Liraglutide vs Semaglutide: How do they compare?
Both liraglutide and semaglutide are prescription GLP-1 receptor agonist medications used to help lower blood sugar in patients with type 2 diabetes, to help people lose weight and keep it off, and to help lower the risk of major heart-related events like a stroke, heart attack or death. These medicines are typically used in addition to diet and exercise for the most benefit.
In general, semaglutide is more effective for weight loss and blood sugar control than liraglutide based on randomized controlled trials, with a greater mean weight reduction of 9.5% with semaglutide in the STEP 8 trial, and a 0.7% greater reduction in blood sugar (HbA1C or A1c) in the SUSTAIN 10 trial.
In addition, semaglutide injection is given once weekly compared to once daily with liraglutide, a significant advantage for many people. However, some studies have shown higher rates of gastrointestinal side effects with subcutaneously injected semaglutide compared to liraglutide.
What are liraglutide and semaglutide used for?
Semaglutide and liraglutide are marketed as the brand name products Ozempic, Rybelsus or Wegovy (semaglutide) and Saxenda or Victoza (liraglutide). The uses and age groups for these medicines vary based on FDA approvals.
Liraglutide
- Saxenda is approved in certain adults and children 12 years and older to help them lose weight and maintain that weight loss.
- Victoza is used in adults and children 10 years of age and older to help lower blood sugar in type 2 diabetes (along with diet and exercise), and help lower the risk of serious heart events in adults with type 2 diabetes and known heart disease.
- Although not approved for weight loss, some people using Victoza for type 2 diabetes may also lose weight during treatment.
- Both Saxenda and Victoza are given as subcutaneous (under the skin) injections once per day. The injection can be given at home after training from a healthcare provider.
Semaglutide
- Ozempic is approved in eligible adults: to lower blood sugar in type 2 diabetes, lower the risk of serious heart events (heart attack, stroke, death) and to help reduce the risk of worsening kidney disease.
- Wegovy is used to help eligible adults and children 12 years of age and older lose weight and maintain that weight loss, and to lower the risk of serious heart events (heart attack, stroke or death) in adults with either obesity or overweight.
- Rybelsus is approved to help lower blood sugar in adults with type 2 diabetes (along with diet and exercise).
- Although not approved for weight loss, some people using Ozempic or Rybelsus may also lose weight during treatment, , an added benefit.
Ozempic and Wegovy are given as subcutaneous (under the skin) injections once per week, while Rybelsus is given as an oral tablet once daily. The injections can be given at home after training from a healthcare provider.
These medicines should not be used together or with any other liraglutide or semaglutide medicines or any other GLP-1 or GLP-1 / GIP receptor agonists.
Ozempic, Rybelsus, Saxenda, Victoza and Wegovy are all manufactured by Novo Nordisk.
Do liraglutide and semaglutide work the same way?
Yes, liraglutide (brands: Saxenda, Victoza) and semaglutide (brands: Ozempic, Wegovy, Rybelsus) are both in the class of drugs known as incretin mimetics. They are commonly referred to as glucagon-like peptide-1 (GLP-1) receptor agonists.
These treatments are man-made versions of GLP-1 and work by mimicking the natural GLP-1 (incretin) hormone in our bodies. Incretin is made primarily in our digestive tract and is released when we eat to help keep levels of blood sugar normal and helps you feel full after meals. GLP-1 binds to the GLP-1 receptor to exert its effect and increase the action of these medicines.
GLP-1 agonists result in improved blood sugar levels (HbA1c levels), help to lengthen the time you feel full after eating, and can help control your appetite and how much you eat (by targeting an area in the brain), which may result in weight loss. It is recommended these medicines are used with a healthy eating plan and an exercise program to maximize the benefits.
The mechanism of action for liraglutide and semaglutide (how they work) is to:
- Stimulate insulin release from the pancreas when needed to help lower your blood sugar.
- Decrease the amount of glucose made by your liver by lowering glucagon secretion. This can help to improve your blood sugar.
- Slow down the movement of food through your stomach (called gastric emptying) which can help you feel fuller for a longer period of time. This can decrease your appetite and lead to weight loss.
How are liraglutide and semaglutide given?
There are some important differences in how these drugs are given.
- Semaglutide (Ozempic and Wegovy) is given once per week as an injection under the skin (subcutaneously) in the stomach area (abdomen), thigh or upper arm.
