The Independent Pharmacy

Saxenda Dosage Guide

Daniel Hurley
Daniel HurleyMPharm IPPharmacist Independent Prescriber

Reviewed on 11 Oct 2023

For those prescribed the injectable Saxenda (liraglutide) for chronic weight management, determining the optimal dosage for safe and effective weight loss can also prove difficult. It's understandably frustrating when an improper liraglutide dose leads to slow progress or uncomfortable side effects like nausea and vomiting.

We'll help you understand how to use the medication for weight loss, liraglutide, by going over the dosage and titration (adjusting the amount over time) in an easy-to-follow way so you get the most out of your weight loss treatment.

Once we get to the end of our learning odyssey, you can feel fully equipped to work with your doctor to tailor your liraglutide dosage plan. With the right approach, you'll gain the key to safely losing excess body fat and reaching your health and wellness goals.

What Is Saxenda?

Saxenda is the brand name for the injectable weight loss medication liraglutide, an anti-obesity agent prescribed for adults with obesity or who are overweight with at least one weight-related comorbid condition like hypertension, type 2 diabetes or hypercholesterolemia.

Saxenda works by targeting specific areas in your brain known as glucagon-like peptide-1 (GLP-1) receptors. The active ingredient, liraglutide, acts like a natural hormone that helps control your appetite. When these GLP-1 receptors are activated, you'll find that you feel full more quickly, your stomach takes longer to empty, and you're satisfied with smaller portions of food. All of this contributes to helping you lose weight.

In studies that lasted over a year, most people who were significantly overweight and took a daily dose of a medication called liraglutide lost at least 5% of their starting weight compared to those who didn't take the medication. However, Saxenda, the brand name for this medication, works best when you take the right amount for you. This amount can vary based on things like your weight, age, and any other health conditions you may have. Taking too little may not help you lose weight effectively while taking too much could lead to health problems like pancreas issues.

How Do I Take Saxenda?

When starting Saxenda treatment for obesity, patients begin with a lower liraglutide dosage that is gradually increased in a stepwise approach over 5 weeks. This dose escalation allows the body to adjust and reduces the risk of adverse gastrointestinal effects. The dosage is then maintained at the level that provides optimal weight loss results.

The recommended starting dosage is 0.6 mg liraglutide injected subcutaneously once daily. The liraglutide dose should be increased by 0.6 mg weekly until the 3.0 mg daily maintenance dosage is reached. If patients are unable to tolerate the maximum dose of 3.0 mg due to nausea or other side effects, the dosage can be lowered to 1.8 mg or 1.2 mg daily to control adverse reactions while still promoting clinically meaningful weight loss.

Managing medication can be overwhelming, but fortunately, Saxenda comes in pre-filled pen injectors with clear dosage markers in 0.6 mg increments. Patients self-administer the medication via subcutaneous injection in the abdomen, thigh, or upper arm and should closely follow the prescribed liraglutide dosing schedule without skipping or doubling doses. Taking Saxenda consistently every day helps maintain its appetite-suppressing effects.

We know how overwhelming it can be when you're trying to get things right and move below your initial body mass index (BMI).

Here's a Saxenda dosage chart to make your journey a bit easier:

Saxenda Dosage Guide Image


How Much Saxenda Should I Use?

Several key factors impact an individual patient's prescribed liraglutide dosage for weight management, including:

Body Weight

A patient's starting Saxenda dosage is based on their initial body weight, with higher doses sometimes prescribed for heavier individuals to improve efficacy. However, the dose escalation schedule still begins at 0.6 mg liraglutide daily, regardless of weight. If the patient weighs 60 kg or less, the maintenance dose is usually capped at 1.8 mg daily. For those weighing over 60 kg, the dosage can typically be increased up to 3.0 mg daily for additional appetite suppression, especially if weight loss plateaus. However, prescribers may customise dosage beyond these typical recommendations based on individual patient factors. The key is to follow the provider’s prescribed dosage schedule for optimal weight loss results.

