Saxenda Dose Ladder (2026 Cheat Sheet)

Saxenda is liraglutide 3.0 mg given as a once-daily subcutaneous injection, FDA-approved in 2014 for chronic weight management. It climbs through five fixed steps over five weeks before reaching the 3.0 mg maintenance dose — a much faster titration than the weekly GLP-1s (Wegovy, Zepbound, Mounjaro) because each daily dose contributes less cumulative exposure. Use this page as a pocket reference; for deeper context, see the links at the bottom.

Dose ladder (subcutaneous, once daily)

Source: DailyMed Saxenda SPL, SetID 3946d389-0926-4f77-a708-0acb8153b143, revision March 11, 2026.

Pediatric patients (ages 12 and older, added to the label in 2020) follow the same ladder, but escalation may take up to 8 weeks instead of 5 if tolerability is poor. If a pediatric patient does not tolerate a step, the label permits dropping back to the previous level.

Quick facts

• Daily injection, not weekly. This is the single biggest practical difference from Wegovy, Zepbound, and Mounjaro. The pen delivers a fixed dose each day at any time, with or without food.
• Injection sites: abdomen, thigh, or upper arm. Rotate sites daily. Avoid bruised, scarred, or tender skin.
• Half-life is about 13 hours. Far shorter than semaglutide (~7 days) or tirzepatide (~5 days), which is why dosing has to be daily and why missed doses lose effect quickly.
• Each step is exactly one week. Slower is allowed if GI symptoms are intolerable, but the label does not permit faster escalation.
• Storage: refrigerate unused pens at 36–46°F. Once in use, a pen can be kept at room temperature (up to 86°F) or refrigerated for up to 30 days, then discarded.
• Do not coadminister with Victoza, another GLP-1 receptor agonist, or insulin used purely for weight loss. If used with insulin or a sulfonylurea in someone with type 2 diabetes, the secretagogue dose typically needs to come down first.

Missed-dose protocol (verbatim from FDA label)

“If a dose is missed, resume the once-daily regimen as prescribed with the next scheduled dose. Do not administer an extra dose or increase the dose to make up for the missed dose.”

“If more than 3 days have elapsed since the last SAXENDA dosage, reinitiate SAXENDA at 0.6 mg daily and follow the dosage escalation schedule… to reduce the risk of gastrointestinal adverse reactions associated with reinitiation of treatment.”

Practical translation: a single missed day is forgivable — pick up where you left off the next day. Three or more consecutive missed days forces a full re-titration from 0.6 mg, because the gut has lost its tolerance to the higher dose.

Call your doctor if...

• Severe, persistent abdominal pain — especially radiating to the back, with or without vomiting. Possible acute pancreatitis; the label says to discontinue Saxenda promptly if suspected.
• Right-upper-quadrant pain, fever, jaundice, or clay-colored stools. Possible gallbladder disease (cholelithiasis and cholecystitis were reported more often on Saxenda than placebo in SCALE).
• Vomiting that prevents fluid intake for more than 24 hours, dizziness on standing, dark urine, or low urine output. Acute kidney injury from volume depletion has been reported.
• A lump or swelling in the neck, hoarseness, or difficulty swallowing. Boxed warning: thyroid C-cell tumors in rodents; do not use with a personal or family history of medullary thyroid carcinoma or MEN 2.
• Hypoglycemia symptoms (shakiness, sweating, confusion) if also taking insulin or a sulfonylurea. The Saxenda label specifically warns of increased hypoglycemia risk in this combination.
• Hives, swelling of the face or throat, or trouble breathing. Postmarketing reports of anaphylaxis and angioedema — stop Saxenda and seek emergency care.

When to consider switching to a weekly GLP-1

For most adults seeking weight loss, weekly semaglutide (Wegovy) or weekly tirzepatide (Zepbound) is the more efficacious choice. STEP-8 directly compared semaglutide 2.4 mg weekly against Saxenda 3.0 mg daily over 68 weeks and found semaglutide produced roughly twice the weight loss (about −15.8% vs −6.4%). The daily injection burden of Saxenda also leads to lower long-term adherence than weekly dosing in real-world data.

Reasonable cases for staying on Saxenda anyway: patients already established on liraglutide who tolerate it well, pediatric patients ages 12 and older (where Saxenda has been on label since 2020 and Wegovy was added later), insurance coverage that favors liraglutide over semaglutide, or patients who specifically want a shorter-half-life option in case of side effects.

What this cheat sheet does not cover

This page is the dosing skeleton for Saxenda (liraglutide 3.0 mg for chronic weight management). It does not cover Victoza (liraglutide up to 1.8 mg), which is the same molecule at a lower maximum dose, FDA-approved for type 2 diabetes only and with a different titration schedule. It also does not cover the diagnostic workup for pancreatitis or gallbladder disease, the pediatric-specific pharmacokinetic adjustments, pregnancy and lactation guidance (Saxenda is contraindicated in pregnancy), perioperative management before procedures requiring fasting, or use in patients with prior bariatric surgery.

Related on Weight Loss Rankings

• All GLP-1 cheat sheets — the full set of one-page references for dosing, missed doses, storage, and sick days.
• Wegovy Dose Ladder cheat sheet — the weekly semaglutide ladder, for patients considering a switch.
• GLP-1 Titration Planner — interactive day-by-day dose schedule with calendar export, including the daily Saxenda cadence.
• STEP-1 trial summary — the landmark semaglutide 2.4 mg weekly trial whose efficacy directly motivated the STEP-8 head-to-head against Saxenda.