- Liraglutide (Saxenda or Victoza) is given once per day as an injection under the skin (subcutaneously) in the stomach area (abdomen), thigh or upper arm.
- You or a caregiver can learn to give these injections at home using a prefilled, disposable, single-patient-use pen. The injectable medicines can be taken with or without food.
Semaglutide (brand: Rybelsus) is a medicine used for type 2 diabetes that you can take by mouth once a day, but it has specific instructions.
- Take Rybelsus on an empty stomach when you first wake up with a sip of plain water only (4 ounces or less). Take it 30 minutes before your first food, drink (except a sip of water), or other oral medications. This helps the medicine to be better absorbed.
- Swallow the tablet whole (do not crush, split or or chew it). If you take other medicines first thing in the morning, ask your doctor about a schedule change.
As you get used to the specific GLP-1 agonist medicine prescribed for you, your healthcare provider will increase your dose to your regular maintenance dose. You will start with lower doses to help prevent side effects like stomach upset (nausea, vomiting, diarrhea).
Your doctor may have you take these medicines in combination with other treatments for type 2 diabetes, like metformin, SGLT-2 inhibitors, insulin or sulfonylurea treatments. Be aware that this may increase your risk for low blood sugar (hypoglycemia).
Learn More
- Dosing for liraglutide (Saxenda, Victoza)
- Dosing for semaglutide (Ozempic, Wegovy, Rybelsus)
How do liraglutide and semaglutide compare in studies?
In head-to-head clinical studies, semaglutide has been shown to be more effective than liraglutide for both weight loss management and control of blood sugar (glucose) in patients with type 2 diabetes, along with diet and exercise.
SUSTAIN 10 Trial
- The SUSTAIN 10 trial was a 30-week long, Phase 3b study in 577 adults with type 2 diabetes taking 1 to 3 oral antidiabetic drugs. Patients were randomized to subcutaneous semaglutide given at a dose of 1 mg per week or daily subcutaneous liraglutide 1.2 mg.
- Semaglutide was shown to lower HbA1c (a long-term measure of blood sugar control) by 1.7% compared to 1% with daily liraglutide 1.2 mg, a significant difference.
- In addition, the mean body weight decreased by 5.8 kg (12.8 lb) with semaglutide vs. 1.9 kg (4.2 lb) with liraglutide, also a significant result.
Side effects were similar with gastrointestinal (stomach) effects as the most commonly reported adverse event. However, more patients reported stomach side effects with semaglutide (43.9%) vs. liraglutide (11.4%), and more people stopped treatment early with semaglutide (38.3%) compared to liraglutide (6.6%) due to adverse events.
STEP 8 Trial
- In the STEP 8, Phase 3 randomized, 68-week controlled trial, investigators compared the efficacy and safety of subcutaneous semaglutide, 2.4 mg given once a week to subcutaneous liraglutide 3 mg given once per day, in addition to diet and exercise, in people with overweight or obesity.
- Participants included 338 adults (without type 2 diabetes) with obesity, or with overweight and one or more weight-related comorbidities (like high blood pressure, high cholesterol, obstructive sleep apnea, or cardiovascular (heart) disease.
- Overall, 271 (80.2%) people completed treatment. In the group randomized to semaglutide 2.4 mg injected weekly, a mean weight loss of 15.8% was seen compared to 6.4% in the group that received liraglutide 3 mg daily, a statistically significant effect.
Related: Will Victoza help with weight loss?
Related questions
- Ozempic Side Effects to Watch For
- Wegovy vs Ozempic: Which is Right for You?
- Tirzepatide vs semaglutide: How do they compare?
How do side effects compare between liraglutide and semaglutide?
Stomach side effects are common with the GLP-1 agonist class, especially when first starting treatment or increasing your dose too quickly. In studies, gastrointestinal side effects occurring in at least 5% of patients for both liraglutide and semaglutide included:
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal (stomach pain) pain
Your doctor will start you on lower doses to help prevent side effects that may interrupt your treatment. Stomach side effects tend to subside over time and while your final maintenance dose is reached. Higher doses may lead to worsened side effects, and stopping and restarting treatment may cause stomach side effects to reoccur.
In general, about 5% to 10% of people will need to stop treatment due to stomach side effects with GLP-1 agonists. In studies, common side effects that led people to stop treatment were nausea, vomiting, and diarrhea.
