Liraglutide vs Semaglutide: Which GLP-1 Is Best for You?

Exploring the world of medical weight loss can be overwhelming, especially with so many options on the market. It’s likely that you’ve heard of two popular options: liraglutide and semaglutide. These are normally sold under brand names like Sadexa, Victoza, Wegovy, and Ozempic. 

The thing is, they have different dosing schedules, efficacy rates, and costs. So, which one is the best for you? 

Here, we will go over everything you need to know about liraglutide vs semaglutide. We will examine how they work, compare their effectiveness for weight loss and blood sugar control, and break down their safety profiles, convenience, and costs. 

By the end, you’ll understand their similarities and differences to make an informed decision on which one is better for you. Now, keep in mind that this is not meant to be taken as medical advice. Always consult a healthcare professional to determine the best option for you. 

How Liraglutide and Semaglutide Work

Both liraglutide and semaglutide belong to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. They work by mimicking the action of GLP-1, a natural hormone your body releases after eating. 

So, what effects does this hormone have on your body?

• Slows stomach emptying: This helps you feel fuller for longer after meals, helping you reduce your overall calorie intake. 
• Signals feelings of fullness to the brain: GLP-1 agonists act on receptors in the brain that control appetite. This can lead to significant reductions in hunger and food cravings.
• Suppresses glucagon: They also limit the release of glucagon, a hormone that raises blood sugar. As a result, it can help control blood sugar levels.  

While both drugs share the same mechanism of action, their molecular structures are very different. Consequently, they have different half-lives. Affecting the frequency at which you get these medications. 

Semaglutide is designed to bind more strongly to the GLP-1 receptor and has a longer half-life. That is why you can get weekly semaglutide injections. 

On the other hand, liraglutide has a shorter half-life of about 13 hours, which is why you require a daily shot to help keep its effects.  

FDA-Approved Uses & Dosing Schedules

Liraglutide and semaglutide are both sold under different name brands, depending on their intended use. Here are some of the most common brand names that use liraglutide and semaglutide.

Liraglutide

Victoza

Victoza is approved to help manage type 2 diabetes in adults and in children aged 10 and older. The dose typically starts at 0.6 mg daily and up to a maximum of 1.8 mg daily. 

Saxenda

Saxenda is currently used as a weight management medication in adults and in adolescents aged 13-17 with obesity. The starting dose is 0.6 mg daily, and you can gradually increase it daily until you reach a total dose of 3.0 mg daily. 

Semaglutide 

Ozempic 

Currently, Ozempic is approved to help manage type 2 diabetes in adults. The dosing starts at 0.25 mg weekly and is titrated up every 4 weeks to a maximum of 2.0 mg weekly. 

Wegovy

A weekly injection of Wegovy is approved to help promote weight management in adults and adolescents aged 12 and older with obesity. The dose starts at 0.25 mg weekly and is increased monthly to a maintenance dose of 2.4 mg weekly. 

Rybelsus

Rybelsus comes in tablets, and you can take one daily on an empty stomach to help control your type 2 diabetes. The doses are available in 7 mg and 14 mg. 

It’s important to note that while a drug like Victoza may promote weight loss, it is not FDA-approved for that purpose (the same with Ozempic). That is why some insurance companies don’t cover these medications when they are used for weight loss purposes. 

Efficacy Head-to-Head (Weight-Loss & A1c)

So, what does the science say about these medications when it comes to efficacy? Different clinical trials have directly compared liraglutide and semaglutide, providing clear insights into their relative effectiveness. Still, semaglutide always demonstrates coming up on top in both weight loss and blood sugar regulation. 

A 2022 study compared liraglutide vs semaglutide regarding weight loss. The clinical trial provided a direct comparison between once-weekly semalgutide (2.4 mg) and once-daily liraglutide (3.0 mg) for weight management over 68 weeks. It showed that the participants taking semaglutide lost an average of 15% while those taking liraglutide only lost 6% of their body weight. 

Another study compared the effects of these medications regarding blood sugar management. The study compared once-weekly semaglutide (1.0 mg) with once-daily liraglutide (1.2 mg). After 30 weeks, people showed significantly lower A1c levels with semaglutide (1.7%), while there was only a 1% reduction with liraglutide. 

Overall, it appears that semaglutide may be a more effective option for individuals seeking to lose substantial weight and achieve better control over their blood sugar levels. Keep in mind that these results were observed when combined with a healthy lifestyle. 

Side Effects & Safety Comparison

As GLP-1 receptor agonists, both medications share similar side effects, with gastrointestinal issues being the most common. Here is a list of the most common side effects for both liraglutide and semaglutide: 

• Nausea 
• Vomiting 
• Diarrhea
• Constipation
• Abdominal pain 

These side effects typically go away after several days, but they may start showing up again when you have an increase in your dosing. Additionally, it seems that people taking liraglutide experience more nausea and vomiting than semalgutide, especially during the first couple of weeks. 

Both liraglutide carry a boxed warning from the FDA about the risk of thyroid C-cell tumors. Keep in mind that these warnings are based on studies done in rats. We still don’t know if the risk applies to humans as well. Still, people with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not use these medications. 

