Saxenda vs Wegovy: Which Works Better and How They Differ
In the 68-week STEP 8 trial, weekly semaglutide 2.4 mg produced −15.8% mean weight loss vs −6.4% for daily liraglutide 3.0 mg — a 9.4-point gap. Generic liraglutide launched in August 2025; a GoodRx coupon listed $372.45 for one 5-pen carton (ZIP 33102, September 14, 2026).
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Wegovy (semaglutide) beat Saxenda (liraglutide) head-to-head on weight loss in a 68-week randomized trial: after that period, people taking once-weekly semaglutide 2.4 mg lost an average of 15.8% of their body weight, versus 6.4% for people taking once-daily liraglutide 3.0 mg — a difference of 9.4 percentage points [2]. The trade-offs are convenience and cost. Saxenda requires a daily injection, but a generic version launched in the United States on August 28, 2025, and a GoodRx coupon price of $372.45 for a 5-pen carton was listed for ZIP code 33102 as of September 14, 2026 [7][8]. Wegovy is injected once a week; the pricing page used here shows only an “as low as $25.00” offer attached to a Wegovy 1.5 mg, 30-tablet listing, which is a promotional offer, not a cash price for the weekly injection, so the two drugs cannot be compared on cash price from this information [8].
Both drugs are GLP-1 receptor agonists — semaglutide and liraglutide are described as GLP-1 analogs available for weight management [2]. The core differences are the molecule, the injection schedule, and the size of the weight-loss effect.
What is the difference between Saxenda and Wegovy?
Saxenda is liraglutide, an injection given under the skin once a day. It was first approved in the United States in 2010 [4]. The pen is a 6 mg/mL solution in a 3 mL prefilled, single-patient-use device that can deliver doses of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg, or 3 mg [4].
Wegovy is semaglutide. In the head-to-head trial, the comparison arms were semaglutide 2.4 mg once weekly versus liraglutide 3.0 mg once daily [2].
So the practical difference for someone holding a pen: Saxenda means 7 injections a week, Wegovy means 1. Saxenda’s maintenance dose per its FDA label is 3 mg daily [4].
How much more weight do people lose on Wegovy than Saxenda?
In the STEP 8 trial, semaglutide produced significantly more weight loss than liraglutide at 68 weeks [2]. The mean weight change from baseline was −15.8% with semaglutide versus −6.4% with liraglutide, a difference of −9.4 percentage points (95% CI, −12.0 to −6.8; P < .001). Pooled placebo produced −1.9% [2].
The gap was just as large when the trial looked at how many people hit meaningful weight-loss thresholds [2]:
| Weight-loss threshold | Semaglutide 2.4 mg weekly | Liraglutide 3.0 mg daily | Odds ratio (95% CI) |
|---|---|---|---|
| 10% or more | 70.9% | 25.6% | 6.3 (3.5–11.2) |
| 15% or more | 55.6% | 12.0% | 7.9 (4.1–15.4) |
| 20% or more | 38.5% | 6.0% | 8.2 (3.5–19.1) |
The primary endpoint of the trial was percentage change in body weight, and the 10%, 15%, and 20% thresholds were confirmatory secondary endpoints, all favoring semaglutide (all P < .001) [2]. These are trial averages, not a promise of what any one person will lose.
How was the head-to-head trial conducted?
STEP 8 was a randomized, open-label, 68-week phase 3b trial at 19 US sites, with enrollment from September 11 to November 26, 2019, and follow-up ending May 11, 2021 [2]. It is registered at ClinicalTrials.gov as NCT04074161 [2][3].
The trial enrolled 338 adults with a body mass index (BMI) of 30 or greater, or 27 or greater with at least one weight-related comorbidity, and without diabetes [2]. Participants were randomized 3:1:3:1 to semaglutide 2.4 mg weekly (n = 126), liraglutide 3.0 mg daily (n = 127), or one of two matched placebo groups, which were pooled (n = 85) [2]. Everyone also received diet and physical activity counseling [2].
