Glucagon-like peptide-1 (GLP-1) receptor agonist
ATC code: A10BJ02 (Liraglutide)
Brand names
Victoza, Saxenda, Xultophy
A human GLP-1 analogue with 97% homology and resistance to DPP-4. Binds GLP-1 receptors on pancreatic β-cells to enhance glucose-dependent insulin secretion and suppress glucagon. Slows gastric emptying and reduces appetite through hypothalamic centers. Affects cardiovascular outcomes – the LEADER trial cut the 3-point MACE (cardiovascular death, non-fatal MI, non-fatal stroke) by 13%. Half-life 13 hours; once-daily subcutaneous dosing.
Second line
For obesity, liraglutide (Saxenda) is used at 3 mg subcutaneously once daily. The SCALE Obesity and Prediabetes trial showed weight loss of 8% at 56 weeks versus 2.6% on placebo. AACE/ACE 2024 and SEEDO 2024 indicate obesity pharmacotherapy at BMI ≥30 or BMI ≥27 with comorbidities after lifestyle change failure. and produce greater weight loss with less frequent injections.
Saxenda is approved for obesity in patients with BMI ≥30 or BMI ≥27 with comorbidities.
First line
First-line in type 2 diabetes alongside metformin in patients with established cardiovascular disease per / 2024 and SED 2023. Reduces by 1.0–1.5%, lowers weight by 2–4 kg, and cuts cardiovascular events. Start at 0.6 mg subcutaneously once daily and titrate to 1.8 mg over 1–2 weeks. With more convenient and effective analogues (semaglutide, tirzepatide), liraglutide is partly losing its first-choice place.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. It is prescribed for type 2 diabetes (Victoza) and for obesity or overweight with comorbidities (Saxenda) ( 2024, AACE 2023, EASO 2023). In people with normal weight (BMI below 27 kg/m²) and without diabetes, liraglutide for appetite correction is not justified. The drug has serious risks: GI disturbances (nausea, vomiting, diarrhea in 25-40%), pancreatitis, medullary thyroid cancer risk ( boxed warning in MEN-2 patients), cholelithiasis, and severe muscle atrophy with rapid weight loss. If liraglutide was prescribed to a person with normal weight, consider seeking a second opinion.
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Boxed warning
FDA boxed warning: in rodent studies liraglutide induced thyroid C-cell tumors. In humans the association is not confirmed, but the drug is contraindicated with personal or family history of medullary thyroid carcinoma or MEN2.
Contraindicated in pregnancy. When pregnancy is planned in a T2D patient, discontinue at least 1 month before conception and switch to insulin.
Limited data. Use during lactation is not recommended.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Liraglutide is evaluated for the following indications with varying evidence strength: Obesity (evidence tier A), Type 2 diabetes mellitus (evidence tier A), Weight loss (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Liraglutide (≥ 1 in 100): Nausea (especially in the first weeks), Vomiting, diarrhea, Reduced appetite, Injection site pain and erythema, Headache, Hypoglycemia with sulfonylureas or insulin. See the Safety section for uncommon and serious reactions.
FDA category X. Contraindicated in pregnancy. When pregnancy is planned in a T2D patient, discontinue at least 1 month before conception and switch to insulin.
Limited data. Use during lactation is not recommended.
Liraglutide is contraindicated in: Liraglutide hypersensitivity; Personal or family history of medullary thyroid carcinoma; Multiple endocrine neoplasia type 2 (MEN2); Type 1 diabetes, diabetic ketoacidosis; Severe hepatic or renal impairment (limited experience). Full list in the Safety section.
FDA boxed warning: in rodent studies liraglutide induced thyroid C-cell tumors. In humans the association is not confirmed, but the drug is contraindicated with personal or family history of medullary thyroid carcinoma or MEN2.