Liraglutide Side Effects
Liraglutide is the generic name for a GLP-1 receptor agonist marketed as Victoza for treating type 2 diabetes and Saxenda for weight loss. Liraglutide, like semaglutide, helps people with a body mass index (BMI) of 30 or greater lose weight and improve their body composition. People with a BMI over 27 may also qualify if they have at least one weight-related medical condition.
Liraglutide reduces cravings, slows stomach emptying, lowers blood sugar, modulates appetite, and reduces heart disease risk. Liraglutide’s many uses and benefits make it a popular weight-loss medication.
Saxenda was evaluated for safety in five double-blind, placebo-controlled clinical trials. Over 3,000 participants were enrolled and followed for 32 to 56 weeks. In the adult clinical trials, 9.8% of people taking Saxenda discontinued treatment due to adverse reactions (4.3% of people taking the placebo drug did as well). The most common side effect reported was nausea, which affected 39% of people taking the medication.
Victoza was also tested for safety in five clinical trials. The most common adverse reaction when taking Victoza was nausea. Between 18% and 20% of participants reported nausea, depending on the dosage.
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Most Common Liraglutide Side Effects
All medications have side effects, but not everyone will experience the same liraglutide symptoms. It is important to discuss the risks and benefits of taking liraglutide with your doctor to develop an individualized risk-benefit profile. The medical condition you are treating has risks if left untreated, and the medication used to treat it also carries risks.
Listed below are the more common side effects associated with liraglutide use. It is not a comprehensive list. Depending on your medical history, you may be at higher or lower risk for some of these adverse reactions when compared to the general population.
Anyone who has a known allergy or hypersensitivity to any of the ingredients in liraglutide will not be prescribed the medication. In clinical trials, 0.7% of people taking liraglutide and 0.5% of people taking a placebo developed urticaria. This itchy skin rash, commonly known as hives, can occur all over the body.
Though rare (between 1 in 1,000 and 1 in 10,000 people), anaphylactic reactions, asthma, airway spasms, and mouth, face, or tongue swelling also occur. These reactions can be life-threatening as they cause low blood pressure, abnormal heartbeats, shortness of breath, and airway swelling. Anaphylactic reactions are emergently treated with an epinephrine injection and further management in an emergency room.
Anyone who experiences an allergic reaction to liraglutide or any other medication should no longer take the medication.
In Saxendra clinical trials, 2.2% of patients experienced gallstones, and 0.8% experienced gallbladder inflammation. In Victoza clinical trials, 0.3% of patients taking Victoza had gallstones, and 0.2% had gallbladder inflammation. Most of these patients required hospitalization and gallbladder surgery to treat the condition.
Substantial or rapid weight loss can increase your risk of gallstones, but the incidence of gallbladder disease was higher in patients taking liraglutide (medication plus diet and exercise) than in the placebo group (diet and exercise alone).
Nausea and stomachache are common symptoms associated with liraglutide, even without gallbladder disease. Common symptoms associated with gallbladder disease include:
- Pain in the upper right or center part of your abdomen
- Nausea and vomiting
- Fever and chills
- Tenderness when you touch your abdomen
- Yellowing of the skin and eyes (jaundice)
- Dark colored urine
- Light colored stool
Seek help immediately if you think you may have gallbladder disease.
Gut Health Issues
Nausea, vomiting, diarrhea, constipation, and indigestion are common gut health issues that people experience when taking liraglutide. These side effects are more common when you first start taking liraglutide and tend to improve over time. However, about 10% of people taking liraglutide stop taking the medication because of gastrointestinal side effects.
In clinical trials, nausea was the most common liraglutide side effect, affecting 20% of people taking Victoza and almost 40% of people taking Saxenda. The higher incidence in the Saxenda clinical trial is to be expected because a higher dose of liraglutide was used.
