Skip to main content

For chronic weight management in adult patients with a BMI ≥30 kg/m2, or ≥27 kg/m2 with one or more weight-related comorbidities, as an adjunct to a reduced-calorie diet and increased physical activity. Click for Limitations of Use.

Saxenda® Dosing

Proper dose escalation can help reduce the likelihood of certain gastrointestinal adverse events

Saxenda® Dosing

Proper dose escalation can help reduce the likelihood of certain gastrointestinal adverse events

Actor Portrayal.

The Saxenda® Dosing Schedule

Patients should follow a 4-week dose escalation to reach the clinically efficacious 3-mg dose. The 4-week dose-escalation period can reduce the likelihood of gastrointestinal symptoms.1

The Saxenda® dosing schedule
The Saxenda® dosing schedule

The Saxenda® starting dose is 0.6 mg per day for 1 week.1

Patients increase the dose by 0.6 mg each week until the full maintenance dose of 3 mg is reached.1            

Patients who start with a sample pen will need a prescription to complete dosage.

Tips for Managing Nausea in Patients

The most common side effect a patient may experience when they first start Saxenda® is nausea. This usually improves as their body adjusts to treatment.1

If patients do experience nausea, there are some general recommendations that they can follow. You can advise them to2:

  • Eat bland, low-fat foods, like crackers, toast, and rice
  • Eat foods that contain water, like soups and gelatin
  • Avoid lying down after they eat
  • Go outside to get some fresh air

Eat bland, low-fat foods, like crackers, toast, and rice

  • Eat bland, low-fat foods, like crackers, toast, and rice
  • Eat foods that contain water, like soups and gelatin
  • Avoid lying down after they eat
  • Go outside to get some fresh air
  • Eat bland, low-fat foods, like crackers, toast, and rice

Eat foods that contain water, like soups and gelatin

  • Eat bland, low-fat foods, like crackers, toast, and rice
  • Eat foods that contain water, like soups and gelatin
  • Avoid lying down after they eat
  • Go outside to get some fresh air
  • Eat foods that contain water, like soups and gelatin

Avoid lying down after they eat

  • Eat bland, low-fat foods, like crackers, toast, and rice
  • Eat foods that contain water, like soups and gelatin
  • Avoid lying down after they eat
  • Go outside to get some fresh air
  • Avoid lying down after they eat

Go outside to get some fresh air

 

  • Eat bland, low-fat foods, like crackers, toast, and rice
  • Eat foods that contain water, like soups and gelatin
  • Avoid lying down after they eat
  • Go outside to get some fresh air
  • Go outside to get some fresh air

 

Side effects callout

Actor Portrayal.

Talk to your patients about potential side effects, including nausea, and how to manage them

  • If patients cannot tolerate an increased dose during dose escalation, consider delaying escalation for approximately 1 week. If a patient cannot tolerate the 3-mg dose, discontinue treatment1

If patients cannot tolerate an increased dose during dose escalation, consider delaying escalation for approximately 1 week. If a patient cannot tolerate the 3-mg dose, discontinue treatment1

Patient image

Actor Portrayal.

Be sure to schedule a 16-week assessment, an important benchmark for measuring weight-loss programs1

16-Week Assessment

After 16 weeks on treatment, evaluate change in body weight, when a prior authorization reauthorization may be necessary to be initiated in-office.

If a patient has not lost ≥4% of baseline body weight by week 16, discontinue Saxenda®, as it is unlikely the patient will achieve and sustain clinically meaningful weight loss with continued treatment.1

Writing a Saxenda® Prescription

Prescribe Saxenda® and NovoFine® 32G Tip needles through your EHR system, including the 4-week dose escalation, and schedule a 16-week follow-up visit.

ePrescribing information

Saxenda®

Form/strengh: 18 mg/3 mL

Quantity: 15 mL

Dosage form: Solution, NDC 0169-2800-15

NovoFine® 32G Tip needle

Quantity: 1 box (#100)

Dosage form: Disposable needles, NDC 0169-1851-89

Starting on Saxenda® (disp: 5 pens)

Week 1 ı 0.6 mg SC once daily x 7 days

Week 2 ı 1.2 mg SC once daily x 7 days

Week 3 ı 1.8 mg SC once daily x 7 days

Week 4 ı 2.4 mg SC once daily x 7 days

Week 5 ı 3.0 mg SC once daily x 7 days

Staying on Saxenda® (disp: 5 pens)

3.0 mg SC once daily

Staying on Saxenda® pen graphic

EHR, electronic health record.

