Published-trial titration record
Liraglutide: published trial titration schedule
Liraglutide is MHRA-licensed as Saxenda (3 mg daily for weight management) and Victoza (1.8 mg daily for T2DM). Daily dosing distinguishes it from weekly semaglutide and tirzepatide — a reflection of the 13-hour half-life from C-16 fatty-acid albumin binding rather than the C-18 fatty diacid used in next-generation analogues.
Trial anchor
SCALE Obesity & Prediabetes (NEJM 2015, PMID 26132939) for Saxenda; LEADER (NEJM 2016, PMID 27295427) for Victoza cardiovascular context.
Full molecule profile: Liraglutide
Published titration schedule (trial record)
| Step | Trial-arm dose | Notes |
|---|---|---|
| Week 1 | 0.6 mg daily s.c. | Initiation dose; non-therapeutic. |
| Week 2 | 1.2 mg daily | Victoza T2DM maintenance starts here for some patients. |
| Week 3 | 1.8 mg daily | Victoza primary maintenance dose. |
| Week 4 | 2.4 mg daily | Saxenda intermediate. |
| Week 5+ | 3.0 mg daily (Saxenda maintenance) | SCALE endpoint dose — ~8% mean weight reduction at 56 weeks. |
Maintenance phase (as reported)
Saxenda is licensed for indefinite maintenance at 3 mg daily. Victoza is typically maintained at 1.2 or 1.8 mg daily for T2DM. The daily schedule is a frequently-cited tolerability disadvantage versus weekly alternatives.
Route & storage (trial protocol)
Subcutaneous via prefilled multi-dose pen (abdomen, thigh, upper arm). Store at 2-8°C; up to 30 days at room temperature (≤30°C) once in use. Discard the pen 30 days after first use even if doses remain.
Missed-dose handling (trial protocol)
If missed by more than 12 hours, skip and resume the next-day schedule. Within 12 hours, administer the missed dose.
Methodological considerations
- Concomitant insulin or sulphonylureas: hypoglycaemia risk — those agents typically dose-reduced.
- Diabetic retinopathy: rapid glycaemic improvement can transiently worsen retinopathy.
- Pregnancy: contraindicated.
- Severe gastroparesis: contraindicated.
- Discontinuation rate from gastrointestinal AEs in SCALE was approximately 6-8%, higher than for weekly weight-management agents.
What this evidence does not prove
- · A published titration arm is not a prescription, recommendation or self-administration guide.
- · Trial-arm doses apply only within the studied population, comparator, duration and primary endpoint.
- · Individual suitability requires qualified clinical assessment where licensed; investigational compounds require authorised research oversight.
- · Off-label, compounded, grey-market or self-supplied versions of the same active ingredient may have substantially different identity, purity, sterility and pharmacokinetics.
FAQs
- Why daily liraglutide when semaglutide is weekly?
- Liraglutide's C-16 fatty-acid moiety gives a ~13-hour albumin-binding half-life. Semaglutide's C-18 fatty diacid plus spacer extends albumin affinity enough to push the half-life to ~7 days. Both compounds are Novo Nordisk modifications of native GLP-1; semaglutide is essentially liraglutide chemistry refined for weekly administration.
- How does Saxenda weight loss compare to Wegovy?
- STEP-8 (JAMA 2022) randomised 338 participants to either Saxenda 3 mg daily or Wegovy 2.4 mg weekly over 68 weeks. Mean weight reduction was -15.8% with semaglutide vs -6.4% with liraglutide — confirming the magnitude advantage of the weekly molecule. Liraglutide remains useful where daily dose flexibility is needed or where weekly compounds are not tolerated.
- Is liraglutide compounded by UK pharmacies?
- Less commonly than semaglutide because the Saxenda supply has been more stable. Compounding of liraglutide by a registered UK pharmacy for an individual patient under prescriber authorisation is permitted but uncommon in current practice.