Since nausea is a dose-related symptom, your doctor will recommend a gradually increasing dose when starting liraglutide. For most people, nausea resolves over time. A bland diet, smaller meals, and drinking plenty of water can also help you manage nausea. If your symptoms worsen or you cannot stay hydrated, contact your doctor for advice.
Diarrhea and constipation can both occur with liraglutide. About 20% of people in the Saxenda clinical trials experienced diarrhea; another 20% had constipation. Increased physical activity, drinking plenty of fluids, and choosing a low-fat, high-fiber diet can improve constipation. A bland, low-fat diet can improve diarrhea. If your diarrhea is persistent and you are dehydrated, contact your doctor. Over-the-counter and prescription medications are available to help with diarrhea and constipation, but check with your doctor or pharmacist to verify that they do not interact with your medications or have the potential to worsen any other symptoms.
Liraglutide slows stomach emptying. This helps you feel full longer and helps you lose weight. However, when food sits in your stomach longer, it can cause nausea and indigestion. Consuming smaller, more frequent meals and sitting upright after eating can help reduce these symptoms.
About 15% of people in the Saxenda trial and 10% of people taking Victoza experienced headaches when taking these medications. While it is currently unknown why liraglutide causes headaches, it may be in response to changes in your blood sugar. In most cases, headaches are not severe and do not lead to treatment discontinuation.
Liraglutide and other GLP-1 agonists can cause acute kidney failure and worsen chronic kidney disease. This can be severe and require dialysis. Kidney disease from liraglutide use has been documented in a few case reports and is rare.
Some people who experience kidney disease when taking liraglutide have underlying kidney disease or are taking more than one medication that affects kidney function.
In most cases, severe fluid loss and dehydration from persistent vomiting and diarrhea can lead to new or worsening kidney problems.
Seek medical attention if you cannot consume enough fluids to stay hydrated or notice decreased urination, swelling of your feet or ankles, or shortness of breath.
Low Blood Sugar
Liraglutide increases insulin release from the pancreas after a meal. Because insulin is released when food is consumed, liraglutide rarely causes severe episodes of hypoglycemia (low blood sugar) on its own. However, the incidence of low blood sugar when taking liraglutide increases when combined with other medications that increase insulin release, such as insulin and sulfonylureas. People who are taking insulin shouldn’t use liraglutide.
Symptoms of hypoglycemia include:
- Blurred vision
- Fast heartbeat
- Loss of consciousness
Liraglutide should not be taken (is contraindicated) by anyone with a family or personal history of medullary thyroid cancers as well as multiple endocrine neoplasia syndrome type 2 because of reports of thyroid tumors in animal trials. Both Saxenda and Victoza carry a boxed warning for this serious adverse event. This is the Food and Drug Administration’s strictest warning for medications.
Victoza and Saxenda are also contraindicated for anyone who has had a serious prior hypersensitivity or allergic reaction to the medication or any of its components.
Liraglutide may cause acute pancreatitis, a rare condition. Pancreatitis is an inflammation and swelling of the pancreas. It causes severe abdominal pain, nausea, vomiting, and jaundice. It can be life-threatening.
Liraglutide is a pregnancy category X drug. People who are breastfeeding or intend to breastfeed shouldn’t take liraglutide because it is unknown whether it excretes in breast milk.
What To Do If You Experience Liraglutide Side Effects
Before starting liraglutide, ensure that your healthcare provider has your complete medical history, including all medications you are currently taking.
Once starting on liraglutide, follow the medication instructions carefully and slowly increase your dose as instructed. Contact your doctor for guidance if you reach a dose that triggers side effects. They may delay raising your dose or have you stop taking liraglutide.
In most cases, liraglutide side effects are mild gastrointestinal side effects that can be managed with dietary changes and increased fluid consumption. Rarely, liraglutide causes serious side effects that require emergency treatment.
Advise a trusted friend or family member that you are taking liraglutide and give them the list of known side effects. They can help ensure you get proper medical treatment if you experience one of the more serious medication side effects.
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