The following are commonly reported reactions to Saxenda: Nausea, vomiting, dyspepsia (indigestion), or appetite loss. Diarrhea, constipation, or gastroenteritis (bowel infection) Injection site reaction. Headache or dizziness. Hypoglycemia (low blood sugar) Fever, cough, or rash. More items... •
Saxenda side effects include nausea, vomiting, and hypoglycemia. More serious side effects like thyroid cancer, pancreatitis, and suicidal ideation can occur. Learn more about avoiding adverse effects.
Saxenda side effects | Nausea/vomiting | Hypoglycemia | Serious side effects | Thyroid cancer | Pancreatitis | Suicidal ideation | How long do side effects last? | Warnings | Interactions | How to avoid side effects
Effective and safe medications to assist with weight loss have long been sought after. In recent years, the search has turned up some new options. The glucagon-like peptide-1 (GLP-1) receptor agonist class of medications has seen increasing use not only for Type 2 diabetes mellitus management but also long-term obesity treatment, thanks to their ability to reduce appetite.
Saxenda (liraglutide) is a GLP-1 receptor agonist that is taken as a 3 mg once daily subcutaneous injection. It was approved by the Food and Drug Administration (FDA) for chronic weight management based on studies showing effectiveness and safety when used along with a reduced-calorie diet and increased physical activity. The safety profile of Saxenda is imperfect, however, and this article will review what you need to know about potential Saxenda side effects and drug interactions.
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Common side effects of Saxenda
The following are commonly reported reactions to Saxenda:
Nausea, vomiting, dyspepsia (indigestion), or appetite loss
Diarrhea, constipation, or gastroenteritis (bowel infection)
Injection site reaction
Headache or dizziness
Hypoglycemia (low blood sugar)
Fever, cough, or rash
Tiredness, insomnia, or asthenia (lack of strength or energy)
Abdominal pain or distention
Elevated lipase (pancreatic enzyme) or creatinine kinase (muscle enzyme)
Eructation (belching) or flatulence
Dyslipidemia (abnormal cholesterol levels)
Gastroesophageal reflux disease (GERD)
Urinary tract infection (UTI)
Depression or anxiety
Pain in extremities
Xerostomia (dry mouth)
Cholelithiasis (gallstones)
Tachycardia (fast heartbeat)
Nausea/vomiting
In aggregate, gastrointestinal (GI) side effects are by far the most common adverse effects of Saxenda. Approximately 68% of users reported some type of gastrointestinal side effect, compared to 39% of placebo users in clinical trials, according to the product monograph. The most prevalent GI side effect was nausea, affecting 39% of Saxenda users. The drug delays gastric (stomach) emptying. Nausea progressed to vomiting in 15% of those taking Saxenda. When fatigue or a lack of strength are experienced, it is usually in connection with gastrointestinal symptoms like nausea.
While strikingly common, these GI problems only led 6% of individuals to discontinue Saxenda, and these adverse effects tend to improve with extended GLP-1 agonist use and can be avoided by gradually increasing the dose. The dose of Saxenda can be increased by 0.6 mg every week, starting with 0.6 mg and ending at 3 mg once daily. The dose escalation can be even slower if needed.
Hypoglycemia
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Victoza is another brand name of liraglutide manufactured by Novo Nordisk, used at lower doses than Saxenda and for Type 2 diabetes mellitus. Saxenda has a dual purpose in those with Type 2 diabetes and obesity, by assisting with blood glucose (sugar) control and weight loss. In this setting, the incidence rate of hypoglycemia was 23% in a clinical study, but the risk depends largely on what other diabetic medications are being taken concurrently. When diabetes was not present, less than 2% of Saxenda users reported hypoglycemia.