At baseline, participants had a mean age of 49 (SD 13), 265 were women (78.4%), mean body weight was 104.5 kg, and mean BMI was 37.5 [2]. Of the 338 randomized, 319 (94.4%) completed the trial and 271 (80.2%) completed treatment [2].
One design detail worth knowing: the semaglutide-versus-liraglutide comparison was open-label, meaning participants knew which active drug they were getting, while each active group was double-blinded against its matched placebo [2]. Also, several authors were Novo Nordisk employees, and the trial carried sponsor-linked disclosures [2].
Which drug has more side effects and dropouts?
Gastrointestinal side effects were nearly identical between the two drugs in STEP 8: 84.1% of the semaglutide group and 82.7% of the liraglutide group reported GI adverse events [2].
What differed was staying power. Discontinuation of treatment for any reason happened in 13.5% of the semaglutide group versus 27.6% of the liraglutide group — roughly double the dropout rate on the daily drug [2].
Dose escalation also differed: semaglutide escalated over 16 weeks, liraglutide over 4 weeks. Participants who could not tolerate semaglutide 2.4 mg could stay on 1.7 mg; those who could not tolerate liraglutide 3.0 mg discontinued and could restart the 4-week titration [2].
Per the FDA label, the most common adverse reactions with Saxenda (reported in 5% or more of patients) are nausea, diarrhea, constipation, vomiting, injection site reactions, headache, hypoglycemia, dyspepsia, fatigue, dizziness, abdominal pain, increased lipase, upper abdominal pain, pyrexia, and gastroenteritis [4]. The label also carries warnings for acute pancreatitis, acute gallbladder disease, hypoglycemia when used with insulin or insulin secretagogues, heart rate increase, acute kidney injury from volume depletion, hypersensitivity, and pulmonary aspiration during anesthesia or deep sedation [4]. A “Severe Gastrointestinal Adverse Reactions” section was added to the label in October 2025, and Saxenda is not recommended in patients with severe gastroparesis [4].
Saxenda also carries a boxed warning: liraglutide caused thyroid C-cell tumors in rats and mice at clinically relevant exposures, and it is unknown whether that applies to humans [4]. It is contraindicated in anyone with a personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2, or with hypersensitivity to liraglutide or its excipients [4][7].
Two more label details worth knowing. Saxenda delays gastric emptying and may affect the absorption of oral medications taken with it, so the label says to use it with caution alongside other oral drugs [4]. And the label was updated on February 25, 2026, at which point a “Suicidal Behavior and Ideation” section was removed from the label in February 2026 [4].
How does Saxenda dosing work?
All dosing details below come from the FDA label; anyone taking the drug should follow their prescriber’s instructions [4].
The recommended maintenance dose of Saxenda is 3 mg daily [4]. Per the label, treatment starts at 0.6 mg per day for one week, then the dose increases at weekly intervals until 3 mg is reached [4]. The injection goes under the skin in the abdomen, thigh, or upper arm, once a day, at any time of day, with or without meals [4].
For pediatric patients, escalation may take up to 8 weeks, the dose may be lowered back to the previous level if an increase is not tolerated, and patients who do not tolerate 3 mg daily may be reduced to 2.4 mg daily [4]. Adults with type 2 diabetes should monitor blood glucose before starting and during treatment [4].
What does independent evidence say about liraglutide’s effects?
A 2025 Cochrane review, funded by the World Health Organization, pooled 24 randomized controlled trials with 9,937 participants, with literature searches run on December 17, 2024 [5].
Against placebo over 26 to 68 weeks, liraglutide’s mean percentage weight change was −4.72% (95% CI, −5.32 to −4.12; I² = 57%; 16 studies, 6,050 participants), though the reviewers rated this as very low certainty evidence [5]. The clearer finding was that liraglutide roughly doubles the share of people achieving at least 5% weight loss: risk ratio 2.10 (95% CI, 1.80 to 2.45; 18 studies, 6,651 participants), rated moderate certainty [5].
