Key Takeaways
- Saxenda is liraglutide 3.0mg — a first-generation GLP-1 that's been approved for weight loss since 2014
- It's a daily injection (not weekly like Ozempic) — this is its biggest practical disadvantage
- Average weight loss is ~8% of body weight — less than semaglutide (~15%) but still clinically significant
- Pricing: RM1,500–2,000/month in Malaysia — more expensive than Ozempic despite being less effective
- Still relevant for patients who don't tolerate semaglutide or who prefer a medication with a longer safety track record
Medical disclaimer: This article is for informational purposes only. Saxenda is a prescription medication. Always consult a licensed doctor before starting any GLP-1 treatment.
What Is Saxenda?
Saxenda is the brand name for liraglutide at 3.0mg, manufactured by Novo Nordisk. If you've heard of Victoza (liraglutide 1.8mg for diabetes), Saxenda is its higher-dose sibling specifically designed for chronic weight management.
Liraglutide was the first GLP-1 receptor agonist approved for obesity by the FDA in December 2014 — years before semaglutide-based products like Ozempic (2017) and Wegovy (2021) arrived. It was genuinely revolutionary at the time and helped establish GLP-1s as legitimate weight loss treatments.
How Saxenda Compares to Newer GLP-1s
Let's address the elephant in the room: in 2026, Saxenda is no longer the best GLP-1 for weight loss. Here's the honest comparison:
| Feature | Saxenda | Ozempic | Wegovy | Mounjaro |
|---|---|---|---|---|
| Active ingredient | Liraglutide | Semaglutide | Semaglutide | Tirzepatide |
| Injection frequency | Daily | Weekly | Weekly | Weekly |
| Average weight loss | ~8% | ~12–14% | ~15% | ~18–22% |
| Monthly cost (RM) | RM1,500–2,000 | RM1,200–1,500 | RM2,000–2,500 | RM2,500–3,500 |
| Years of safety data | 12+ years | 9+ years | 5+ years | 4+ years |
So why does Saxenda still exist? And why do some doctors still prescribe it? Several legitimate reasons, which we'll cover below.
How Saxenda Works
Like all GLP-1 receptor agonists, Saxenda mimics the incretin hormone GLP-1:
- Suppresses appetite through hypothalamic signalling
- Slows gastric emptying to increase satiety
- Modulates insulin and glucagon to stabilise blood sugar
The difference from semaglutide is pharmacological: liraglutide has a shorter half-life (~13 hours vs ~168 hours for semaglutide). This is why Saxenda requires daily injections while Ozempic works with weekly dosing. The shorter half-life also means side effects tend to resolve faster if you stop — a feature some patients and doctors value.
Saxenda Dosing Schedule
Saxenda uses a 4-week titration with the same multi-dose pen:
| Week | Daily Dose |
|---|---|
| Week 1 | 0.6mg |
| Week 2 | 1.2mg |
| Week 3 | 1.8mg |
| Week 4 | 2.4mg |
| Week 5+ | 3.0mg (maintenance) |
One Saxenda pen contains 18mg of liraglutide, lasting 6 days at the full 3.0mg dose. You'll need approximately 5 pens per month at maintenance dose.
The injection is subcutaneous (abdomen, thigh, or upper arm) using a very fine needle. Most patients describe it as a small pinch — less painful than a blood test. You can inject at any time of day, with or without food, but consistency helps.
Saxenda Price in Malaysia (2026)
| Item | Cost (RM) |
|---|---|
| Single pen (18mg) | RM350–450 |
| Monthly supply (5 pens at 3.0mg/day) | RM1,500–2,000 |
| Annual cost estimate | RM18,000–24,000 |
This pricing makes Saxenda an awkward proposition: it costs more than Ozempic while delivering less weight loss. The price gap is the primary reason most new patients now start with semaglutide-based options instead.
See our complete pricing comparison for all available options.
Clinical Evidence: The SCALE Trials
Saxenda's evidence base comes from the SCALE (Satiety and Clinical Adiposity — Liraglutide Evidence) programme:
SCALE Obesity and Prediabetes
- 3,731 participants — one of the largest obesity drug trials at the time
- 56 weeks of treatment
- Average weight loss: 8.0% vs 2.6% with placebo
- 63.2% of participants lost ≥5% body weight (vs 27.1% placebo)
- 33.1% lost ≥10% body weight (vs 10.6% placebo)
- Significant reduction in prediabetes progression to type 2 diabetes
SCALE Diabetes
- Patients with type 2 diabetes lost 6.0% body weight on average
- HbA1c improvements alongside weight loss
SCALE Maintenance
- Patients who had already lost ≥5% through diet alone maintained and extended their weight loss with Saxenda
- Average additional 6.2% weight loss beyond diet-induced loss
These were strong results when published. They've since been superseded by semaglutide and tirzepatide data, but 8% weight loss remains clinically meaningful — enough to improve blood pressure, lipid profiles, and insulin sensitivity.
Who Still Benefits from Saxenda in 2026?
Despite newer options, Saxenda remains a valid choice for specific patient populations:
1. Patients Who Don't Tolerate Semaglutide
A small percentage of patients experience intolerable side effects on semaglutide (severe, persistent nausea even at low doses) but do fine on liraglutide. The shorter half-life means side effects clear faster, and the daily dosing allows for more precise dose adjustment.
