Liraglutide

GLP-1 Receptor Agonistapproved

Also known as: Victoza, Saxenda, NN2211

An FDA-approved GLP-1 receptor agonist used for type 2 diabetes and obesity management, with cardiovascular and neuroprotective benefits.

Overview

Liraglutide is a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist with 97% amino acid homology to native human GLP-1. Developed by Novo Nordisk, it is FDA-approved as Victoza for type 2 diabetes (1.8mg daily) and as Saxenda for chronic weight management (3.0mg daily). Liraglutide works by enhancing insulin secretion, suppressing glucagon, slowing gastric emptying, and reducing appetite through central satiety pathways. It was one of the first GLP-1 receptor agonists to demonstrate cardiovascular benefits in the landmark LEADER trial, reducing major adverse cardiovascular events in high-risk patients. Liraglutide is administered via once-daily subcutaneous injection using a pre-filled pen device.

Mechanism of Action

Liraglutide binds to and activates the GLP-1 receptor, a G-protein coupled receptor present on pancreatic beta cells, the GI tract, brain, heart, and other tissues. Key actions include: (1) Glucose-dependent insulin secretion enhancement from pancreatic beta cells; (2) Suppression of inappropriately elevated glucagon secretion; (3) Delayed gastric emptying, prolonging satiety; (4) Central appetite suppression via hypothalamic GLP-1 receptors; (5) Cardioprotective effects through anti-inflammatory and anti-atherosclerotic pathways; (6) A fatty acid side chain enables albumin binding, extending half-life to ~13 hours for once-daily dosing.

Molecular Formula

C172H265N43O51

Molecular Weight

3751.2 g/mol

Sequence

Modified GLP-1(7-37) with Arg34Lys substitution and C16 fatty acid acylation at Lys26

Dosage Protocols

Dose Range

0.6mg1.8mg

Frequency

Once daily

Route

subcutaneous

Cycle Length

Ongoing / chronic

Start at 0.6mg for one week, titrate to 1.2mg, then optionally to 1.8mg. Inject in abdomen, thigh, or upper arm. Any time of day regardless of meals.

Source: FDA prescribing information (Victoza)

Side Effects

EffectSeverity
Nauseamoderate
Vomitingmoderate
Diarrheamild
Constipationmild
Injection site reactionmild
Headachemild
Pancreatitissevere
Hypoglycemiamoderate

Pros & Cons

FDA-approved with extensive clinical trial data supporting safety and efficacy

Proven cardiovascular benefit — reduced MACE by 13% in the LEADER trial

Effective for both diabetes management and weight loss with dual approved indications

Convenient once-daily dosing with easy-to-use pre-filled pen

Well-established long-term safety profile over 10+ years of clinical use

Significant GI side effects (nausea, vomiting) especially during initiation, causing discontinuation in some patients

Requires daily injection, unlike weekly alternatives such as semaglutide

Expensive without insurance; brand-name cost can exceed $1000/month

Black box warning for thyroid C-cell tumors (observed in rodents, relevance to humans uncertain)

Less potent for weight loss than newer agents like semaglutide and tirzepatide

Research Studies

Legal Status

FDA-approved (Victoza for T2DM, 2010; Saxenda for weight management, 2014). Prescription-only medication worldwide. EMA-approved. Covered by most insurance plans for approved indications.

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