Saxenda dosing schedule in Canada

Strengths and form

Saxenda is liraglutide injection. It is a clear, colourless solution for injection under the skin.

It comes in a disposable, pre-filled, multi-dose pen. Each pen can deliver a dose of 0.6 mg, 1.2 mg, 1.8 mg, 2.4 mg or 3.0 mg.

Each pen contains 3 mL of solution at a concentration of 6 mg/mL. This equals 18 mg of liraglutide.

Pens are available in packages of three and five. Needles are not included in the pack.

Each pen is for one patient. The product monograph says never to share a pen, even if the needle is changed.

Starting dose and dose steps

The starting dose is 0.6 mg once a day. The dose increases after one week at each step, until it reaches 3.0 mg.

The doses of 0.6 mg, 1.2 mg, 1.8 mg and 2.4 mg are intended to reduce gastrointestinal symptoms during the dose escalation.

If a patient does not tolerate an increased dose, the dose escalation can be changed with a total delay of up to 7 days.

The dose escalation schedule of the product monograph is:

• 0.6 mg a day for 1 week.
• 1.2 mg a day for 1 week.
• 1.8 mg a day for 1 week.
• 2.4 mg a day for 1 week.
• 3.0 mg a day: the maintenance dose.

Maintenance dose and maximum dose

For adults, the recommended maintenance dose is 3.0 mg a day. The product monograph does not recommend daily doses higher than 3.0 mg.

The pen can dial up to a maximum of 3.0 mg.

After 12 weeks on the 3.0 mg dose, treatment should stop if the patient has not lost at least 5% of the initial body weight.

For patients aged 12 to less than 18 years, the product monograph applies a similar dose escalation schedule. The dose increases until 3.0 mg or the maximum tolerated dose.

A patient of this age who does not tolerate 3 mg a day may have the maintenance dose reduced to 2.4 mg a day. If the patient cannot tolerate the 2.4 mg dose, the product monograph says to discontinue Saxenda.

If a patient of this age does not tolerate an increased dose, the dose may also go down to the previous level. For these patients, the dose escalation may take up to 8 weeks.

For this age group, the product monograph says to evaluate the change in BMI after 12 weeks on the maintenance dose. It says to discontinue Saxenda if the patient has not had a reduction in BMI of at least 1% from baseline.

How and when to inject it

Saxenda is injected 1 time each day, at any time during the day. You can take it with or without food.

Saxenda is an injection under the skin (subcutaneous). Do not inject it into a vein or a muscle.

The product monograph names three injection areas: the abdomen, the thigh and the upper arm. The injection site and the timing can change without a dose adjustment.

Change the place within the area where you inject each day. This reduces the risk of lumps under the skin.

Use the solution only if it is clear and colourless and contains no particles.

Before you use the pen for the first time, your doctor or Diabetes Nurse Educator shows you how to use it.

Use a new needle for each injection. Check the flow before the first injection with each new pen.

After the dose counter returns to 0, keep the needle in the skin and count slowly to 6.

The product monograph says that Saxenda and insulin should not be used together.

Saxenda and Victoza contain the same active ingredient (liraglutide). The product monograph says that they should not be used together.

Missed dose

The patient part of the product monograph says this: if you miss your daily dose, use Saxenda as soon as you remember. Then take the next daily dose as usual on the following day.

Do not take an extra dose or increase the dose on the following day to make up for the missed dose.

If you miss your dose for 3 days or more, call your healthcare professional to talk about how to restart your treatment.

The part for health professionals says to resume the once-daily regimen with the next scheduled dose. It says to advise patients to restart at 0.6 mg if more than 3 days have passed since the last dose.

Ask a health professional

This page repeats what the Canadian product monograph says. It is not medical advice. Ask your pharmacist or your prescriber what applies to you.