Saxenda in Ireland: How It Works, Who It Suits and How to Get It

• What it is
• Who it suits
• Dose schedule
• Side effects
• How to get it
• HSE cover
• FAQs

What is Saxenda?

Saxenda is the brand name for liraglutide 3mg. Liraglutide is a GLP-1 receptor agonist. It copies a hormone your gut releases after a meal. That hormone tells your brain you are full and slows how quickly your stomach empties, so you feel less hungry and fuller for longer. The HSE lists it among the medicines that can be prescribed to treat obesity, alongside changes to eating, activity and sleep.

It comes as a pre-filled pen holding 3mL of solution at 6mg/mL. The pen can give doses of 0.6mg, 1.2mg, 1.8mg, 2.4mg and 3mg. You inject it under the skin once a day. Pen needles are not included in the pack.

Saxenda was authorised in the EU in March 2015, earlier than the weekly semaglutide and tirzepatide pens. The Irish Summary of Product Characteristics (SmPC) is published on medicines.ie, and the facts on this page come from it, from the HSE and from the European Medicines Agency.

In the main 56-week trial in adults without diabetes, people using Saxenda alongside diet and exercise advice lost 8.0% of their body weight on average, compared with 2.6% in the placebo group. Results vary from person to person, which is why the licence includes a check after 12 weeks on the full dose (see below).

Who is Saxenda prescribed for?

The Irish SmPC licenses Saxenda for weight management in adults, together with a reduced-calorie diet and increased physical activity, who have:

• a BMI of 30 kg/m² or more, or
• a BMI of 27 to under 30 kg/m² with at least one weight-related condition, such as prediabetes or type 2 diabetes, high blood pressure, raised cholesterol or other blood fats, or obstructive sleep apnoea.

The licence also covers adolescents from 12 years with obesity who weigh more than 60kg, and some children from 6 years, where treatment is started by a doctor experienced in treating obesity in children. The same dose build-up is used.

Who it is not recommended for

The SmPC says Saxenda is not recommended if you:

• are aged 75 or over
• have severe kidney disease or severe liver disease
• have severe heart failure (NYHA class IV)
• have inflammatory bowel disease or diabetic gastroparesis
• take another GLP-1 medicine or another weight-loss medicine
• have weight gain caused by a hormone condition, an eating disorder or another medicine
• are pregnant, planning a pregnancy or breastfeeding

You must not use it if you are allergic to liraglutide. The NHS adds that it may not suit you if you have or have had pancreatitis. If you have type 2 diabetes and take insulin or a sulfonylurea, your prescriber may lower those doses because of the risk of low blood sugar, and you will need to check your glucose. It should be used with caution if you have thyroid disease. Your prescriber makes the decision. Our pharmacist checks the prescription against your other medicines before dispensing.

Saxenda dose schedule

Treatment starts low and builds up over four weeks so your stomach can adjust. Each step is at least one week apart.

If a step is not tolerated for two weeks in a row, your prescriber may consider stopping treatment. Inject under the skin of the stomach area, thigh or upper arm, at any time of day, with or without food. Pick a time that suits you and keep to it. Change the injection spot each day. Saxenda must never be injected into a vein or muscle.

How long a pen lasts: each pen holds 18mg of liraglutide. At the full 3mg dose a pen lasts 6 days, so five pens cover 30 days. During the first four weeks you use less each day, so the pens last longer.

The 12-week check

After 12 weeks on the full 3mg dose your prescriber checks your weight. If you have not lost at least 5% of your starting weight, the SmPC says treatment should be stopped, because it is unlikely to work well enough for you. For adolescents the check is at least a 4% fall in BMI or BMI z-score. Do not stop on your own for other reasons, talk to your prescriber first.

Common side effects and when to stop

Very common (more than 1 in 10 people): nausea, vomiting, diarrhoea, constipation and headache. These usually go away after a few days or weeks. The slow dose build-up is designed to reduce them.

