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Liraglutide

Also known as: Saxenda, Victoza

FDA Approved

Molecular Formula

C172 H265 N43 O51

Molecular Weight

3,751.262 Da

Half-Life

~13 hours

Sequence

HAEGTFTSDVSSYLEGQAAKEFIAWLVRGRG (C-16 palmitic acid via glutamic acid spacer at Lys26)

Clinical Applications & Evidence

Mechanism of Action

Liraglutide selectively activates the GLP-1 receptor. It stimulates glucose-dependent insulin secretion from pancreatic beta cells, suppresses postprandial glucagon secretion from alpha cells, delays gastric emptying, and increases satiety via central hypothalamic signaling to reduce caloric intake. In preclinical models, GLP-1 receptor activation has also been hypothesized to modulate cellular autophagy and neuroinflammation, though clinical translation for neurodegenerative conditions remains investigational.

Investigated Uses

  • Type 2 Diabetes mellitus (FDA-approved as Victoza for age 10+; generic available)
  • Cardiovascular risk reduction (FDA-approved as Victoza for adults with T2D + established CVD; LEADER trial)
  • Chronic weight management (FDA-approved as Saxenda for adults and age 12+ weighing >60 kg)
  • NASH / MASH (Investigational — Phase 2 LEAN trial showed histological improvement; not FDA-approved)
  • Parkinson's disease (Investigational — Phase 2 NCT02953665 explored motor scores; not clinically established)
  • Alzheimer's disease (Investigational — Phase 2b ELAD trial missed primary glucose metabolism endpoint)
  • Preclinical autophagy & longevity hypotheses (Preclinical animal/cellular models only)
Extensive Clinical Data

Regulatory & Safety Status

FDA Status

FDA Approved

WADA / Athletic Status

Not Explicitly Prohibited

Known Side Effects

Nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsiaBoxed Warning: Risk of thyroid C-cell tumors (observed in rodents; human relevance undetermined)Warnings: Acute pancreatitis, acute gallbladder disease (cholelithiasis), acute kidney injury (secondary to dehydration)Increased resting heart rateHypoglycemia (increased risk when co-administered with insulin or sulfonylureas)Headache, dizziness, fatigueLabeling Update (Feb 2026): Prior Saxenda warning for suicidal behavior/ideation was removed by FDA following post-marketing evaluation

Contraindications

  • Personal or family history of Medullary Thyroid Carcinoma (MTC)
  • Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
  • Prior serious hypersensitivity reaction to liraglutide or formulation excipients
  • Pregnancy (Saxenda formulation is contraindicated in pregnancy)

Drug Interactions

  • Insulin and sulfonylureas (increased risk of severe hypoglycemia; dosage reduction required)
  • Oral medications (delayed gastric emptying may slow or alter oral drug absorption)
  • General anesthesia / deep sedation (ASA guidelines recommend withholding once-daily GLP-1 RAs on the day of elective procedures due to delayed gastric emptying and pulmonary aspiration risk)

Citations & Clinical Trials

PubMed LEADER Trial — Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes PubMed SCALE Obesity and Prediabetes Trial — A Randomized Trial of Liraglutide 3.0 mg PubMed LEAN Trial — Liraglutide in non-alcoholic steatohepatitis (NASH) Nature Medicine ELAD Trial — Liraglutide in Mild Alzheimer's Disease (Nature Medicine 2025) FDA FDA Prescribing Information: Victoza (Liraglutide Injection) FDA FDA Prescribing Information: Saxenda (Liraglutide Injection) FDA FDA Approves First Generic Once-Daily GLP-1 Injection (Dec 2024)