Other stomach side effects reported in at least 5% of patients for either liraglutide or semaglutide include:
- Dyspepsia (heartburn)
- Abdominal distention
- Eructation (belching)
- Flatulence (gas)
- Gastroenteritis
- Gastroesophageal reflux disease (GERD)
- Decreased appetite
Tips for managing stomach side effects
If you have stomach side effects when first starting treatment, you may be able to better manage it by:
- Eating more slowly and eating smaller meals
- Eating more bland, low-fat foods (like crackers, toast and rice)
- Avoiding fried, greasy foods and fast foods
- Eating foods that contain water (like soup or gelatin)
- Not lying down right after after eating
- Getting fresh air outside
Learn More: 6 Wegovy Side Effects You Need to Be Aware Of
If you experience stomach side effects with a GLP-1 agonist like liraglutide or semaglutide that concern you, worsen, or do not go away, call your healthcare provider for further evaluation.
Other common side effects reported for either liraglutide or semaglutide in at least 5% of patients included:
- Headache
- Fatigue
- Dizziness
- Hypoglycemia (low blood sugar)
- Nasopharyngitis (the common cold)
- Elevated lipase (enzyme from the pancreas)
- Fever
GLP-1 Boxed Warnings
A Boxed Warning is the most serious safety warning from the FDA. It details important or life-threatening risks or side effects that may occur. Boxed warnings appear prominently at the top of the package insert as well as in the Patient Medication Guide.
- All GLP-1 agonists, including liraglutide and semaglutide, carry a Boxed Warning for possible thyroid tumors, including cancer, which has been seen in animal studies
- Do not use liraglutide or semaglutide if you or anyone in your family has a history of medullary thyroid carcinoma (MTC), or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- Discuss these warnings and the risk for MTC and the symptoms of thyroid tumors further with your healthcare provider.
Precautions / Warnings
Other precautions and warnings may include: acute pancreatitis, hypoglycemia (low blood sugar), acute gallbladder disease, acute kidney injury, hypersensitivity (allergic) reactions, severe stomach problems, and food or liquid getting into the lungs (aspiration) during surgery or other procedures that use anesthesia or deep sleepiness (deep sedation).
Before you start treatment, tell your healthcare provider if you have or have had depression, suicidal thoughts, or mental health issues.
- Suicidal ideation and behavior have been reported as precautions in studies for weight management.
- If you experience depression, any unusual changes in mood or behavior and/or have thoughts of suicide, contact your health care provider right away or get emergency help if you have any mental changes that are new, worse, or worry you.
Related: Review the following Precautions, Warnings and Side Effects (in more detail)
- Liraglutide (Saxenda, Victoza)
- Semaglutide (Ozempic, Rybelsus, Wegovy)
Note: This is not a full list of side effects, precautions or warnings for these medications. Review your drug product information and discuss this with your healthcare provider.
How does the cost compare between liraglutide and semaglutide?
GLP-1 agonist medications can be expensive for many people in the U.S., and prices can vary based on your insurance coverage, available manufacturer copay programs and your location.
Discuss your insurance coverage and ability to pay for these medications with your healthcare provider before they write you a prescription.
Contact your prescription insurance company to find out which of these drugs are covered on your plan, and your expected costs.
Liraglutide costs
- Liraglutide (Saxenda 18 mg/3 mL) subcutaneous solution used for weight loss management costs about $1,450 for a supply of 15 milliliters, depending upon the pharmacy that you visit.
- Liraglutide (Victoza 18 mg/3 mL) subcutaneous solution used for management of type 2 diabetes costs around $590 for a supply of 6 milliliters, depending on the pharmacy you visit. There is a generic version of Victoza (liraglutide) available in the U.S. that is about $444 for 6 milliliters.
- How long the medicine will last you will depend upon your daily dose. Ask your pharmacist when you will need to refill your medicine.
Semaglutide costs
- Semaglutide (Wegovy) injection, used for weight loss treatment, costs about $1349 per month if you are paying cash and not using insurance. Most people do not pay this price.
- Wegovy cost is $499 per month without insurance for all strengths, when supplied from Novo Nordisk’s NovoCare Pharmacy, a direct-to-patient delivery option for cash-paying patients.
- Semaglutide for treatment of type 2 diabetes costs about $1075 per month for either the Ozempic pen injection or 30 oral tablets of Rybelsus.
Related: How much does semaglutide cost?
Drugs.com Pricing, Online Coupons and Manufacturer’s Savings
Liraglutide (18 mg/6 mL), a generic for Victoza, is approved in the U.S. to improve blood sugar control in people with type 2 diabetes. The other GLP-1 products are available only as brand name drugs - a generic version is not yet on the market.
