Victoza vs Ozempic: The Daily and Weekly Diabetes Shots Compared

Victoza and Ozempic are both GLP-1 receptor agonists for type 2 diabetes, both made by Novo Nordisk, and both have large trials showing they reduce heart attacks and strokes in the right patients. The difference: Victoza is liraglutide, injected once a day. Ozempic is semaglutide, injected once a week. And since late 2024, Victoza has something Ozempic does not — FDA-approved generics.

This article compares them on blood sugar, weight, heart outcomes, side effects, price and availability, using the labels and the trials rather than marketing claims.

This is not medical advice. Where it describes doses, escalation, storage or stopping, it is summarizing the FDA-approved prescribing information and Instructions for Use. Follow your own prescription and the directions your provider and pharmacist give you.

Which one lowers A1C more?

There is a direct comparison: SUSTAIN 10, an open-label phase 3b trial that randomized 577 adults with type 2 diabetes already taking one to three oral diabetes drugs. Half got once-weekly semaglutide 1.0 mg, half got once-daily liraglutide 1.2 mg, and the trial ran 30 weeks [1].

Outcome at 30 weeks	Semaglutide 1.0 mg weekly	Liraglutide 1.2 mg daily
A1C change from baseline 8.2%	−1.7 points	−1.0 points
Weight change from baseline 96.9 kg	−5.8 kg	−1.9 kg
Gastrointestinal side effects	43.9%	38.3%
Stopped early because of a side effect	11.4%	6.6%

The estimated treatment difference was −0.69 percentage points of A1C (95% confidence interval −0.82 to −0.56) and −3.83 kg of body weight (95% CI −4.57 to −3.09). Both favored semaglutide with p values below 0.0001 [1].

There is an important asterisk. The liraglutide dose in SUSTAIN 10 was 1.2 mg, which the authors chose because it was the most commonly prescribed dose in Europe at the time — not liraglutide’s maximum labeled dose of 1.8 mg. The Victoza label says 1.8 mg produces a larger A1C reduction than 1.2 mg [2]. So SUSTAIN 10 shows semaglutide beating a mid-range liraglutide dose, not a maximum one. The gap at maximum doses would probably be smaller, though almost certainly still in semaglutide’s favor.

What does Victoza do on its own?

The Victoza label reports a 52-week monotherapy trial in 746 adults, comparing Victoza 1.8 mg, Victoza 1.2 mg and the sulfonylurea glimepiride 8 mg [2]:

Outcome	Victoza 1.8 mg	Victoza 1.2 mg	Glimepiride 8 mg
A1C change from baseline 8.2%	−1.1	−0.8	−0.5
Reached A1C below 7%	51%	43%	28%
Fasting plasma glucose change	−26 mg/dL	−15 mg/dL	−5 mg/dL
Stopped for ineffective therapy	3.6%	6.0%	10.1%

The label is blunt about one thing worth knowing before you start: the 0.6 mg starting dose is not effective for blood sugar control in adults. It exists purely to reduce gastrointestinal intolerance during the first week [2].

What about heart protection?

This is where Victoza has a genuinely strong record.

LEADER was a double-blind placebo-controlled trial in 9,340 adults with inadequately controlled type 2 diabetes and atherosclerotic cardiovascular disease, randomized to Victoza 1.8 mg or placebo and followed for a median of 3.5 years. Mean age was 64 and mean diabetes duration 12.8 years [2][3].

Endpoint	Victoza (n=4,668)	Placebo (n=4,672)	Hazard ratio
Major adverse cardiovascular events	608 (13.0%)	694 (14.9%)	0.87 (0.78–0.97)
Cardiovascular death	219 (4.7%)	278 (6.0%)	0.78 (0.66–0.93)
Non-fatal heart attack	281 (6.0%)	317 (6.8%)	0.88 (0.75–1.03)
Non-fatal stroke	159 (3.4%)	177 (3.8%)	0.89 (0.72–1.11)
Death from any cause	—	—	0.85 (0.74–0.97)

The p value for superiority on the primary endpoint was 0.011 [2]. The benefit was driven mainly by fewer cardiovascular deaths. That trial is why the Victoza label carries an indication “to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus and established cardiovascular disease” [2].

Worth knowing: generic liraglutide referencing Victoza carries that same indication, because a generic copies the reference product’s label. Generic liraglutide referencing Saxenda does not, because Saxenda never had it.

Are they actually different on hard outcomes?

A 2025 study in JAMA Network Open used linked Department of Veterans Affairs, Medicare and US Renal Data System data to emulate a trial among 21,790 veterans with type 2 diabetes on metformin who started liraglutide, semaglutide or dulaglutide between 2018 and 2021 [4].

