The Independent Pharmacy

How Do I Use The Saxenda Weight Loss Injection?

Daniel Hurley
Daniel HurleyMPharm IPPharmacist Independent Prescriber

Reviewed on 28 Sep 2023

Now that you and your healthcare provider have agreed that it's time for you to start your weight loss treatment with Saxenda, you might be a bit nervous about using the injections.

But don't worry, Saxenda comes in a special pen that makes the process easier. Just clean the area where you'll inject—usually your belly or thigh—with an alcohol wipe, gently push the needle in, and press the button on the pen. You're not alone in this; we're here to guide you every step of the way.

With obesity rates rising globally, many are struggling to lose weight and keep it off. Diet and exercise alone often fall short for sustainable weight loss, leading people to seek medical solutions.

One option is Saxenda, a prescription shot you can take to help you manage your weight over the long term. But how should you use it to achieve optimal results?

Once you understand how Saxenda works and how to use it, you'll be able to start your journey with comfort and confidence.

How to Use Saxenda

Using Saxenda properly is important for safety and effectiveness. Follow these steps when taking Saxenda for weight management.

Preparing the Injection

Saxenda comes in a prefilled, pen injector that is ready for use. To prepare your dose:

  1. Take the Saxenda pen out of the refrigerator and allow it to reach room temperature for a minimum of 15 minutes before injecting. The cold solution is more painful to inject.
  2. Check the pen label and expiration date. The expiration date is usually printed on the side of the pan, often near the barcode or on the pen's label. It's typically in the format of "EXP", followed by the month and year. Do not use it if expired. Expired medication might lose its effectiveness and may not be safe to use. So, always make sure that your pen is within its valid usage period.
  3. Wash hands thoroughly with soap and water for at least 20 seconds. The soap should be mild and non-perfumed so you don't put yourself at risk of any potential irritation or allergic reaction at the injection site.
  4. Inspect the pen for damage, cloudiness, or contamination. Look for any cracks or breaks in the pen. If the pen is damaged, it might not deliver the medication correctly. The solution should be clear and colourless. Cloudiness could indicate contamination or that your medication has gone bad. You should also check for any particles or discolouration in the solution. Any foreign particles could be a sign of contamination. Use a new pen if you notice any issues.
  5. Attach a new disposable needle. But how can you do that? First, remove the protective seal from the new disposable needle. Then, attach the needle to the pen by screwing it on tightly. Make sure it's secure to prevent any leaks during the injection. Saxenda pens are meant for single use only, and you should use a new needle for each injection to maintain sterility and reduce the risk of infection.
  6. Dial your prescribed dose by turning the dose selector until the right number lines up with the pointer. That way, you'll get the correct amount of medication during each injection.
  7. Pull off the outer needle cap and set aside. Do not throw it away.
  8. Pull off the inner needle cap and discard. This reveals the needle, and you're now ready to administer the injection.

Administering the Injection

Saxenda is injected just under the skin, usually in the stomach area, thigh, or upper arm. To inject:

  1. Use an alcohol swab to disinfect the injection site in a circular motion, starting at the centre and moving outward. Swab for about 10 seconds to ensure the area is thoroughly cleaned. Allow the alcohol to dry for at least 30 seconds. That gives the alcohol time to evaporate, and you'll feel less sting when injecting.
  2. Insert the needle all the way into the skin fold at a 90-degree angle to the skin surface. If you have thinner skin or less fatty tissue, it might be helpful to pinch or fold the skin to ensure the injection goes into the fatty tissue and not the muscle beneath. Hold the skin fold throughout the injection process.
  3. Press and hold down the dose button until the dose counter returns to 0.
  4. Keep the needle in for 6 seconds, then withdraw and gently release the skin fold. Withdraw the needle slowly and steadily to reduce any discomfort or bleeding. Ensure you pull the needle out in the same straight line as it was inserted to minimise tissue damage.
  5. Apply pressure with a cotton ball or gauze if there's any bleeding.
  6. Recap the needle using the external cap. This prevents accidental pricks and makes disposal safer. To dispose of the used pens safely, you need to use a sharps bin. It's a specially designed box with a lid that is available from a pharmacist or your GP. When the box is full, it can be collected by your local council for disposal.

