Liraglutide vs semaglutide: Victoza, Saxenda, Ozempic, Wegovy, and Rybelsus explained

Key Points

• Semaglutide and liraglutide are GLP-1 medications that mimic natural hormones to control blood sugar and reduce appetite
• Semaglutide produces roughly 2.5 times more weight loss than liraglutide in head-to-head studies
• Both medications are similar in their blood glucose control
• Liraglutide requires daily injections, while semaglutide offers weekly injections or a daily oral tablet option

Choosing between GLP-1 medications can feel overwhelming when multiple options promise similar benefits. Liraglutide and semaglutide (available under various brand names) both help control blood sugar and support weight loss, but there are some differences.

Understanding these evidence-based distinctions empowers you to make informed treatment decisions.

Liraglutide vs. semaglutide: How do they work?

Both semaglutide and liraglutide are GLP-1 receptor agonists. They work by mimicking a natural hormone, GLP-1, that your body naturally produces after eating to help control blood sugar and appetite.

GLP-1 receptor agonists work in three main ways:

• Boost insulin production when your blood sugar rises
• Reduce glucose production by your liver
• Slow stomach emptying to help you feel full longer

How is liraglutide administered?

Liraglutide is available under the brand names:

• Victoza: Once-daily injection for type 2 diabetes in adults and children 10 years and older
• Saxenda: Once-daily injection for weight loss in adults and children 12 years and older with obesity

Dosing frequency represents the biggest difference between these medications.

Victoza dosage and administration

Victoza is given as a daily injection under the skin. You usually start with a 0.6 mg dose for at least one week to allow the body to adjust to the medication.

The dose is then increased to 1.2 mg for at least a week and then to 1.8 mg for further blood sugar control, if needed.

Saxenda dosage and administration

Saxenda is also a daily injection under the skin. You start with a 0.6 mg dose for the first week to help your body adjust to the medication.

The dose is then increased by 0.6 mg each week until you reach the target dose of 3.0 mg daily for weight loss.

How is semaglutide administered?

Semaglutide is available under the brand names:

• Ozempic: Once-weekly injection for type 2 diabetes
• Wegovy: Once-weekly injection for weight loss
• Rybelsus: Daily oral tablet for type 2 diabetes

Ozempic dosage and administration

Ozempic is given as a weekly injection under the skin.

With Ozempic, your healthcare provider will typically start you off on a 0.25 mg dose once weekly for 4 weeks to help your body adjust to the medication. The dose is then increased to 0.5 mg weekly. If additional blood sugar control is needed after at least 4 weeks, your doctor may increase it to 1.0 mg weekly, with a maximum dose of 2.0 mg weekly.

Wegovy dosage and administration

Wegovy is also given as a weekly injection under the skin. You begin with a 0.25 mg dose once weekly for 4 weeks. The dose is gradually increased every 4 weeks: first to 0.5 mg, then 1.0 mg, then 1.7 mg, and finally to the target maintenance dose of 2.4 mg weekly for weight management.

Rybelsus dosage and administration

Rybelsus is taken as a daily oral tablet on an empty stomach. You start with a 3 mg tablet once daily for 30 days, allowing your body to adjust. The dose is then increased to 7 mg daily.

If additional blood sugar control is needed after at least 30 days, your doctor may increase the dose to a maximum of 14 mg daily.

Liraglutide vs semaglutide: Which one is better for weight loss?

In a head-to-head study, semaglutide outperformed liraglutide for weight loss. After 16 months, people on semaglutide lost about 16% of their body weight compared to just 6% with liraglutide—making semaglutide roughly 2.5 times more effective.

However, your healthcare provider will help you determine what's best for you based on your needs and how your body reacts to the medication.

Liraglutide vs semaglutide: Which one is better for blood sugar control?

Studies show that semaglutide provides slightly better blood sugar control than liraglutide.

One meta-analysis of 16 studies found that the HbA1c reduction with semaglutide was 0.56% greater than that with liraglutide. However, both medications were equally effective in lowering fasting blood sugar levels.

Liraglutide vs semaglutide: Which one is better for heart health?

Both medications offer cardiovascular benefits for people with type 2 diabetes and heart disease.