Compared with semaglutide, liraglutide showed:

• Similar risk of kidney failure (hazard ratio 0.93, 95% CI 0.60–1.44)
• Similar risk of the combined cardiovascular-and-kidney outcome (0.96, 95% CI 0.84–1.10)
• Similar risk of major adverse cardiovascular events (0.95, 95% CI 0.83–1.09)
• Lower all-cause death in the intent-to-treat analysis (0.83, 95% CI 0.69–0.99), which lost significance in the per-protocol analysis

The authors were careful to say head-to-head randomized trials are still needed. But the finding is worth sitting with: on the outcomes that matter most, an observational comparison of more than 21,000 people did not separate the older daily drug from the newer weekly one.

Semaglutide clearly does more for A1C and weight. Whether that translates into meaningfully better long-term organ protection is, on this evidence, not settled.

What do the labels say about taking each one?

This is a summary of the FDA-approved prescribing information and Instructions for Use, not a set of instructions for you. Dosing is a prescriber’s decision, and your own prescription and the Instructions for Use in your carton govern what you actually do. Nothing below is medical advice.

What the Victoza label describes [2]:

• An adult starting dosage of 0.6 mg once daily for one week, then 1.2 mg once daily, then a maximum recommended dosage of 1.8 mg once daily after at least one week at 1.2 mg, if additional glycemic control is required.
• For pediatric patients aged 10 and older, a starting dosage of 0.6 mg once daily, increased in 0.6 mg increments after at least one week on the current dosage, to a maximum of 1.8 mg.
• Subcutaneous injection in the abdomen, thigh or upper arm, at any time of day, independently of meals.
• That when Victoza is used with insulin, the two are administered as separate injections and never mixed.
• That when more than three days have elapsed since the last dose, treatment is reinitiated at 0.6 mg, and that on reinitiation the drug “should be titrated at the discretion of the healthcare provider.”
• That injection sites are rotated within the same region to reduce the risk of a skin condition called cutaneous amyloidosis.

Ozempic is a once-weekly injection with its own escalation schedule, covered elsewhere on this site. The authority for it is the current Ozempic label and your prescriber’s instructions.

The labels describe the same storage conditions for both: refrigeration between 36 and 46 degrees Fahrenheit before first use, no freezing, and after first use a 30-day period either at controlled room temperature (59 to 86 degrees Fahrenheit) or refrigerated [2].

What are the side effects?

The Victoza label lists the most common adverse reactions at 5% or more as nausea, diarrhea, vomiting, decreased appetite, indigestion and constipation. In the pooled adult trials, nausea occurred in 18% to 20% of Victoza-treated patients versus 5% on placebo, diarrhea in 10% to 12% versus 4%, and vomiting in 6% to 9% versus 2% [2]. Withdrawals due to gastrointestinal reactions were 4.3% on Victoza versus 0.5% on placebo.

Both drugs carry the same boxed warning about thyroid C-cell tumors seen in rats and mice, and both are contraindicated in people with a personal or family history of medullary thyroid carcinoma or with Multiple Endocrine Neoplasia syndrome type 2 [2][5].

Other warnings on the current Victoza label include acute pancreatitis, low blood sugar (particularly with insulin or a sulfonylurea — and the label notes the hypoglycemia risk was higher in children aged 10 and older regardless of other medicines), kidney injury from dehydration, severe gastrointestinal reactions with a note that the product is not recommended in severe gastroparesis, serious allergic reactions, and food or liquid entering the lungs during anesthesia or deep sedation. Never share a pen between people, even with a new needle [2].

What does each one cost?

Here the comparison inverts.

The FDA approved the first generic referencing Victoza on December 23, 2024, granted to Hikma Pharmaceuticals USA. The agency specifically noted that liraglutide injection was on the drug shortage list and that it prioritizes generic applications for drugs in shortage [5]. Teva had already launched an authorized generic — Novo Nordisk’s own product under Teva’s label — in June 2024, citing Victoza annual sales of $1.656 billion as of April 2024 [6].

Since then the list has grown. Reading the FDA’s National Drug Code directory on September 11, 2026, these companies had a Victoza-referenced liraglutide listed as marketed [7]:

Company	Application	First listed as marketed
Hybio Pharmaceutical	ANDA215503	2024-06-21 (single pen); 2024-12-24 (cartons)
Teva (authorized generic)	NDA022341	2024-06-24
Hikma Pharmaceuticals USA	ANDA215503	2024-12-24
Meitheal Pharmaceuticals	ANDA218115	2025-04-02
Lupin Pharmaceuticals	ANDA215421	2025-10-02
Orbicular Pharmaceutical	ANDA217590	2026-01-21
Cipla USA	ANDA217590	2026-01-22
NorthStar Rx	ANDA218115	2026-03-01
Biocon Pharma	ANDA215245	2026-04-25

One caveat on that first row. Drugs@FDA records ANDA215503 as approved on December 23, 2024, with Hikma as the applicant, so the June 21, 2024 marketing start date the NDC directory carries for a Hybio single-pen presentation predates the approval of the application it is filed under [7][10]. The two- and three-pen Hybio cartons start on December 24, 2024, alongside Hikma’s. Read the table as a listing record, not as evidence that a true ANDA generic was sold before the FDA approved one — the first generic liraglutide a US patient could buy was Teva’s authorized generic on June 24, 2024.

