Saxenda dosage: daily steps, pen doses and missed doses

What is the Saxenda dose schedule?

Saxenda starts at 0.6 mg injected once a day for one week. The dose then goes up by 0.6 mg every week, through 1.2 mg, 1.8 mg and 2.4 mg, until you reach 3 mg a day in week 5¹. For adults, 3 mg is the dose the US label recommends. The lower doses are only for stepping up¹.

You can inject at any time of day, with or without food, in the belly, thigh or upper arm¹. The UK SmPC says it's better to inject at about the same time each day once you've picked a time³.

Can you stay on a Saxenda dose longer than a week?

Yes, for a short time. The US label says that if adults don't tolerate a step up, the prescriber can consider waiting about one more week before the next increase¹. For teens 12 and older, the dose can go back to the previous step, and stepping up can take up to 8 weeks¹.

• Adults (US): stop Saxenda if 3 mg isn't tolerated. Check weight at 16 weeks and stop if you haven't lost at least 4% of your starting weight¹.
• Teens 12 and older (US): the maintenance dose can drop to 2.4 mg if 3 mg isn't tolerated. Stop if BMI hasn't dropped at least 1% after 12 weeks on the maintenance dose¹.
• UK: if the next step isn't tolerated for two weeks in a row, the SmPC says to consider stopping. Adults stop if they haven't lost at least 5% of their starting weight after 12 weeks on 3 mg a day³.

For how other GLP-1 labels word this, see staying on a GLP-1 dose longer.

How many doses are in a Saxenda pen?

A Saxenda pen holds 18 mg of liraglutide in 3 mL, and dials 0.6, 1.2, 1.8, 2.4 or 3 mg^1,3. The label doesn't print a doses-per-pen number, so the table divides the 18 mg by each dose to give the most full doses one pen can hold.

• Don't count clicks. The pen clicks as you turn the dial, but the Instructions for Use say not to set your dose by counting clicks. Use the dose counter and pointer^4–5.
• Near the end of a pen, the dose counter stops before 3 if less than 3 mg is left^4–5. The US instructions allow splitting a dose across the old and a new pen only if your healthcare provider trained you or told you to⁴.
• Flow check: with each new pen, check the flow once before the first injection⁴.
• Needles aren't included. The pen takes disposable needles up to 8 mm long. Use a new needle each time^3–4.

What if you miss a dose of Saxenda?

In the US, skip the missed Saxenda dose and take the next one at your usual time. Don't take an extra dose or a bigger dose to make up for it¹.

In the UK, the SmPC uses a 12-hour rule. If you remember within 12 hours of your usual time, take it as soon as you can. If there are less than 12 hours to your next dose, skip it³. The UK leaflet says not to take a double dose or raise the next day's dose⁶.

Missed more than 3 days of Saxenda: do you restart at 0.6 mg?

Yes, by the US label. If more than 3 days have passed since your last Saxenda dose, it says to restart at 0.6 mg a day and follow the weekly steps again, to lower the chance of stomach side effects¹. The Victoza label has the same 3-day rule².

The UK Saxenda SmPC and leaflet don't give a restart rule for longer gaps^3,6. Ask your prescriber which dose to restart on. See restarting a GLP-1 after a break for the other labels.

Saxenda vs Victoza: how do the doses compare?

Saxenda and Victoza are both liraglutide in the same 18 mg/3 mL pen. Saxenda is for weight and goes to 3 mg a day. Victoza is for type 2 diabetes and goes to 1.8 mg a day^1–2.

Don't use them together. Both labels advise against combining two liraglutide products, and Saxenda's also advises against any other GLP-1 medicine^1–2. FDA has approved generic liraglutide for both brands⁷.