Liraglutide Side Effects: What You Should Expect

Starting liraglutide for the first time? In this article, we’ll unpack common side effects of liraglutide, what to expect and how to manage them.

What is Liraglutide?

Liraglutide is the active ingredient in daily injectable weight loss medications: Saxenda, Victoza and Compounded* Liraglutide with B12. It is a part of a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists (or simply GLP-1s). Liraglutide was originally developed for the treatment of type 2 diabetes in adults and it first gained FDA approval in 2010, under the brand name Victoza. Later, it was approved for chronic weight management under the brand name Saxenda in 2014, making it one of the first daily GLP-1 receptor agonists to become widely available.

How does Liraglutide work?

Liraglutide works in the same way as other popular GLP-1s, Ozempic and Wegovy (which contain the active ingredient semaglutide), by influencing three main factors: 

• Regulating appetite by increasing feelings of fullness and reducing hunger levels to help you eat less and stick to healthy lifestyle changes. [1]
• Reducing blood sugar levels by stimulating insulin secretion (the hormone that lowers blood sugar) and lowering glucagon secretion (the hormone that increases blood sugar), to help combat cravings for high-calorie or sugary foods. [1]
• Delaying how quickly food laves your stomach (gastric emptying) to keep you feeling fuller for longer. [1]

Efficacy of Liraglutide

Studies show an average weight loss of 8% by week 56 for patients taking liraglutide alongside a reduced calorie diet and increased physical activity. 

The same clinical trial also found that the group taking liraglutide alongside a diet and exercise plan lost an average of 18.5 lbs after 56 weeks, while the group using a placebo alongside the same diet and exercise plan lost an average of 6.2 lbs. This means that, based on the average body weight lost, liraglutide with diet and exercise was about 3 times more effective than diet and exercise alone. [2]

Common Side Effects of Liraglutide

The good news is that not everyone taking Liraglutide experiences side effects and the severity of symptoms depends on the person, the dose and medication type. Plus, most patients find that digestive side effects usually improve within a few days to a week.

Gastrointestinal Side Effects

Some of the most common side effects of liraglutide are gastrointestinal, which means they are related to your digestive system and include nausea, diarrhea, constipation and vomiting. [1]

Nausea

Liraglutide helps you feel full longer by slowing down how quickly your stomach empties but because food stays in your stomach longer, it can cause stretching, which sends signals to your brain that may lead to nausea. To manage nausea we recommend drinking plenty of fluids (cold water, herbal teas), getting lots of fresh air, eating small and frequent meals and avoiding foods high in sugar.

Vomiting

Liraglutide can cause vomiting, just like it can cause nausea, because the food stays in your stomach longer and causes it to stretch. This triggers signals that are sent to the brain, which may lead to vomiting. We recommend staying hydrated, eating small and frequent meals and sticking to a bland diet that is easy on your stomach, such as toast, rice and bananas to prevent vomiting.

Diarrhea

Diarrhea can happen while using liraglutide because it slows down how quickly food moves through your stomach, disrupting normal digestion.  To manage symptoms you should stay hydrated, eat small and frequent meals and consider taking oral rehydration salts from a pharmacist to replace lost fluids and electrolytes

Constipation

Liraglutide slows down the movement of food and waste through your digestive system which may cause constipation. To manage constipation, try drinking plenty of fluids, eating high-fibre foods such as prunes, figs, and oats and taking regular walks, as exercise can stimulate bowel movements.

Headache

Liraglutide can lead to side effects like vomiting and diarrhea, which cause fluid loss and increase the risk of dehydration (a key trigger for headaches). It also slows how quickly food leaves your stomach, which can impact hydration and nutrient absorption, further contributing to headaches.

To manage symptoms, we recommend drinking plenty of fluids (water, herbal teas), use simple pain relief like paracetamol and ensure you are getting enough sleep.

