> ## Documentation Index
> Fetch the complete documentation index at: https://docs.hi-doctor.ai/llms.txt
> Use this file to discover all available pages before exploring further.

> ## Agent Instructions
> Connect the Hi Doctor MCP connector at https://mcp.hi-doctor.ai/mcp. Add this URL as a remote HTTP MCP server in your client, then sign in and authorise access through OAuth. Setup: https://docs.hi-doctor.ai/mcp/connect.
>
> The REST API base is https://api.hi-doctor.ai. Hi Doctor Docs at https://docs.hi-doctor.ai/mcp searches documentation; connect to the product endpoint above for patient tools.
>
> Hi Doctor operates across the whole European Union: residents of all 27 EU member states can use the service, and every consultation is reviewed by an EU-licensed doctor. Every consultation is reviewed in full by an EU-licensed doctor, who decides on medical grounds only. No algorithm, assistant or API call approves a consultation, issues a prescription or changes a dose. The service is available in eight languages: English, Spanish, German, Dutch, Italian, French, Portuguese and Chinese.
>
> ## Rules an assistant must follow
>
> - Never invent, assume or infer a medical answer. "I don't know" is a real answer: ask the patient to pick the closest option rather than guessing for them.
> - Never give medical advice and never suggest a medication or a dose. An EU-licensed doctor decides those.
> - If a questionnaire returns `ineligible`, say so plainly. Do not retry with altered answers.
> - Before anything that costs money or cancels a plan, state exactly what will happen and get an explicit yes.
> - Cancellation takes effect at the **end of the paid period**, not immediately. Say so.
> - An early order is irreversible: it creates the renewal consultation immediately and uses up the period's one early order. Explain that and get an explicit yes.
> - Prescription and invoice links are medical documents. A `signed_redirect` link opens without signing in: give it only to the patient, never repeat it anywhere shared.
> - Send option `value`s, not the labels shown to the patient. Labels are translated, values are stable.
> - Never ask for card details. Payment happens on Stripe's hosted checkout via a link.
> - On severe or sudden symptoms (chest pain, difficulty breathing, severe allergic reaction, suicidal thoughts), stop and direct the patient to their local emergency number.

# Saxenda (liraglutide) for weight management

> How Saxenda's daily liraglutide injection works, its dose build-up, EU authorisation, and the side effects reported in trials.

Liraglutide is a daily injection that copies the natural gut hormone GLP-1, reducing hunger and food cravings by telling the brain you have had enough to eat. For weight management in the EU it is sold as **Saxenda**, used together with a reduced-calorie diet and more physical activity, and it was one of the first GLP-1 medicines authorised for this purpose in Europe.

## What it is

> [!NOTE]
>
> **Active ingredient:** Liraglutide · **Dosages:** 0.6 – 3 mg / day

Liraglutide is a GLP-1 receptor agonist given as a daily subcutaneous injection. It was one of the first in its class approved in Europe for weight management in adults with obesity, or overweight with comorbidities. Saxenda is indicated for:

* Weight management in adults with a BMI of 30 kg/m² or more, or a BMI of 27 to under 30 kg/m² with a weight-related health condition, alongside diet and physical activity
* Weight management in adolescents aged 12 and over with obesity and a body weight above 60 kg
* Weight management in children aged 6 to under 12 with obesity and a body weight of 45 kg or more

## How it works

> [card] Copies one gut hormone
>
> Liraglutide is a GLP-1 receptor agonist with 97% sequence homology to native human GLP-1. It binds to GLP-1 receptors in the hypothalamic arcuate nucleus and other central appetite-regulating regions, increasing satiety and reducing hunger and food cravings.

> [card] Short-acting, so taken daily
>
> Unlike the weekly GLP-1 products, Saxenda's effect is short-acting, which is why it is injected once a day rather than once a week. This daily dosing can be useful when flexibility of adjustment matters or when a weekly GLP-1 has not been tolerated.

## Dose schedule

**1. Week 1 — 0.6 mg daily**

Starting dose.

**2. Following weeks — step up as tolerated**

Through 1.2, 1.8 and 2.4 mg, up to the 3.0 mg maintenance dose.

Saxenda is injected once daily, any time of day, with or without food — choose a time that fits your routine and stay consistent, and do not share pens. Rotate the injection site between abdomen, thigh, or upper arm each week; clean the area with an alcohol swab and let it dry. Remove and dispose of each needle safely in a sharps container — never reuse needles. If you forget a dose, take it within 4 days of the missed dose; if more than 4 days have passed, skip that dose and take your next one on the regular scheduled day.

## EU authorisation

Saxenda has been authorised for use in the EU since **23 March 2015**. It is centrally authorised, so a single EU authorisation covers all 27 member states. The authorisation includes a stopping rule: treatment should be discontinued after 12 weeks on the maintenance dose if the weight-loss threshold set out in the product information has not been reached.