On safety, liraglutide was associated with more adverse events of any kind (RR 1.07, 95% CI 1.04–1.11) and more serious adverse events (RR 1.20, 95% CI 1.00–1.43), both rated low certainty; adverse events leading to withdrawal showed RR 1.98 (95% CI 1.30–3.02), rated very low certainty [5]. For major adverse cardiovascular events, the review found little to no difference versus placebo (RR 0.86, 95% CI 0.66–1.10; 6 studies, 5,762 participants; moderate certainty) [5]. On quality of life measured by the IWQOL-Lite-CT physical function scale, the review found little to no difference (MD 2.90, 95% CI −0.08 to 5.89) [5].
At long-term follow-up (104 to 162 weeks), mean weight change was −4.34% (95% CI, −5.26 to −3.43; low certainty), and the effect on achieving 5% weight loss persisted (RR 1.78, 95% CI 1.51–2.09; moderate certainty) [5]. The reviewers noted that 22 of the 24 included studies were funded by the drug manufacturer, with major sponsor involvement in 13 [5].
Who is Saxenda approved for?
Saxenda is indicated, along with a reduced-calorie diet and increased physical activity, for adults and pediatric patients aged 12 and older weighing more than 60 kg with obesity, and for adults with overweight plus at least one weight-related comorbid condition [4][7].
The label states that coadministration with other liraglutide-containing products or with any other GLP-1 receptor agonist is not recommended [4][7]. Safety and effectiveness have not been established in pediatric patients with type 2 diabetes, and it is unknown for children under 12 [4][7]. Hypoglycemia occurred in pediatric trial patients who did not have type 2 diabetes [4]. In children, fever and gastroenteritis are listed as additional common side effects [7].
What does Saxenda cost, and can it be compared with Wegovy on price?
The pricing information available here covers liraglutide only, so a direct cash-price comparison between the two drugs cannot be made from it. What the sources do show: Teva announced FDA approval and US launch of generic Saxenda on August 28, 2025 — the first generic GLP-1 indicated for weight loss [7]. Brand Saxenda had annual sales of $165 million as of June 2025 [7].
GoodRx lists a standard coupon price of $372.45 for liraglutide (Saxenda), 5 pens of 18 mg/3 mL, one carton, against a listed retail price of $717.63, with prices last updated September 14, 2026 for ZIP code 33102 [8]. These are coupon and retail estimates for one ZIP code and date, not a manufacturer list price or a nationwide price, and GoodRx notes prices are subject to change without notice and sales tax may apply [8].
The pharmacy spread for that same carton is wide [8]:
| Pharmacy | Listed price (1 carton, 5 pens) |
|---|---|
| Walgreens | $372.45 |
| Capsule | $550.25 |
| CVS / Target / Navarro | $570.06 |
| Walmart Neighborhood Market | $732.12 |
| Publix | $732.92 |
| Walmart | $1,236 |
| Sam’s Club | $1,239 |
| Costco | $1,241 |
For Wegovy, the GoodRx page shows an “as low as $25.00” offer attached to a Wegovy 1.5 mg, 30-tablet listing — a coupon or promotional offer rather than a cash price for the weekly injection [8]. No comparable Wegovy cash price for the injection appears on that pricing page, so the out-of-pocket answer for each drug depends on the individual’s pharmacy benefit and which coupons or programs they qualify for.
Can you switch from Saxenda to Wegovy?
Switching is a prescriber decision. The Saxenda label states that liraglutide is not recommended for people also taking liraglutide or any other GLP-1 receptor agonist, which covers taking both drugs at the same time [4][7]. No published equivalence table maps a liraglutide dose to a semaglutide dose, so there is no established conversion schedule between the two drugs [2]. Anyone considering a switch should talk with the prescriber who manages their prescription.
Saxenda vs Wegovy: the bottom line
On efficacy, the evidence from the 68-week head-to-head trial is one-sided: once-weekly semaglutide produced significantly greater weight loss than once-daily liraglutide [2]. On tolerability, GI side effects were similar, but twice as many liraglutide participants stopped treatment [2]. On cost, the information here prices only liraglutide: a generic exists in the United States, and a coupon-price carton was listed under $400 at some pharmacies for one ZIP code and date [7][8]. Which drug makes sense for a given person depends on their health history, insurance, and what their prescriber advises — this page is information, not medical advice.
