Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. GLP-1 is a physiological regulator of appetite and food intake, but the exact mechanism of action is not entirely clear (summary of product characteristics [SPC]: Saxenda).
Liraglutide (SPC: Saxenda) is licensed as an adjunct to a reduced-calorie diet and increased physical activity for weight management in adults with an initial BMI of:
30 kg/m² or more (obese), or
from 27 kg/m² to less than 30 kg/m² (overweight) in the presence of at least 1 weight-related comorbidity such as dysglycaemia (prediabetes or type 2 diabetes mellitus), hypertension, dyslipidaemia or obstructive sleep apnoea.
Treatment should be discontinued after 12 weeks on the 3.0 mg daily dose (recommended maintenance dose) if people have not lost at least 5% of their initial body weight.
Liraglutide (Saxenda) is a different licensed product to liraglutide (Victoza) and the doses of liraglutide (Saxenda) used for weight management are different to that used in managing type 2 diabetes (Victoza). Liraglutide (Victoza) has been licensed in the UK for the treatment of type 2 diabetes in adults since 2009. Victoza is not licensed as a pharmacological treatment for weight management and it also has a different licensed dose range (with a maintenance dose of 1.2 mg to 1.8 mg daily).
One pre-filled Saxenda pen contains 18 mg liraglutide in 3 ml, delivering doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg and 3.0 mg. The starting dose is 0.6 mg daily and the maintenance dose is 3.0 mg daily. The dose should be increased to 3.0 mg daily in increments of 0.6 mg with at least 1 week intervals to improve gastro-intestinal tolerability. If escalation to the next dose step is not tolerated for 2 consecutive weeks, discontinuation of treatment should be considered. Daily doses higher than 3.0 mg are not recommended (SPC: Saxenda).
Liraglutide18 mg/3 ml solution for injection costs £196.20 for 5 prefilled pens (MIMS, May 2017). The 5 prefilled pens equate to 30 days' supply at the maintenance dose of 3.0 mg daily.