Age

No liraglutide dosage adjustment is required based solely on the patient's age. However, elderly patients may require more careful monitoring during dose escalation for increased risks of adverse reactions.

Medical History

If you have certain health issues—like an overactive thyroid, kidney problems, a history of pancreatitis and other pancreas issues, or if you've had weight-loss surgery—you may need a special plan for taking Saxenda, the weight loss medication. Your doctor will keep a closer eye on you to make sure the treatment is safe and effective. Also, if you or anyone in your family has had medullary thyroid carcinoma (MTC), a specific type of thyroid cancer, you shouldn't use Saxenda.

Concurrent Medications

Saxenda dosing may need adjustment if a patient is taking medications like insulin, sulfonylureas, or oral contraceptives due to potential pharmacokinetic drug interactions with liraglutide.

How Do I Take Saxenda?

Properly administering prescribed liraglutide doses from Saxenda pens is vital for safe and effective weight management. Follow these steps when preparing, injecting, and storing your obesity medication:

Preparation

Taking time to correctly prepare Saxenda prior to the first dose is important to promote proper administration.

  • Saxenda comes in pre-filled, 3 mL pen injectors meant only for subcutaneous use. The liraglutide solution should never be transferred out of the pen into a syringe or mixed with other agents, as this could negatively impact the dosage and effectiveness.
  • Prior to first use of a new Saxenda pen, it must be stored properly in a refrigerator between 2°C and 8°C to maintain drug potency. Do not freeze the medication.
  • For a pen that you intend to use ensure that it has aclimitised to room temperature before using. Injecting a cold solution will be more painful.
  • Before injecting a liraglutide dose, visually inspect the Saxenda solution for any particles or discolouration. Do not use the pen if the medication appears cloudy or shows signs of colour change. Only a clear, colourless solution should be injected to avoid adverse reactions.

Following the proper preparation steps helps set patients up for success in their weight loss journey.

Injection Technique

Using the correct injection process is vital for Saxenda to work effectively.

  • Saxenda is administered via subcutaneous injection once daily. Patients should inject into clean skin in areas like the abdomen, thighs, or upper arms using the pen's thin, hidden needle.
  • To reduce the risk of injection site reactions, patients should rotate where they inject each day. Pinch the skin while injecting, and hold for 6 seconds before releasing to ensure full dose delivery.
  • Follow the manufacturer's instructions closely for attaching needles, priming pens, and administering prescribed doses using proper technique.

Closely adhering to the proper injection technique maximises Saxenda's efficacy.

Storage

Appropriately storing Saxenda pens preserves the medication's potency and shelf life.

  • After first use, Saxenda pens can be stored for 30 days at room temperature up to 30°C. Pens should be discarded if any solution remains after 30 days unrefrigerated.
  • Do not store pens with the needle still attached. Always recap needles immediately after use and store pens without any needles attached.
  • Avoid freezing Saxenda or leaving pens exposed to excessive heat over 30°C, as temperature extremes can negatively impact drug potency and effectiveness.

Proper storage helps ensure patients get the full benefits from their Saxenda treatment.

Saxenda Side Effects and the Role of Dosage

Like all prescription medications, liraglutide (Saxenda) can potentially cause adverse reactions in some patients. The most commonly reported adverse effects of Saxenda treatment include:

  • Nausea
  • Diarrhoea
  • Constipation
  • Headache
  • Vomiting
  • Hypoglycemia
  • Dizziness
  • Fatigue

Rarer but potentially serious liraglutide side effects may include:

  • Acute gallbladder disease
  • Acute kidney injury
  • Acute pancreatitis
  • Anaphylactic reactions
  • Thyroid C-cell tumors
  • Severe allergic reaction

Proper liraglutide dosing and titration plays an important role in minimising adverse reactions during Saxenda therapy. Initiating treatment at lower doses and slowly escalating over several weeks allows the body to adjust gradually and reduces gastrointestinal side effects. Not exceeding the maximum recommended 3.0 mg daily maintenance dosage can also lower risks.

