Liraglutide (Saxenda / Victoza) Protocol Guide
Liraglutide is an acylated GLP-1 receptor agonist with 97% amino acid homology to native human GLP-1. FDA-approved as Victoza (1.8mg) for type 2 diabetes and Saxenda (3.0mg) for chronic weight management, it was the first GLP-1 agonist to demonstrate cardiovascular risk reduction (LEADER trial: 13% MACE reduction, 22% CV death reduction). Liraglutide slows gastric emptying, enhances glucose-dependent insulin secretion, suppresses glucagon, and reduces appetite via hypothalamic signaling. This protocol covers the 0.6-3.0mg daily titration, GI management, and metabolic monitoring.
Protocol Overview
- Compound
- Liraglutide (Saxenda 3.0mg / Victoza 1.8mg)
- Category
- GLP-1 Receptor Agonist
- Mechanism
- GLP-1R agonism: glucose-dependent insulin secretion, glucagon suppression, delayed gastric emptying, hypothalamic appetite reduction, cardioprotection
- MW
- 3,751 Da
- Half-Life
- ~13 hours (daily dosing required)
- Form
- Pre-filled pen (6mg/mL solution)
- Route
- Subcutaneous
- Frequency
- Once daily
- Cycle
- Ongoing (chronic therapy)
Dosing — Titration Schedule
| Week | Dose | Indication | Notes |
|---|---|---|---|
| Week 1 | 0.6 mg/day | Both | GI adaptation phase |
| Week 2 | 1.2 mg/day | Both | Appetite effects begin |
| Week 3 | 1.8 mg/day | Victoza max / Saxenda titration | T2DM therapeutic dose reached |
| Week 4 | 2.4 mg/day | Saxenda titration | Continue if tolerated |
| Week 5+ | 3.0 mg/day | Saxenda maintenance | Full weight management dose |
Inject at any time of day, with or without food, at the same time each day. Abdomen, thigh, or upper arm. If a titration step is not tolerated, remain at that dose for an additional week before advancing. If 3.0mg is not tolerated after extended titration, 2.4mg may be used as maintenance.
Timeline
Side Effects & Stacking
Side Effects
- Nausea (40% initially, improves with titration)
- Diarrhea or constipation
- Headache (early, transient)
- Injection site reactions (mild)
- Hypoglycemia (mainly if combined with sulfonylureas/insulin)
- Increased heart rate (4-6 bpm average)
- Rare: pancreatitis, gallbladder disease
- Contraindicated: personal/family history of MTC or MEN2
Stacking
- BPC-157: GI support during nausea phase
- MOTS-C: Metabolic synergy
- NAD+: Cellular energy and metabolic support
- GHK-Cu: Skin elasticity during weight loss
- Do NOT combine with: Semaglutide, Tirzepatide, or Retatrutide (same class)
Blood Work
| Panel | Markers | Timing |
|---|---|---|
| Metabolic | Fasting glucose, HbA1c, fasting insulin | Baseline, Week 12, 26 |
| Lipids | Full lipid panel, ApoB, triglycerides | Baseline, Week 12, 26 |
| Pancreatic | Lipase, amylase | Baseline, if symptoms arise |
| Thyroid | TSH, calcitonin (if risk factors) | Baseline |
| Basic | CBC, CMP, kidney function | Baseline, Week 12 |