Rotate your daily injection sites. Saxenda can be injected any time of day without regard to meals.

If you're feeling unsure about how to use Saxenda, it's completely okay. Your healthcare provider is just a call away and more than willing to guide you through the process.

Choosing an Injection Point

Selecting the right injection point is crucial for comfort and effectiveness:

  1. Preferred Sites: The best sites for subcutaneous injections like Saxenda are the thighs, stomach, or upper arms. These areas have a good amount of fatty tissue, which is ideal for this type of injection.

  2. Avoiding Veins: Saxenda is a subcutaneous injection, meaning it's intended to be injected into the fatty tissue just below the skin and not into a vein. Before injecting, ensure you're not targeting a visible vein.

  3. Rotating Sites: It's essential to rotate your injection sites daily. This helps reduce the risk of developing lumps or hardened areas. If you inject in the same spot repeatedly, you might experience skin issues or reduced absorption of the medication.

  4. Avoiding Problematic Areas: Do not inject into areas with scars, bruises, or any skin abnormalities. These might interfere with the absorption of the medication.

Common Problems with Injections and How to Handle Them

  1. Bleeding or Bruising: Some minor bleeding or bruising at the injection site is common. Applying pressure with a cotton ball or gauze pad immediately after the injection can help. If you're experiencing excessive bruising, consider rotating your injection sites more frequently.

  2. Lumps or Hardened Areas: If you notice lumps, bumps, or hardened areas at the injection site, it might be due to frequent injections in the same spot. Ensure you're rotating your injection sites and not injecting into scar tissue.

  3. Pain or Burning Sensation: If the medication stings or burns during the injection, ensure the alcohol used to clean the site has fully dried before injecting. Also, allowing the medication to reach room temperature before injecting can reduce discomfort.

  4. Redness or Swelling: Some redness or swelling is normal after an injection. However, if it persists or is accompanied by warmth, it might be a sign of an infection. In such cases, consult your healthcare provider.

  5. Air Bubbles: Before injecting, check the Saxenda pen for air bubbles. If you notice any, hold the pen with the needle facing up and tap it gently to move the air bubbles to the top. Then, press the plunger slightly to expel them.

  6. Missed Dose: If you forget to take your dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and return to your regular schedule. Do not take two doses at once.

Emergency Situations with Saxenda

In rare cases, emergencies may arise with Saxenda treatment. Being prepared with the right response can ensure safety.

If an accidental overdose occurs:

  • Seek emergency medical care if a significantly larger than prescribed dose was injected. Overdose can cause nausea, vomiting, and low blood sugar.
  • Bring the Saxenda pen you injected from and inform healthcare providers of the approximate dose administered so they can best treat you.

If Saxenda is accidentally injected into a vein:

  • Apply gentle pressure and contact your doctor. Vein injections of Saxenda may cause a temporary increase in heart rate and bruising.
  • Though not ideal, occasional injection into a vein is not dangerous. But let your doctor know so they can check for any issues.

If Saxenda is accidentally injected into the muscle:

  • The medication may be absorbed faster, increasing side effects like nausea or headache. Apply ice to the injection site to reduce discomfort.

If an allergic reaction occurs:

  • Seek emergency care immediately if you experience signs of an allergic reaction like rash, itching, swelling, trouble breathing, or dizziness.
  • Inform healthcare providers you recently took Saxenda and may be having an allergic reaction.

Though rare, being prepared for emergencies can help mitigate risks when using Saxenda. Reach out to your doctor or emergency services for severe reactions or accidental overdoses.

How to Store Saxenda

Saxenda is a delicate medication that requires some special care when storing the pens:

  • Before first use, Saxenda pens should be stored in the refrigerator between 2°C to 8°C. Keeping them chilled helps maintain drug potency.
  • Do not freeze the Saxenda pens, even by accident. Frozen medication may become less effective. If a pen has been frozen, it should be safely discarded.
  • After taking the first dose, Saxenda pens can be stored for 30 days, either refrigerated or at room temperature between 15°C and 30°C. Keep pens away from direct heat and sunlight.
  • Always discard Saxenda pens 30 days after first opening, even if some medication remains. The expiration date printed on the pen or carton refers to an unopened, unused pen.

