What is the difference between Saxenda and Wegovy?

If you’re considering starting a weight-loss medication, you’ve likely come across the names Saxenda and Wegovy, two GLP-1 drugs that can help you lose weight. But all GLP-1s are not the same, including these two. Understanding their key differences — active ingredient, cost, efficacy, side effects, and even how often they’re administered — can help you have a more informed discussion with your healthcare provider about which one might be right for you. Read on for everything you need to know about Saxenda vs. Wegovy.

What is Saxenda?

Saxenda was a bit of a trailblazer, being the first GLP-1 to get FDA approval for weight loss back in 2014. It contains the active ingredient liraglutide, which works by mimicking the naturally occurring hormone GLP-1. Through this action, Saxenda controls blood sugar and appetite, keeping you fuller longer.

Saxenda is approved for chronic weight management in adults with a body mass index (BMI) of 30 or higher, or 27 or higher with one weight-related condition (such as prediabetes or high blood pressure). When paired with a healthy diet and exercise, it is an effective medication for long-term weight management.

What is Wegovy?

Wegovy mimics the same hormone as Saxenda, GLP-1, but has a different active ingredient: semaglutide. Like Saxenda, Wegovy is FDA-approved for chronic weight management in adults with a BMI of 30 or higher or those with a BMI of 27 or higher who have at least one weight-related condition like high cholesterol, high blood pressure, or prediabetes. A Wegovy prescription is typically most effective when combined with a healthy diet and exercise.

In 2024, Wegovy received an additional FDA approval saying it can help reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and living with either obesity or overweight.

Key differences between Wegovy and Saxenda

While both Wegovy and Saxenda are GLP-1 medications approved for chronic weight management, they aren’t identical. “These are two different medications with different chemical compositions and properties,” says Dr. Amit Algotar, M.D., clinical associate professor at the University of Arizona College of Medicine and board-certified obesity medicine specialist. Here are the big ways they compare and contrast:

1. They are taken at different frequencies. Saxenda’s active ingredient, liraglutide, has a half-life (a way of measuring how long the drug sticks around in your system) of about 13 hours. As a result, it needs to be taken daily to be effective. Wegovy’s active ingredient, semaglutide, has a much longer half-life and is taken once a week.
2. They have (slightly) different FDA approvals. While both Sexenda and Wegovy are approved for chronic weight management, Wegovy has an additional approval: to reduce the risk of major cardiovascular events, like heart attacks and strokes, in adults with cardiovascular disease who also have obesity or are overweight.
3. Their injection pens work differently. Wegovy uses a single-use prefilled pen that comes in five doses, so you throw the pen away after you give yourself the injection. Saxenda has a multi-dose pen that is used multiple times before you throw it away and requires separate needle purchases.
4. They vary in effectiveness. In a head-to-head clinical trial, liraglutide (Saxenda) showed about 6% weight loss over 56 weeks, while semaglutide (Wegovy) led to about 16% weight loss. That said, results can look different for everyone.

Saxenda vs. Wegovy: uses

Both medications are FDA-approved for chronic weight management in adults with either obesity or overweight with a weight-related health condition, as well as children age 12 and up with obesity. As of 2024, Wegovy also has an additional approval: to reduce the risk of major cardiovascular events (like heart attack and stroke) in adults with obesity or overweight.

Saxenda vs. Wegovy: dosages and administration

Both medications come in prefilled injectable pens that are self-administered at home, but their dosing schedules and frequency are different. Here’s how they compare:

• Saxenda is a once-daily injection that comes in five different doses — 0.6mg, 1.2mg, 1.8mg, 2.4mg, 3.0mg — and each multi-dose pen contains 18mg of medication. Most people start out on the 0.6mg dose for the first week and increase the dose by 0.6mg each week. This would continue until you reached the full dose of 3.0mg by week five, but not everyone requires the maximum Saxenda dosage. Your doctor will advise you on whether or not you should continue going up in dose or if you should stay where you are.
• Wegovy is a once-weekly injection with five dose strengths: 0.25mg, 0.5mg, 1.0mg, 1.7mg, and 2.4mg. You’ll likely start at the 0.25mg dose and increase every four weeks until you reach a maintenance Wegovy dosage of either 1.7mg or 2.4mg, as determined by your healthcare provider. Each pen is designed to be used once, then thrown away.