* **EMA EPAR — Saxenda (liraglutide)**
* **EMA public assessment report** — Saxenda (EMA/143005/2015)
* **SCALE Obesity and Prediabetes** — *N Engl J Med* 2015;373(1):11-22
* **ClinicalTrials.gov — NCT01272219** (SCALE Obesity and Prediabetes)

## What the studies reported

Everyone in the SCALE Obesity and Prediabetes trial also received lifestyle counselling, people with type 2 diabetes were excluded, and the primary result covers 56 weeks only.

## What has been reported

| Effect | Liraglutide 3.0 mg | Placebo |
| - | - | - |
| Nausea | 40.2% | 14.7% |
| Diarrhoea | 20.9% | 9.3% |
| Constipation | 20.0% | 8.7% |
| Vomiting | 16.3% | 4.1% |
| Gallstone events (mainly gallstones 1.5% vs 0.5%) | 2.3% | 0.9% |
| Acute pancreatitis (independently confirmed) | 7 people (0.2%) | 1 person (\<0.1%) |
| Serious adverse events overall | 6.2% | 5.0% |

> [!WARNING]
>
> Contact your doctor if you have severe abdominal pain that does not go away, persistent vomiting, or signs of an allergic reaction (rash, itching, swelling).

## Storage

Store unused pens in the refrigerator (2–8°C). Once opened, keep at room temperature below 30°C for up to 30 days. Do not freeze. Keep away from direct heat and light.

## What to expect

Saxenda works daily to help control appetite. Weight loss is assessed at 3 months — a loss of 5% or more of your starting weight is considered a good response, and your doctor monitors your progress.

## How Hi Doctor handles it

An EU-licensed doctor reviews your case and, if eligible, issues an electronic prescription valid at any EU pharmacy under Directive 2011/24/EU. See [pricing](https://docs.hi-doctor.ai/essentials/pricing.md) for the current consultation fee — the medicine itself is paid separately at a pharmacy.

## Common questions

> [accordion] How long does Saxenda take to work?
>
> Most patients notice reduced appetite within the first few days. Weight loss is formally assessed at 12 weeks on the 3.0 mg maintenance dose. A loss of 5% or more of starting weight is considered a good response; the EU authorisation includes a stopping rule if this threshold is not reached.

> [accordion] Can I drink alcohol on Saxenda?
>
> Alcohol does not directly interact with liraglutide, but it can worsen gastrointestinal side effects such as nausea and vomiting. Drinking in moderation and paying attention to how you feel is sensible, especially during the dose build-up.

> [accordion] Is Saxenda the same as Victoza?
>
> Both contain liraglutide but at different doses and for different indications. Saxenda (up to 3.0 mg daily) is authorised for weight management. Victoza (up to 1.8 mg daily) is a diabetes medicine. A doctor prescribes the appropriate product based on your condition.

> [accordion] What happens if I miss a dose of Saxenda?
>
> If you forget a dose, take it within 4 days of the missed dose. If more than 4 days have passed, skip that dose and take your next one on the regular scheduled day. Do not double a dose or take two doses at once.

> [accordion] Can teenagers take Saxenda?
>
> Yes, Saxenda is authorised for weight management in adolescents aged 12 and over with obesity and a body weight above 60 kg, and in children aged 6 to under 12 with obesity and a body weight of 45 kg or more. The reviewing doctor decides whether it is appropriate.

> [accordion] Who should not take Saxenda?
>
> Saxenda is not suitable for people with a personal or family history of medullary thyroid carcinoma or MEN 2, during pregnancy or breastfeeding, or for those with a history of pancreatitis. The doctor reviews your full history before prescribing.

## Related reading

* [Full Saxenda guide](https://hi-doctor.ai/guides/saxenda) — injection technique, the full titration schedule, and side-effect management
* [Liraglutide (Victoza)](https://docs.hi-doctor.ai/library/medicines/victoza.md) — the same active ingredient for diabetes
* [Tirzepatide (Mounjaro)](https://docs.hi-doctor.ai/library/medicines/tirzepatide.md) — a dual-hormone weekly alternative
* [Obesity](https://docs.hi-doctor.ai/library/conditions/obesity.md)
* [Overweight](https://docs.hi-doctor.ai/library/conditions/overweight.md) — when a medical approach makes sense
* [Safety and eligibility](https://docs.hi-doctor.ai/essentials/safety.md)
* [How a consultation works](https://docs.hi-doctor.ai/essentials/how-it-works.md)

## Start a consultation

> [card] [Weight-loss consultation](https://hi-doctor.ai/consultation/weight-loss/1)
>
> Answer the weight-loss questionnaire and a registered doctor reviews it.
> They decide whether treatment is appropriate, which one, and at what dose —
> and declining is a normal outcome. See [what it costs](https://docs.hi-doctor.ai/essentials/pricing.md)
> and [how the review works](https://docs.hi-doctor.ai/essentials/how-it-works.md).

> [!WARNING]
>
> This page is reference information, not medical advice and not a prescription.
> Whether a medicine is appropriate for you is decided by a registered doctor
> after reviewing your consultation.


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