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liraglutide (Saxenda) to semaglutide (Wegovy). Dose mapping, washout, expected side effects, and the editorial verdict.
Saxenda is daily liraglutide. Wegovy is weekly semaglutide. Most patients prefer the weekly cadence, and STEP trials show greater weight loss with semaglutide than liraglutide head-to-head. Saxenda is increasingly relegated to pediatric or specialty use.
No washout. Take your last Saxenda dose, then start Wegovy 0.25 mg the next day at the new weekly cadence. Restart titration regardless of Saxenda dose; the molecules differ enough that dose-equivalence does not apply.
Saxenda-to-Wegovy is one of the cleanest switches in the class.
Side effects reset because you are titrating again. Semaglutide tends to cause more GI effects than liraglutide at matched relative doses, so expect transient nausea.
Wegovy authorization is usually easier than Saxenda these days. Saxenda is on fewer formularies and has lost favor with PBMs since 2023.
Wegovy is broadly available; Saxenda has narrowing supply. Cost similar (~$1,300 retail, $499 NovoCare cash).
Pediatric patients (ages 12+) for whom Saxenda has on-label data and Wegovy may not be approved by individual plans yet.
Editorial summary, not medical advice. Drug switches should be coordinated with your prescriber. Dose conversions reflect typical practice; your prescriber may adjust based on tolerance, comorbidities, or interactions.