Prices without insurance will vary depending on the pharmacy and any discounts or patient assistance programs you use. The Drugs.com Pricing and Coupon Guide is based on the Drugs.com discount card (for cash-paying customers) which is accepted at most U.S. pharmacies. Quoted prices are for cash-paying customers and are not valid with insurance plans.
Key Takeaways
- In general, semaglutide is more effective for weight loss and blood sugar control than liraglutide based on randomized, controlled trials.
- Some studies have shown that semaglutide may be associated with higher rates of stomach side effects like nausea, diarrhea and vomiting compared to liraglutide. Both medicines can lead to gastrointestinal side effects, which is a class side effects of GLP-1 agonists. Stomach side effects tend to lessen over time.
- Semaglutide is an injection given under the skin (subcutaneoulsy), once per week while liragutide is given as an injection once per day. Some people may prefer the weekly injections. Semaglutide is also available in an oral formulation for type 2 diabetes.
- Liraglutide is now available as a generic option in the U.S., which may be more affordable for many patients.
This is not all the information you need to know about liraglutide or semaglutide for safe and effective use and does not take the place of your doctor’s directions. Review the full patient medication guide and discuss this information and any questions you have with your doctor or other health care provider.
References
- Voelker R. Medications for Obesity. JAMA. 2025;333(1):96. doi:10.1001/jama.2024.18189
- Wegovy [prescribing information]. 11/2024. Bagsvaerd, Denmark. Novo Nordisk. Accessed May 28, 2025 at https://www.novo-pi.com/wegovy.pdf
- Capehorn MS, Catarig AM, Furberg JK, et al. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1-3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes Metab. 2020 Apr;46(2):100-109. doi: 10.1016/j.diabet.2019.101117
- Table: GLP-1 and GIP/GLP-1 Receptor Agonists for Chronic Weight Management. Med Lett Drugs Ther. 2024 Aug 5;66(1708):e1-2 doi:10.58347/tml.2024.1708d
- Victoza [prescribing information]. 11/2024. Bagsvaerd, Denmark. Novo Nordisk. Accessed May 28, 2025 at https://www.novo-pi.com/victoza.pdf
- Rubino DM, Greenway FL, Khalid U, et al. STEP 8 Investigators. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022 Jan 11;327(2):138-150. doi: 10.1001/jama.2021.23619
- Ozempic [prescribing information]. 1/2025. Bagsvaerd, Denmark. Novo Nordisk. Accessed May 28, 2025 at https://www.novo-pi.com/ozempic.pdf
- Xie Z, Yang S, Deng W, et al Efficacy and Safety of Liraglutide and Semaglutide on Weight Loss in People with Obesity or Overweight: A Systematic Review. Clin Epidemiol. 2022 Dec 6;14:1463-1476. doi: 10.2147/CLEP.S391819. PMID: 36510488; PMCID: PMC9738168
- Rybelsus [prescribing information]. 12/2024. Bagsvaerd, Denmark. Novo Nordisk. Accessed May 28, 2025 at https://www.novo-pi.com/rybelsus.pdf
- Saxenda [prescribing information]. 11/2024. Bagsvaerd, Denmark. Novo Nordisk. Accessed May 28, 2025 at https://www.novo-pi.com/rybelsus.pdf
Read next
Which GLP-1 drug is best for weight loss?
Among the GLP-1 drugs currently available, tirzepatide and semaglutide stand out as the most effective for weight management. When choosing the best GLP-1 drug for weight loss, some things to consider include effectiveness, dosage formulation, frequency of administration, cost, and side effects. Continue reading
Why am I not losing weight on Ozempic?
Although Ozempic is not FDA-approved for weight loss, over 86% of people lose at least 5% of their body weight in trials that have studied semaglutide, the active ingredient of Ozempic. But the same clinical trials also show that just under 14% don’t lose weight, and some may even gain weight. Continue reading
Does Ozempic cause muscle loss and how to prevent it?
Clinical trials have shown GLP-1 agonist drugs like semaglutide (Ozempic) can lead to a 13.9% loss of lean muscle mass (equal to a 6.9 kg or 15 lb) during treatment. Strategies to help prevent muscle loss include regular strength (resistance) training, aerobic exercise and adequate dietary protein, fluid and nutrient intake. Continue reading
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