What you’ll learn:
- Saxenda® is a daily injectable medication FDA-approved for weight management.
- Common side effects of Saxenda® include nausea, vomiting, and diarrhea, which typically improve over time.
- Following a gradual dose increase and making small lifestyle adjustments—like modifying meals and staying hydrated—can help minimize side effects.
If you’re thinking about starting a medication to help with weight loss, chances are you’ve heard of FDA-approved options like Wegovy® or Zepbound®. Saxenda® is another GLP-1 medication that works similarly, but it’s been around longer.
Like these newer medications, Saxenda® mimics GLP-1 (glucagon-like peptide-1), a natural hormone that helps regulate appetite, increase feelings of fullness, and support weight loss. The biggest difference? Saxenda®’s active ingredient, liraglutide, requires a once-daily injection compared to the weekly schedule of Wegovy® (semaglutide) and Zepbound® (tirzepatide).
Because they work in a similar way, side effects often overlap—most commonly digestive issues like nausea, diarrhea, or constipation, along with occasional fatigue. For most people, these side effects improve over time. Saxenda®’s step-up dosing schedule is designed to help minimize discomfort. Lifestyle changes like adjusting your meals and staying hydrated can also make a big difference in how you feel. With consistency, many people lose 1 to 2 pounds per week and find side effects manageable.
Let’s go through what to expect when starting Saxenda®, the most common side effects, why they happen, why dosage matters, and how to manage them. We’ll also cover important safety considerations to help you feel more prepared and confident along the way.
Why Saxenda can cause side effects
Saxenda® works by mimicking the GLP-1 hormone, leading to significant changes in how your body regulates appetite, digestion, and blood sugar. These changes can support meaningful weight loss, but they can also trigger side effects, especially when you’re first starting the medication.
One of the key ways Saxenda® helps with appetite control is by slowing the rate at which food moves through your stomach, a process known as delayed gastric emptying. This creates a longer-lasting feeling of fullness, making it easier to reduce portion sizes and avoid overeating. However, this slowdown in digestion can also cause uncomfortable side effects like nausea, diarrhea, constipation, and even vomiting.
In addition to slowing digestion, Saxenda® enhances fullness signals sent to your brain, which can significantly reduce appetite. While this helps many people stay on track with lower calorie intake, eating too little too quickly can sometimes cause low energy, dizziness, or fatigue.
These side effects tend to be most noticeable when first starting the medication or when your dose increases. Your healthcare provider’s step-up dosing schedule is designed to help ease this transition and minimize side effects along the way.
When are side effects most likely with Saxenda®?
Side effects with Saxenda® usually show up when you first start the medication or when your dose increases. That’s because your body and how you eat need time to adjust to the way Saxenda® slows digestion and affects your appetite.
To make that adjustment easier, Saxenda® follows a gradual dose increase called titration. This means you don’t start on a high dose right away. Instead, your provider will guide you through a weekly schedule. Which will typically look like this:
- Week 1: 0.6 mg
- Week 2: 1.2 mg
- Week 3: 1.8 mg
- Week 4: 2.4 mg
- Week 5 and beyond: 3.0 mg (maintenance dose)
Each step gives your body a chance to adapt before moving to the next level. Keep in mind that if you are comfortable and losing steady weight at a lower dose, there is no need to increase your dose.
One note: If you are having trouble adjusting to Saxenda®, it might not be the right medication for you. If you haven’t lost at least 4% of your initial body weight after 12 weeks at the 3 mg dose, your provider may recommend stopping Saxenda® and considering other options.
The most common Saxenda® side effects
When starting Saxenda®, the most common side effects are gastrointestinal-related, including nausea, vomiting, and diarrhea. These digestive issues affect about 68% of people taking Saxenda®.
Here’s a breakdown of the most commonly reported GI side effects in clinical trials, along with practical tips that may help manage them:
| Symptom | Saxenda® (3.0 mg) | What can help |
|---|---|---|
| Nausea | 39% | Choose smaller, low-fat meals throughout the day. Eat bland foods like crackers, toast, and rice. Don’t lie down after you eat.Go outside to get some fresh air. |
| Diarrhea | 21% | Drink plenty of fluids to stay hydrated. Focus on light, easy-to-digest foods like soup and gelatin. |
| Constipation | 19% | Increase fiber slowly to give your body time to adjust. Daily movement and drinking more water can also help keep things regular. |
| Vomiting | 16% | Stick with bland foods and clear liquids. Take slow sips of water or ginger tea to ease your stomach. |
| Dyspepsia (indigestion) | 10% | Eat slowly, avoid eating late at night, and stay upright for at least 30 minutes after meals to ease symptoms. Consider gentle activity after meals. |
| Abdominal pain | 5% | Try eating smaller portions and avoiding solid food for the first few hours. Light movement after meals can support digestion, and using a warm compress on your abdomen may help ease cramping or general discomfort. |
If any of these symptoms feel severe or don’t improve, it’s a good idea to check in with your provider. They might suggest adjusting the timing of your dose or offering other ways to make treatment easier.
