Living with diabetes can be managed by proper medication. However, you may have questions regarding the medications available to you. Here, we will take a closer look at two medications, Ozempic and Saxenda, so that you can see how these medications can impact your health.
A Closer Look at Diabetes
Diabetes can be divided into two categories, type 1 diabetes (T1D) and type 2 diabetes (T2D).
Type 1 diabetes is an autoimmune disorder and is commonly diagnosed in children. Individuals with T1D require lifelong insulin treatment to manage their diabetes. Type 2 diabetes is diagnosed later in life due to genetics, lifestyle, and other risk factors. Unlike T1D, there are numerous treatment options other than insulin therapy to manage type 2 diabetes.
GLP-1 Receptor Agonists
A common drug class used to treat type 2 diabetes is glucagon-like peptide 1 (GLP-1) receptor agonists. GLP-1 receptor agonists work by lowering blood glucose and slowing gastric emptying. Benefits of using a GLP-1 receptor agonist include: weight loss, atherosclerotic cardiovascular disease (ASCVD) benefits, lowering A1C values, and chronic kidney disease (CKD) benefits with little risk of hypoglycemia. Common GLP-1 receptor agonist side effects include nausea, vomiting, diarrhea, weight loss, and injection site reactions. GLP-1 receptor agonists should not be used in patients with a personal or a family history of medullary thyroid cancer.
GLP-1 receptor agonists should not be used with dipeptidyl peptidase-4 (DPP4) inhibitors, as both drug classes have the same mechanism of action and are unlikely to provide better effects when combined. GLP-1 receptor agonists are preferred for treating type 2 diabetes compared to DPP4 inhibitors because they significantly lower A1C values, Common GLP-1 receptor agonists used to treat type 2 diabetes include Byetta, Victoza, Trulicity, and Ozempic. Although GLP-1 receptor agonists are safe and effective options for managing type 2 diabetes, patients may be hesitant as GLP-1 agonists are mainly only available as injectables.
Ozempic
Ozempic (semaglutide) is a common GLP-1 receptor agonist used as an adjunct alongside diet and exercise to treat type 2 diabetes. Ozempic was approved by the FDA in 2017 and indicated for adults with type 2 diabetes and adults with type 2 diabetes with cardiovascular disease. Ozempic is currently available in 3 doses: 0.5mg, 1mg, and 2mg. Ozempic should be administered once weekly, on the same day, at any time of the day. Ozempic can be taken with or without food. Ozempic should be injected subcutaneously into the abdomen, thigh, or upper arm. Pen needles are provided with weekly injections of Ozempic.
The recommended initial dose of Ozempic is 0.25mg subcutaneous injection once weekly for four weeks. After four weeks, the initial dose must be increased to at least 0.5mg weekly for effective glycemic control. Dosage may be increased if additional glycemic control is needed after at least four weeks on the 0.5mg dosage.
Common Ozempic side effects include nausea, vomiting, diarrhea, and weight loss. Patients with retinopathy should not use Ozempic as Ozempic has higher rates of diabetic retinopathy than other GLP-1 receptor agonists.
Clinical trials have shown that Ozempic has many health benefits besides efficiently lowering A1C levels. Ozempic also has benefits such as weight loss, ASCVD benefits, and CKD benefits. Results concerning Ozempic ASCVD benefits have shown that patients on Ozempic have a reduced risk of heart attacks, strokes, and other heart-related deaths. Results have also shown that patients on Ozempic have slower kidney function loss.
Ozempic should not be confused with Rybelsus; an oral semaglutide formulation used to treat adults with type 2 diabetes.
Saxenda
Weight loss medications can improve disorders such as diabetes and hypertension; therefore, these conditions must be monitored closely as medication dose reductions may be required.
Saxenda (liraglutide) is a GLP-1 receptor agonist used for weight loss. Saxenda was approved by the FDA in 2014 and is indicated for weight loss in pediatric and adult individuals. Saxenda should only be used in adults with a body mass index (BMI) of 30kg/m2 or greater and adults with a BMI of 27kg/m2 or greater with one weight-related condition such as type 2 diabetes or high blood pressure.
Saxenda should only be used in pediatric patients 12 years and older with body weight above 60kg or a BMI of 30kg/m2 and above. Saxenda is currently only available in 3mg daily injections. Saxenda should be administered once daily at any time of the day with or without food. Saxenda should be injected into the abdomen, thigh, or upper arm.
The recommended initial dose of Saxenda is 0.6mg daily for one week. After one week, Saxenda doses may be increased weekly until the targeted dose of 3mg daily is reached.
Common Saxenda side effects include nausea, vomiting, diarrhea, and injection site reactions. Saxenda is contraindicated in pregnancy and has a black box warning for the risk of thyroid C-cell carcinomas. Saxenda also has a warning concerning suicidal behavior and ideations. Patients on Saxenda should be monitored for behavioral and mood changes. Saxenda should be stopped if patients experience suicidal thoughts or behaviors while taking it.
Saxenda should not be confused with Victoza; an injectable liraglutide formulation used to treat adults with type 2 diabetes.
Ozempic vs. Saxenda
Although Ozempic and Saxenda are both GLP-1 receptor agonists, they are not identical and can’t be used interchangeably. Ozempic (semaglutide) is indicated for treating type 2 diabetes, while Saxenda (liraglutide) is indicated for weight loss in pediatric and adult patients. While Ozempic does cause weight loss, it will not have the same degree of weight loss as Saxenda. Ozempic should be administered as weekly injections, while Saxenda should be administered as daily injections.
It is also important to note that suicidal behaviors and ideations were seen in patients taking Saxenda and not in patients on Ozempic therapy. Another significant difference between the two agents concerns insurance coverage. Many insurances, including public health insurances such as Medicare and Medicaid, will cover Ozempic for treating type 2 diabetes. Many insurances, however, will refuse to cover weight-loss drugs such as Saxenda or require prior authorizations before approval.
A Look at the Details
A Comparison of Ozempic vs. Saxenda
|
Pharmaceutical Name |
Saxenda |
Ozempic |
|
Manufacturer |
Novo Nordisk |
Novo Nordisk |
|
Active Ingredient |
Liraglutide |
Semaglutide |
|
Uses |
Adult Obesity (In some situations) |
Type II Diabetes |
|
Delivery Method |
Subcutaneous injection |
Subcutaneous injections with a prefilled Ozempic Pen. |
|
Frequency of Delivery |
Once Daily |
Once Weekly (Differing Strengths) |
|
Common Side Effects |
Fatigue, Nausea, Diarrhea, Vomiting, Constipation, Headaches, Dizziness |
Nausea, Diarrhea, Vomiting, Abdominal Pain, Constipation |
|
Severe Side Effects |
Certain Thyroid Cancers, Elevated Heart Rate, Allergic Reactions, Kidney Problems or Failure, Suicidal Thoughts, Increased Heart Rate, Hypoglycemia, Pain/Difficulty Urinating, Jaundice |
Pancreatitis, Allergic Reactions, Changes to Vision, Hypoglycemia |
Work with Your Doctor to Create a Treatment Plan
Remember that many factors are used to determine which type of medication is the appropriate course of action. Your medical history, lifestyle factors, and other information are considered when determining the best plan. Speak with your doctor to learn which treatment option is right for you.