2. Patients Who Value Long Safety Track Record
Saxenda has 12+ years of real-world safety data. For risk-averse patients or those with specific medical concerns, this longer track record provides peace of mind. The LEADER cardiovascular outcomes trial also showed cardiovascular safety for liraglutide.
3. Patients Wanting Easier Discontinuation
Because liraglutide clears the body much faster (half-life ~13 hours vs ~7 days for semaglutide), stopping Saxenda means the drug is out of your system within 2–3 days. If you experience a serious side effect, this matters.
4. Adolescent Patients
Saxenda was one of the first GLP-1s approved for adolescents (ages 12–17) with obesity. In markets where Wegovy hasn't received paediatric approval, Saxenda may be the only GLP-1 option for teens.
5. Patients Already Responding Well
If you're already on Saxenda and achieving your goals, there's no clinical reason to switch. "Don't fix what isn't broken" applies.
Side Effects
Saxenda's side effect profile is similar to other GLP-1s but with some nuances:
Common
- Nausea (39%) — most common during titration
- Diarrhea (21%)
- Constipation (19%)
- Vomiting (16%)
- Injection site reactions (14%) — redness, itching at injection site
- Headache (14%)
- Hypoglycaemia — primarily in patients also taking insulin or sulfonylureas
Serious (Rare)
- Pancreatitis: Report severe abdominal pain immediately
- Gallbladder disease: Increased risk with rapid weight loss
- Thyroid C-cell tumours: Rodent data; boxed warning applies. Contraindicated with personal/family history of medullary thyroid carcinoma or MEN 2
- Acute kidney injury: Usually from dehydration due to GI side effects
One practical advantage: because liraglutide clears faster, if you experience severe nausea, skipping one daily dose provides meaningful relief within hours. With weekly semaglutide, you're stuck with side effects for days.
Saxenda Availability in Malaysia
Saxenda is available through private clinics and hospital pharmacies across Malaysia. Availability is generally good in major cities:
- KL/Selangor: Readily available at most endocrinology and weight management clinics
- Penang, JB, Ipoh: Available at major private hospitals
- East Malaysia: Limited — may need to order through KL distributors
Saxenda pens should be stored refrigerated (2–8°C) before first use. Once in use, they can be kept at room temperature (below 30°C) for up to 30 days. In Malaysia's climate, avoid leaving pens in hot cars or direct sunlight.
Switching from Saxenda to Semaglutide
This is a common conversation in Malaysian clinics. If you're on Saxenda and considering a switch:
- Saxenda → Ozempic: Stop Saxenda, start Ozempic 0.25mg the next day. No washout period needed (different molecules, but same receptor target). Begin the standard Ozempic titration
- Saxenda → Wegovy: Same approach — stop Saxenda, begin Wegovy titration at 0.25mg
- Saxenda → Mounjaro: Stop Saxenda, start Mounjaro at 2.5mg. Slightly different receptor profile (GLP-1 + GIP dual agonist)
Expect a brief adjustment period as the new medication reaches steady-state levels. Some patients experience temporary return of appetite during the transition.
Saxenda vs Ozempic: The Malaysian Decision
For most new patients in Malaysia, Ozempic wins on three fronts:
- Better efficacy: ~12–14% weight loss vs ~8%
- More convenient: Once weekly vs daily injections
- Often cheaper: RM1,200–1,500/month vs RM1,500–2,000/month
Saxenda's advantages are limited to the specific scenarios outlined above: semaglutide intolerance, preference for shorter-acting medication, adolescent patients, or existing treatment success.
For a full comparison of all options, see our Ozempic vs Wegovy vs Mounjaro guide.
Frequently Asked Questions
Is Saxenda the same as Victoza?
Same molecule (liraglutide), different dose and indication. Victoza is 1.8mg for type 2 diabetes. Saxenda is 3.0mg for weight management. They come in different pen configurations.
Can I use Saxenda during Ramadan?
Since Saxenda is a daily injection, discuss timing with your doctor. Most patients inject at iftar or before bedtime during Ramadan. Subcutaneous injections don't break the fast according to most Islamic scholars' rulings, but confirm with your own religious authority if uncertain.
How long should I take Saxenda?
Current guidelines suggest evaluating at 16 weeks: if you haven't lost at least 4% of body weight by then, the medication isn't working well enough for you and your doctor should discuss alternatives. For responders, treatment is typically long-term.
Will I regain weight after stopping Saxenda?
Like all GLP-1s, weight regain after discontinuation is common. The key is establishing sustainable diet and exercise habits while on the medication, and discussing a gradual taper with your doctor rather than abrupt cessation.
The Bottom Line
Saxenda is the "original" GLP-1 weight loss injection, and it still works. But in 2026's landscape, it occupies a niche position rather than a leading one. It costs more and delivers less than semaglutide, with the added burden of daily injections.
If your doctor specifically recommends Saxenda — perhaps because you've had issues with semaglutide or for other clinical reasons — it remains a solid, well-studied option. But for most Malaysians starting their GLP-1 journey, the conversation should begin with semaglutide or tirzepatide and consider Saxenda as a fallback.