Other symptoms
While digestive issues like nausea and constipation tend to get the most attention, they’re not the only symptoms you might notice when taking Saxenda®. Some people experience changes in energy levels, sleep patterns, or even how their body feels throughout the day.
These symptoms are generally mild and temporary, but they can still catch you off guard if you’re not expecting them. Headaches, fatigue, dizziness, and sleep disturbances can happen as your body adjusts to eating less, shifting blood sugar levels, or simply adapting to a new medication in your system.
In many cases, adjustments to your routine—like changing the time of your injection or focusing on hydration and movement—can make a big difference in how you feel.
Here’s a closer look at these non-digestive side effects and what can help:
| Symptom | Saxenda® (3.0 mg) | What can help |
|---|---|---|
| Headache | 14% | Stay well hydrated and rest your eyes by taking short breaks from screens. Stepping away from bright lights or loud environments can also help. |
| Fatigue | 8% | Try to maintain a steady sleep schedule and fit in some light movement like walking or gentle stretching to help boost your energy levels. |
| Dizziness | 7% | Rise slowly from sitting or lying positions to avoid sudden lightheadedness. Keep up with fluids throughout the day to support circulation and hydration. |
| Insomnia | 2% | Cut back on caffeine later in the day and aim for a consistent, relaxing bedtime routine. Dimming lights and limiting screen use before bed can also improve sleep quality. |
If any of these symptoms start to interfere with your daily life—or don’t seem to improve after a few weeks—check in with your healthcare provider. They may suggest adjusting your dose, switching your injection to the evening, or layering in other strategies to make the experience smoother.
Injection site reactions
Since Saxenda® is a daily injection, it’s normal to notice some mild reactions at the spot where you inject. These usually aren’t serious and often go away on their own. Knowing what to expect—and how to prevent discomfort—can make your routine easier.
Common reactions include:
- Redness or swelling right after the injection
- Mild itching or irritation around the site
- Tenderness or bruising, especially if you inject in the same area too often
These symptoms are generally short-lived and improve as you get used to the injections. But there are a few tips from the Saxenda® medication guide you can follow to help minimize them:
- Rotate between the abdomen, thigh, or upper arm to give each area time to recover
- Always use a new needle for every injection
- Clean the skin with an alcohol swab and let it dry completely before injection
If the site becomes increasingly red, warm, painful, or starts to ooze, reach out to your healthcare provider. That could be a sign of infection and needs medical attention. With a little practice, most people find that Saxenda® injections become part of their daily routine, and skin reactions become less frequent over time.
Side effects in females: Are there any differences?
Saxenda® works the same way in both males and females, but some females may notice additional changes due to how hormones respond to weight loss and appetite shifts. These aren’t official warnings, but they’re often reported in real-world use and supported by clinical research.
What some females experience:
- Stronger digestive symptoms: Females may be more likely to experience nausea or vomiting, especially during dose increases. One study on GLP-1 medications found that females reported higher rates of gastrointestinal symptoms than males.
- Menstrual changes: As your weight changes, so can your hormone levels. Some females report irregular periods, lighter or heavier flow, or spotting between cycles. This is especially common in the first few months and often settles as your weight stabilizes.
- Might increase fertility: For females with (polycystic ovarian syndrome) PCOS or irregular cycles, Saxenda® may help support ovulation and hormonal balance. By improving metabolic health and insulin sensitivity, Saxenda® may also increase fertility in some individuals.
Here are some things to keep in mind about liraglutide:
- Stop Saxenda® at least 2 months before trying to conceive.
- Don’t use Saxenda® during pregnancy or breastfeeding.
- Saxenda® may interfere with the absorption of oral contraceptives—talk to your provider about using backup birth control if needed.
If you notice changes in your menstrual cycle or have questions about fertility, talk to your healthcare provider. They can help you understand what’s normal, what needs monitoring, and how to plan around your reproductive goals.
Side effects of stopping Saxenda®
Saxenda® is designed for long-term use, but if you decide to stop, you might experience some changes in your appetite and how you feel.
Here’s what you might notice:
- Appetite may return quickly: Saxenda® helps regulate hunger; without it, your appetite can return to the way it was before taking the medication. You might find yourself feeling hungrier than usual, craving larger portions, or snacking more often, especially in the first couple of weeks after stopping.
- Weight regain is possible: GLP-1 medications support weight loss by changing both your biology and eating patterns. Without ongoing behavioral support, it’s common to regain some of the weight you lost. That’s why it’s so important to have healthy habits in place—like regular movement, mindful eating, and meal planning—to stay on track.
- Blood sugar levels may shift: If you have type 2 diabetes or prediabetes, your blood sugar could rise after stopping Saxenda®. Liraglutide helps lower glucose after meals, so stopping it may require changes to your diet, medication, or monitoring routine. Always check in with your provider so they can adjust your care plan as needed.
- Tapering may help: Some providers recommend gradually lowering your dose, especially if you’ve been taking Saxenda® for several months or are sensitive to appetite or energy changes. This slower approach can give your body more time to adjust and may reduce rebound hunger or discomfort.