There is no generic Ozempic. Semaglutide is still under patent in the United States.

Checked on September 14, 2026, GoodRx listed generic liraglutide at $112.19 with a coupon for a two-pen carton (verified 2026-09-14) and $154.01 for a three-pen carton, against GoodRx average retail prices of $615.85 and $924.00. Those retail figures are GoodRx’s own averages rather than any one pharmacy’s price — GoodRx states “Save 81.78%” against $615.85, which reconciles exactly with $112.19, while its own editorial page gives a different average retail pair for the same packages, $464.86 and $711.39 [8]. GoodRx separately advertises $101.90, but that is a GoodRx Companion paid subscription price, not the free coupon. Other cash sellers differ sharply: Cost Plus Drugs lists the same generic at $87.80 to $129.20 per its stated unit, and SingleCare at $63.10 a pen with its card against a $400.18 cash price [11][12]. Prices change daily and vary by pharmacy and location, so a quote from your own pharmacy is the only one that applies to you.

That is the practical headline, with one correction to how it is usually told. Nine labelers is not nine independent manufacturers. Those nine products sit on five generic applications plus one authorized generic: Hikma and Hybio share ANDA215503, Meitheal and NorthStar Rx share ANDA218115, Orbicular and Cipla share ANDA217590, Lupin holds ANDA215421, Biocon holds ANDA215245, and Teva’s 2024 product is an authorized generic under Novo Nordisk’s own NDA022341 [7][10]. Five independent generic applications is still real competition — and it is five more than semaglutide or tirzepatide has.

Is Victoza available right now?

Partly. As of September 14, 2026 the FDA lists Liraglutide Injection as Currently in Shortage, a listing first posted in July 2023. Within it [9]:

• Hikma’s presentations: Available (revised 2026-09-03)
• Meitheal’s presentations: Available (revised 2026-08-27)
• Novo Nordisk’s Victoza NDCs 0169-4060-12 and -13: Limited Availability, reason given as a shipping delay, with no estimated end date (revised 2026-08-25)
• Teva-distributed liraglutide NDCs 0480-3667-20 and -22: Available

The FDA also posts a banner on that database saying it is “currently experiencing technical difficulties” and that some information may not reflect current supply. Ask your pharmacy directly.

So which should you be on?

That is a conversation with your clinician, not a conclusion this article can reach for you. But the factual picture is reasonably clear:

• Ozempic gives more A1C reduction and considerably more weight loss. SUSTAIN 10 showed that directly, even against a sub-maximal liraglutide dose.
• Victoza has a proven cardiovascular benefit and a label indication to match, and an observational study in more than 21,000 veterans found no separation from semaglutide on kidney or cardiovascular outcomes.
• Victoza is dramatically cheaper as a cash price because it has real generic competition and Ozempic has none.
• Victoza is a daily injection. Over a year that is 365 shots versus 52, and adherence data across this class suggest that matters.
• Victoza covers children from age 10; check the current pediatric labeling for any alternative you are considering.

If cost or coverage is the binding constraint — and for a great many Americans it is — generic liraglutide is the one GLP-1 where the price problem has an actual answer. Bring the pharmacy quote and your A1C history to your provider and decide together.

Sources

1. Capehorn MS et al. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg (SUSTAIN 10). Diabetes & Metabolism, 2020
2. VICTOZA (liraglutide) injection — prescribing information, DailyMed, revised 10/2025
3. Marso SP et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes (LEADER). New England Journal of Medicine, 2016
4. Derington CG et al. Liraglutide vs Semaglutide vs Dulaglutide in Veterans With Type 2 Diabetes. JAMA Network Open, 2025-10-01
5. FDA Approves First Generic of Once-Daily GLP-1 Injection to Lower Blood Sugar in Patients with Type 2 Diabetes, 2024-12-23
6. Teva Announces Launch of Authorized Generic of Victoza (liraglutide injection 1.8 mg), 2024-06-24
7. FDA National Drug Code Directory — liraglutide products, openFDA API, data updated 2026-09-11
8. Liraglutide (Victoza) prices — GoodRx, retrieved 2026-09-14
9. FDA Drug Shortages — Liraglutide Injection, current shortage record
10. Drugs@FDA application, approval-date and therapeutic-equivalence records for liraglutide, openFDA drugsfda endpoint, retrieved 2026-09-14
11. Liraglutide 18 mg/3 mL solution pen-injector — Mark Cuban Cost Plus Drug Company, two listings, retrieved 2026-09-14
12. Liraglutide prices — SingleCare, retrieved 2026-09-14