Liraglutide: what it is and which brands are available in Spain

What is liraglutide and how does it work?

Liraglutide activates the GLP-1 receptor, which responds to a hormone released by the gut when you eat. This receptor is involved in appetite and fullness signals. It also helps release insulin when blood glucose rises and slightly delays stomach emptying [1] [3]. People respond differently and tolerate it differently.

It is injected once a day [1] [3]. Two pens may contain the same molecule but have different indications and doses. Your doctor will decide which product is right for you, review your other health conditions and adjust the dose. We support you with your diet throughout the process.

Liraglutide is one of the longer-established medicines in this family. Victoza, the first liraglutide brand for type 2 diabetes, received European authorisation in 2009 [6]. This history provides clinical experience, although the date does not determine which treatment is right for you.

For an overview of the medicines, their uses and follow-up, see our GLP-1 medicines guide. It helps distinguish the active ingredient, brand and indication.

Which product is used for each indication?

Saxenda contains liraglutide and is indicated for weight management in people who meet the criteria in its product information [1]. It is used alongside changes to diet and physical activity. The Saxenda guide covers its conditions of use and questions specific to this product.

Plyzari is another liraglutide product authorised in Spain for weight management. Its product information indicates it for adults with obesity or overweight and other associated conditions, and also for children and adolescents with obesity [2].

Liraglutide products for type 2 diabetes, such as Diavic EFG, are used when blood glucose is not adequately controlled with diet and exercise [3]. In some cases they can be used alone or added to other medicines. Its product information does not include weight management as an indication.

If your treatment is for type 2 diabetes, discussion of blood glucose and other medicines is different. The Trulicity guide describes another medicine in the same family, dulaglutide, with its own regimen. Being in the same family does not mean one can be substituted for another without medical assessment.

First, it matters why the product was prescribed; then, how it fits into your life and follow-up.

How does it compare with semaglutide and tirzepatide?

The most obvious difference is how often they are given. Liraglutide is injected daily [1]. Injectable semaglutide and tirzepatide are given once a week [7] [8]. Tirzepatide also acts on two hormone receptors, GLP-1 and GIP [8]. These are different medicines, and none of these differences amounts to a recommendation to switch.

In a trial directly comparing them for weight management, people taking weekly semaglutide lost an average of 15.8% of their starting weight. With daily liraglutide, the loss was 6.4% at 68 weeks [7]. The participants were adults with overweight or obesity without diabetes, and received support with diet and physical activity. These are trial averages; each person responds differently.

For tirzepatide, results from separate trials cannot be used to calculate an exact advantage over liraglutide because the populations, doses and follow-up periods differ. If you want to change medicines, your doctor will consider the indication, medical history, tolerability and goals.

A question that comes up in consultations is whether a weekly regimen might be more convenient than a daily one. Convenience matters, but the decision depends on medical assessment.

Nausea and other digestive symptoms can occur during treatment [1] [3]. Tell the person who prescribes it. Changing the dose or pen yourself would alter your prescribed regimen. Our nutrition team can help you continue eating and drinking enough when your appetite decreases.

If you take warfarin or other coumarin derivatives when starting treatment, the product information recommends more frequent INR monitoring [1]. Severe diarrhoea can affect the absorption of other oral medicines [1]. Reduced effectiveness of oral contraceptives is not expected [1]. Always discuss this with the person who prescribes your medicine.

Is generic liraglutide available, and how much does it cost compared with Saxenda?

Yes. Diavic EFG is a generic liraglutide authorised for type 2 diabetes [3]. Its indication differs from Saxenda, and its product information does not authorise it for weight management [1] [3]. For weight management, Plyzari is also available alongside Saxenda [2].

Price is compared by pack and presentation. The table shows the current retail prices for Saxenda and Diavic. If either price is missing, we do not give a difference in euros or say which costs less.

Reimbursement also affects what you pay. Saxenda is not reimbursed by the public system [4]. Diavic is reimbursed with prior authorisation for type 2 diabetes in people with a body mass index of 30 or more, alongside oral antidiabetic medicines or basal insulin [5]. With a prescription from Spain’s National Health System and prior authorisation, Diavic has a reduced patient contribution; what you pay depends on your circumstances — some people are exempt — and is shown when the prescription is dispensed. The retail price of one pack is not the same as the cost of a month.

What to eat when your appetite decreases

When you feel less hungry, it can be difficult to finish your usual meal. In consultations, we see people simplify their plate so much that they leave out protein. A small meal can still be complete if it includes a protein food, vegetables and a source of carbohydrate [9]. For example, scrambled eggs with tomato and toast, or plain yoghurt with fruit and two or three walnuts.

If nausea is putting you off, divide what you eat into smaller meals and sip drinks throughout the day. Our GLP-1 weekly menu suggestion includes examples you can adapt. If the nausea does not settle, tell the person who prescribes your medicine.

Muscle strength deserves attention while you are losing weight. A joint recommendation from several professional organisations on nutrition with GLP-1 medicines suggests assessing strength, function and body composition, and maintaining physical activity [9]. Our protein and muscle guide explains how to organise meals and exercise.

What we see in consultations

A common question is whether simply eating less is enough to look after yourself during treatment. In consultations, we review whether meals are still varied, whether you are drinking enough and whether you are keeping active. We also ask about sleep and your relationship with food [9].

If you have had an eating disorder, discuss it with your doctor and a mental health professional before starting or changing a GLP-1 medicine [9]. This helps tailor the regimen to your circumstances.

Your first step this week

Look at one meal. Note whether your reduced appetite is leaving you short of protein, and bring this up at your next medical or nutrition appointment.