- Support matters after medication: Even if you’re no longer taking Saxenda®, you still need to maintain healthy habits to keep weight off. Noom can help you stay consistent with coaching, habit tracking, and personalized tools that support sustainable health behaviors over time.
Before stopping Saxenda®, always talk to your provider. Together, you can come up with a plan that keeps you feeling your best, whether that includes continuing medication, switching to another option, or focusing on lifestyle strategies alone.
Saxenda®: Severe side effects and warnings
Most people tolerate Saxenda® well, but it can come with a few serious, though rare, risks. Knowing the signs of a severe reaction can help you act quickly and stay safe. You should seek immediate medical attention if you experience any of the following:
- Pancreatitis: Signs include severe stomach pain that may spread to your back, especially if it comes with nausea or vomiting
- Gallbladder issues: Pain in the upper right abdomen, fever, nausea, or yellowing of the skin or eyes are signs of gallbladder issues.
- Kidney problems: Dehydration from vomiting or diarrhea may lead to fatigue, swelling, or changes in urination
- Severe allergic reactions: Facial swelling, difficulty breathing, widespread rash, or itching
- Low blood sugar (hypoglycemia): Shakiness, sweating, confusion, or fainting—especially if you’re also taking insulin or sulfonylureas
- Increased heart rate: Some people have reported a faster resting heart rate with Saxenda®, with an average of a 2 to 3 beats per minute (bpm) increase. Some people have experienced 4 to 9 bpm increases over 24 hours. Call your provider if you notice a consistently fast or pounding heartbeat. Seek emergency care if you experience chest pain, fainting, shortness of breath, or feel like your heart is racing or skipping beats.
- Thyroid tumors: All versions of liraglutide, including Saxenda®, come with an FDA-boxed warning about a potential risk of thyroid tumors. This warning is based on animal studies, and it’s still unclear whether the same risk applies to humans. If you notice a lump in your neck, hoarseness, or trouble swallowing, tell your healthcare provider right away.
Who shouldn’t take Saxenda®?
Before starting Saxenda®—or any GLP-1 medication—make sure to discuss your full medical history and current medications with your healthcare provider. They’ll help you decide whether it’s a safe, effective fit for your goals.
You shouldn’t take Saxenda® if:
- You or a family member has a history of medullary thyroid carcinoma (MTC)
- You have multiple endocrine neoplasia syndrome type 2 (MEN 2)
- You are pregnant or planning to become pregnant
- You are breastfeeding
- You’ve had a serious allergic reaction to liraglutide or any ingredient in Saxenda®
Let your doctor know if you:
- Have a history of pancreatitis
- Have severe gastrointestinal issues, such as gastroparesis (delayed stomach emptying)
- Are taking insulin or sulfonylureas, as these may increase your risk of low blood sugar when used with Saxenda®
Comparing Saxenda® side effects to other GLP-1 drugs
If you’re considering GLP-1 medications for weight loss, it’s helpful to understand how Saxenda® compares to other options. While GLP-1 receptor agonists work similarly, they vary in how often they’re taken, how much weight loss they deliver, and how well they’re tolerated.
Here’s a breakdown of the most commonly prescribed GLP-1 medications for weight loss and how often certain side effects occur:
| Medication | Nausea | Vomiting | Diarrhea | Constipation | Key differences |
|---|---|---|---|---|---|
| Saxenda® (liraglutide) – 3.0 mg (daily injection) | 39% | 16% | 21% | 19% | Tends to cause fewer digestive side effects than Wegovy® (semaglutide), but typically results in less weight loss overall |
| Semaglutide (Wegovy®) – 2.4 mg (weekly injection) | 44% | 24% | 30% | 24% | Higher rates of digestive side effects compared to Saxenda®, but greater average weight loss. |
| Tirzepatide (Zepbound®) – 15 mg (weekly injection) | 28% | 13% | 23% | 11% | Tends to cause fewer side effects than both Saxenda® and Wegovy® despite higher efficacy. |
Managing the side effects of Saxenda®
Saxenda® is a well-established GLP-1 medication that can help support meaningful, long-term weight loss. Like other drugs in its class, it works by reducing appetite, slowing digestion, and helping you feel fuller for longer, but it may also cause side effects, especially in the early weeks of treatment.
Most of those side effects—like nausea, fatigue, or mild digestive issues—are temporary and improve as your body adjusts. And if you’re feeling unsure along the way, you’re not alone. Having the right tools and support can make a big difference.
That’s where Noom Med comes in. If you’re eligible, Noom Med connects you with licensed clinicians who can prescribe Saxenda® (or other GLP-1 medications) and help monitor your progress. You’ll also get access to behavior change tools, symptom tracking, and personalized coaching—so you’re not just managing side effects, you’re building a sustainable, healthy lifestyle.
If you’re ready to take the next step, see if you qualify for Saxenda® through Noom Med. Whether you’re just starting out or looking to stay on track long-term, support is here when you need it.