Proper storage and careful handling of Saxenda pens help ensure you get the full effectiveness from your medication.

Travelling with Saxenda

If you need to travel with your Saxenda medication, be sure to take the following precautions:

  • When crossing international borders, bring a doctor's note or prescription with the generic name of the drug (liraglutide) to avoid issues.
  • Pack your Saxenda pens in coolers with ice packs to maintain appropriate temperature. Keep pens in carry-on luggage, not checked bags.
  • If travelling by car, use a small cooler. If flying, freeze ice packs ahead of time and keep your medication insulated.
  • Adjust your dosing schedule to account for time zone changes. Take your daily Saxenda dose at the same time relative to your home time zone.
  • For example, if you inject Saxenda daily at 7 a.m. at home and are travelling across multiple time zones, continue taking it at 7 a.m. according to your home time.
  • Set calendar alerts on your phone to remember your normalised injection times. This maintains consistency.
  • Never leave Saxenda pens in direct sunlight or unattended in a hot vehicle. Heat can damage the medication.

With some preparation and planning, you can confidently travel with your Saxenda. Maintaining proper storage temperature and an adjusted injection schedule will keep your treatment on track.

Dosage Guidelines

Saxenda dosing should be personalised based on your health profile and needs. Always follow your doctor’s recommendations. General dosage guidelines are:

  • Starting dose: 0.6 mg once daily for at least one week
  • Increase by 0.6 mg each week until reaching 3.0 mg daily
  • Effective dose: 3.0 mg once daily is the recommended maintenance dose
  • Maximum daily dose: Do not exceed 3.0 mg
  • Take Saxenda at the same time each day, with or without food
  • Use each Saxenda pen for a maximum of 56 doses - label the date of first use
  • Increase the dose slowly to help your stomach get used to the medicine
  • If 3.0 mg daily has not produced adequate weight loss after 12 weeks, discontinue Saxenda as unlikely to be effective for you
  • If a dose is missed for 3 days or more, restart at 0.6 mg and gradually increase to 3.0 mg
  • Saxenda and insulin should not be mixed. Consult a doctor for insulin dosing if using both.

Following dosage instructions carefully can help maximise Saxenda's effectiveness and safety.

Side Effects and Precautions

Like any medication, Saxenda may cause side effects [link to our Saxenda side effects piece] or interact with other drugs. Being aware of the risks can help make sure you use it safely.

Common Side Effects

The most common side effects of Saxenda are gastrointestinal issues like nausea, vomiting, diarrhoea, constipation, abdominal pain, indigestion, or loss of appetite. These tend to be mild to moderate and decrease over time. Injecting Saxenda slowly can help minimise these side effects. Notify your doctor if any side effects are severe or persistent.

Serious Side Effects

Rare but serious risks of Saxenda include inflammation of the pancreas (pancreatitis) - which is a condition that can cause severe stomach pain, kidney problems, gallbladder disease, low blood sugar (hypoglycemia) in patients with type 2 diabetes using other medications, and increased heart rate. Seek emergency care for symptoms like severe stomach pain, vomiting, shortness of breath, or rapid heartbeat.

Saxenda may also increase the risk of thyroid tumours or gland inflammation. People with thyroid nodules, a family history of thyroid cancer, or multiple endocrine neoplasia syndrome type 2 should not use Saxenda.

Precautions

Take care when using Saxenda to reduce risks. Precautions include:

  • Tell your doctor about any medical conditions and all medications you are taking to prevent drug interactions.
  • Do not reuse Saxenda pens or share them with others. Use a new needle for each injection.
  • Store pens in the refrigerator prior to first use. Do not freeze them.
  • Contact your doctor immediately if you notice unusual masses, pain, or numbness near injection sites that don’t go away.

Who Should Use Saxenda?

We understand that finding the right weight loss solution is a personal journey. Saxenda may be a good fit for some, but it's not for everyone. We're here to help you understand if Saxenda could be the right choice for you.