RECOMMENDED CONTENT

Using the Saxenda® Pen

Selected Important Safety Information

WARNING: RISK OF THYROID C-CELL TUMORS
Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Saxenda® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Saxenda® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC with use of Saxenda® and inform them of symptoms of thyroid tumors (eg, a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Saxenda®.

Indications and Usage

  • Saxenda® (liraglutide) injection 3 mg is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adult patients with an initial body mass index (BMI) of 30 kg/m2 or greater (obesity) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbid condition (eg, hypertension, type 2 diabetes mellitus, or dyslipidemia)

Limitations of Use

  • Saxenda® is not indicated for the treatment of type 2 diabetes 
  • Saxenda® and Victoza® both contain the same active ingredient, liraglutide, and therefore should not be used together. Saxenda® should not be used in combination with any other GLP-1 receptor agonist 
  • Saxenda® has not been studied in patients taking insulin. Saxenda® and insulin should not be used together 
  • The safety and efficacy of Saxenda® in combination with other products for weight loss, including prescription drugs, over-the-counter drugs, and herbal preparations, have not been established

Important Safety Information

Contraindications

Saxenda® is contraindicated in:

  • Patients with a personal or family history of MTC or MEN 2 
  • Patients with a prior serious hypersensitivity reaction to liraglutide or to any of the product components 
  • Pregnancy

Warnings and Precautions

  • Risk of Thyroid C-cell Tumors: If serum calcitonin is measured and found to be elevated, the patient should be further evaluated. Patients with thyroid nodules noted on physical examination or neck imaging should also be further evaluated 
  • Acute Pancreatitis: Acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with liraglutide postmarketing. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Saxenda® promptly and if pancreatitis is confirmed, do not restart 
  • Acute Gallbladder Disease: Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in patients treated with Saxenda® than with placebo even after accounting for the degree of weight loss. If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated 
  • Risk of Hypoglycemia with Concomitant Use of Anti-Diabetic Therapy: When Saxenda® is used with an insulin secretagogue (eg, a sulfonylurea) serious hypoglycemia can occur. Consider lowering the dose of the insulin secretagogue to reduce the risk of hypoglycemia. Monitor blood glucose parameters prior to starting Saxenda® and during treatment and adjust anti-diabetic drugs as needed 
  • Heart Rate Increase: Mean increases in resting heart rate of 2 to 3 beats per minute (bpm) were observed in patients treated with Saxenda®. Monitor heart rate at regular intervals and inform patients to report palpitations or feelings of a racing heartbeat while at rest during treatment with Saxenda®. Discontinue Saxenda® in patients who experience a sustained increase in resting heart rate 
  • Renal Impairment: Acute renal failure and worsening of chronic renal failure, which may sometimes require hemodialysis, have been reported, usually in association with nausea, vomiting, diarrhea, or dehydration. Use caution when initiating or escalating doses of Saxenda® in patients with renal impairment 
  • Hypersensitivity Reactions: Serious hypersensitivity reactions (eg, anaphylaxis and angioedema) have been reported in patients treated with liraglutide. If a hypersensitivity reaction occurs, patients should stop taking Saxenda® and promptly seek medical advice 
  • Suicidal Behavior and Ideation: In clinical trials, 9 (0.3%) of 3,384 patients treated with Saxenda® and 2 (0.1%) of the 1,941 treated with placebo reported suicidal ideation; one of the patients treated with Saxenda® attempted suicide. Monitor patients on Saxenda® for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior. Discontinue treatment if patients experience suicidal thoughts or behaviors. Avoid Saxenda® in patients with a history of suicidal attempts or active suicidal ideation

Adverse Events

  • The most common adverse reactions, reported in ≥5% are: nausea, hypoglycemia, diarrhea, constipation, vomiting, headache, decreased appetite, dyspepsia, fatigue, dizziness, abdominal pain, and increased lipase

Drug Interactions

  • Saxenda® causes a delay of gastric emptying, and has the potential to impact the absorption of concomitantly administered oral medications. Monitor for potential consequences of delayed absorption of oral medications concomitantly administered with Saxenda®

Use in Specific Populations

  • There are no data on the presence of liraglutide in human breast milk; liraglutide was present in the milk of lactating rats 
  • Saxenda® has not been studied in patients below 18 years of age and is not recommended for use in pediatric patients 
  • Saxenda® slows gastric emptying. Saxenda® has not been studied in patients with preexisting gastroparesis

Please click here for Prescribing Information, including Boxed Warning.

 

Click below to expand

1. Saxenda® [package insert]. Plainsboro, NJ: Novo Nordisk Inc; 2018.

2. When you have nausea and vomiting. Medline Plus website. https://medlineplus.gov/ency/patientinstructions/000122.htm. Updated August 22, 2016. Accessed November 14, 2018.