Sources
- JAMA. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial.
- PubMed. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial.
- ClinicalTrials.gov. Research Study to Investigate How Well Semaglutide Works Compared to Liraglutide in People Living With Overweight or Obesity (NCT04074161).
- DailyMed. SAXENDA (liraglutide) injection, solution. Drug label information updated February 25, 2026.
- PubMed. Liraglutide for adults living with obesity.
- US Food and Drug Administration. Drug shortage information for liraglutide injection.
- Teva Pharmaceuticals. Teva Launches First Generic Saxenda (Liraglutide) Injection.
- GoodRx. Liraglutide (Saxenda) 2026 Prices, Coupons & Savings Tips.
- Reddit. r/liraglutide discussion thread on the US generic Saxenda shortage.
- PubMed. A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity.
- DailyMed. VICTOZA (liraglutide) injection. Drug label information updated October 14, 2025.
- NovoCare. Saxenda (liraglutide) injection 3mg List Price & Insurance Coverage Explained.
Frequently asked questions
How much more weight do people lose on semaglutide than liraglutide?
In the 68-week STEP 8 trial, mean weight change was −15.8% with once-weekly semaglutide 2.4 mg versus −6.4% with once-daily liraglutide 3.0 mg — a difference of 9.4 percentage points (95% CI, −12.0 to −6.8). Pooled placebo produced −1.9%. Far more semaglutide participants hit 10% or greater loss: 70.9% versus 25.6%.
Are side effects worse on the daily shot?
Not by the trial's numbers. Gastrointestinal adverse events were reported by 84.1% of the semaglutide group and 82.7% of the liraglutide group — essentially the same. Common liraglutide side effects per the FDA label include nausea, diarrhea, constipation, and vomiting, and the drug delays gastric emptying, which may affect absorption of oral medications.
Why do more people quit liraglutide?
In STEP 8, 27.6% of the liraglutide group discontinued treatment for any reason versus 13.5% of the semaglutide group. The trial did not break down a single cause; participants intolerant of liraglutide 3.0 mg discontinued and could restart the 4-week titration, while those intolerant of semaglutide 2.4 mg could stay on 1.7 mg.
Is there a generic version of either drug?
A generic of Saxenda exists. Teva announced FDA approval and US launch of generic liraglutide injection on August 28, 2025, described as the first generic GLP-1 indicated for weight loss. Brand Saxenda had annual sales of $165 million as of June 2025. No comparable Wegovy generic launch appears in the information used here.
How much does liraglutide cost without insurance?
GoodRx listed a coupon price of $372.45 for one 5-pen carton of liraglutide (Saxenda), against a listed retail price of $717.63, updated September 14, 2026 for ZIP 33102. The same carton ranged from about $372 to $1,241 across pharmacies, and prices can change without notice. These are coupon and retail estimates, not a manufacturer list price.
Can you take Saxenda and Wegovy at the same time?
The FDA label states that coadministration of liraglutide with other liraglutide-containing products or with any other GLP-1 receptor agonist is not recommended, which covers taking both drugs at once. Whether and how to use or switch between these drugs is a decision for a prescriber who knows the person's full medical history.
Can teens use liraglutide?
Saxenda is approved for patients aged 12 and older weighing more than 60 kg with obesity, alongside a reduced-calorie diet and increased physical activity. Safety and effectiveness in pediatric patients with type 2 diabetes have not been established, and use under age 12 is unknown. Hypoglycemia occurred in pediatric trial patients without type 2 diabetes.
Does liraglutide keep working long term?
At 104 to 162 weeks, a 2025 Cochrane review found the effect on achieving at least 5% weight loss persisted (RR 1.78, 95% CI 1.51–2.09, moderate certainty), with mean weight change of −4.34% (low certainty). Serious adverse events may increase (RR 1.20, 95% CI 0.98–1.48, low certainty), and evidence on any adverse events was rated very uncertain.
This article summarizes FDA labeling, published research and company information current as of September 14, 2026. It is not medical advice and does not replace a conversation with your own healthcare provider. How we research and verify.