Victoza (liraglutide) is FDA-approved to reduce the risk of major cardiovascular events like heart attack, stroke, and cardiovascular death in adults with type 2 diabetes and known heart disease.

Similarly, Wegovy (semaglutide) is FDA-approved to reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and obesity or being overweight.

Liraglutide vs semaglutide: How long do they stay in your system?

These medications have significantly different elimination times.

How long does liraglutide stay in your system?

Liraglutide has a relatively short half-life of around 13 hours, which means the medication level in your bloodstream drops by half in about half a day. Due to its shorter duration of action, liraglutide requires daily dosing to maintain effective levels in the system.

After you stop taking liraglutide, it takes approximately 3-4 days for the medication to be completely eliminated from your body. This faster clearance is one reason why liraglutide needs to be administered daily rather than weekly.

How long does semaglutide stay in your system?

Semaglutide has a significantly longer half-life of about 7 days, meaning it takes a whole week for the medication level in your bloodstream to reduce by half.

After you stop taking semaglutide, it takes around 5 weeks or even longer for the medication to be completely eliminated from your system.

Liraglutide vs semaglutide: Which one has fewer side effects?

Both medications share similar side effects, but research suggests important differences in tolerability.

Common side effects for both include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Stomach pain
• Decreased appetite

However, one study suggests that semaglutide has lower discontinuation rates. In the study, 13.5% of people in the semaglutide group discontinued treatment compared to 27.6% in the liraglutide group.

"Your healthcare provider will advise on whether semaglutide or liraglutide is better for you based on your individual health needs and tolerance,” explains Eapen, MD. “Most side effects occur when starting treatment and typically improve over time. If side effects continue or become severe, please consult your doctor.”

Liraglutide vs semaglutide: Which one is covered by insurance?

Insurance coverage for liraglutide and semaglutide varies significantly depending on your insurance plan and the health condition being treated.

Generally, insurance companies are more likely to cover GLP-1 medications when they are prescribed for diabetes rather than for weight loss alone. Ozempic, Rybelsus, and Victoza (for diabetes) may have better coverage than Wegovy and Saxenda (for weight management).

Many insurance plans require prior authorization, step therapy (which involves trying other medications first), or documentation of medical necessity before approval.

Please check with your insurance provider and discuss coverage options with your doctor before starting any of these medications.

Liraglutide vs semaglutide: What’s the best diet for these medications?

As Rita Faycurry, RD, Registered Dietitian, explains: "GLP-1 medications like liraglutide and semaglutide are powerful tools, but they work best when patients embrace comprehensive lifestyle changes. Healthy eating patterns support long-term success."

The medications are to be paired with:

• A balanced, calorie-controlled diet
• Regular physical activity
• Consistent meal timing
• Adequate hydration
• Stress management

If you’re experiencing gastric side effects or struggling to get the necessary nutrition due to a reduced appetite, working with a registered dietitian can help you optimize the benefits of your medication through sustainable eating habits.

Final thoughts

Both medications represent advances in how diabetes and obesity are treated. Research shows semaglutide offers key advantages: greater weight loss, slightly better blood sugar control, weekly (not daily) dosing, and fewer side effects.

However, the “best” choice is the medication that works for your goals, injection preference, sensitivity to the medication, costs, and how they interact with other medicines you may be taking.

Get a personalized GLP-1 diet plan, covered by your insurance. 

Frequently asked questions (FAQs)

Which is better, liraglutide or semaglutide?

Semaglutide is generally more effective for weight loss, but it is similar to liraglutide for blood sugar control. Discuss with your doctor which medication is best suited for you, taking into account your individual health needs and treatment goals.

Is Ozempic and liraglutide the same thing?

No, Ozempic contains semaglutide, while liraglutide is found in the medications, Victoza and Saxenda. Both semaglutide and liraglutide are GLP-1 receptor agonists that work similarly; however, they have distinct chemical structures, dosing schedules, and effectiveness profiles. Ozempic is given weekly, while liraglutide medications require daily injections.

Which is better: Saxenda or semaglutide?

Semaglutide (Wegovy) is generally more effective for weight loss than Saxenda (liraglutide). Clinical trials show semaglutide produces 15.8% weight loss compared to 6.4% with liraglutide. Semaglutide also requires only weekly injections versus daily injections for Saxenda.

Find a weight loss dietitian near you, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.