Eligibility Criteria

Saxenda is approved for adults 18 years and older with:

  • A BMI of 30 or higher (obesity)
  • A BMI of 27 or higher (overweight) with at least one weight-related health condition such as high blood pressure, type 2 diabetes, or high cholesterol

Liraglutide might also be prescribed for children. However, that depends on the doctor's assessment and their final recommendation.

Who Should Avoid Saxenda

Saxenda is not recommended for those with:

  • A personal or family history of specific types of thyroid cancer or a rare genetic condition known as MEN type 2
  • Severe kidney disease, severe gastroparesis (a severe condition where the stomach takes too long to empty its contents, leading to digestion issues), or diabetic retinopathy (eye problems related to diabetes that can affect your vision)
  • A history of pancreas issues, such as pancreatitis
  • Pregnancy or breastfeeding

In general, Saxenda should be avoided in patients with a high risk or history of thyroid tumours and used with caution in those with other medical conditions. Always consult a doctor first.

What Is Saxenda?

Saxenda is a brand name for the injectable drug liraglutide. It is classified as a GLP-1 receptor agonist, meaning it mimics the hormone GLP-1 that is released naturally in the body after eating.

In simpler terms, it works by copying the actions of a natural hormone in your body that helps control hunger after you eat. Saxenda was approved by the FDA in 2014 as an addition to diet and exercise for chronic weight management in obese adults or overweight adults with at least one weight-related health condition such as high blood pressure or type 2 diabetes. 2

However, it wasn't until December 2020 that Saxenda was approved for use within the UK's NHS.

How Does Saxenda Work?

Saxenda helps regulate appetite by acting on receptors in the brain that control hunger and fullness. It slows digestion and promotes satiety to reduce calorie intake. The end result is supporting weight loss along with diet and exercise. Clinical studies show Saxenda use helps people lose 5-10% of their body weight compared to placebo over 6 months.

FDA Approval and Medical Backing

In addition to FDA approval, Saxenda for weight loss is recommended by the Endocrine Society clinical practice guidelines for the medical management of obesity. Multiple clinical trials have demonstrated its effectiveness for weight loss in obese and overweight adults. However, it is not meant for short-term or rapid weight loss and requires following dosage guidelines.

Frequently Asked Questions

We understand if you feel nervous about starting your weight loss journey, Saxenda, even after reading the instructions, and you're bound to have questions. But remember that you're not alone. There have been many other patients in your shoes before, and we know how it feels when you're getting to know a new treatment. Here are some of the most common questions we've heard from people like you:

Where is the best place to inject Saxenda?

The best sites for subcutaneous injection are the thighs, stomach, or upper arms. Rotate sites daily. Avoid injecting into areas with scars or bruises.

How do you inject Saxenda in your stomach?

To inject in the stomach, pinch excess abdominal skin/fat and insert the needle fully into the skin fold at a 90-degree angle. Press the dose button and hold for 6 seconds before removing the needle.

Is it better to inject Saxenda in the morning or night?

Saxenda can be injected any time of day without regard to meals. However, taking it at the same time daily provides consistency. Morning injections may cause fewer gastrointestinal issues.

What happens if I inject Saxenda into the muscle?

Injecting Saxenda into the muscle should be avoided, as it can increase side effects. Saxenda is meant for subcutaneous injection only. If injected into the muscle, you may experience muscle soreness, but there is no long-term harm.

Conclusion

Saxenda can be an effective prescription option for weight management in obese adults or overweight adults with obesity-related health conditions. When used properly, along with diet, exercise, and doctor supervision, it may help some people lose significant weight and keep it off.

We know that every individual is unique, and what works for one person may not work for another. That's why it's crucial to consult with your healthcare provider to see if Saxenda is the right fit for you. Make sure to follow dosage guidelines carefully and be aware of potential side effects and drug interactions. Consult your doctor to see if Saxenda may be right for your weight loss goals and to ensure safe, effective treatment.

We recognise that the rising rates of obesity make long-term solutions like Saxenda more important than ever. But remember, there's no magic wand for weight loss—it's a journey that requires lifestyle changes, and it's okay to take it one step at a time. We're here to support you in that journey.

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