Other serious but less common risks include: 

• Pancreatitis (inflammation of the pancreas)
• Gallbladder problems (like gallstones)
• Kidney problems (particularly in those who become dehydrated from severe vomiting or diarrhea)
• Diabetic retinopathy (especially for those taking semaglutide)

Convenience, Adherence, and Lifestyle

The dosing schedule is one of the biggest differentiators between the two medications since it can significantly impact a person’s ability to stick with the treatment. 

As mentioned, liraglutide requires a daily injection. For some, this can be a difficult routine to keep up with, and the daily reminder of being on medication can create a psychological burden. 

On the other hand, semaglutide is taken only once a week. This is one of the biggest benefits of semaglutide since it’s more convenient and can promote better adherence. In fact, studies have shown that weekly dosing regimens for chronic conditions generally lead to better patient compliance compared to daily ones. 

But what happens if you hate getting injections? 

The oral semaglutide options (Rybelsus) offer an alternative for those who prefer to avoid injections. However, it does come with strict rules. For example, you need to take it on an empty stomach with no more than 4 ounces of water, and you must wait at least 30 minutes before eating, drinking, ot taking any other medications. 

Cost and Insurance Coverage

The cost of the medication is typically the primary deciding factor. Both liraglutide and semaglutide are expensive brand-name drugs with no generic alternatives currently available. Without insurance, the monthly pricing for these medications can range from approximately $1,000 to $1,350. Here is a breakdown of the pricing for each of the brands: 

• Victoza: $1,000 per month
• Ozempic: $1,100 per month
• Saxenda: $1,350 per month
• Wegovy: $1,350 per month 

The good news is that some insurance companies cover some of these medications. 

• For type 2 diabetes (Victoza, Ozempic, and Rybelsus): Most insurance plans, including Medicare, cover these medications. However, you may need prior authorization. 
• For weight management (Saxeda, Wegovy): In this case, coverage may be less consistent. Many commercial insurance plans don’t cover weight loss medications. In fact, Medicare is prohibited from covering weight loss medications. It’s best to consult with your insurance company to determine what is covered under your policy. 

Now, there are some ways to help reduce the pricing. Manufacturer savings cards and patient assistance programs can help reduce out-of-pocket costs for eligible patients with commercial insurance. 

Which GLP-1 Fits You? A Decision Guide

We now know the differences between liraglutide and semaglutide. So, choosing the best option comes down to personal preference. Remember that any decision you make should be made with your healthcare provider. 

However, if you want to know if there is one better than the other, here is a simple decision tree to help you decide. 

• If your main goal is maximum weight loss or A1c reduction, choose semaglutide. This is the clear winner between the two based on clinical trial data. Its superior efficacy makes it a great option for those achieving aggressive health targets. 
• If you prioritize convenience and adherence, choose semaglutide. The weekly injection of semaglutide is a better option than getting a daily semaglutide shot.
• If you want to avoid injections entirely, choose oral semaglutide (Rybelsus). This is your best option. However, keep in mind that you need to follow strict daily dosing rules. 
• If cost is your main concern or insurance coverage is limited, choose liraglutide. This may be the most affordable option. Additionally, its patents are set to expire soon, which could lead to more affordable generic versions in the future. 
• If you are concerned about long-term safety, choose liraglutide. Since it has been on the market for longer (since 2010), it has a longer track record of real-world safety data compared to semaglutide (approved in 2017). 

FAQs

Is Victoza the same drug as Saxenda?

Yes, they have the same active ingredient, which is liraglutide. However, they have different maximum doses and are FDA-approved for different conditions. Victoza is prescribed for people with type 2 diabetes, while Saxenda is for weight management. 

Can I lose as much on Saxenda as Wegovy if I exercise?

While diet and exercise are important components of any weight management plan and can enhance results, there is a big difference in efficacy between Saxenda and Wegovy. Studies show that you can lose up to 15% of your body weight using semaglutide and only 6% with liraglutide. And, no matter how much you exercise, you will still get roughly the same results. 

Why is semaglutide stronger?

Semaglutide is stronger than liraglutide because of how it was made. It was designed to have a longer half-life and a higher binding affinity for the GLP-1 receptor. This means that it can stay longer in the body and activates the receptor more strongly. As a result, it can lead to bigger effects on appetite and blood sugar management.  

Key Takeaways & Next Steps

• Higher efficacy: Semaglutide has shown better results on appetite suppression (leading to bigger weight loss) and blood sugar management compared to liraglutide. 
• Improved convenience: Since semaglutide has a longer half-life, it means less frequent dosing. That is why semaglutide is a more user-friendly option. 
• Cost considerations: Keep in mind that semaglutide is typically more expensive than liraglutide. Liraglutide is a better option for those looking for a budget-friendly alternative. 
• Insurance coverage: Some insurance companies cover these medications, but it’s all based on your current plan. It’s essential to discuss your current policies with your insurance company to gain a clear understanding. 
• Personalized treatment: Always consult with your healthcare provider to determine the best option based on your medical needs and current lifestyle. 

If you have any more questions regarding medication costs, you can explore our pricing page. And, if you are considering starting your medication weight loss journey, schedule a tele-health consultation with one of our healthcare providers. 

This article is for informational purposes only and does not replace medical advice. Always speak with your doctor about the risks and benefits of any treatment. Both liraglutide and semaglutide carry a boxed warning for the risk of thyroid C-cell tumors. 

Important Safety Information: Semaglutide carries an FDA boxed warning regarding potential thyroid C-cell tumours observed in animal studies. Patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 should not use semaglutide.