are LEAD for type 2 diabetes and SCALE for weight management, alongside the LEADER cardiovascular outcomes trial. All were funded by Novo Nordisk.

Liraglutide has a longer real-world track record than the newer drugs simply because it has been in use longer, which is worth something when judging safety.

05Reported harms

The side effect profile is the class profile: gastrointestinal effects most commonly, with rarer signals set out in the Summary of Product Characteristics. The surgery and contraception advice for GLP-1 medicines applies.

06Sources

Links go to the primary source. Where a source is behind a paywall or requires registration, the citation is given so you can find it yourself.

1. Summary of Product Characteristicselectronic medicines compendium
2. Liraglutide monographBNF
3. Technology appraisal guidanceNICE
4. SCALE trialNew England Journal of Medicine, 2015
5. LEADER trialNew England Journal of Medicine, 2016