Less Common Side Effects

Less common side effects of liraglutide include:

• Indigestion
• Fatigue
• Dizziness 
• Stomach pain 
• Heartburn 
• Bloating
• Burping
• Flatulence 
• Injection site reaction 
• Dry mouth 
• Gallstones

Uncommon side effects

• Dehydration
• Increased heart rate

Rare and Serious Side Effects

Rare but side effects include:

• Pancreatitis
• Acute gallbladder disease
• Acute kidney injury
• Anaphylaxis 

The following symptoms could indicate pancreatitis, a serious condition that requires urgent medical attention.

• Severe, persistent stomach pain. Severe means:
  • It’s so intense (around 8 or more out of 10) that you can’t focus on anything else
  • It makes it nearly impossible to handle normal daily tasks (like walking, getting dressed, or eating)
  • It doesn’t improve with over-the-counter pain relief or rest
  • It radiates to your back or underneath your right ribcage or your right shoulder 
  • You also have severe vomiting (3 or more times a day, or having blood or something that looks like coffee grounds in vomit)

The following symptoms could indicate anaphylaxis or a severe allergic reaction that requires urgent medical attention. If you experience any of the following, stop taking your medication immediately.

• Difficulty breathing, or swelling of the lips, tongue, or throat as these could be signs of a severe allergic reaction, which can be life-threatening. 
• Severe pain underneath your right ribcage that may spread to your shoulder or back. This may be accompanied by vomiting, a high temperature or a rapid heartbeat. These symptoms could suggest acute gallbladder problems.

Medication Interactions

You should never use liraglutide in combination with any other GLP-1s (like semaglutide), GIP/GLP-1s (like tirzepatide) or insulin, as they can increase the risk of hypoglycemia (dangerously low blood sugar).

Research has found that liraglutide doesn't affect the absorption of oral medications, and it is unlikely to cause problems with most other medicines, including common ones like acetaminophen. 

Taking antibiotics while on liraglutide is considered safe; however, they may increase digestive side effects such as nausea and diarrhea. This is because both GLP-1s and antibiotics can affect the digestive system in similar ways, and taking them together may make these symptoms more noticeable.

You should always tell your healthcare provider about all the medicines you're taking before starting liraglutide.

Medical History Considerations

Like with any medication, your healthcare provider will consider your medical and family history before prescribing liraglutide.

This is because liraglutide is not prescribed to patients with a family history of medullary thyroid carcinoma (MTC) or with multiple endocrine neoplasia syndrome type 2 (MEN 2). [1]

If anything in your family history changes during treatment, you should immediately notify your healthcare provider so they can assess your treatment plan.

Impact on Pregnant and Breastfeeding Individuals

Liraglutide should not be used during pregnancy. If pregnancy occurs while on treatment or you are trying to conceive, liraglutide should be discontinued immediately.

Correct Dosage Practices

Administering your medication properly and listening to your body can help keep side effects at bay. If you experience symptoms such as persistent nausea, vomiting or diarrhea with your new dose, speak to your healthcare provider. They may recommend remaining on your current dose for longer than 4 weeks, or decreasing your dose to see if that helps improve your side effects. 

If a dose is missed, the once-daily schedule should be resumed as prescribed with the next scheduled dose. An extra dose or an increase in dose should not be taken to make up for the missed dose. If more than 3 days have passed since the last liraglutide dose, patients should restart treatment at 0.6 mg daily and follow the official titration schedule from the start. This is to reduce the occurrence of digestive symptoms associated with restarting treatment.

Interested in Liraglutide?

If you’re looking to start your weight loss journey, ZipHealth can help you find out if Compounded* Liraglutide with B12 treatment is the right fit for you by taking a short online consultation.

*Compounded drugs are permitted to be prescribed under federal law but are not FDA-approved and do not undergo FDA review for safety, effectiveness, or quality.

References:

[1] HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use SAXENDA® safely and effectively. See full prescribing information for SAXENDA. SAXENDA (liraglutide) injection, for subcutaneous use Initial U.S. Approval: 2010 FORMS AND STRENGTHS[Internet]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/206321s007lbl.pdf

[2] Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. New England Journal of Medicine [Internet]. 2015 Jul 2;373(1):11–22. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa1411892