Serious side effects of Saxenda
Thyroid C-cell cancer in animal studies
Medullary thyroid carcinoma (MTC) risk or papillary thyroid carcinoma
Colorectal neoplasm (tumor)
Hypersensitivity reactions or anaphylaxis (a serious allergic reaction that can be life-threatening)
Angioedema (sudden swelling of the face or body)
Acute renal failure (sudden kidney failure) or chronic renal failure exacerbation (worsening of kidney function in one who has pre-existing kidney impairment)
Acute pancreatitis (inflammation of the pancreas)
Gallbladder disease including cholecystitis or cholelithiasis
Suicidal ideation
Thyroid cancer
Liraglutide was associated with higher rates of thyroid C-cell tumors in studies of rodents. The applicability of this finding to humans is unknown as it has not been demonstrated in humans. Compared to rodents, humans also have fewer C-cells and a low level of GLP-1 on C-cells. Despite these mitigating facts, more research is needed, and until then, the FDA has a black box warning on Saxenda regarding this concern. The warning states that anyone with a personal or family history of thyroid cancer or a history of Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should not use GLP-1 agonists. These historical circumstances are mentioned because of their association with thyroid tumors.
Pancreatitis
Non-severe abdominal or stomach pain is listed as one of Saxenda’s common side effects, approaching a 5% incidence rate among users. Pain in the abdomen should be brought to medical attention to determine a cause, as it may be a symptom of pancreatitis. Less commonly, severe causes, such as acute pancreatitis, could be present. Since GLP-1 agonists have been in use, sporadic cases of pancreatitis have been noted during treatment, although a causal effect has not been defined.
Suicidal ideation
Uncommonly, in less than 1% of users, suicidal thoughts have occurred during Saxenda therapy. Confusing the matter is the fact that some placebo (inactive pill for comparison) users in the studies also experienced suicidal ideation. Consequently, no causal association between Saxenda and suicidal thoughts has been confirmed.
How long do side effects last?
Adverse events with Saxenda range from self-limited symptoms to severe events. Nausea may subside despite continued use or could resolve with lowering the dose. Otherwise, mild, common side effects usually resolve with the discontinuation of the drug. Serious side effects, such as allergic reactions, renal failure, and pancreas or gallbladder problems, may require emergent treatment and drug stoppage.
Saxenda contraindications & warnings
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Saxenda is not habit-forming and does not induce withdrawal symptoms when stopped.
Overdose
The maximum dosage of Saxenda is the recommended dose, that is 3 mg injected subcutaneously daily. Considering potential effects on the gastrointestinal tract and blood sugar level, an overdose of Saxenda necessitates emergency medical attention and a call to the Poison Helpline at 1-800-222-1222.
Restrictions
Adults of all ages and children as young as 12 years with a bodyweight of more than 60 kg (132 pounds) can use Saxenda for weight loss if they meet need-based criteria and do not have a contraindication. Criteria for use in adults is defined as being obese, having a body mass index (BMI) of at least 30 kg/m2, or a BMI of at least 27 kg/m2 with associated comorbidity such as hypertension (high blood pressure). Saxenda should not be used in pregnancy or while breastfeeding. Other contraindications include a personal history of hypersensitivity allergic reaction to this drug or other GLP-1 agonists; a personal history of MEN 2 syndrome, suicidality, or pancreatitis; or a personal or family history of medullary thyroid cancer.
Saxenda interactions
Saxenda can interact with a substantial list of medications. For example, any drug whose action is altered by delayed gastric emptying can be affected by Saxenda. Review your entire list of prescription drugs and over-the-counter medications, as well as supplements, with the healthcare provider before starting on treatment. The following are some specific drug interactions.
The antiviral cidofovir is contraindicated with Saxenda, due to potential bone marrow and kidney side effects with concurrent use.
Other types of diabetic medications, including sulfonylureas, can be used cautiously in combination with Saxenda. In these situations, blood sugar levels should be monitored to look for hypoglycemia, and dosing may need to be adjusted.
Aminoglycoside antibiotics, such as gentamicin, may need to be avoided due to a possible increased risk of kidney problems.
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