Common (up to 1 in 10): indigestion, gastritis, heartburn, upper stomach pain, bloating, wind, belching and dry mouth; feeling weak or tired; dizziness; a changed sense of taste; difficulty sleeping, mostly in the first three months; gallstones; rash; injection-site reactions such as bruising, pain or itching; low blood sugar, mainly if you also take diabetes medicines; and raised pancreatic enzymes on blood tests.

Uncommon (up to 1 in 100): dehydration, more likely early on with vomiting or diarrhoea; delayed stomach emptying; an inflamed gallbladder; allergic reactions including rash; feeling generally unwell; a faster pulse. Rare: reduced kidney function or acute kidney failure. Frequency not known: bowel obstruction, and lumps under the skin caused by a protein build-up (amyloidosis).

Tell your prescriber soon if you notice palpitations or a racing heartbeat while resting, severe pain in your upper tummy that could be gallstones or an inflamed gallbladder, vomiting or diarrhoea that stops you keeping fluids down, severe constipation with stomach ache, bloating and vomiting, or symptoms of low blood sugar while on insulin or a sulfonylurea. If you feel dizzy, do not drive or use machinery until it passes. Before any operation or procedure under anaesthetic or sedation, tell the team that you use Saxenda, because GLP-1 medicines slow stomach emptying.

For the everyday side effects, the HSE suggests small regular meals, eating slowly, stopping as soon as you feel full and including lean protein. Our guide on what to eat on GLP-1 medicines has meal ideas that apply to Saxenda too. You can report any side effect to the HPRA, or tell us and we will help you report it.

How dispensing works at Laois Pharmacy

Saxenda, Wegovy and Mounjaro: the licensing differences in plain terms

All three weight-management licences require a reduced-calorie diet and more physical activity alongside the medicine, and all three use the same adult BMI rules. They differ in the active ingredient, how often you inject and what else they are licensed for.

Which medicine, if any, suits you is your prescriber’s decision. It depends on your health history, your other medicines, how you tolerate each one and whether you prefer a daily or a weekly injection. Laois Pharmacy dispenses all of them on prescription. Our post Ozempic vs Wegovy vs Mounjaro goes into the differences, and our weight management page covers the full service.

Does the HSE pay for Saxenda?

For most people, no. The HSE says that not everyone who is prescribed liraglutide can get it on their medical card or the Drugs Payment Scheme. It may be covered if you:

• have a BMI of 35 or more
• have prediabetes
• are at high risk of a heart attack or stroke, for example because you have high blood pressure or high cholesterol
• are aged 18 to 74

Cover is for up to 6 months, and can be extended if you have lost at least 5% of your weight in the first 6 months. Your GP applies for it. If you qualify, the usual scheme rules apply: the prescription charge under the medical card, or the €80 a month household cap under the Drugs Payment Scheme.

Outside that group, Saxenda is paid for privately. Medicines prescribed by a doctor count as qualifying health expenses with Revenue, so keep your receipts and claim the 20% relief at the end of the year. The HSE is separately reviewing whether to fund the weekly injections; our post on HSE funding for weight-loss injections tracks that.

How to store Saxenda

• Before first use: keep pens in a fridge at 2 to 8°C. Do not freeze, and keep them away from the freezer compartment. Do not use a pen that has been frozen.
• After first use: keep the pen below 30°C or in the fridge. Throw it away one month after first use, even if there is medicine left.
• Keep the cap on the pen to protect it from light. Do not use it if the liquid is not clear and colourless.
• If you are travelling, the pen you are using can stay out of the fridge below 30°C for that month. Unused pens still need a fridge.

If you miss a dose

• If it is within 12 hours of your usual time, inject the dose as soon as you remember.
• If more than 12 hours have passed, skip the missed dose and inject the next one the following day at the usual time.
• Never inject a double dose or a bigger dose to make up for a missed one.
• If you have missed several days, check with your prescriber or ask us before you restart, because the stomach side effects can return when you begin again.

Saxenda in Ireland: your questions answered