Victoza/Saxenda

How many of us have been on metformin for years but still do not see any change in weight just from taking metformin? Research points to a new medication that may help in weight loss, and is found to be even more effective when taken with metformin. This medication is called Liraglutide (brand name Victoza/Saxenda).

Liraglutide is marketed in two forms Victoza and Saxdenda. The difference between the two is Victoza has a max dosage of 1.8mg and is used for diabetes, whereas, Saxdenda has a max dosage of 3mg and is used for weight loss. Both of these come in pre-filled injectable pens.

So what does the research say? As I told you in the previous post I am one to research products, treatments, and pretty much anything I may use to help myself. With that being said I have done that on the use of Liraglutide.

First we will review liraglutide given as victoza (max dose of 1.8mg). In the quick summary what is shown is that liraglutide provides significant weight loss in both diabetics and non-diabetics alike (Visboll, Christensen, Junker, Knop, & Gluud, (2012); Sever, Kocjan, Pfeifer, Kranvos, & Janez, 2014). Furthermore, when liraglutide is combined with metformin a greater amount of weight loss is seen than with a stand-alone treatment of either metformin or liraglutide (Visboll et. al, 2014; Sever et. al, 2014).

           

        Now let’s look at what the research says about the use of liraglutide given as saxenda (max dose of 3mg). Jay, Lewis, Hung, Squires, & Ngal (2015) reviewed studies of saxenda use for the purpose of weight loss. What was seen with in the research was that just as with victoza significant weight loss was achieved only at a higher amount than victoza. This weight loss was found to be sustainable (Jay et. al, 2015).

        What about side effects? So side effects for both victoza and Saxenda is the same, after all they are both liraglutide just marketed for different purposes and dosages. The most common side effects reported where the following:  headache, nausea, diarrhea, vomiting, and anti-liraglutide antibodies in your blood (Jay et. al, 2015; Saxenda, 2016; Sever et. al, 2014; Victoza, 2016; Vilsboll et. al, 2012). Those who should not use this medication would include those with the following issues: 

        -self or family history of medullary thyroid cancer

        -you have multiple endocrine neoplasia syndrome

        -allergy to liraglutide

        -are pregnant or planning to become pregnant (Saxenda, 2016; Victoza, 2016)

There was evidence in rats that victoza/saxenda caused thyroid tumors and cancer; however, it is unknown if it would cause it in humans (Saxenda, 2016; Victoza, 2016).



        So why aren’t more people willing to take this medication as weight loss drug? Well to be frank the cost is high. Most with insurance are able to get victoza as it is a diabetic med and is covered my most insurance policies. However, many insurance companies or rather polices do not cover saxenda because it is a weight loss medication and most plans do not cover weight loss medications.

Cost breakdown as reported by goodrx.com

Victoza   30 day supply         lowest price (in MI)         $827.00

Saxenda 30day supply         lowest price (in MI)         $1260.00



        Of course both companies have discount coupons that you can apply for. Victoza (2016) coupon is if your insurance covers part of the cost your cost will be 25 per month for up to 2 years. For those who do not have coverage there is another application that you can fill out and possibly get the medication for free through the manufacture (Victoza, 2016).

        Saxenda also has manufacture coupon. If you have insurance that will pay for part of your cost, prescription will cost you 30 per month (Saxenda, 2016). If you do not have coverage, the coupon will take 200.00 per month off your prescription for up to 12 months (Saxenda, 2016).

        Of course with both products you have to apply for the savings coupons/cards. There may be requirements and/or restrictions (Saxenda, 2016; Victoza, 2016).

Personal Usage

        I personally am on metformin 2000mg and victoza 1.8mg. My insurance covers both medications. However my insurance does not cover Saxenda. I currently am waiting for the va to send me my victoza again and thus have run out so I have only been on the med for one month. Within that time frame I lost 15lbs. I am hoping to continue with the weight loss, however, I had to ask my dr to switch my rx to a 90 day supply in order to be able to see the full effect this medication could have. I say this because I will have to start all over with titrating back to full dosage, and thus this far I have not had a full month at full dosage yet. My hope is I keep on the downward trend, time will tell. Side effect wise I had to increase dosage slow every 10 days I went up 0.6 mg. Manufacture says every 7 days. I tried that however, I ended up with an upset stomach so went with ten days. Doing so helped with side effects.



        I may in the future see if my Dr. would be willing to give me an rx for saxenda at the dose of 1.2mg (to equal the 3mg) and take with the victoza. I would have to pay out of pocket for the saxenda however the cost should be far less as one normal 30 day supply would last 90 days if done this way. However, I have no way of knowing if my Dr. will do so. For now we will see how I do with what my insurance does cover.


       So for those of you who may take issue with needles, this may not be for you. However, personally I do not feel them. I have to do 2 injections of b-12 which really are not bad, but I can feel those. These injections for victoza/saxenda are no where near the same size of needle. Not only are they super short, they are also a smaller gage. These two factors make it so I personally do not feel the injections.


        Let me make this perfectly clear, I am not saying this is right for you, however, I am just presenting you with the research I found, and my experience I have with the medication. With anything like this of course talk it over with your doctor, may be even look up the research to print and take with you. Find out if this is right for you if it sounds like something you want to try.

References

Jay, M., Lewis, K., Hung, W., Squires, A., & Ngal, G. (2015). Liraglutide produces clinically significant weight loss in nondiabetic patients, but at what cost?. Journal of Clinical Outcomes Management, 22(9), 394-396.



Saxenda. (2016). Retrieved from www.saxenda.com



Sever, M. J., Kocjan, T., Pfeifer, M., Kravos, N. A., & Janez, A. (2014). Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin. European Society of Endocrinology, 170(3), 451-459. doi:10.1530/EJE-13-0797.



Victoza. (2016). Retrieved from www.victoza.com



Vilsboll, T., Christensen, M., Junker, A. E., Knop, F. K., & Gluud, L. L. (2012). Effects of glucagon-like peptide-1 receptor agonists on weight loss:  systematic review and meta-analyses of randomized controlled trials. British Medical Journal, 344. doi:http//dx.doi.org/10.1136/bmj.d7771.