We understand that managing medication can be overwhelming, so it's crucial to closely monitor your liraglutide dosing schedule and any side effects you may experience. We're here to guide you every step of the way. If you experience trouble swallowing, shortness of breath, hoarseness or notice a lump or swelling on your neck, get in touch with a healthcare professional immediately.

We know it's a lot to manage, but with careful dosage and close medical monitoring, Saxenda can be an effective and tolerable option for many. We understand setbacks can be disheartening, but don't lose hope during dose adjustments.

Dosage Mistakes to Avoid

To get the maximum benefit from Saxenda, it is important to avoid certain dosing mistakes:

Overdosing

  • Taking too much liraglutide can increase the risk of common side effects like nausea, vomiting, pancreatitis, and thyroid tumors.
  • Never take more than the prescribed dosage for weight loss without consulting your healthcare provider.

Underdosing

  • Taking too little liraglutide may not produce adequate appetite suppression for meaningful weight loss.
  • Follow dosage schedule closely and speak to your provider if dose adjustments are needed.

Ignoring Medical Advice

  • Self-adjusting dosage schedules or discontinuing Saxenda prematurely against medical advice can be unsafe and lead to treatment failure.
  • Always consult your provider before making any dosage changes.

With Saxenda, the proper prescribed dosage maximizes results and minimizes risks. Carefully follow your doctor’s guidance for safe, effective treatment.

Frequently Asked Questions

When taking a medication like Saxenda for weight loss, patients often have questions about the dosage and effects. The proper liraglutide dose is essential for safety and results. This section answers some frequently asked questions about Saxenda dosage and administration:

Can I increase my Saxenda dosage faster than prescribed?

No, you should not increase your liraglutide dose faster than the schedule provided by your healthcare provider. Going up too quickly can increase side effects.

What if I miss a dose of Saxenda?

Take the missed dose as soon as you remember, as long as it is within 12 hours of the regularly scheduled time. If over 12 hours, skip the missed dose and take the next scheduled dose. Do not take an extra dose or increase the dosage to make up for the missed one.

Is it safe to drink alcohol while taking Saxenda?

Alcohol intake should be limited to avoid increased risk of side effects like low blood sugar, dizziness, and nausea when combined with liraglutide. Avoid excessive alcohol consumption while on Saxenda.

How long does it take Saxenda to start working?

It may take several weeks after starting liraglutide for appetite suppression to fully take effect. Weight loss results are gradual but often become noticeable after about 4 weeks at a maintenance dosage. Be patient.

Conclusion: Start Your Weight Loss Journey Today

Losing excess weight can be very challenging, but determining the optimal liraglutide dosage provides a major key to success with Saxenda therapy. As you can tell, Saxenda dosing is complex but manageable with your healthcare provider’s guidance.

Once you understand all the aspects of Saxenda dosage, you can feel empowered to collaborate with a medical professional to tailor the right dosage plan for your needs. While some adverse reactions are possible, appropriate Saxenda dosing helps maximize weight loss benefits and minimize health risks.

With the new knowledge in your arsenal, you can have an in-depth discussion with a health care professional about getting the most out of Saxenda treatment. We understand setbacks can be disheartening, but don't lose hope during dose adjustments. Monitor your response and modify dosages as clinically warranted while making healthy lifestyle changes. Achieving meaningful weight loss results is absolutely possible with the right Saxenda dosage regimen.

Sources:

Obesity - Treatment - NHS (www.nhs.uk)

Liraglutide for weight management: a critical review of the evidence - PMC (nih.gov)

A 2021 Update on the Use of Liraglutide in the Modern Treatment of ‘Diabesity’: A Narrative Review - PMC (nih.gov)

Saxenda, INN-liraglutide (europa.eu)

Impact of dose‐escalation schemes and drug discontinuation on weight loss outcomes with liraglutide 3.0 mg: A model‐based approach - PMC (nih.gov)

Effectiveness and cost of integrating a pragmatic pathway for prescribing liraglutide 3.0 mg in obesity services (STRIVE study): study protocol of an open-label, real-world, randomised, controlled trial | BMJ Open

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