Effectiveness of Saxenda vs. Wegovy

In a clinical trial of adults with overweight or obesity (without diabetes), once-weekly semaglutide (Wegovy) led to significantly greater weight loss over 68 weeks compared to once-daily liraglutide (Saxenda). Saxenda users lost about 6% of their body weight over 56 weeks, while Wegovy users lost around 16% of their weight.

That said, individual results can vary widely, says Dr. Amy Rothberg, M.D., a board-certified obesity medicine specialist and clinical professor at the University of Michigan School of Public Health. “Some people respond beautifully to one drug and don’t to another, and we don’t understand why they might respond to a theoretically less potent drug, like Saxenda, and then not respond at all to Wegovy or have less response.”

Saxenda vs. Wegovy: cost and insurance coverage

GLP-1 drugs are known for being on the pricey side, and both Saxenda and Wegovy come with a high list price of $1,349.02 for a one-month supply. But what you actually pay depends on factors like insurance, pharmacy pricing (which can include discounts), and manufacturer savings programs.

Wegovy, for example, has a savings card offer through its manufacturer Novo Nordisk that brings the cost of Wegovy down to $499 per month without insurance and as little as $0 if you have commercial insurance. Saxenda does not have a savings program at this time, but you should check for updates as these offers tend to change over time. Visit the manufacturer's website or ask your doctor or pharmacist about how to bring down the cost of Saxenda.

Many insurance plans don’t cover weight-loss medications like Saxenda and Wegovy, with less than one-fifth of large companies’ health care plans covering GLP-1s for weight loss, as of fall 2024. However, you might have a better chance of Wegovy being covered if it’s prescribed for reducing cardiovascular risk as opposed to weight loss.

Saxenda vs. Wegovy: side effects

Because they both mimic the same hormone, GLP-1, Saxenda and Wegovy have the potential for the same kinds of side effects. Here are the most common:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Stomach pain

These side effects are mostly gastrointestinal, which is why Rothberg advises caution for people with pre-existing digestive issues, such as delayed gastric emptying or reflux disease. Since GLP-1s further slow down digestion, they can make symptoms worse, she says.

There are some important nuances to keep in mind between the two medications, says Algotar. Semaglutide (the active ingredient in Wegovy), for example, tends to be associated with more constipation and diarrhea than liraglutide (the active ingredient in Saxenda). And liraglutide has higher rates of people discontinuing the medication. Gallbladder issues (such as gallstones) are also more common with liraglutide.

Although rare, serious side effects for both Saxenda and Wegovy may include inflammation of the pancreas (pancreatitis), gallbladder problems, low blood sugar (hypoglycemia), increased heart rate, or kidney problems. Talk with your doctor right away if you experience any Saxenda or Wegovy side effects, as they can recommend things you can do to feel better.

For a full list of side effects, visit the Saxenda site and the Wegovy site.

Saxenda and Wegovy drug warnings

Both medications have an FDA-mandated black box warning for thyroid cancer. This is because animal studies showed that the drugs can cause a specific kind of thyroid tumor, though that link hasn’t been found in any studies on humans. Because of this, your doctor likely won’t prescribe either Saxenda or Wegovy (or any other GLP-1 medication) if you or anyone in your immediate family has had medullary thyroid cancer or if you have a rare genetic condition called multiple endocrine neoplasia syndrome type 2 (MEN 2).

The bottom line

Saxenda and Wegovy are both GLP-1 weight-loss medications that help reduce your appetite. While they work in a similar way in your body and are both self-administered with an injection pen, they have different active ingredients and Saxenda is taken daily while Wegovy is taken weekly. Both medications have the same list of common side effects, including nausea and diarrhea, and the same list price. If you’re considering taking Saxenda or Wegovy, talk to your doctor. “Given the complexity associated with making a choice between these two medications, thoroughly discuss the pros and cons with your provider to customize your treatment plan,” says Algotar.