Semaglutide vs Saxenda: Weight Loss, Side Effects, Price
Semaglutide and Saxenda (liraglutide) are both GLP-1 medicines, weekly injection or daily tablet versus daily injection. In their own trials, average weight loss was 14.9% and 7.4%. Semaglutide self-pay starts at $149 per month.
Quick facts on Wegovy and Saxenda
Saxenda and semaglutide compared side by side
| Semaglutide | Saxenda | |
|---|---|---|
| Medicine | semaglutide |  Saxenda |
| Active ingredient | semaglutide | liraglutide |
| Manufacturer | Novo Nordisk | Novo Nordisk |
| How it is taken | Weekly injection or daily tablet | Daily injection |
| Approved for | Type 2 diabetes, weight loss, MASH liver disease, heart risk, and kidney disease for people who have type 2 diabetes | Weight loss |
| First FDA approval | 2017 | 2014 |
| Average weight loss in trials | 14.9% (STEP 1, 68 weeks) | 7.4% (SCALE Obesity and Prediabetes, 56 weeks) |
| Most common side effect | Nausea 20.3% vs 6.1% on placebo | Nausea 39.3% vs 13.8% on placebo |
| List price | $1,027.51 per pen | $1,349.02 per 5 pens |
| Self-pay from | $149 per month | Not listed |
| Medicare GLP-1 Bridge | $50 per month, eligible Part D | Not listed |
| FDA shortage | Resolved February 21, 2025 | On the FDA shortage list |
Sources: FDA label, FDA label (DailyMed), Novo Nordisk pricing, TrumpRx.
Weight loss comparison
No trial has tested the two against each other. The figures come from trials run separately, with different groups and time frames.
| Trial | Who took part | Length | Group | Average weight loss | Placebo |
|---|---|---|---|---|---|
| OASIS 4 | Adults with obesity or overweight, without diabetes | 64 weeks | Wegovy pill 25 mg daily | 13.6% | 2.4% |
| STEP 1 | Adults with obesity or overweight, without diabetes | 68 weeks | Semaglutide 2.4 mg weekly | 14.9% | 2.4% |
| STEP 2 | Adults with obesity or overweight who also have type 2 diabetes | 68 weeks | Semaglutide 2.4 mg weekly | 9.6% | 3.4% |
| SCALE Obesity and Prediabetes | Adults with obesity or overweight who do not have type 2 diabetes | 56 weeks | Liraglutide 3.0 mg daily | 7.4% | 3% |
Trial sources: OASIS 4 (FDA label (DailyMed)), STEP 2 (PubMed), STEP TEENS (PubMed), SCALE Obesity and Prediabetes (FDA label (DailyMed)).
Side effect comparison
Each label studied its own group against its own placebo group, so compare each drug with its own placebo first.
| Side effect | Ozempic | Placebo (Ozempic trials) | Saxenda | Placebo (Saxenda trials) |
|---|---|---|---|---|
| Nausea | 20.3% | 6.1% | 39.3% | 13.8% |
| Vomiting | 9.2% | 2.3% | 15.7% | 3.9% |
| Diarrhea | 8.8% | 1.9% | 20.9% | 9.9% |
| Abdominal pain | 7.3% | 4.6% | Not listed | Not listed |
| Constipation | 5% | 1.5% | 19.4% | 8.5% |
| Injection Site Reaction | Not listed | Not listed | 13.9% | 10.5% |
| Headache | Not listed | Not listed | 13.6% | 12.6% |
| Hypoglycemia in T2DM | Not listed | Not listed | 12.6% | 6.6% |
| Dyspepsia | Not listed | Not listed | 9.6% | 2.7% |
Price and coverage compared
| Medicine | How you pay | Price |
|---|---|---|
 Ozempic | List price before insurance | $1,027.51 per pen |
| Ozempic | Ozempic Savings Offer (insured) | from $25 each month for up to 3 months |
| Ozempic | Self-pay: Ozempic pill (from 1.5 mg) | $149 per month |
 Wegovy | List price before insurance | $1,349.02 per month |
| Wegovy | Wegovy Savings Offer (insured) | from $25 per month |
| Wegovy | Self-pay: Wegovy pill 1.5 mg | $149 per month |
| Wegovy | Medicare GLP-1 Bridge (Wegovy, eligible Part D) | $50 per month |
 Rybelsus | List price before insurance | $1,027.51 per 30 tablets |
| Rybelsus | RYBELSUS Savings Offer (insured) | for a fill covering 1, 2 or 3 months, the starting price is $25 |
| Saxenda | List price before insurance | $1,349.02 per 5 pens |
Who should pick which?
- Only Semaglutide has approval for type 2 diabetes.
- For kidney disease with type 2 diabetes, approval goes to Semaglutide.
- Semaglutide is approved for MASH liver disease.
- For lowering heart attack and stroke risk, approval goes to Semaglutide.
- Medicare: Semaglutide appears on the Medicare GLP-1 Bridge list.
- Paying cash: Semaglutide has a published self-pay price of $149 a month.
Your prescriber considers your health history along with other medicines and coverage. Any switch between them is their decision.