Interest in medications for weight management has led many to ask about the 3 mg dose of Victoza. This inquiry stems from its active ingredient, liraglutide, which influences both blood sugar and body weight. However, the 3 mg dosage is not associated with the Victoza brand, which is prescribed for type 2 diabetes. The 3 mg dose of liraglutide is approved for chronic weight management, but it is marketed under the name Saxenda.
Victoza and Saxenda: The Same Drug for Different Purposes
Victoza and Saxenda both contain the same active ingredient, liraglutide, but they are not interchangeable medications. Victoza was first approved by the FDA in 2010 to improve glycemic control in adults with type 2 diabetes, with a maximum recommended dose of 1.8 mg injected daily. It is also approved to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established heart disease.
During its use for diabetes, researchers observed that patients taking liraglutide often experienced weight loss. This finding prompted further clinical investigation to explore its potential as a dedicated weight management therapy. These studies led to the FDA approval in 2014 of Saxenda, a higher-dose version of liraglutide specifically for chronic weight management.
Saxenda is formulated with a target and maintenance dose of 3 mg per day. Using Victoza to achieve the 3 mg dose for weight loss would be considered an “off-label” use. The two products are packaged in different injection pens that deliver their respective dose ranges.
Mechanism of Action for Weight Loss
Liraglutide facilitates weight loss by functioning as a glucagon-like peptide-1 (GLP-1) receptor agonist. This means it mimics the action of GLP-1, a naturally occurring hormone released from the gut after eating. Liraglutide is about 97% similar to human GLP-1, allowing it to bind to and activate GLP-1 receptors.
One of the primary ways liraglutide works is through its effects on the brain. GLP-1 receptors are located in areas of the brain responsible for appetite regulation, including the hypothalamus. By activating these receptors, liraglutide sends signals to the brain that promote feelings of fullness and satiety, which can lead to a reduction in food intake.
Another significant mechanism is the delay of gastric emptying. Liraglutide slows down the rate at which food moves from the stomach into the small intestine, contributing to a prolonged feeling of fullness after a meal. The medication also helps regulate blood sugar by stimulating insulin secretion and suppressing glucagon secretion, which can help manage hunger.
Clinical Efficacy of the 3 mg Dose
The effectiveness of liraglutide 3 mg for weight management was established in the SCALE (Satiety and Clinical Adiposity–Liraglutide Evidence) clinical trials. These studies, which combined the 3 mg dose with diet and exercise, showed significant weight loss compared to a placebo.
In the SCALE Obesity and Prediabetes trial, participants without type 2 diabetes lost an average of 8.4 kg (18.5 lbs) over 56 weeks. The SCALE Diabetes trial focused on individuals with both type 2 diabetes and obesity or who were overweight. In this group, participants on the 3 mg dose lost an average of 5.9% of their body weight over 56 weeks, compared to a 2.0% loss in the placebo group.
The SCALE Diabetes study also found that nearly 50% of people treated with the 3 mg dose lost at least 5% of their body weight, and 22% lost more than 10%. It is important to remember these outcomes were achieved as an adjunct to lifestyle modifications.
Potential Side Effects
Treatment with liraglutide at the 3 mg dose is associated with potential side effects, the most common of which are gastrointestinal. Nausea, diarrhea, constipation, and vomiting are frequently reported, particularly during the initial phase of treatment as the dose is gradually increased. These side effects are often mild to moderate and tend to decrease over time as the body adjusts.
Beyond the common gastrointestinal issues, there are less frequent but more serious risks. The medication carries a boxed warning from the FDA regarding thyroid C-cell tumors. This warning is based on studies in rodents where liraglutide caused these tumors; however, it is not known if it causes them in humans. It is contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Other serious potential side effects include acute pancreatitis (inflammation of the pancreas) and gallbladder problems such as gallstones. Due to the potential for dehydration from vomiting or diarrhea, there is also a risk of new or worsening kidney problems.
Obtaining a Prescription for Liraglutide 3 mg
A prescription for liraglutide 3 mg, marketed as Saxenda, is intended for individuals who meet specific criteria. It is approved for adults with a Body Mass Index (BMI) of 30 or greater, which is classified as obesity. It is also approved for adults with a BMI of 27 or greater (overweight) who have at least one weight-related health condition, such as high blood pressure, type 2 diabetes, or high cholesterol.
The treatment process begins with a low starting dose that is gradually increased over several weeks. This dose titration is designed to minimize gastrointestinal side effects. Patients start with a 0.6 mg daily injection for the first week. The dose is then increased weekly in 0.6 mg increments until the full 3 mg maintenance dose is reached at the start of the fifth week. A healthcare provider may adjust this schedule based on how well a patient tolerates the medication.